Immunohistochemical study of neuronal markers in human gingiva with phenytoin-induced overgrowth

Abstract – The immunohistochemical occurrence of several different neuronal markers has been investigated in human gingiva with phenytoin-induced overgrowth. The material was compared to gingival material taken following surgical orthodontic treatment. Gingiva obtained from the phenytoin-treated groups seemed to have a reduced number of neurofilament (NF) immunoreactive nerve fibers in the propria compared to control material. In both phenytoin as well as control gingiva sparsely distributed, thin, calcitonin gene-related peptide (CGRP) and substance P (SP) immunoreactive fibers were found in the propria. No obvious differences between the two groups could be observed for CGRP and SP. Immunoreactive cells for somatostatin (SOM) with a dendritic cell shape were found in the propria in both groups, sometimes in densely packed clusters. A tendency for increase of SOM-immunoreactive cells in the phenytoin-treated gingiva was observed. A few γ-melanocyte stimulating hormone (γ-MSH)-immunoreactive cells with a round appearance were found in control as well as phenytoin-affected gingiva. In one instance, however, a heavy γ-MSH-immunoreactive cell infiltration was seen in the phenytoin sample. No immunoreactivity in either the phenytoin-treated group or in the control group was seen for proctolin or galanin. The results indicated that gingiva with phenytoin-induced overgrowth has a reduced innervation density revealed with NF immunohistochemistry.     

Geographic risk factors for viral hepatitis and cytomegalovirus infection among United States Armed Forces blood donors

In an effort to determine whether residence in a foreign country increases the risk of hepatitis B and C and cytomegalovirus (CMV) infection in United States (US) Armed Forces blood donors, 5719 volunteer donors at four US Navy blood banks were evaluated. Most participants were repeat donors (68%) and were young (mean age, 25 years), male (88%), and white (80%), black (10%), or Hispanic (7%). Birth outside of the United States was reported by 6 percent of subjects, and 34 percent had lived in a foreign country for more than 3 months. Twenty (0.3%) subjects had hepatitis B surface antigen (HBsAg), and 100 (1.7%) had antibody to hepatitis B core antigen (anti-HBc). Thirty-four (0.6%) were repeatably reactive in enzyme-linked immunosorbent assay for antibody to hepatitis C virus (anti-HCV); 11 (0.2%) had anti-HCV in immumoblot assay. Of the 3484 donors tested for anti-CMV, 1117 (32.1%) were positive. When demographic characteristics were controlled for both anti-HBc and anti-CMV seropositivies were independently associated in male blood donors with residence in the Philippines. Geographic factors were not associated with HBsAg and anti-HCV positivity. These findings indicate that the prevalence of serologic markers for viral hepatitis is low in military blood donors, but that residence in the Western Pacific is a risk factor for hepatitis B and CMV infection.     

Orotic Acid Improves Recovery of Left Ventricular Function Days After Heterotopic Transplantation

The preclinical evidence for a potential influence of calcium channel blockers (CCBs) on carcinogenesis is discussed in the light of a broad database from rodent carcinogenicity studies as well as literature data. In all bioassays performed in rats and mice on the dihydropyridine CCBs — nifedipine, nimodipine, nisoldipine, and nitrendipine — no evidence was found for a carcinogenic potential of these compounds. Calcium is an essential intracellular signal for cell proliferation and apoptosis. The crucial role of increased cell proliferation in all stages of carcinogenesis is well documented. Some indirect experimental evidence also points to a role of defective apoptosis in tumor promotion. CCBs uniformly inhibit cell proliferation, whereas the influence of CCBs on apoptosis is inconsistent, resulting in an inhibition or increase in apoptosis dependent on cell type. Accordingly, antitumorigenic effects of CCBs have been reported based on their antiproliferative action. A tumor-promoting effect of CCBs based on inhibition of apoptosis, however, remains purely speculative and, in fact, can be denied based on the results of in vivo bioassays. It is therefore concluded that there is no preclinical evidence that should give rise to concern over the carcinogenic potential of dihydropyridine-type CCBs.     

PIC1 Markov Chain Estimation of Life Expectancy of HIV-Infected Patients: Comparison of Two Treatment Alternatives

In RA clinical trials, functional status is increasingly being used as an outcome measure. While it is rather simple to determine the statistical significance of changes, placing the magnitude of these changes into a clinically meaningful context has not been well documented. MIC is "the smallest difference in score, which patients perceive as beneficial and which would mandate, in the absence of troublesome side-effects and excessive cost, a change in the patient's management" [Jaeschke et al. 1989].
OBJECTIVE: To determine the MIC in functional status, as measured by the Modified Health Assessment Questionnaire (MHAQ).
METHODS: Data from 123 patients were obtained from a randomized clinical trial of a new RA therapy. Outcomes were MHAQ and patient global assessment, measured at baseline and after 4 weeks of treatment. Eight scale items of MHAQ were summed to obtain a total score ranging from 0 to 24. MIC was determined based on unit changes in patient globals. The accompanying change in MHAQ was calculated. Similar analysis was conducted with physician global assessment for comparative purposes.
RESULTS: Changes of 1, 2, and 3 points in patient globals were accompanied by changes of 2.11, 4.14, and 8.4 points in MHAQ. Changes in MHAQ corresponding to patient globals were proportionate, but similar results were not obtained for the physician global.
CONCLUSION: Inconsistencies in patient and physician assessments stress the continued need for including both perspectives in assessments of new RA therapies. For the overall MHAQ score, the MIC was approximately 2. These results should increase the ability to interpret results using MHAQ.     

Degradation of Abamectin and Doramectin on Sheep Grazed Pasture

Avermectins are widely used veterinary medicines. They bind strongly to faeces in their non-metabolized form and their half-life in faeces depends on field conditions. There are conflicting data regarding the behaviour of avermectins in the environment. Therefore, we investigated the degradation of abamectin and doramectin on sheep grazed pasture under field conditions in soil, soil–faeces and faeces samples from day 6 to day 70 (abamectin) or to day 50 (doramectin) after sheep treatment. Field conditions were recorded periodically during the experiment. Degradation of abamectin in sheep faeces and in soil–faeces was observed until day 60, with small amounts present in faeces until 70 days post treatment. Because the concentration of abamectin residues in soil was very low on day 6 after treatment, further significant degradation could not be measured. The concentration of doramectin in all analysed matrices decreased rapidly until day 50. It can be concluded that high concentrations of both avermectins were present during the first 20 days after treatment and that field conditions have an important role in degradation of avermectins on grazed pasture of treated animals. Clear identification of the consequences of avermectin exposure and the period of the greatest environmental risk will require further investigations.     

Slow onset cauda equina syndrome: a case report

Cauda equina syndrome (CES) is characterized by low back pain, sciatica, lower limb motor weakness and sensory deficits, saddle anaesthesia, bowel and bladder dysfunction and occasionally paraplegia. The syndrome is classified according to onset: rapid or slow. Rapid onset CES, because of its characteristic presentation is easily recognized. The slow, chronic progression and varying presenting signs and symptoms of slow onset CES often mimic mechanical low back pain and makes the diagnosis difficult in its early stages. The case of a 23-year-old female with slow onset cauda equina is presented to illustrate this. A discussion of lumbar spine anatomy as it relates to the clinical presentation of cauda equina syndrome and the influence of associated degenerative factors follows. The most common presenting signs and symptoms are reviewed with special emphasis on those which can help diagnose CES in its early stages. Patients prognosis following surgical decompression is highlighted.