Pivot appliances ? is there a distractive effect on the temporomandibular joint?

The purpose of this study was to investigate the distractive effect of posterior occlusal pivots on the temporomandibular joint. The study comprised 23 healthy subjects. None of them had a third molar and none of them had a missing tooth or showed tooth mobility. All subjects clenched (i) on 1 mm tin foil positioned between the teeth 17/47 and 27/37; (ii) on a stiff bite registration material of 1 mm thickness that prevented protrusion because of its bold occlusal relief. During clenching on the tin foil and on the protrusion preventing bite registration material, respectively, the vertical and horizontal condylar position was measured using a 6 d.f. ultrasonic motion analyser. Clenching with maximal force on the tin foil lead to a noticeable anterior downward directed movement of the condyle. Clenching on the protrusion preventing pivot, however, caused a statistically significant upward condylar movement of about 0.3 mm. These results indicate that occlusal pivots have no distractive effect on the temporomandibular joint but can lead to unwanted joint compression, if they are designed in a way that is preventing protrusion.

[In memory of our Jewish colleagues who were murdered or committed suicide during the National Socialist Era]

With this article, we commemorate our Jewish colleagues who were murdered or committed suicide during the National Socialist Era in 1933-1945. Additionally, this article should provide an impulse to create a worthy memorial place. We thereby propose to put up commemorative plaques, e.g. in front of the administrative office of the German Dermatologic Society. Fifty-six Jewish dermatologists were killed in concentration camps in the National Socialist Era; 23 died in Theresienstadt, 19 in Auschwitz, and 14 in other concentration or extermination camps. Thirteen Jewish dermatologists committed suicide.

Cardiac function and haemodynamics during transition to high-frequency oscillatory ventilation

BACKGROUND AND OBJECTIVE

This prospective observational study analyses cardiovascular changes in adult patients with acute respiratory distress syndrome (ARDS) during transition from pressure-controlled ventilation to high-frequency oscillatory ventilation (HFOV), using transoesophageal echocardiography (TOE) and invasive haemodynamic monitoring.

METHODS

Nine patients (median age 65 years; range 42-70) with ARDS were studied. HFOV was started and maintained with an adjusted mean airway pressure of 5 cmH2O above the last measured mean airway pressure during pressure-controlled ventilation. Haemodynamic and TOE measurements were performed in end-expiration during baseline pressure-controlled ventilation, and again 5 and 30 min after the start of during uninterrupted HFOV.

RESULTS

Right atrial pressure increased immediately (P = 0.004). After 30 min, pulmonary arterial occlusion pressure increased (P = 0.008), cardiac index decreased (P = 0.01), stroke volume index decreased (P = 0.02) and both left ventricular end-diastolic and end-systolic area indices decreased (P = 0.02). Fractional area change, left ventricular end-systolic wall stress, heart rate, mean arterial pressure and mean pulmonary artery pressure remained unchanged.

CONCLUSIONS

Transition to HFOV at a mean airway pressure of 5 cmH2O above that during pressure-controlled ventilation induced significant, but clinically minor, haemodynamic effects, which are most probably due to airway pressure-related preload reduction.

High-frequency oscillatory ventilation in adults with traumatic brain injury and acute respiratory distress syndrome

BACKGROUND

This study observed adverse events of rescue treatment with high-frequency oscillatory ventilation (HFOV) in head-injured patients with acute respiratory distress syndrome (ARDS).

METHODS

Data of five male patients with ARDS and traumatic brain injury, median age 28 years, who failed to respond to conventional pressure-controlled ventilation (PCV) were analyzed retrospectively during HFOV. Adjusted mean airway pressure at initiation of HFOV was set to 5 cm H2O above the last measured mean airway pressure during PCV. Frequency of pulmonary air leak, mucus obstruction, tracheal injury, and need of HFOV termination due to increased intracranial pressure, decreased cerebral perfusion pressure, or deterioration in P(a)CO2 were analyzed.

RESULTS

During HFOV we found no complications. We recorded 390 datasets of intracranial pressure, cerebral perfusion pressure and P(a)CO2 simultaneously. Intracranial pressure increased (>25 mmHg) in 11 of 390 datasets, cerebral perfusion pressure was reduced (<70 mmHg) in 66 of 390 datasets, and P(a)CO2 variations (<4.7 kPa; >6.0 kPa) were observed in eight of 390 datasets after initiation of HFOV. All these alterations were responsive to treatment. P(a)O2/F(I)O2-ratio improved in four patients during HFOV.

CONCLUSION

High-frequency oscillatory ventilation appears to be a promising alternative rescue treatment in head-injured patients with ARDS if continuous monitoring of intracranial pressure, cerebral perfusion pressure and P(a)CO2 are provided, in particular during initiation of HFOV.

[Albert Neisser's expeditions to Java in 1905 and 1907. Syphilis research and travel experiences]

Albert Neisser, the noted dermatologist from Breslau, went on study tours to Java in 1905 and 1907 in order to conduct experiments on monkeys to investigate a number of open questions concerning etiology, course and therapy of syphilis. These large-scale research efforts brought many results, which were somewhat overshadowed by more up-to-date investigations of other groups. Neisser considered his main achievement to be new insights into the immunity and therapy of syphilis.

Chlamydia trachomatis infection in pregnant women hospitalised in the Institute of Mother and Child in Warsaw, Poland

Chlamydia trachomatis infection is the most common sexually transmitted disease. It concerns both epidemiologists and clinicians as it is often asymptomatic and can cause permanent sequelae. Chlamydia trachomatis infection in women causes nongonococcal cervicitis, endometritis, urethritis, inflammation of the Bartholin's gland, acute and chronic pelvic inflammatory disease, Fitz-Hugh-Curtis syndrome and can lead to Fallopian tube obstruction, infertility and ectopic pregnancy. During pregnancy it can cause chorioamnionitis, premature rupture of membranes, premature delivery, intrauterine growth restriction, low birth weight. post partum endometritis and also infection in the newborn.

AIM

To assess the prevalence and to describe risk factors (behavioural and clinical) of genital infection caused by Chlamydia trachomatis in the population of pregnant women attending the Obstetrics Clinic at the Institute of Mother and Child and to study the impact of this infections of pregnancy outcome.

METHODS

We have tested 80 pregnant women attending the clinic of obstetrics and gynaecology of the Mother and Child Institute in Warsaw: The presence of C. trachomatis in cervical swabs was assessed using the Polymerase Chain reaction (PCR).

RESULTS

We found two cases of C. trachomatis infection, which represents 2.5% of the tested population.

CONCLUSIONS

controversial data on the prevalence of C. trachomatis in pregnant women and its influence on pregnancy duration justify further investigations despite the observed law prevalence in this study. This will allow to determine the role and usefulness of routine screening for C. trachomatis in pregnant women in Poland.

Chlamydia trachomatis infection in sexually active adolescents and young women

BACKGROUND

The prevalence of Chlamydia trachomatis infections among Polish teenagers is unknown. Sexually active adolescents are at a greater risk for sexually transmitted infections, including Chlamydia trachomatis (ChT). Most inflections are asymptomatic and therefore untreated. Early detection and treatment of cervical chlamydial infections can prevent pelvic inflammatory disease and has a strong protective effect against infertility.

AIM

To determine the prevalence and risk factors of Chlamydia trachomatis infections among sexually active female adolescents attending the outpatient gynaecological clinic of the Institute of Mother and Child in Warsaw.

MATERIALS AND METHODS

249 sexually active girls, 16-19 years old, attending the outpatient clinic of the Institute of Mother and Child in Warsaw were enrolled in this study from December 2002 to May 2004, The participants filled out a questionnaire containing informations on age, purpose of the visit, level of education, age of the first intercourse, number of lifetime sexual partners, number of current partners (in the last 3 months), number of sexual partners in the past (patients' partner), contraceptive methods, use of condoms at the first and the last intercourse, past history of STD and obstetric history at first visit. Pelvic examination was done for the following reasons: checking vaginal discharge, presence of abnormalities of the cervix such as ectopy, erythroplakia and uterine tenderness and taking a Pap smear and a cervical swab for Chlamydia trachomatis detection. Cervical swabs for Chlamydia trachomatis were tested by Polymerase Chain Reaction (PCR).

RESULTS

The prevalence of ChT genital infection in the studied group was 3.2%. Adolescent females infected by ChT less frequently reported the use of condom and more often did not use any contraception in comparison with the girls without ChT genital infections (42.8% and 42.8% vs. 49% and 12.8%), The existence of other STDs was more frequently noted in adolescents with Chlamydial infection in comparison to healthy girls (14.2% vs. 8.3%). There were no statistically significant differences in results of the Pap smears and the incidence of cervical ectopy between the two groups.

Impact of posterior occlusal support on the condylar position

The purpose of this study was to investigate condylar displacement related to the loss of posterior occlusal support. Each of 23 subjects received one occlusal adjusted splint that covered all teeth from the right to the left second mandibular molar. None of the subjects had a third molar and none of them had a missing tooth or showed tooth mobility. The splint was inserted and vertical and horizontal condylar position was measured by an ultrasonic motion analyser. The splint was then unilateraly shortened tooth-by-tooth up to the canine tooth and the measurement was repeated after each shortening. Cutting off the splint's second molar on one side lead to a slight ipsilateral cranial motion of the condyle if subjects clenched with maximum voluntary force. If the second and first molar were cut off, a noticeable cranial condylar movement of about 0.3 mm was observed even when teeth occluded with low force. These results suggest that loss of posterior occlusal support as it happens in routine oral rehabilitation leads to a noticeable cranial condyle movement during registration, even if the clenching force is low.

Hypoxic increase in nitric oxidegeneration of rat sensory neurons requires activation of mitochondrial complex II and voltage-gated calcium channels

Recently, we have demonstrated that sensory neurons of rat lumbar dorsal root ganglia (DRG) respond to hypoxia with an activation of endothelial nitric oxide (NO) synthase (eNOS) resulting in enhanced NO production associated with mitochondria which contributes to resistance against hypoxia. Extracellular calcium is essential to this effect. In the present study on rat DRG slices, we set out to determine what types of calcium channels operate under hypoxia, and which upstream events contribute to their activation, thereby focusing upon mitochondrial complex II. Both the metallic ions Cd2+ and Ni2+, known to inhibit voltage-gated calcium channels and T-type channels, respectively, and verapamil and nifedipine, typical blocker of L-type calcium channels completely prevented the hypoxic neuronal NO generation. Inhibition of complex II by thenoyltrifluoroacetone at the ubiquinon binding site or by 3-nitropropionic acid at the substrate binding site largely diminished hypoxic-induced NO production while having an opposite effect under normoxia. An additional blockade of voltage-gated calcium channels entirely abolished the hypoxic response. The complex II inhibitor malonate inhibited both normoxic and hypoxic NO generation. These data show that complex II activity is required for increased hypoxic NO production. Since succinate dehydrogenase activity of complex II decreased at hypoxia, as measured by histochemistry and densitometry, we propose a hypoxia-induced functional switch of complex II from succinate dehydrogenase to fumarate reductase, which subsequently leads to activation of voltage-gated calcium channels resulting in increased NO production by eNOS.

The emigration of Germany's Jewish dermatologists in the period of National Socialism

In the context of our investigation, we found information on 432 (76%) of the 569 Jewish dermatologists in Germany. There is evidence that 57 (10%) of the Jewish dermatologists were murdered in concentration camps, 61 (10.7%) died a natural death, 13 (2%) committed suicide, and 25 (4%) survived the Third Reich in Germany. After 1933, 276 (49%) Jewish dermatologists were able to leave Germany; the United States of America was the main destination and 107 (or 41%) emigrated there. A total of 34 (13%) Jewish dermatologists emigrated from Germany to Palestine and 16 to Latin America. Regarding emigration to other European countries, 20 of the Jewish dermatologists from Germany went to Great Britain (including Walter Freudenthal, 1893-1952, and Ernst Sklarz, 1894-1975), and 24 emigrated to other European countries, such as France (Rudolf Mayer, 1895-1962), Sweden (Carl Lennhoff, 1883-1963), and the Netherlands (Otto Schlein, 1895-1944).

[The fight against venereal diseases in different political systems]

The fight against venereal diseases (VD) has often been influenced by the prevailing political and social conditions. At the end of 19th century the increase of VD demanded new strategies. In 1902 the German Society for the Control of VD was founded in Berlin. It was then followed by the foundation of the International Society against VD in Brussels in 1899. In the German empire and during the Nazi regime, authoritarian structures dominated the strategies against VD. The individual had to submit the interests of the society. Sociopolitical aspects influenced the discussions in the fight against VD during the Weimar republic. In 1927 the new laws to control VD met liberal demands.

Prediction of the &lt;i&gt;in vivo&lt;/i&gt; Body Composition of Pigs Based on Cross- Sectional Region Analysis of Dual Energy X-Ray Absorptiometry (DXA) Scans

Abstract. The purpose of this study was to evaluate the use of a cross-sectional scan as an alternative to the total body DXA scan for predicting the body composition of pigs in vivo. A total of 212 pigs (56 to 138 kg live body weight) were scanned by DXA. The DXA scans were analyzed for percentage fat and lean in the total body and in 14 cross-sections (57.6 mm wide): 5 in the front leg/thoracic region, 4 in the abdominal region, and 5 in the back leg region. Regression analysis was used to compare total body and cross-sectional DXA results and chemical analysis of total body fat, protein and water. The relation (R2) between the percentage fat in individual slices and the percentage of total body fat measured by DXA ranged from 0.78 to 0.97 and by chemical analysis from 0.71 to 0.85, respectively. The relation between the percentage of lean in the individual slices and chemical analysis for percentage of total body protein and water ranged from 0.48 to 0.60 and 0.56 to 0.76, respectively. These results indicate that total body composition of the pig can be predicted (accurately) by performing a time-saving single-pass cross-sectional scan.