Sex Differences in Inflammatory and Apoptotic Signaling Molecules In Normal and Diseased Human Gingiva

Background: The purpose of this study is to determine whether sex dimorphism exists in the expression of inflammatory and apoptotic mediators in gingiva obtained from normal and diseased sites of periodontal disease. Methods: Gingival papillae were obtained from individuals (56 males and 62 females) who required extraction of adjacent teeth. Gingival samples were grouped by adjacent sulcus depth: 1 to 3 mm (normal), 3 mm with bleeding on probing (slight disease), 3 to 6 mm (moderate disease), and >6 mm (severe disease). The tissue concentrations of cysteine‐requiring aspartate‐directed protease 3 (caspase‐3), interleukin‐2, tumor necrosis factor–related apoptosis‐inducing ligand, Fas ligand, p38α mitogen‐activated protein kinase, extracellular signal‐related kinase 1/2, and survivin were determined by enzyme‐linked immunosorbent assay. These mediator concentrations, age of donor, sex of donor, and gingival sulcular depth were the outcome variables. Data were compared by factorial analysis of variance, post hoc Tukey, and Pearson correlation test. P <0.05 was used to indicate significant differences among the outcome variables. Results: The mean gingival sulcular depth was significantly greater in male than in female groups (P <0.05). The majority of the tested mediators were significantly correlated with both sex and sulcular depth and with caspase‐3 (P <0.05). The concentration of caspase‐3 in female gingiva at all diseased sites was significantly greater than in gingiva derived from male sites (P <0.05). Conclusions: These data suggest sex dimorphism in the presence of gingival apoptosis at sites of periodontal disease, with females having the highest incidence of apoptosis. Because apoptosis clears inflammatory cells and promotes healing, this phenomenon could provide a mechanism for sex dimorphism for the incidence of periodontal disease.     

Convulsions occurring under anesthesia: Analysis of six cases

Convulsions during anesthesia are rather uncommon but it is important for physicians to be on the alert to treat these unfortunate occurrences and prevent them if possible. Six convulsions during anesthesia were encountered in one year.The etiology of these convulsions is extremely vague. The literature is replete with possible causes, many of which contradict each other, thereby making the situation more confusing.Despite lack of knowledge concerning the causative factors, we should give strict attention to the preoperative care of our patients, particularly those who are acutely ill and toxic, thereby very likely lessening the number of convulsions during anesthesia. The authors recommend the prompt administration of sodium pentothal as advocated by Lundy.Heretofore the mortality in patients having convulsions during anesthesia was extremely high. With sodium pentothal at hand, this figure should be lower. There was only one death among the six patients herein presented and this was attributable, not to the convulsion but to hepatorenal failure on the fifth postoperative day.