The use of locally-delivered chlorhexidine in the treatment of periodontitis. Clinical results*

Abstract. Since the advent of a nondegradable controlled local delivery of antibiotics in 1979, several second generation systems have been developed. Second generation systems have attempted to improve on the early system. Chlorhexidine has been used effectively for over 30 years as an antiseptic. In the early 1970s, chlorhexidine gluconate was incorporated at 0.2% into mouthrinses in Europe and in 1986 it was incorporated at 0.12%, in a mouthrinse in the United States. Since these mouthrinses were effective in reducing the supragingival flora, had a high safety margin, and had no reported bacterial resistance, chlorhexidine offered a therapeutic advantage for a local delivery system. This system was developed and studied. This report will discuss this new biodegradable system containing chlorhexidine gluconate as the active agent (PerioChip^®). Parmacokinetics of the system and a review of the multicenter studies in Europe and the United States are discussed. In these randomized clinical trials the chlorhexidine chip has been shown to enhance the effects of scaling and root planing. Chlorhexidine chip in conjunction with scaling and root planing, when compared to scaling and root planing alone, has shown significant improvement in probing pocket depth reduction, probing attachment level and bleeding on probing. This delivery system, in combination with scaling and root planing, has also resulted in significantly more probing depth reductions of 2 mm or more. The system is safe and efficacious. Placement of the chip is usually done in less than 1 min, it requires no retention system, biodegrades, and does not require a follow-up dental appointment.     

Immunology: Diversity of the blocking effects of antisperm antibodies on fertilization in human and mouse

The blocking effects of complement-dependent sperm immobilizingantibodies in the sera of infertile women and monoclonal antispermantibodies against humans and mice on fertilization were investigated.The hemizona assay (HZA) and sperm penetration assay (SPA) wereused to study the inhibitory effects of sera from 22 infertilepatients positive for sperm immobilizing antibodies. Use ofthese tests allowed us to differentiate whether the antibodyblocked sperm—zona pellucida tight binding and/or spermpenetration into the ooplasm. The zona pellucida penetrationassay (ZPA) was also used to study the effects of four monoclonalantibodies (mAbs) on human sperm penetration into the zona pellucida.Seven mAbs against murine spermatozoa were tested for theirinhibitory effects on in-vitro fertilization (IVF) and HZA inmice. Of 22 patient sera with sperm immobilizing antibodies,21 (95.5%) inhibited HZA attachment and penetration, whereasthis did not occur in any of 13 patient sera without these antibodies.However, 19 of 22 (86.4%) patient sera with sperm immobilizingantibodies and eight of 13 (61.5%) patient sera without theseantibodies inhibited the SPA. Two (2C6, 1G12) of four mAbs againsthuman spermatozoa showed strong inhibitory effects in all theassays (HZA, ZPA and SPA). One mAb (3B10) did not inhibit HZAbut blocked ZPA and SPA. Another mAb (H6-3C4) seemed to haveno inhibitory effects on fertilization. Two (Vx 5 and Vx 8)of seven mAbs against murine spermatozoa inhibited IVF in micebut did not block mouse HZA. These findings suggest that antispermantibodies block fertilization at specific stages. Some of themmay inhibit sperm capacitation and thus prevent all processesof fertilization that follow. Some other antibodies may notaffect capacitation and sperm binding to zona pellucida butinhibit the acrosome reaction, followed by the blocking of spermpenetration through zona pellucida and ooplasm.     

Crossed inhibition of the soleus H reflex during passive pedalling movement

We hypothesized that sensory input from the moving leg induces presynaptic inhibition of the soleus H reflex pathway in the contralateral stationary leg. The results showed a crossed inhibition during passive pedalling movement of the leg, which was not removed by low levels of tonic contraction of soleus in the stationary leg. The inhibition was correlated exponentially to the rate of the movement (R²=0.934, P<0.05) and was not dependent on the quadrants through which the moving leg was passing. Static flexion of the stationary leg caused ipsilateral inhibition of the reflexes (t=5.590, P<0.05), independent of the orientations of the other leg. We concluded that sensory inflow from the moving leg induces presynaptic inhibition in the stationary leg, that a complex transformation of the sensory input in the spinal cord or brain underlies the tonic crossed inhibition and phasic ipsilateral inhibition, and that descending motor commands exert a powerful control over these sensorimotor modulatory mechanisms.     

活血祛风法治疗慢性活动性乙型肝炎临床观察

用活血祛风法治疗反复发作的慢性活动性乙型肝炎７０例，总有效为９５．７％，对照组６５例健脾清热利湿法治疗，总有效率为７８。５％（Ｐ＜０．０５）．治疗组抗ＬＳＰ，ＬＭＡ，抗核抗体，类风湿因子阴转率，ＨＢｅＡｇ，抗ＨＢｃＩｇＭ，ＨＢＶ－ＤＮＡ阴转率，抗ＨＢｅ阳转率均优于对照组（Ｐ＜０．００１）。     

超声导向肝组织微波固化的实验研究

目的：探讨不同穿刺方案形成的肝组织微波凝固区的大小、形态，为临床治疗，特别是大肝癌的治疗，提供实践基础。方法：利用离体新鲜牛肝，比较ＵＭＣ－Ｉ型微波仪单针、两针及多针组合所形成凝固区的大小、形态。结果：单针穿刺可形成３．０ｃｍ×４．０ｃｍ头宽尾窄的滴水状凝固区。两针组合，距离在２．５～３．０ｃｍ之间造成的完全凝固区最大。不同穿刺方案，可形成８ｃｍ以下不同直径的球形凝固区。结论：适当的穿刺方案可使８ｃｍ以下的球形区域完全凝固     

Spontaneous ovarian hyperstimulation mimicking an ovarian tumour

Ovarian hyperstimulation syndrome in a spontaneous singletonpregnancy is exceedingly rare. We report a case of ovarian hyperstimulationpresenting as bilateral ovarian masses in association with spontaneouspregnancy, occurring in a woman with disturbed liver function.A possible mechanism is discussed.     

双侧唇裂术后的唇部继发畸形

本文报告了35例双侧唇裂术后唇部继发畸形。这些畸形主要包括唇红缘不整齐、上唇中份厚度不足以及上唇过紧。Z 字成形、V-Y 推进和 Abbe 瓣法常用于矫正这类继发畸形。     

胃癌c-erbB-2过度表达与预后的关系

探讨c－erbB－2过度表达与胃癌预后的关系。方法：用免疫组化ABC法对103例胃癌手术标本及151个转移淋巴结进行c－erbB－2表达检测。结果：21．4％胃癌手术标本出现阳性表达．其中进展期胃癌、乳头状腺癌、高中分化胃癌及伴淋巴与肝转移的胃癌阳性率显著增高（P＜0．05与＜0．01）；转移淋巴结表达阳性率高于胃癌原发灶（X2＝3．7．P＞0．05）。高中分化胃癌伴c－erbB－2过度表达者5年生存率显著低于阴性者（P＜0．01）。结论：c－erbB－2过度表达可作为胃癌预后估计指标之一。     

Case report: Osseous metaplasia of the endometrium: a rare cause of infertility and its hysteroscopic management

This case report presents a very rare and long-standing causeof infertility, osseous metaplasia of the endometrium, and describesits successful management by hysteroscopy. A woman with a historyof induced abortion 12 years ago, failed to conceive from thattime on. The infertility work-up was unrevealing except forthe presence of intracavitary calcification on ultrasonography.After diagnostic hysteroscopy, solid bony spicules coveringthe posterior wall of the endometrial cavity were removed bywire loop resectoscope. Histology established the diagnosisof osseous metaplasia of the endometrium. The patient conceivedin her second spontaneous cycle and has an ongoing pregnancyat the time of writing. Hysteroscopy was an effective meansof extracting this heterotopic tissue, thereby re-establishingfertility even after a long period of infertility.     

垂体腺瘤的CT诊断(附60例分析)

分析了60例垂体腺瘤的CT表现。1例垂体微腺瘤缺乏特异性征象,59例大腺瘤大多数表现典型,诊断依据为肿瘤位置和蝶鞍改变。垂体腺瘤的形态学表现无特异性。应加强对垂体瘤卒中和侵袭征象的认识。对成人鞍区肿瘤的鉴别诊断进行了简短讨论。