Progression of interproximal caries in the primary dentition

While studies have addressed the diagnosis and progression of interproximal carious lesions within a primary tooth, few studies have addressed the development of proximal lesions in adjacent primary molars. The purpose of this study was to examine retrospectively the long term interproximal caries progression in primary molar teeth. Dental records of 150 children were retrospectively reviewed, 76 from a university pediatric dentistry clinic and 74 from a pediatric dentistry private practice. Out of the 387 teeth initially diagnosed with proximal caries, the combined university and private practice results for timing of the development of proximal lesions on adjacent tooth surfaces showed the following: simultaneous development-162 (41.9%); 1 to 24 months-65 (16.8%); 24 to 60 months-40 (10.3%); never-120 (31.0%). The combined results for formation of proximal caries in posterior quadrants showed that out of the 150 patients, the timing for development of additional quadrants with proximal caries was as follow: simultaneous development: 77 (51.3%); 1 to 24 months 31, (20.7%); 24 to 60 months 25, (16.7%); never 17 (11.3%). The conclusions of the study are that 69% of the primary molar teeth with proximal caries developed caries on the adjacent proximal surface and 89% of the patients who developed a proximal carious lesion on a primary molar tooth within one quadrant developed another primary molar proximal lesion in another quadrant.

Platelet function in autoimmune (idiopathic) thrombocytopenic purpura

Platelets play an essential role in the formation of haemostatic plugs. The quantitative defect of platelets in autoimmune (idiopathic) thrombocytopenic purpura (ITP) can result in bleeding complications, but most ITP patients have platelets with normal or enhanced function. Platelets in ITP are large, young, so-called "stress" platelets with increased platelet-associated autoimmune antibody (immunoglobulin G). Young stress platelets are more functional platelets, and their presence may account for bleeding times in ITP patients that are shorter than would be predicted on the basis of the patients' (low) platelet counts. Some ITP patients have significant mucocutaneous bleeding with platelet counts >50 x 10(9) l(-1); this may be due to qualitative platelet dysfunction (e.g. brought about by inhibitory antiplatelet autoantibodies).

The Platelet Function Analyzer (PFA-100): a novel in-vitro system for evaluation of primary haemostasis in children

The PFA-100 system provides an in-vitro method of assessing primary platelet-related haemostasis by measuring the time (the closure time, or CT) taken for a platelet plug to occlude a microscopic aperture cut into a membrane coated with collagen and either epinephrine or ADP. We used the system to establish normal ranges for CTs in healthy children, adults and neonates. Mean CTs of healthy children were independent of the needle gauge used (21G or 23CG) for blood sampling; they were very similar to the mean CTs of healthy adults, but longer than mean CTs of healthy neonates. Although children with haemophilia had normal CTs, the PFA-100 system was found to be potentially useful in screening for von Willebrand disease in children.

A comparison of a hybrid light-cured glass-ionomer base and liner vs. a light-cured resin tooth fragment attachment

PURPOSE

The purpose of this study was to compare the dislodgement strengths and fracture types for reattached tooth fragments using a light-cured composite resin material, a hybrid light-cured glass ionomer base, and a hybrid light-cured glass ionomer liner.

METHODS

Seventy-five bovine incisor teeth were fractured, randomly divided into three groups of equal number, and then luted back together with three different materials (Universal Bonding Agent/TPH Composite Resin; VariGlass VLC Base; and VariGlass VLC Liner: LD Caulk Div Dentsply Int Inc, Milford, DE). The reattached fragments were subjected to thermocycling with a 40 degrees C differential and then were loaded until the force required to dislodge the fragment was reached.

RESULTS

The mean dislodgement strengths were 36.8 (+/- 25.6) kg for the composite resin, 36.4 (+/- 26.7) kg for the glass ionomer base, and 31.4 (+/- 29.5) kg for the glass ionomer liner. Cohesive fractures occurred in 73% of the dislodgements.

CONCLUSIONS

There was no statistically significant difference demonstrated (P < 0.05) between the three groups in terms of both dislodgement strength and fracture type.

Dentin dysplasia, type II linkage to chromosome 4q

Dentin dysplasia, type II (MIM*125420) is an autosomal dominant disorder of dentin development. Clinically the primary dentition appears opalescent, and radiographically the pulp chambers are obliterated, resembling dentinogenesis imperfecta. However, unlike dentinogenesis imperfecta, the permanent teeth in dentin dysplasia, type II are normal in color and, on radiographs, have a thistle-tube pulp chamber configuration with pulp stones. The similarity of the primary dentition phenotype suggested that the gene for dentin dysplasia, type II is allelic with the gene for dentinogenesis imperfecta, Shields type II (DGII; MIM*125490), which has been localized to chromosome 4q13-q21. Twenty-four members of a three generation family in which ten members are affected with dentin dysplasia, type II were genotyped for microsatellite alleles specific for the area of chromosome 4q linked to DGII. Linkage was assessed by using the LINKAGE computer program, assuming autosomal dominant inheritance, a disease allele frequency of 0.0001, and complete penetrance. The maximum two-point LOD score (Zmax = 4.2 at theta = 0.0) was obtained with SPPI and D4S2691. Multipoint analysis gave a maximum LOD score of 4.33. The candidate region for dentin dysplasia, type II is approximately 14.1 cM, includes SPPI, D4S2691, D4S2690, D4S451, and D4S2456, and overlaps the most likely location of the DGII locus. A candidate gene for DGII should also be considered a candidate gene for dentin dysplasia, type II.

One-stage reconstruction for defects caused by cancrum oris (noma)

Cancrum oris is a disease process that has been described for centuries, but now presents primarily in developing countries. The disease in known to occur in association with poor nutrition and exanthematous infections. The acute disease occurs usually in young children, and the infectious process causes destruction of the involved orofacial tissues with variable degrees of tissue loss and scar reaction in those who are affected and survive. The chronic sequelae of the acute disease process often require reconstructive surgery. We present the natural history of the disease process and its causes, and demonstrate the wide spectrum of resulting defects that challenge the reconstructive surgeon. Because of the socioeconomic situation inherent with these patients and the volume of patients in need of treatment with this disease, innovative and efficient treatment is required. We have demonstrated methods of reconstructive surgery that differ from the multiple staged procedures described in previous studies by allowing for one-stage surgical reconstruction of even the most complex cases. This allows for treatment of the majority of patients in their native countries in a cost-effective and safe manner, and treatment of more severely afflicted individuals in modern medical centers without their having to spend a long time period away from their homes.

Using a resin-modified glass ionomer as an occlusal sealant: a one-year clinical study

The authors compared the retention and clinical performance of a resin-modified glass ionomer, or RMGI, restorative and a light-cured resin sealant. The first permanent molars on one side of the dental arch in 50 children were sealed with an RMGI, and the same teeth on the other side were sealed with a resin sealant. At baseline, six months after placement and one year after placement, examiners documented sealant retention, secondary caries, marginal discrepancy and marginal staining. In general, the RMGI appeared to wear markedly. At one year, the retention of the RMGI was significantly less than the resin, but the RMGI had significantly fewer marginal discrepancies. There were no significant differences in caries development or marginal discoloration.

Electrosurgical pulpotomy: a retrospective human study

While the formocresol pulpotomy has enjoyed long-term clinical use and success, concerns over its toxicity and mutagenicity have prompted research into other pulpotomy techniques. The purpose of this study was to observe retrospectively the results of the electrosurgical pulpotomy technique used on primary molar teeth requiring pulp therapy, secondary to carious involvement. The mean age at the time of treatment was 5 years, 11 months and the mean postoperative observation time was 2 years, 3 months. Of the 164 teeth studied, 127 were normal at the last observation visit; 32 had undergone exfoliation; 4 had an abnormality associated with the pulpotomized tooth, but were not considered failures; and 1 was considered a failure. This is a 99.4 percent success rate. Compared to a formocresol pulpotomy study of similar design, the success rate for the electrosurgical pulpotomy procedure in this study is higher at the statistically significant level of p < 0.01.

The brow slide: a technique for the aesthetic treatment of eyebrow tumors

Skin neoplasms involving the eyebrow are not an uncommon problem. Standard surgical resections that depend on elliptical excision and closure tend to either remove an excessive amount of brow or place scars in an unfavorable position. We present a simple technique that allows for maximal brow preservation, alignment of remaining brow, and a minimal amount of exposed scars.

Epi Info: a general-purpose microcomputer program for public health information systems

Epi Info is a general-purpose set of computer programs for word processing, database management, statistics, and graphics developed over the past five years at the Centers for Disease Control and the World Health Organization. The programs allow rapid questionnaire construction, data entry, and analysis during epidemic investigation. Both data entry and analysis can be programmed to provide customization and automatic operation for more permanent systems, such as those for disease or injury surveillance. Epi Info is in the public domain and copies may be freely distributed. It requires an IBM-compatible micro-computer with at least 512 kilobytes of memory. Translations into French and Spanish are in progress; a translation kit is available to facilitate translation into other languages.

Diphallia and hindgut duplication

Diphallia is a rare congenital condition that presents in many, varied ways. Associated anomalies are to be expected. These anomalies should be sought out and treated as early in the patient's life as possible because they are the principal cause of mortality in these individuals. Half the patients reviewed by Ravitch in 1953 with duplication of the colon and genital tracts died of intestinal complications. Definitive genital repair should be done at an age where the anatomy is of large enough caliber for eased surgical manipulation, but prior to the age of recall. From our experience with hypospadias repair, the optimal age seems to be 12 months of age. Each case must be treated individually in order to achieve the best functional and aesthetic result.

Indiana infant-toddler dental care survey

The purpose of this project was to survey Indiana dentists concerning dental care for Indiana infants and toddlers. Dental care issues covered were the age for a child's first dental visit, frequency of rampant or nursing caries cases examined, and dental referral sources for infants and toddlers. The survey also helped determine the dentist's perception of parents' attitudes toward services recommended by the dentist. A twelve question survey was mailed to 2006 general and pediatric dentists in the State of Indiana. The results of the survey were: 1. A large percentage of Indiana dental practitioners do not recommend the first dental visit or examine children for their dental visit until the child is more than one year of age. 2. A majority of Indiana dental practitioners see children with nursing caries or rampant caries on a monthly basis. 3. The majority of Indiana dental practitioners refer children with nursing caries to pediatric dentists for treatment. 4. Although the full treatment plan may undergo some modification based on various parental concerns, a majority of practitioners do not experience difficulty in obtaining treatment plan acceptance for nursing or rampant caries cases.

Reconstruction of traumatically acquired defects of the phallus

Trauma to the male phallus may be treated in a systematic approach to achieve aesthetically and functionally pleasing results. Isolated burns should be treated early with excision and preputial flap or skin graft closure. Avulsion injuries are closed primarily or skin grafted. Subtotal loss can be treated with penile lengthening techniques. Total loss is treated with reimplantation or microvascular free tissue transfer phalloplasty. There are reconstructive surgical options, instead of penectomy, in patients with penile malignancies.

Pharmacological control of the pattern of activity in leech Retzius neurones

1. Changes in the activity pattern of leech Retzius (R) cells were investigated using intracellular recording. 2. The presence of an after-hyperpolarisation (AHP) is closely related to activity pattern; regular firing being associated with an AHP, bursting with its absence. 3. Increasing external calcium (Cao), cyclic AMP levels or activity of kinase A enhanced the AHP. 4. Bursting was induced by low Cao, EGTA, barium, cobalt or injection of phorbol ester. 5. Reduction of Cao to zero caused long paroxysmal depolarising shifts of potential which could be reversed to bursting by cobalt, IBMX or injection of kinase A catalytic subunit. 6. The possible roles of a calcium-activated potassium channel and protein phosphorylation in regulating the activity of the cell are discussed.

Dental management of oculodentodigital dysplasia: report of case

Oculodentodigital dysplasia is a rare autosomal dominant syndrome characterized by typical facies and certain anomalies of the eyes, dentition and digits. This report describes the case of a 2.5-year-old white male with oculodentodigital dysplasia and his comprehensive dental treatment. Aggressive treatment to maintain the integrity of the patient's primary dentition was provided. The characteristic physical and genetic findings of oculodentodigital dysplasia were also described.

A new approach to the analysis of complex dose-response relationships: a multivariate study of octopamine action on the leech Leydig neurone

Octopamine (OA) hyperpolarizes leech Leydig neurones but response amplitudes and thresholds vary. Associations between response, OA dose and other variables [initial resting potential, action potential (AP) frequency and amplitude, temperature, microelectrode resistance, position of ganglion along nerve cord, animal, treatment order] were examined using canonical correlation. A complex response was expressed by summing changes in membrane potential and AP frequency over 2 min of OA treatment. Only dose and ganglion position influenced this response. One significant canonical variate related dose to immediate changes in membrane potential and summed changes in AP frequency throughout the OA effect. Response to OA was greater in cells in posterior ganglia.

Medical and nutritional aspects of intractable diarrhea

Diarrhea can be due to at least five pathogenetic mechanisms. Major examples of each are presented to better illustrate each type of diarrhea and to provide a springboard for discussion of the nutritional management of each class of diarrhea. Certainly, specific diseases require specific therapies, such as avoidance of gluten in adult coeliac disease, but the major dietary/nutritional alterations and subsequent treatment are similar for each class of disease. Nowhere in medicine and nutrition is an admonition to the health care team more important and more proper than in the treatment of chronic diarrheas: The feeding of healthy man, as well as the diet of the sick cannot be left to chance, guided by the appetite, or ruled by tradition, but can be safely directed only according to the laws of digestion and metabolism.

Determination of phosphorus and sulfur in fuel rich air-hydrogen flames

Excitation conditions for the green HPO bands, the uv PO bands, and the violet S(2) bands were explored. A cylindrical glass shield placed around the tip of a Beckman (sprayer) burner provided a simple arrangement to isolate a fuel rich environment of a reversed air-hydrogen flame. Samples were converted to aerosol in a separate nebulization chamber. The HPO band at 5262 A gave a detection limit of 6 microg/ml; the S(2) band, 5 microg/ml. Owing to low flame noise, both detection limits could be improved with interference filters in place of the Beckman small quartz monochromator. The PO bands are emitted best from fuel rich oxygen-acetylene flames with the normal Beckman sprayer burner. The significant aspect of this study lies in the introduction of liquid samples and circumvention of lengthy, and often uncertain, decomposition steps when handling many types of organic and biochemical compounds containing phosphorus and sulfur.