Full-mouth profile of active MMP-8 in periodontitis patients

BACKGROUND AND OBJECTIVE

MMP-8 in gingival crevicular fluid is considered as a protease with high destructive potential because of its ability to degrade collagen in periodontitis-affected patients. The aim of this study was to investigate whether there was a relationship between clinical diagnostic parameters and the concentration of active MMP-8 (aMMP-8) in gingival crevicular fluid in a site-level full-mouth analysis. Based on these data, the prognostic value of aMMP-8 levels in relation to pocket depth may be evaluated.

MATERIAL AND METHODS

Clinical measurements of pocket depth, bleeding on probing (BOP), plaque index (PlI) and gingival index (GI), as well as samples of gingival crevicular fluid, were obtained from four sites of each tooth of nine healthy female patients with chronic generalized periodontitis. The aMMP-8 concentration in gingival crevicular fluid was quantified by ELISA using specific monoclonal antibodies. Multiple linear regression models for the single measures of aMMP-8 and pocket depth were calculated with GI and BOP as additional variables.

RESULTS

Between 92 and 112 recordings were obtained for each parameter in each patient. Mean values of between 31.5 and 88.8% were calculated for pocket depths of ≥ 4 mm. Mean pocket depths ranged from 3.11 to 4.73 mm, the mean BOP values ranged from 34.0 to 96.7% and the mean full-mouth gingival crevicular fluid aMMP-8 concentration ranged from 3.2 to 23.7 ng/mL.

CONCLUSION

In this sample of female periodontitis patients, a broad range of intra-individual and interindividual aMMP-8 values was found. Although the explained variance was rather weak, a statistically significant relationship between aMMP-8 and pocket depth was proven.

Cathodoluminescence of rare earth implanted Ga2O3 and GeO2 nanostructures

Rare earth (RE) doped gallium oxide and germanium oxide micro- and nanostructures, mostly nanowires, have been obtained and their morphological and optical properties have been characterized. Undoped oxide micro- and nanostructures were grown by a thermal evaporation method and were subsequently doped with gadolinium or europium ions by ion implantation. No significant changes in the morphologies of the nanostructures were observed after ion implantation and thermal annealing. The luminescence emission properties have been studied with cathodoluminescence (CL) in a scanning electron microscope (SEM). Both β-Ga(2)O(3) and GeO(2) structures implanted with Eu show the characteristic red luminescence peak centered at around 610 nm, due to the (5)D(0)-(7)F(2) Eu(3+) intraionic transition. Sharpening of the luminescence peaks after thermal annealing is observed in Eu implanted β-Ga(2)O(3), which is assigned to the lattice recovery. Gd(3+) as-implanted samples do not show rare earth related luminescence. After annealing, optical activation of Gd(3+) is obtained in both matrices and a sharp ultraviolet peak centered at around 315 nm, associated with the Gd(3+) (6)P(7/2)-(8)S(7/2) intraionic transition, is observed. The influence of the Gd ion implantation and the annealing temperature on the gallium oxide broad intrinsic defect band has been analyzed.

[Effect of various compositions of riboflavin eye drops on the intraoperative corneal thickness during UVA-cross-linking in keratoconus eyes]

BACKGROUND

During the UVA-cross-linking treatment in keratoconus patients, the UVA rays are partially absorbed in the stroma of the riboflavin-loaded cornea. This effect protects the corneal endothelium from UVA irradiation damage. The intensity of UVA light reaching the endothelium is inversely correlated with corneal thickness. The common composition of riboflavin eye drops may lead to a marked reduction in corneal thickness increasing the risk of endothelial damage.

PATIENTS AND METHODS

In a retrospective analysis of 23 UVA-cross-linking procedures on 23 patients we collected data about the pre-, intra- and postoperative corneal thickness (measured with ultrasound). Among these patients and depending on the preoperative state, 8 eyes received Medio Cross (TM) eye drops (group 1), 8 eyes received Medio Cross (TM) eye drops combined with riboflavin 0.1 %/methylhydroxypropylcellulose 1,5 %/NaCl 1.1 % (group 2) and 7 eyes received riboflavin 0.2 %/methylhydroxypropylcellulose 0.5 %/NaCl 0.7 % eye drops (group 3) before and during UVA irradiation. Data are presented as means ± standard deviation. A comparison of the data was performed using (one-way) ANOVA.

RESULTS

The mean corneal thickness at the end of the UVA cross-linking procedure was 67 ± 9 % (means ± standard deviation) of preoperative thickness in group 1, 118 ± 14 % in group 2 and 140 ± 23 % in group 3. The values in groups 2 and 3 were significantly different from those in the reference group 1.

CONCLUSIONS

Our results show a strong variability of the postoperative corneal thickness using different standard compositions of riboflavin eye drops. Further studies are needed to find a composition of riboflavin eye drops ensuring a moderate increase in intraoperative corneal thickness to protect the corneal endothelium.

[Surgical management of renal hyperparathyroidism]

Conservative management of renal hyperparathyroidism has changed recently. Innovative substances, especially the advent of calcimimetics, have influenced the therapeutic concept. Consequently, a decline in surgical frequency for renal hyperparathyroidism has been reported. In this context it is now mandatory to evaluate the role of surgery, the surgical strategy and procedures for renal hyperparathyroidism anew. Based on a review of the literature the current position of surgical indications and care for renal hyperparathyroidism as well as possible influences of innovative medical treatment are highlighted. In summary, the timing and indications for surgery have been influenced, however, surgery still remains the only permanently effective treatment option for renal hyperparathyroidism.

Optical and structural properties of an Eu implanted gallium nitride quantum dots/aluminium nitride superlattice

GaN/AIN structures made of GaN quantum dots (QDs) separated by AIN spacer layers, were doped with Europium by ion implantation. Rutherford Backscattering/Channelling measurements showed that Eu is incorporated mainly on near-substitutional cation sites within the superlattice region. Only slight deterioration of the crystal quality and no intermixing of the different layers are observed after implantation and annealing. After thermal annealing, photoluminescence associated with Eu3+ ions was observed. From its behaviour under different photon energy excitation and sample temperature we concluded that the Eu-related emitting centres are located inside the GaN QDs or dispersed in the GaN and AIN buffer or spacer layers. The 624 nm PL line, associated with Eu-doped GaN QDs, shows very low thermal quenching, suggesting recombination of confined carriers through rare-earth ion excitation.

Cryopreservation of organotypical cultures based on 3D scaffolds

An integral component of the manufacture of a skin substitute is the cryopreservation of the complete skin construct. Under this demand, investigations were carried out in the present work in the case of cryopreservation of human fibroblasts and keratinocytes composed to organotypical skin substitutes (OTS). Two scaffolds made up of gelatine and collagen/elastin were seeded with human fibroblasts via centrifugation method. Subsequent human keratinocytes were applied on the preceded scaffolds and cultivated under air-exposed conditions. For the investigation of the cryopreservation, OTS were frozen after 10 days cultivation via computer-controlled CryoMed included defined freezing conditions. After 24 hours storage in fluid nitrogen the OTSs were thawed and recultivated under airlift conditions. After that metabolic activity and immunfluorescent staining was analyzed in comparison with conventionally produced OTSs on basis of collagengel and/or OTSs based on scaffolds without cryopreservation. It could be assessed that cryopreservation has no negative influence on vitality and differentiation capacity of the cultivated constructs. The determination of OTS vitality after 14 days airlift culture delivered persistent higher metabolic activities of the scaffold based constructs in comparison with the corresponding controls. This could be confirmed by investigation of OTSs with and without cryopreservation. All expression patterns of differentiation marker could be detected after cryopreservation and subsequent recultivation. The results from cryopreservation of OTSs introduced here prove the possibility of temporally independent tailor-made applications by means of a complete skin substitute for example in the area pharmascreening.

How to select study designs and parameters to investigate the effect of mouthrinses? Part II: comparisons between the parameters used

A variety of parameters is available to assess the efficacy of oral antiseptics. Most study protocols select the parameters according to the specific study goal or according to preferences of the researchers. Beside general recommendations for home-use studies, no recommendations exist for other study types. Therefore, pre-selected parameters should be compared within several study designs and the most suitable parameters should be recommended for further application. The following parameters were selected before study start: plaque indices (PlI, Silness & Loe 1964, M-QHI, Turesky et al. 1970), plaque area (PlA), bacterial vitality (BV, Netuschil et al. 1989), gingivitis indices (GI, Loe 1967; M-GI, Lobene et al. 1986; BOP, Ainamo & Bay 1975), gingival crevicular fluid, colony forming units, and the discoloration index (DI, Brecx et al. 1993). The parameters were applied in four study designs: eight-hour substantivity studies, four-day plaque re-growth studies, 21-day experimental gingivitis studies, and six-month home-use studies. Pearson correlation coefficients were computed. The highest correlations were found between PlI and M-QHI and between GI and M-GI (p<0.01) in all corresponding studies and treatment groups. Few middle correlations existed between BOP and the other gingival indices. Neither GI nor M-GI correlated with GCF nor did BV with plaque indices. Inconsistent correlations were obtained between PlA and plaque indices and between PlI and GI. It is concluded, that primary parameters for these designs should be one plaque index and/or one gingivitis index to monitor plaque and gingivitis. The other parameters did not yield additional information about the study outcome.

How to select study designs and parameters to investigate the effect of mouthrinses? Part I: rationale and background

In the literature and in the daily study routine, a wide range of study designs exists to test the efficacy of mouthrinses. Within these various designs, a considerable number of parameters is applied. Due to the different protocols currently used the outcome of these investigations is hardly to compare. Therefore, it was the aim of the present investigation to assess suitable study designs of different durations, to select and compare parameters, and to find suitable study participants in order to finally recommend more standardized protocols for future studies on oral antiseptics. Eight-hour substantivity studies, four-day plaque re-growth studies, 21-day experimental gingivitis studies, and six-month home-use studies were performed either cross-over or parallel. The clinical studies were randomized, controlled, and investigator-blinded. From most often applied clinical and laboratory parameters, two plaque indices, bacterial vitality, three gingivitis indices, gingival crevicular fluid, colony forming units, and the discoloration index were selected to assess plaque inhibition, gingivitis development, tooth staining, and possible bacterial shifts in the oral cavity. Four or five, respectively, treatment groups were formed that rinsed with the following solutions: chlorhexidine digluconate 0.06%, 0.12%, 0.20%, amine fluoride/stannous fluoride, and a negative control. In addition, all study designs were tested on two different study populations. Population alpha consisted of persons who had a gingival index <0.8 while population beta participants presented a mean gingival index of >/=0.8. Pearson correlation coefficients were calculated between parameters and between subsets of teeth and full-mouth recording. T-tests were applied to compare between populations alpha and beta.

Constitutive RET tyrosine kinase activation in hereditary medullary thyroid cancer: clinical opportunities

The ground-breaking discovery of genotype-phenotype relationships in hereditary medullary thyroid cancer has greatly facilitated early prophylactic thyroidectomy. Its timing depends not solely on a positive gene test but, more importantly, on the type of the REarranged during Transfection (RET) mutation and its underlying mode of RET receptor tyrosine kinase activation. In the past decade, the therapeutic corridor opened by molecular information has been defined down to a remarkable level of detail. Based on mutational risk profiles, preemptive thyroidectomy is recommended at 6 months of age for carriers of highest-risk mutations, before the age of 5 years for carriers of high-risk mutations, and before the age of 5 or 10 years for carriers of least-high-risk mutations. Additional lymph node dissection may not be needed in the absence of increased preoperative basal calcitonin levels. Better comprehension of RET function should enable the design of targeted therapies for RET carriers beyond surgical cure in whom the DNA-based 'window of opportunity' has been missed.

Hospice utilization by men dying of prostate cancer

9501

Background: The 25,000 American men who die of prostate cancer each year often suffer from fatigue, bone pain, and weight loss. Enrollment in hospice programs improves both the quality of life and the quality of death for this cohort. However, previous data suggest that hospice is often used inappropriately, either through underuse or through improperly timed referral. We sought to characterize sociodemographic and clinical factors that affect appropriate and inappropriate utilization of hospice services by men with metastatic prostate cancer in a population-based dataset. Methods: We used linked data from Surveillance, Epidemiology, and End Results and Medicare data to identify a cohort of beneficiaries who died of prostate cancer between 1992 and 2005. We then evaluated the bivariate association between sociodemographic and clinical data and any hospice enrollment. Hospice referrals within 7 days of death or more than 180 days before dying were considered inappropriate. Results: Of the 14,521 men dying of prostate cancer, 7,646 (53%) utilized hospice resources. Enrollment within 7 days of death was noted in 1699 subjects (22% of hospice users), and enrollment more than 180 days prior to death was seen in 717 participants (9% of hospice users). Subjects who utilized hospice within the appropriate time frame were enrolled for a mean of 47 days (S.D. 41, range 7–180 days) prior to death, with a median of 31 days. In our bivariate analysis, white ethnicity, partnered status, and achieving at least a high school diploma were significantly associated with hospice use ( Table ). Conclusions: Hospice utilization rates in our cohort compared favorably with previous analyses, but the frequency of improperly timed hospice referrals was similar to prior reports and provides an opportunity for improvement.

[Table: see text]

No significant financial relationships to disclose.

[Intersectoral collaboration of institutions in Germany and Europe in the field of food-borne zoonoses]

Prevention and control of food-borne zoonoses is given high priority in Germany and in the European Union. To implement targeted control measures, detailed data are necessary on human zoonoses and on the prevalence of zoonotic agents along the food chain. EU-wide legislations have been stipulated that allow collection and collation of relevant data across member states. The necessary structures have been established and are being constantly refined. In addition, surveillance systems and early warning systems have been improved or set up, respectively, to timely investigate and control food-borne outbreaks and to transnationally communicate food safety risks. For prevention and control to be effective, well-defined responsibilities and close collaboration of public health, veterinary public health and food safety authorities are needed. This report reviews the pertinent legislation, the established structures, and the collaboration of competent authorities in Germany and particularly in Europe. In the future, data quality and collaboration on national and EU levels will likely be further improved. Targeted control measures, particularly at primary production, are expected to lead to a sustainable reduction of the incidence of food-borne zoonoses.

Effect of N-chlorotaurine mouth rinses on plaque regrowth and plaque vitality

The purpose of this 4-day plaque regrowth study was to assess the effect of N-chlorotaurine (NCT) mouth rinses on plaque inhibition and plaque vitality. Eighty volunteers participated in this investigator-blind, randomized, clinical controlled study in parallel groups. No oral hygiene was permitted except rinsing with a 2% or 3% NCT mouth rinse, a positive or a negative control. Primary parameters were the plaque index (Silness and Löe, Acta Odontol Scand, 22:121-135, 1964) and plaque vitality (Netuschil et al., J Clin Periodontol, 16:484-488, 1989) after the final rinse. In addition, another plaque index (Turesky et al., J Periodontol, 41:41-43, 1970), plaque area, and bleeding on probing were recorded. All parameters were taken at baseline and day 5. U test was applied on a 5% error level. No differences in plaque inhibition were found between the two NCT formulations and the negative control. However, a statistically significant reduction of plaque vitality compared to the negative and positive control was observed. Discoloration of the tongue and unpleasant taste were recorded in participants in the NCT groups. NCT mouth rinses did not inhibit plaque regrowth, but they did reduce the vitality of plaque bacteria. Methods of prolonging the substantivity of the NCT mouth rinses should be investigated to enhance the antibacterial properties of these formulations.

Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration. A randomized, investigator-blind, placebo-controlled, 3-week experimental gingivitis study

OBJECTIVE

The aim of this experimental gingivitis study was to assess the efficacy and safety of two new chlorhexidine (CHX) mouthrinses.

MATERIAL AND METHODS

Ninety volunteers participated in this investigator-blind, randomized, clinical-controlled trial in parallel groups. During the treatment period, no oral hygiene measures except rinsing with non-alcoholic 0.2% CHX or 0.2% CHX/0.055% sodium fluoride mouthrinses, a positive control, or a negative control were permitted. The primary parameter was the gingival index; the secondary parameters were plaque index, discolouration index, and bleeding on probing. Clinical examinations were conducted 14 days before the start of the study, at baseline, and after 7, 14, and 21 days. The two sample t-test, anova, and ancova were used for the statistical analysis.

RESULTS

No difference in efficacy was found between the two new CHX formulations and the positive control. On day 21, statistically significantly less gingival inflammation and plaque accumulation compared with placebo were observed. Besides discolouration and taste irritations, no adverse events were recorded.

CONCLUSION

The two new CHX mouthrinses were able to inhibit plaque re-growth and gingivitis. Neither the omission of alcohol nor the supplementation with sodium fluoride had weakened the clinical efficacy of CHX with respect to the analysed clinical parameters.