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Preliminary evaluation of a commercial shampoo and fine bubble bathing in the treatment of canine atopic dermatitis: A single-blinded, randomised, controlled study. Vet Dermatol 2024. [PMID: 38418417 DOI: 10.1111/vde.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/05/2023] [Accepted: 02/16/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Fine bubble (FB) bathing has shown benefits on a mouse model of atopic dermatitis (AD). However, its efficacy in dogs with AD remains to be evaluated. OBJECTIVE This study aimed to assess the clinical effectiveness of FB bathing in dogs with AD. ANIMALS Seventeen dogs with AD whose clinical presentation showed a Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) score of <40. MATERIALS AND METHODS The dogs were randomly assigned to either the FB bathing group or the shampoo group. The treatments were administered once a week as per the instructions, in a trial totalling 4 weeks. Evaluations were conducted on Day (D)0 and D28 to assess the outcomes of the trial. The severity of AD was measured using the CADESI-04 and the pruritus Visual Analog Scale (PVAS). The skin barrier function parameters, transepidermal water loss (TEWL) and stratum corneum hydration were measured before and after the treatment. RESULTS Both treatment groups demonstrated a decreasing trend in CADESI-04 scores, yet the FB group exhibited significant improvement in comparison to the shampoo group after 1 month of trial. There were no significant changes in PVAS scores in either group. No significant difference was found in skin barrier function parameters between the two treatments, although TEWL slightly decreased in the FB group and slightly increased in the shampoo group after treatment. CONCLUSIONS AND CLINICAL RELEVANCE These results suggested that FB treatment provides benefits for dogs with AD and offers an alternative topical treatment option with a lesser impact on skin barrier function compared to frequent shampooing.
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A randomised, double-blinded, controlled trial to determine the efficacy of combined therapy of oclacitinib and marine oil extract PCSO-524 in dogs with atopic dermatitis. Vet Dermatol 2023; 34:523-531. [PMID: 37485602 DOI: 10.1111/vde.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/07/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFA) can be beneficial in the management of canine atopic dermatitis (cAD). A commercial product PCSO-524 containing PUFA has demonstrated anti-inflammatory effects in dogs. HYPOTHESIS/OBJECTIVES To evaluate the efficacy of PCSO-524, in combination with oclacitinib in dogs with cAD. ANIMALS Seventeen client-owned dogs with cAD. MATERIALS AND METHODS A randomised, double-blinded, controlled trial. All dogs were treated with oclacitinib (0.4-0.6 mg/kg) twice a day for 14 days, then once a day until Day (D)42. They were randomly divided into two groups: PCSO-524 (n = 9) and sunflower oil (n = 8). Clinical status was assessed by Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and pruritus Visual Analog Scale (pVAS) at baseline (D0), D14, D28 and D42. Trans epidermal water loss (TEWL) was measured at the same time points. RESULTS CADESI scores decreased significantly after treatment and there was a significant difference between the PCSO-524 and the control group at D28 (p = 0.04) and D42 (p = 0.03). The PCSO-524 group also demonstrated a significantly decreased pVAS on D28 and D42 (p < 0.001 and p < 0.001) compared to D0, while significant differences were observed in the control group at D14 and D28 (p < 0.01 and p = 0.04) and not at D42 (p = 0.12). The mean TEWL showed a significant decrease at D28 and D42 in the PCSO-524 group, compared to the control group (p = 0.002 and p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE The combination of PCSO-524 and oclacitinib may help to alleviate the rebound effect that occurs when tapering down the dosage of oclacitinib, as compared to using oclacitinib alone for the management of cAD.
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Efficacy and safety of 0.0584% hydrocortisone aceponate topical spray and systemic oclacitinib combination therapy in dogs with atopic dermatitis: a randomized, double-blinded, placebo-controlled trial. Vet Dermatol 2020; 32:119-e25. [PMID: 33185330 DOI: 10.1111/vde.12909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Oclacitinib is an effective systemic therapy for dogs with atopic dermatitis (AD). Few studies have evaluated concurrent topical treatment with oclacitinib in dogs. OBJECTIVES To evaluate the efficacy and safety of combination therapy of oclacitinib and 0.0584% hydrocortisone aceponate (HCA) spray in dogs with AD. ANIMALS Eighteen dogs with AD. METHODS AND MATERIALS This study was a randomized, double-blinded, placebo-controlled trial. All dogs were treated with oclacitinib (0.4-0.6 mg/kg twice daily for 14 days, then once daily for 14 days) and randomized to receive either HCA spray or placebo spray, applied once daily for seven days then every other day through to Day (D)28. Clinical assessments included the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-4) and the pruritus Visual Analog Scale (PVAS) every seven days, and blood and urine tests every 14 days. RESULTS The mean CADESI-4 and PVAS scores were significantly reduced on D7 and D14 compared to D0 in both groups (P < 0.05). From D14 to D21, CADESI-4 and PVAS scores were significantly increased in the placebo group (P < 0.005), and not in the HCA-treated group. The mean reduction from baseline of the HCA-treated group was significantly higher than that of the placebo group for the PVAS and CADESI-4 on D21 (59.9% versus 27.6%, P = 0.0216) and D28 (56.0% versus 30.5%, P = 0.0109), respectively. One dog in the HCA-treated group was withdrawn as a consequence of developing diarrhoea. CONCLUSION Topical application of 0.0584% HCA spray may be useful for preventing exacerbation of pruritus and clinical lesions when tapering oclacitinib therapy in dogs with AD.
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Eriodictyon angustifolium extract, but not Eriodictyon californicum extract, reduces human hair greying. Int J Cosmet Sci 2020; 42:336-345. [PMID: 32324292 DOI: 10.1111/ics.12620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Yerba Santa (Eriodictyon angustifolium and Eriodictyon californicum) has been used for many years in traditional medicine. However, the effect of Yerba Santa on melanogenesis has not yet been investigated. We aimed to assess the biological effects of Yerba Santa on hair pigmentation. METHODS Yerba Santa extracts were assessed for their cytological effects following X-ray irradiation treatment and then tested directly for the prevention of human hair greying. Ultra-performance liquid chromatography (UPLC) was utilized to identify the individual extract components. RESULTS Eriodictyon angustifolium extract significantly increased melanin synthesis in the melanoma cell line through activation of the WNT/MITF/tyrosinase-signalling pathway. In contrast, E. californicum had no effect on melanin synthesis. E. angustifolium extract also demonstrated a protective effect against the damage induced by X-ray irradiation in human keratinocytes. Application of the extracts to subjects who had grey beards demonstrated a reduced number of grey beard hair per year specifically with the E. angustifolium extract. A significant decrease in grey head hair was also observed after application of E. angustifolium extract. Upregulation of gene expression related to melanin production and WNT signalling was observed after the application of E. angustifolium extract. Sterubin was the most abundant flavonoid detected by UPLC in E. angustifolium extract. In addition, sterubin showed the highest difference in terms of quantity, between E. angustifolium and E. californicum extract. CONCLUSION Eriodictyon angustifolium extract, which is abundant in sterubin, may be suitable as a potential cosmetic and medical agent for the prevention and improvement of hair greying.
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Dual-layer detector CT of chest, abdomen, and pelvis with a one-third iodine dose: image quality, radiation dose, and optimal monoenergetic settings. Clin Radiol 2018; 73:1058.e21-1058.e29. [DOI: 10.1016/j.crad.2018.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/24/2018] [Indexed: 12/12/2022]
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Possible role of PPARγ in the negative regulation of ovulatory cascade and luteal development in rats. J Vet Med Sci 2017; 79:1043-1051. [PMID: 28529269 PMCID: PMC5487780 DOI: 10.1292/jvms.17-0162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Peroxisome proliferator-activated receptor γ (PPARγ), a member of a nuclear receptor family, has been shown to be implicated in various reproductive processes. Here, we evaluated possible roles of PPARγ in ovulation and luteal development in a gonadotropins-primed immature rat model. Immunoreactive PPARγ was expressed in granulosa cells of eCG-stimulated mature follicles, and its expression level decreased following ovulatory hCG stimulus. Intra-bursal treatment with rosiglitazone (a PPARγ agonist) simultaneously with subcutaneously administered hCG blocked the induction of cyclooxygenase-2 and steroidogenic acute regulatory protein (StAR) in preovulatory follicles. Consistently, tissue levels of their respective products, prostaglandin (PG) E2 and progesterone (P4), were reduced, leading to significantly decreased ovulation rate. GW9662, a PPARγ antagonist, was almost ineffective to alter those values. Local treatment with rosiglitazone 24 hr after hCG administration caused reductions in the size, StAR expression and P4 secretion of corpus luteum 48 hr later. Obtained data are possible functional evidence with rats for granulosa cell PPARγ as a negative regulator of PG and P4 synthesis during follicle rupture and transformation to luteal tissue. LH/hCG-induced decreases in PPARγ expression and its activity would be an early component in the proper induction of following ovulatory cascade and luteal development.
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Abstract
Soft denture liners are used for edentulous patients to cushion functional forces. We hypothesized that the application of soft liners having viscoelastic properties would lead to the most marked improvement in masticatory function. The shear storage modulus ( G′), shear loss modulus ( G′′), and loss tangent (tan δ) were determined for 6 materials by means of a dynamic viscoelastometer. Masticatory function of ten subjects was evaluated by measurements of maximum bite forces and chewing times and frequencies for 2 food samples, and by the use of visual analogue scales. The acrylic materials exhibited viscoelastic behavior, while the silicones exhibited elastic behavior. The improvement in masticatory function compared with hard resin was found to be in the order: acrylic permanent materials > silicone > acrylic temporary materials. The results suggest that the use of materials with higher tan δ and G′ provides the most optimum masticatory function for patients requiring the provision of soft liners on their dentures.
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Study of factors related to the reflection abilities of dental trainees. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:13-16. [PMID: 26344846 DOI: 10.1111/eje.12169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/30/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study analysed the internal and external factors related to the reflection abilities of dental trainees. PARTICIPANTS AND METHODS We created transcripts from oral presentations by the dental trainees of Hiroshima University Hospital (n = 35, 2012-2013) at a significant event analysis conference. The reflection depths were compared between the trainees of the university hospital and external clinical combination groups. We determined and statistically analysed the reflection depths. RESULTS At the end of training, a Mann-Whitney U-test revealed a significant difference in the median reflection depths of the groups (U = 66, W = 342 and P = 0.007). The results of multiple regression analysis indicated a significant relation between the reflection depth and external training completion (P = 0.024). There were no relations with other factors, including gender and academic background. CONCLUSION Experiences in external clinics create a close connection between the staff and trainees because communities of practice can cause deeper reflections. We need to create small groups in large-scale organisations such as university hospitals. This construct can be adapted not only for Japanese dental trainees but also for global dental and other medical trainees.
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Perceived Stress and Coping Strategies in Relation to Body Mass Index: Cross-Sectional Study of 12,045 Japanese Men and Women. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Interaction between Interleukin1-β Gene Polymorphism and Cigarette Smoking on HbA1c in a Japanese General Population. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Effectiveness of a simulated patient training programme based on trainee response accuracy and appropriateness of feedback. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2014; 18:241-251. [PMID: 25318559 DOI: 10.1111/eje.12093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/28/2013] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Simulated patients (SPs) need education and training in required skills to be effective resources in education. This study was conducted to examine the effectiveness of an SP training programme based on the accuracy of trainee responses and the appropriateness of their feedback. METHODS Thirty-two applicants to the training programme and 35 experienced SPs were included in this study. The experienced SPs served as a reference group. The rate of accurate responses and the rate of appropriate feedback were assessed with pre- and post-training tests, and these two outcome measures were compared with those of the experienced SPs. RESULTS No significant differences were found in trainee response accuracy or appropriateness of feedback between pre- and post-training tests. The response accuracy rate of the trainees on the pre-training test was significantly lower than that of SPs with 1-2 years of experience, whilst there was no significant difference between these SPs and the trainees on the post-training test. CONCLUSIONS Although our study suggests that more training is needed to improve the skills of SPs, the training programme may contribute to helping trainees reach a novice level in the skill of providing accurate responses. SP training should be encouraged to contribute to the effectiveness of such teaching and to establish the validity of the assessment.
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A case of Björnstad syndrome caused by novel compound heterozygous mutations in the BCS1L gene. Br J Dermatol 2013; 170:970-3. [PMID: 24236502 DOI: 10.1111/bjd.12736] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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P2-213 Association between dietary patterns and serum C-reactive protein among Japanese men and women. J Epidemiol Community Health 2011. [DOI: 10.1136/jech.2011.142976j.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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P2-112 Association between PPARG2 Pro12Ala gene variant and HbA1c in a middle-aged Japanese population. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976i.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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OSCEs in Japanese postgraduate clinical training Hiroshima experience 2000-2009. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2010; 14:203-9. [PMID: 20946247 DOI: 10.1111/j.1600-0579.2009.00610.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Hiroshima University Hospital used the Objective Structured Clinical Examination (OSCE) as a formative and summative assessment tool to evaluate trainees' competence. AIM To reflect on Hiroshima University Hospital experience of OSCEs in postgraduate training in terms of OSCE structure and trainees' perception of the OSCE they attended. METHODS A total 27 OSCEs implemented in Hiroshima University Hospital from 2000 to 2009 were examined. The OSCE in postgraduate training, Hiroshima University Hospital, was influenced by many factors from organisational and pedagogical perspectives, and changed to meet social and curriculum needs. At each OSCE, all examinees were required to answer an anonymous questionnaire, which consisted of ten checklists, just after their experience of OSCE. RESULTS Five hundred and forty trainees who attended each OSCE were required to answer a questionnaire and 510 were returned (94.4%). In the comparison between formative and summative OSCEs, the number of trainees who answered "the OSCE is meaningful" in formative OSCE was significantly higher than that in summative OSCE (P < 0.001). In the comparison between before and after the 2006/2007 academic year, trainees who indicated that OSCEs were meaningful increased after 2006/2007 (P < 0.05), and trainees who felt they were evaluated appropriately by these OSCEs increased after 2006/2007 (P < 0.01). CONCLUSION Trainees viewed OSCEs positively and appreciated their effectiveness from a pedagogical perspective, and OSCE positively affected the trainees' approach to learning. A ten-year process of OSCE change has helped with educational reforms because of its adaptability. Flexible attitudes to change are necessary for stakeholders to achieve the desired reforms.
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Influence of socio-economic background and antenatal care programmes on maternal mortality in Surabaya, Indonesia. Trop Med Int Health 2003; 8:847-52. [PMID: 12950671 DOI: 10.1046/j.1365-3156.2003.01101.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the risk factors, such as socio-economic background, quality of antenatal care and availability of family planning, responsible for high maternal mortality in Surabaya, Indonesia. METHODS The study used a case-control design. Descriptive, bivariate and multivariate analyses were carried out, comparing 59 maternal deaths and 177 women survivors in the referral hospital, from 1996 to 1999. RESULTS The risk factors for maternal mortality were: living outside of Surabaya [odds ratio (OR) = 11.7, 95% confidence interval (CI) = 5.0-29.2], unemployment (OR = 4.4, 95% CI = 1.7-13.8), unavailability of toilet facilities (OR = 2.9, 95% CI = 1.0-7.7), <4 antenatal visits (OR = 2.5, 95% CI = 1.1-5.5) and initial visit to antenatal care facilities after the fourth month of pregnancy (OR = 3.0, 95% CI = 1.3-7.0). There was no significant association between maternal mortality and the availability of family planning. CONCLUSION Low socio-economic background and the availability of antenatal care have a significant influence on maternal mortality in Surabaya, Indonesia.
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Abstract
UNLABELLED We compare hemodynamic responses in normotensive and hypertensive anesthetized paralyzed patients among three intubation devices: the Macintosh laryngoscope (LS), the Trachlight lightwand (LW), and the intubating laryngeal mask airway Fastrach (ILM). Seventy-five normotensive and 75 hypertensive patients were randomly assigned to each intubation device (n = 25). Noninvasive systolic blood pressure (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were recorded immediately preinduction, immediately preintubation, and every minute for the first 5 min after the successful intubation. The number of intubation attempts, the time to successful intubation, and any airway injuries were recorded. Pharyngolaryngeal morbidity was assessed 18-24 h after surgery by a blinded investigator. In all groups, there was a reduction in SBP and DBP but no change in HR immediately preintubation compared with baseline values. In all groups, HR increased, but there were no increases in SBP and DBP other than in DBP in the LS/hypertensive group after intubation compared with baseline values. In normotensive patients, there were no differences in any hemodynamic variables among the three devices. In hypertensive patients, SBP and DBP in the LS group were significantly higher than the ILM and LW groups for 2 min after intubation, but there were no differences in HR among the devices. The number of intubation attempts was similar among groups, but intubation time was longer for the ILM group. The incidence of airway injury was more frequent for the ILM than the LS and LW groups (16% versus 0% versus 0%). There were no differences in pharyngolaryngeal morbidity among groups. We conclude that both the ILM and the LW attenuated the hemodynamic stress response to tracheal intubation compared with the LS in hypertensive, but not in normotensive, anesthetized paralyzed patients. IMPLICATIONS Both the intubating laryngeal mask airway Fastrach and the Trachlight lightwand attenuate the hemodynamic stress response to tracheal intubation compared with the Macintosh laryngoscope in hypertensive, but not in normotensive, anesthetized paralyzed patients.
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Human GLUT5 immunolabeling is useful for evaluating microglial status in neuropathological study using paraffin sections. Acta Neuropathol 2003; 105:157-62. [PMID: 12536226 DOI: 10.1007/s00401-002-0627-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2002] [Revised: 08/22/2002] [Accepted: 08/30/2002] [Indexed: 12/01/2022]
Abstract
In neuropathological studies it is important to detect both resting and reactive microglia in paraffin sections. We examined the usefulness of human (h) GLUT5, a glucose transporter, as a microglial marker. We produced an hGLUT5 antibody against its C-terminal sequence and stained human brain tissue sections. The hGLUT5 antibody consistently stained microglia in cryostat sections. In paraffin sections fixed with formalin, paraformaldehyde or ethanol, both resting and reactive microglia were stained; the latter were stained more intensely than the former. The hGLUT5 and glial fibrillary acidic protein labeling did not overlap each other in double immunofluorescence analyses. Oligodendrocytes, perivascular cells, choroid plexus epithelium and ependymal cell were negative for hGLUT5. Even after 1-month fixation in formalin, the hGLUT5 antibody stained microglia well. Microwave pretreatment enhanced the immunoreactivity of hGLUT5. As compared with other microglial markers, KP-1, KiM1p, CR3.43 and RCA-1, the hGLUT5 antibody could be considered good morphological marker. hGLUT5 immunolabeling clearly showed the detailed microglial processes, whereas immunolabeling with Ki-M1P and KP-1 showed cytoplasmic granules, and it was difficult to trace the microglial processes. The hGLUT5 antibody stained both resting and reactive microglia, whereas CR3.43 stained only reactive microglia, and RCA-1 labeled microvessels more intensely than microglia. Thus, hGLUT5 is a marker that is suitable for routine histopathological staining procedures.
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Intubating laryngeal mask airway size selection: a randomized triple crossover study in paralyzed, anesthetized male and female adult patients. Anesth Analg 2002; 94:1023-7, table of contents. [PMID: 11916817 DOI: 10.1097/00000539-200204000-00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED We determined the optimal size of intubating laryngeal mask airway (ILM) for ventilation and blind tracheal intubation in men and women. We also determined the distance the tracheal tube needs to protrude beyond the distal aperture to ensure that the cuff is through the vocal cords. Fifty male and 50 female anesthetized, paralyzed patients (ASA physical status I or II, aged 18-80 yr) were studied. Three operators (A, B, and C) were involved for the purposes of blinding. The size 3, 4, or 5 ILM was inserted into each patient in random order by Operator A, and the quality of ventilation was scored (adequate, suboptimal, or failed) by Operator B. The fiberoptic position (correct, too shallow, or too deep) and the distance between the distal aperture and the vocal cords was determined by Operator B. A single attempt at blind intubation was made by Operator C. Operators B and C were blinded to the size of the ILM. Operator C was also blinded to the information recorded by Operator B. All ILMs were inserted into the laryngopharynx at the first attempt. For men and women, the ventilation score was smaller for the Size 3 than the Size 4 or 5 (all: P < 0.002). For men, correct positioning was less common with the Size 3 than the Size 4 or 5 (both: P < 0.02). For women, correct positioning was similar among sizes. For men, tracheal intubation was successful less frequently with the Size 3 (84%) than the Size 4 (100%) or 5 (98%) (both: P < or = 0.01). For women, tracheal intubation success was similar among sizes (Size 3, 4, and 5: 86%, 96%, and 92%, respectively). Intubation was always successful if the ILM was correctly positioned and always failed if it was too shallow or deep. In both male and female patients, the distance between the distal aperture and the vocal cords increased with increasing ILM size (all: P < 0.04) and patient height (P < 0.0001) and was always longer for men (all: P < 0.0001). The overall mean distance (95% confidence interval) that the tracheal tube needed to protrude was 10-12 cm (8-13 cm) in men and 8-11 cm (8-12 cm) in women. We conclude that for men, the Size 4 and 5 ILMs are better than the Size 3 for ventilation and blind intubation. For women, the Size 4 and 5 ILMs are better than the Size 3 for ventilation, but there is no difference among sizes for blind intubation. The length the tracheal tube must protrude from the distal aperture to ensure that the cuff is completely through the vocal cords is 8-13 cm, depending on ILM size, the tracheal tube size, and the sex and height of the patient. IMPLICATIONS For men, the Size 4 and 5 intubating laryngeal mask airways are better than the Size 3 for ventilation and blind tracheal intubation. For women, the Size 4 and 5 are better than the Size 3 for ventilation, but there is no difference among sizes for blind intubation. The length the tracheal tube must protrude from the distal aperture of the intubating laryngeal mask airway to ensure that the cuff is completely through the vocal cords is 8-13 cm, depending on the size of the mask and tracheal tube and on the sex and height of the patient.
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Dynamic viscoelasticity of soft liners and masticatory function. J Dent Res 2002; 81:123-8. [PMID: 11827257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Soft denture liners are used for edentulous patients to cushion functional forces. We hypothesized that the application of soft liners having viscoelastic properties would lead to the most marked improvement in masticatory function. The shear storage modulus (G'), shear loss modulus (G''), and loss tangent (tan delta) were determined for 6 materials by means of a dynamic viscoelastometer. Masticatory function of ten subjects was evaluated by measurements of maximum bite forces and chewing times and frequencies for 2 food samples, and by the use of visual analogue scales. The acrylic materials exhibited viscoelastic behavior, while the silicones exhibited elastic behavior. The improvement in masticatory function compared with hard resin was found to be in the order: acrylic permanent materials > silicone > acrylic temporary materials. The results suggest that the use of materials with higher tan delta and G' provides the most optimum masticatory function for patients requiring the provision of soft liners on their dentures.
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Abstract
In order to evaluate the influence of viscoelastic properties of resilient denture liners on the pressures under dentures, a series of creep and stress relaxation tests were carried out using a simplified mandibular edentulous model and denture model. Two diaphragm pressure sensors were attached to the edentulous model so that they contacted the residual ridge and the buccal slope. The results may be summarized as follows: (i) The use of resilient denture liners is effective for stress relief under dentures. (ii) The thickness increase of each denture liners causes the effect of stress relaxation. (iii) The material exhibited viscoelastic behaviour after applying the stress and has the ability to distribute stress or stress relaxation. It is important to understand the viscoelastic behaviours of each resilient denture liner and choose the material according to the clinical situation. The information obtained should be useful to clinicians when they select materials for their patients.
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Effect of triacylglycerols containing medium- and long-chain fatty acids on body fat accumulation in rats. J Nutr Sci Vitaminol (Tokyo) 2001; 47:267-9. [PMID: 11575585 DOI: 10.3177/jnsv.47.267] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Effect of triacylglycerols containing medium- and long-chain fatty acids (TML) on body fat accumulation was studied in rats. Male Wistar rats were fed an experimental diet containing 25% soybean oil or TML for 6 weeks. The food intake for 6 weeks did not significantly differ between the two diet groups. However, the perirenal and mesenteric adipose tissue weight and carcass fat content were significantly lower in the TML diet group than in the soybean oil diet group. The epididymal adipose tissue weight and liver triacylglycerol content did not significantly differ between the two diet groups. The digestibility of dietary fat did not significantly differ between the two diet groups. These results suggest that an intake of TML decreases body fat accumulation compared to an intake of soybean oil in rats.
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Routine use of the intubating laryngeal mask airway results in increased upper airway morbidity. Can J Anaesth 2001; 48:604-8. [PMID: 11444458 DOI: 10.1007/bf03016840] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The classic laryngeal mask airway (LMA) has a soft, silicone tube and the intubating laryngeal mask airway (ILM) has a rigid, silicone-coated steel tube. We compare postoperative pharyngolaryngeal morbidity in patients randomised to receive either device. METHODS Sixty-five female patients (ASA physical status class I or II, aged 18-80 yr) undergoing balanced regional anesthesia for gynecological laparotomy expected to last one to two hours were randomly assigned for airway management with the LMA or ILM. Intracuff pressure was maintained at 60 cm H20. Postoperative pharyngolaryngeal morbidity (sore throat, difficulty swallowing, sore mouth, sore neck/jaw, hoarseness) was assessed at two, 24 and 48 hr by blinded investigators. RESULTS The number of insertion attempts and duration of anesthesia was similar between groups. Sore throat was more common for the ILM at two hours (44 vs 15%, P=0.01), 24 hr (59 vs 21%, P=0.008) and 48 hr (34 vs 3%, P=0.005). Sore mouth was more common for the ILM at two hours (16 vs 0%, P=0.02) and 24 hr (12 vs 0%, P=0.04), but not at 48 hr (6 vs 3%). Difficulty swallowing was more common for the ILM at two hours (25 vs 0%, P=0.04), but not at 24 hr (31 vs 3%) and 48 hr (12 vs 9%). There were no differences in the incidence of sore jaw/neck (ILM, 3-12%; LMA, 0-3%) and hoarseness (ILM, 12-31%; LMA, 16-18%). There was no correlation between postoperative pharyngolaryngeal morbidity and duration of anesthesia. CONCLUSION Pharyngolaryngeal morbidity is more common with the ILM than the LMA following anesthesia lasting one to two hours.
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Abstract
New Zealand Black mice as well as several other murine models of murine lupus are well known for premature degeneration of thymus and development of autoimmunity. To focus on molecular events unique to murine lupus, we performed differential display using arbitrary primer pairs to distinguish NZB versus BALB/c thymus at 5 weeks of age. Following an extensive analysis of DNA bands that were either consistently up or downregulated and from studies of expression pattern of thymic genes by in situ nucleic acid hybridization, we focused on one clone that was consistently differentially expressed between NZB and BALB/c thymus. This clone was isolated, sequenced, and identified as the murine homologue of the human X box binding protein (hXBP-1), also known as TREB 5. mXBP-1 was found to be consistently upregulated in B cells in the thymic cortex of NZB and (NZBxNZW)F1, but not BALB/c, C3H/HeJ or C57BL/6 mice. In addition, it was dramatically elevated in MRL/ lpr but not MRL/++ mice; similarly, it was increased in BXSB/ Yaa male but not BXSB female thymic cortex. Of particular interest was an absence of mXBP-1 expression in the thymus of NZB/ Bln- Igh6(null)homozygotes. mXBP-1 has several putative functions, including the regulation of MHC class II expression and by virtue of its ability to recognize CRE-like elements shown to be involved in HTLV-1 transcription.
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Abstract
Abnormal expansion of autoantibody-synthesizing B cells and self-reactive T cells, which most likely escape negative selection within the thymus, have both been characterized and reasoned to play a role in the pathogenesis of autoimmunity in NZB mice. Support for this thesis has been our observation that NZB mice have severe cortical and medullary thymic microarchitectural defects. As a means to dissect the roles of T and B cells in the induction of such abnormalities, B cell-deficient NZB mice were bred by backcrossing the Igh6(null)allele on to the NZB background (NZB-muMT mice). Such mice showed undetectable levels of autoantibodies. NZB-muMT mice, as compared to wild-type NZB mice, had lower absolute numbers of CD4(+)T cells. Furthermore, thymic abnormalities in NZB-muMT mice were restricted to the medulla. These data suggest that, while B cells may play a role in thymic cortical abnormalities, the medullary abnormalities are induced by other mechanisms.
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The thermic effect is greater for structured medium- and long-chain triacylglycerols versus long-chain triacylglycerols in healthy young women. Metabolism 2001; 50:125-30. [PMID: 11172486 DOI: 10.1053/meta.2001.18571] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to investigate the hypothesis that a single dose of structured medium- and long-chain triacylglycerols (SMLCTs) composed of medium-chain (20%) and long-chain (80%) fatty acids would increase the metabolic rate more than a dose of long-chain triacylglycerols (LCTs) in 15 healthy young women aged 18 to 28 years. The effects on postingestive energy expenditure were compared for SMLCTs versus LCTs. On the experimental days, the subjects fasted overnight and then ingested 1,680 kJ SMLCTs or LCTs each day. Energy expenditure and the respiratory quotient (RQ) were measured before and after SMLCT and LCT ingestion by indirect calorimetry. Blood samples were collected before and after ingestion to obtain plasma and serum. Postingestive total energy expenditure (PTEE) was significantly higher after SMLCT ingestion versus LCT ingestion (26.9 +/- 1.0 v 25.5 +/- 1.1 kJ/kg/6 h, P < .05). The thermic effects of the test oil were also significantly greater after SMLCT ingestion compared with LCT ingestion (3.02 +/- 0.49 v 1.47 +/- 0.82 kJ/kg/6 h, P < .01). Plasma glucose and serum triacylglycerol concentrations were not significantly different. Serum free fatty acid and 3-hydroxybutyric acid concentrations were higher after SMLCT ingestion versus LCT ingestion. These results suggest that long-term substitution of SMLCTs for LCTs will produce body fat loss if energy intake remains constant.
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Airway rescue with the intubating laryngeal mask in a patient with an unexpectedly large epiglottic cyst. Anasthesiol Intensivmed Notfallmed Schmerzther 2000; 35:774-5. [PMID: 11194523 DOI: 10.1055/s-2000-8931] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We report the successful use of the intubating laryngeal mask airway for rescue and intubation in an anaesthetised patient with an unexpectedly large epiglottic cyst. This case illustrates that airway rescue and intubation with the intubating laryngeal mask is possible and preoperative airway assessment does not always provide reliable information about airway management.
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Abstract
We determined (a) the haemodynamic responses to intubating laryngeal mask (ILM) airway insertion/intubation and removal in anaesthetized patients, and (b) whether the timing of ILM removal influences these responses. One-hundred and twenty patients without cardiovascular disease were studied. ILM airway insertion/intubation was 5 min after induction with propofol 2 mg kg(-1) and maintenance of anaesthesia with sevoflurane 2% in oxygen 33% and nitrous oxide. Patients were randomly assigned for removal of the intubating laryngeal mask airway at 1, 3 and 5 min after successful intubation. Systolic and diastolic arterial pressures and heart rate were recorded preinduction (baseline), before ILM airway insertion/intubation, at 1-min intervals after insertion/intubation, and at 1-min intervals for 5 min after ILM removal. ILM insertion was successful at the first attempt in all patients, but 46 patients required more than one intubation attempt. Compared with baseline values, there were no increases in systolic or diastolic arterial pressure, but there was an increase in heart rate 1 min after ILM insertion/intubation (9%, P<0.001) and 1 min after ILM removal (8%, P<0.01). There was a significant increase in systolic and diastolic pressures and heart rate 1 min after ILM insertion/intubation (30%, 31% and 15%; all: P<0.002) compared with before ILM insertion/intubation values and 1 min after ILM removal (9%, 8% and 7%; all P<0.05) compared with 1 min after ILM insertion/intubation values. Removal of the ILM 1 min after successful intubation resulted in higher arterial pressure compared with removal at 3 min (systolic arterial pressure 10% higher for 1 min, P = 0.01) and 5 min (systolic arterial pressure 10-23% higher for 3 min, P<0.01; diastolic arterial pressure 10-20% higher for 4 min, P>0.02), but there were no differences in heart rate between groups. Systolic and diastolic arterial pressures were greater if more than one intubation attempt was required. Early removal or multiple intubation attempts did not exceed baseline haemodynamic values. We conclude that ILM insertion/intubation and removal in anaesthetized patients produces little or no haemodynamic response, even if multiple intubation attempts are required. The timing of removal exerts a small, but clinically unimportant influence on these responses.
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Tissue inhibitor of metalloproteinases-1, matrix metalloproteinases-1 and -8, and collagenase activity levels in peri-implant crevicular fluid after implantation. Clin Oral Implants Res 2000; 11:430-40. [PMID: 11168235 DOI: 10.1034/j.1600-0501.2000.011005430.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The integrity of connective tissues surrounding dental implants may be influenced by a balance between matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). The purpose of this study was to provide an overall assessment of TIMP-1, MMP-1 and -8 levels as well as collagenase activities during the wound healing process after implantation and in peri-implantitis lesions. Peri-implant crevicular fluid (PICF) was sampled with sterile paper strips from 10 osseointegrated implants of 6 subjects. Ten implants from 6 patients affected with peri-implantitis were also assessed. Gingival crevicular fluid (GCF) from 11 periodontitis-affected patients and 10 healthy volunteers served as controls. TIMP-1 and MMP-1 and -8 protein levels in the PICF were measured by ELISA, and active and APMA-activatable collagenase activities were determined by functional assays using image-analysis after SDS-PAGE. The experiment showed a significant increase in the TIMP-1 level at 1 week after implantation as compared with that in GCF from healthy periodontium. Four weeks after implantation it had reached the same level as that in the GCF of healthy subjects. The data has also disclosed a higher post-implantation collagenase activity level at 1 week than at weeks 2, 4, and 12. This may be due to the increase in MMP-1 and -8. Furthermore, peri-implantitis and periodontitis were shown to be similar inflammatory lesions in respect to MMP-1 and -8 and collagenase activities, even though the TIMP-1/MMP-1 + MMP-8 ratio was significantly lower in peri-implantitis than in periodontitis. In conclusion, the overproduction of TIMP-1 in the wound area after implantation could, to some extent, inhibit excessive tissue destruction and degradation of the neo-matrix in wound repair due to MMPs.
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Determination of sugar alcohols in confectioneries by high-performance liquid chromatography after nitrobenzoylation. J Chromatogr A 2000; 893:195-200. [PMID: 11043600 DOI: 10.1016/s0021-9673(00)00694-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A method was developed for the determination of sugar alcohols, meso-erythritol, xylitol, D-glucitol, D-mannitol, maltitol and parachinit by high-performance liquid chromatography (HPLC). The sugar alcohols were converted into strong ultraviolet (UV)-absorbing derivatives with p-nitrobenzoyl chloride. HPLC was performed on a phenyl column, using acetonitrile-water (67:33) as mobile phase and UV detection (260 nm). The calibration curves for all sugar alcohols tested were linear in the 10-250 microg/ml range. The average recoveries of the sugar alcohols from four sugarless confectioneries spiked at 5 and 10% levels of six sugar alcohol standards ranged from 73.2 to 109.0% with relative standard deviations ranging from 0.7 to 9.0%. The detection limit of the developed method was 0.1% for the above sugar alcohols contained in the samples.
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Abstract
There are many controversies about the long-term prognosis of hydroxyapatite (HA)-coated implants. Failure may be related to compositional and structural changes of the coating occurring during implantation. Two retrieved and two unused HA-coated blade-type implants were examined by stereomicroscopy, secondary electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, and electron probe microanalysis. The objective was to investigate the HA morphology, composition, and structure, and to characterize the changes that occurred in the retrieved implant coatings. Retrieved implants presented partial loss of the coating, especially at the apical and mesiodistal edges. Remaining HA was thick and flattened in the cervical and central areas and gradually thinner and rougher towards the apical and mesiodistal edges. Increase of Cl and Mg, decrease of OH, and X-ray diffraction peak broadening were found in the retrieved implant coatings, in comparison with the unused implants. Morphological changes of the retrieved implants seem to depend on stress values in the surrounding bone and on implant mobility. Compositional changes and increased amount of lattice imperfections appeared in the retrieved implant coatings, as a result of ion substitutions in the apatite lattice. However, the present study could not confirm the influence of these changes on implant failure.
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[Under water exercise]. NIHON RINSHO. JAPANESE JOURNAL OF CLINICAL MEDICINE 2000; 58 Suppl:240-4. [PMID: 11085122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Segmental Cervical Spine Movement with the Intubating Laryngeal Mask During Manual In-Line Stabilization in Patients with Cervical Pathology Undergoing Cervical Spine Surgery. Anesth Analg 2000. [DOI: 10.1213/00000539-200007000-00037] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
The dynamic viscoelastic properties of long-term soft denture liners were measured over a wide range of frequencies using a dynamic viscoelastometer based on a non-resonance-forced vibration principle. Changes in properties over a 3 yr period have also been monitored. One acrylic material, one fluoroelastomer, one heat cured silicone and one self-curing addition silicone were used. Complex dynamic tensile modulus (E*), tensile storage modulus (E'), tensile loss modulus (E") and loss tangent (tan delta) were determined over the frequency range from 0.01 to 100 Hz on administration of a 0.27% strain at 37 degrees C. The dynamic viscoelasticity of the acrylic and fluoroelastomer products was more sensitive to changes in frequency than that of silicone products. The acrylic material and fluoroelastomer exhibited viscoelastic behaviour whilst silicones exhibited elastic behaviour. The silicone products remained unchanged after soaking for 3 yr whilst the acrylic and fluoroelastomer products underwent significant change.
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Segmental cervical spine movement with the intubating laryngeal mask during manual in-line stabilization in patients with cervical pathology undergoing cervical spine surgery. Anesth Analg 2000; 91:195-200. [PMID: 10866912 DOI: 10.1097/00000539-200007000-00037] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED We quantified the extent and distribution of segmental cervical movement produced by the intubating laryngeal mask (ILM) during manual in-line stabilization in 20 anesthetized patients with cervical pathology undergoing cervical spine surgery. All patients had neurological symptoms preoperatively. The ILM was inserted with the head and neck in the neutral position. Intubation was facilitated by transillumination of the neck with a lightwand. Cervical movement was recorded with single-frame lateral radiographic images taken 1) immediately before induction (baseline); 2) during ILM insertion (insertion); 3) when transillumination was first seen at the cricothyroid membrane (intubation A); 4) when the tube was being advanced into the trachea (intubation B); and 5) during ILM removal (removal). Radiographic images were digitized and the degree of flexion/extension and posterior movement measured for the occiput (C0) through to C5. During ILM insertion, C0-5 were flexed by an average of 1-1.6 degrees (all P < 0.05). During intubation A/B, C0-4 were flexed by an average of 1.4-3.0 degrees (all P < 0.01), but C5 was unchanged. During ILM removal, C0-3 were flexed by an average of 1 degree (all: P < 0.05), but C3-5 were unchanged. During insertion and intubation A/B, C2-5 were displaced posteriorly by an average of 0.5-1.0 mm (all: P < 0.05). During removal, there was no change at C1-5. Neurological symptoms improved in all patients. We conclude that the ILM produces segmental movement of the cervical spine despite manual in-line stabilization in patients with cervical spine pathology undergoing cervical spine surgery. This motion is in the opposite direction to direct laryngoscopy, suggesting that different approaches to airway management may be more appropriate depending on the nature of the cervical instability. IMPLICATIONS The intubating laryngeal mask produces segmental movement of the cervical spine, despite manual in-line stabilization in patients with cervical spine pathology undergoing cervical spine surgery. This motion is in the opposite direction to direct laryngoscopy, suggesting that different approaches to airway management may be more appropriate depending on the nature of the cervical instability.
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Tracheal intubation with the Macintosh laryngoscope versus intubating laryngeal mask airway in adults with normal airways. Anaesth Intensive Care 2000; 28:281-6. [PMID: 10853210 DOI: 10.1177/0310057x0002800305] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We tested the hypothesis that haemodynamic changes to intubation and postoperative pharyngolaryngeal morbidity are similar for blind intubating laryngeal mask (ILM)-guided compared with laryngoscope-guided tracheal intubation in adults with normal airways. We also compared intubation success rates and airway complications. One-hundred and fifty paralysed, anaesthetized adult patients undergoing elective surgery were randomly assigned to one of three equal-sized groups: 1. blind intubation via the ILM using a straight, silicone tube; 2. intubation with a Macintosh laryngoscope using a straight silicone tube and 3. intubation with a Macintosh laryngoscope using a polyvinyl chloride tube (controls). A standard sequence of adjusting manoeuvres was followed if intubation was difficult. The number of adjusting manoeuvres and intubation attempts, time to intubation, intubation success rate (first attempt and within 3 min), haemodynamic changes (pre-induction, post-induction, post-intubation), oesophageal intubation, mucosal trauma (blood detected), hypoxia (SpO2 < 95%) and postoperative pharyngolaryngeal morbidity (double-blinded) were documented. Time to successful intubation was longer (57 vs 35 s), and more intubation attempts were required in the ILM group (P < 0.0001). The intubation success rate was 100% (all first attempt) for the laryngoscope groups and 94% (56% first attempt) for the ILM group. There were no significant differences in heart rate or blood pressure among groups. Oesophageal intubation (26 v 0%) and mucosal trauma (19 v 2%) were more common in the ILM group. Hypoxia and postoperative pharyngolaryngeal morbidity were similar among groups. Blind intubation through the ILM offers no advantages over the Macintosh laryngoscope for adult patients requiring intubation for elective surgery with normal airways, but it is a feasible alternative.
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Abstract
We have tested the hypothesis that intubation success rates, haemodynamic changes, airway complications and postoperative pharyngolaryngeal morbidity differ between blind and lightwand-guided intubation through the intubating laryngeal mask airway. One hundred and twenty paralysed anasthetised adult patients (ASA I-II, no known or predicted difficult airways) were assigned in a random manner to one of two equal-sized groups. In the blind group, patients were intubated blindly through the intubating laryngeal mask airway. In the lightwand group, patients were intubated through the intubating laryngeal mask airway assisted by transillumination of the neck with a lightwand. A standard sequence of adjusting manoeuvres was followed if resistance occurred during intubation or if transillumination was incorrect. The number of adjusting manoeuvres, time to intubation, intubation success rates, haemodynamic changes (pre-induction, pre-intubation, postintubation), oesophageal intubation, mucosal trauma (blood detected), hypoxia (oxygen saturation < 95%) and postoperative pharyngolaryngeal morbidity (double-blinded) were documented. Overall intubation success was similar (blind, 93%; lightwand, 100%), but time to successful intubation was significantly shorter (67 vs. 46 s, p = 0. 027) and the number of adjusting manoeuvres was significantly fewer (p = 0.024) in the lightwand group. There were no significant differences in blood pressure or heart rate between the groups at any time. Oesophageal intubation occurred more frequently in the blind group (18 vs. 0%, p = 0.002). The incidence and severity of mucosal injury, sore throat and hoarseness were similar between the groups. We conclude that lightwand-guided intubation through the intubating laryngeal mask is superior to the blind technique.
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A histochemical investigation of the bone formation process by guided bone regeneration in rat jaws. Effect of PTFE membrane application periods on newly formed bone. J Periodontol 2000; 71:341-52. [PMID: 10776920 DOI: 10.1902/jop.2000.71.3.341] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Guided bone regeneration (GBR) has been widely utilized for the promotion of bone augmentation in bone loss areas. However, little information has been available regarding chronological changes in newly formed bone and alterations in the nature of newly formed bone after removal of a barrier membrane. The present study attempted to establish a GBR model for rat maxillae. We also examined the effects of membrane application periods on newly formed bone and its remodeling process after removal of the membrane in this experimental model. METHODS Thirty-five Wistar rats were divided into 2 groups: a membrane application group and a membrane removal group. The chronological changes of newly formed bone were evaluated histologically and statistically. RESULTS At 2 weeks after the GBR procedure, bony cavities had completely filled the newly formed bone in the experimental side. In the control side, corticalization on the surface of the newly formed bone proceeded with a decrease in the bone marrow cavity, whereas the bone marrow space had enlarged by 12 weeks post-surgery in the experimental side. In the membrane removal group, the osteoblasts appeared on newly formed bone at 1 week after membrane removal. Comparatively thick compact bone had formed on the surface of the newly formed bone at 4 weeks after membrane removal, and corticalization proceeded later. CONCLUSIONS The long-term application of a barrier membrane induces the enlargement of the bone marrow spaces. We suggest that PTFE membrane removal in adequate time promotes the corticalization and maturation of the newly formed bone by the GBR technique.
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Tissue response to titanium implants in the rat maxilla: ultrastructural and histochemical observations of the bone-titanium interface. J Periodontol 2000; 71:287-98. [PMID: 10711620 DOI: 10.1902/jop.2000.71.2.287] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The detailed mechanism of osseointegration, the most appropriate implant-bone interface, remains unclear in jaw tissues at the ultrastructural level in contrast to the many reports using long bones. The present study reports on tissue response to titanium-implantation on an animal model using rat maxilla. METHODS Animals were sacrificed at 1 to 28 days post-implantation and prepared tissue specimens, freed from implants by a cryofracture technique, were processed for transmission electron microscopy and histochemistry for tartrate resistant acid phosphatase activity (TRAPase). RESULTS Different patterns in bone formation were recognized between lateral and base areas of implant cavities. In the lateral area with narrow gaps, bone deposition took place from the pre-existing bone towards the implant after active bone resorption by osteoclasts reactive to TRAPase. However, no distinct bone formation appeared in the lateral area where the implant had been installed close to the osteotomy margin. On the other hand, new bone formation was found at the base area without any apparent bone resorption. Interestingly, mononuclear cells reactive to TRAPase, presumably preosteoclasts, frequently occurred near preosteoblasts. Osseointegration around the implants was obtained in this model by 28 days post-implantation except for the lateral area with complete contact with implants, where the thin layer remained in contact with the implant surface. CONCLUSIONS These findings indicate that ossification proceeds at different modes around the titanium implant in rat maxilla, depending on the nature of the recipient bones and the dimension of the gap between the implant and osteotomy margin.
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NZB mice exhibit a primary T cell defect in fetal thymic organ culture. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2000; 164:1569-75. [PMID: 10640776 DOI: 10.4049/jimmunol.164.3.1569] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Defects in T cell development have been suggested to be a factor in the development of systemic autoimmunity in NZB mice. However, the suggestion of a primary T cell defect has often been by extrapolation, and few direct observations of T cell precursors in NZB mice have been performed. Moreover, the capacity of NZB bone marrow T cell precursors to colonize the thymus and the ability of the NZB thymic microenvironment to support T lymphopoiesis have not been analyzed. To address this important issue, we employed the fetal thymic organ culture system to examine NZB T cell development. Our data demonstrated that NZB bone marrow cells were less efficient at colonizing fetal thymic lobes than those of control BALB/c or C57BL/6 mice. In addition, NZB bone marrow cells did not differentiate into mature T cells as efficiently as bone marrow cells from BALB/c or C57BL/6 mice. Further analysis revealed that this defect resulted from an intrinsic deficiency in the NZB Lin-Sca-1+c-kit+ bone marrow stem cell pool to differentiate into T cells in fetal thymic organ culture. Taken together, the data document heretofore unappreciated deficiencies in T cell development that may contribute to the development of the autoimmune phenotype in NZB mice.
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Abnormal thymic expression of epithelial cell adhesion molecule (EP-CAM) in New Zealand Black (NZB) mice. J Autoimmun 1999; 13:393-404. [PMID: 10585755 DOI: 10.1006/jaut.1999.0332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
New Zealand Black (NZB) mice have been well documented to have a variety of thymic epithelial cell microenvironmental abnormalities, including disruption of corticoepithelial cell networks and medullary cell clusters. These abnormalities of the thymic stromal network are particularly important because similar observations have been noted in other models of murine lupus. Thymic epithelial cells, a key component of the microenvironment, play an important role in selection of the mature T cell receptor repertoire. Recently, a homotypic calcium-independent human and murine epithelial cell adhesion molecule, Ep-CAM, has been described which is located at the thymocyto-cortical cell junction. The function of Ep-CAM is still unclear but its unique location within the thymus suggests that it is critical in the process of providing maturation signals. Consequently, we examined the thymic expression of Ep-CAM in a series of autoimmune prone mice by thymic distribution of Ep-CAM in NZB, NZW, NZB/W, BXSB-Yaa, MRL- lpr/lpr, C3H- gld/gld and the control strains BALB/c, C57BL6, C3H and MRL(+/+), by immunohistology and flow cytometry. Interestingly, NZB mice are similar to control mice from day 4 to 2 weeks of age, having a very low expression of Ep-CAM at the thymocyto-cortical junction. In control strains, there is a marked increased in expression of Ep-CAM beginning at 5 weeks of age. In contrast, NZB mice fail to show significant expression of Ep-CAM even well into adulthood. This abnormality of NZB mice was also noted in NZB/W F1 and BXSB mice, but not MRL- lpr/lpr or C3H- gld/gld mice. Given the potential importance of Ep-CAM in thymic selection, this study provides important evidence that a defective stromal microenvironment is likely to be of etiological significance in the susceptibility of NZB to autoimmune disease.
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Abstract
The thymus of New Zealand black (NZB) mice undergoes premature involution. In addition, cultured thymic epithelial cells from NZB mice undergo accelerated preprogrammed degeneration. NZB mice also have distinctive and well-defined abnormalities of thymic architecture involving stromal cells, defined by staining with monoclonal antibodies specific for the thymic microenvironment. We took advantage of these findings, as well as our large panel of monoclonal antibodies which recognize thymic stroma, to study the induction of apoptosis in the thymus of murine lupus and including changes of epithelial architecture. We studied NZB, MRL/lpr, BXSB/Yaa, C3H/gld mice and BALB/c and C57BL/6 as control mice. Apoptosis was studied both at basal levels and following induction with either dexamethasone or lipopolysaccharide (LPS). The apoptotic cells were primarily found in the thymic cortex, and the frequency of apoptosis in murine lupus was less than 20% of controls. Moreover, all strains of murine lupus had severe abnormalities of the cortical network. These changes were not accentuated by dexamethasone treatment in cultured thymocytes. However, the thymus in murine lupus was less susceptible to LPS-induced apoptosis than control mice. Finally we note that the number of thymic nurse cells (TNC) was lowest in NZB mice. Our findings demonstrate significant abnormalities in the induction of apoptosis and the formation of TNC-like epithelial cells in SLE mice, and suggest that the abnormalities of the thymic microenvironment have an important role in the pathogenesis of murine lupus.
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Improvement of thermal effects in a diode-end-pumped, composite Tm:YAG rod with undoped ends. APPLIED OPTICS 1999; 38:1788-1791. [PMID: 18305807 DOI: 10.1364/ao.38.001788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We present comparative studies of the laser performance of a diode-end-pumped, composite Tm:YAG rod with undoped ends. Efficient heat removal in a composite rod can reduce the peak of the rise in temperature in the 2-mm-long active segment by 19% compared with that in a noncomposite rod by theoretical calculation. The threshold pump power was reduced by 10%, and the focal power of the thermal lens was improved by 15%. These improvements permit high output performance and flexible design of laser cavities in diode-end-pumped Tm:YAG lasers.
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Thymic microenvironment and NZB mice: the abnormal thymic microenvironment of New Zealand mice correlates with immunopathology. Clin Immunol 1999; 90:388-98. [PMID: 10075868 DOI: 10.1006/clim.1998.4655] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There are distinct microenvironmental abnormalities of thymic architecture in several murine models of SLE defined using immunohistochemistry and a panel of mAb dissected at thymic epithelial markers. To address the issue of the relationship between the thymic microenvironment and autoimmunity, we studied backcross (NZB x NZW) F1 x NZW mice in which 50% of offspring develop nephritis associated with proteinuria and anti-DNA antibodies. We reasoned that if thymic abnormalities are associated with development of disease, the correlation of abnormalities with lupus-like disease in individual backcross mice will form the foundation for identification of the mechanisms involved. In parallel, we directed a genetic linkage analysis, using markers previously shown to be linked to nephritis and IgG autoantibody production, to determine if such loci were similarly associated with microenvironmental changes. Our data demonstrate that all (NZB x NZW) F1 x NZW backcross mice with disease have microenvironmental defects. Although the microenvironmental defects are not sufficient for development of autoimmune disease, the severity of thymic abnormalities correlates with titers of IgG autoantibodies to DNA and with proteinuria. Consistent with past studies of (NZB x NZW) F1 x NZW mice, genetic markers on proximal chromosome 17 (near MHC) and distal chromosome 4 showed trends for linkage with nephritis. Although the markers chosen only covered about 10-15% of the genome, the results demonstrated trends for linkage with thymic medullary abnormalities for loci on distal chromosome 4 and distal chromosome 1. We believe it will be important to define the biochemical nature of the molecules recognized by these mAbs to understand the relationships between thymic architecture and immunopathology.
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Liquid chromatographic determination of sugar alcohols in beverages and foods after nitrobenzoylation. J AOAC Int 1999; 82:134-40. [PMID: 10028682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Use of p-nitrobenzoyl chloride (PNBC) to form an ultraviolet-absorbing derivative was attempted to determine the sugar alcohols meso-erythritol, xylitol, D-sorbitol, and D-mannitol by liquid chromatography (LC). LC determination of derivatives was performed on an ODS column with acetonitrile-water (65 + 35) as mobile phase. Calibration curves were linear in the concentration range 0.01-100 micrograms/mL. Method sensitivity is 10 to 1000 times higher than that of LC with refractive index detection and gas chromatography with flame ionization detection. Recoveries of sugars added to various foods at 0.1 and 1% ranged from 91 to 102% for meso-erythritol, 75 to 115% for xylitol, 81 to 105% for D-sorbitol, and 81 to 108% for D-mannitol.
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Effects of an artificially carbonated bath on athletic warm-up. JOURNAL OF HUMAN ERGOLOGY 1998; 27:22-9. [PMID: 11579696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The effects of an artificially carbonated bath (36 degrees C, CO2 300 ppm, 20 minutes) on the warm-up of swimmers was compared with those of a freshwater bath (36 degrees C, 20 minutes). Carbon dioxide is reported to have a vasodilatory effect on peripheral blood vessels of cutaneous and muscular tissue and to promote blood flow. We observed that the warm-up effects of a carbonated bath before swimming on the hematocrit, white blood cell, total plasma protein, and total cholesterol levels in venous blood were significantly increased more than those of a freshwater bath before swimming in recovery period (p < 0.05). Thus the carbonated bath tended to be more effective for increasing the concentrations of blood components. In the recovery period, the carbonated bath before swimming also resulted in significantly smaller changes in blood lactic acid and heart rate than those of a freshwater bath before swimming (p < 0.05). The decrease in electromyography of the M. rectus femoris during swimming suggested more efficient muscle activity after a carbonated bath. Therefore after a carbonated bath, swimmers should have a higher reserve left in the cardiovascular system, resulting in better performance during swimming and less accumulation of fatigue-related metabolites after swimming.
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Abstract
STATEMENT OF PROBLEM Resilient denture liners are widely used for the patients who are not comfortable with correctly made conventional hard-based dentures because of thin and relatively nonresilient mucosa or severe alveolar resorption. There are several materials used for denture liners and the efficacy in their use is influenced by their viscoelastic properties. PURPOSE This study evaluated the setting behavior and viscoelastic properties of various types of resilient denture liners and the changes in viscoelasticity with the passage of time. MATERIAL AND METHODS Four types of resilient denture liners were used. Setting behavior of 5 autopolymerizing materials was evaluated with an oscillating rheometer. Stress relaxation tests were conducted to evaluate the viscoelastic properties of 9 materials and changes that occurred over time by means of Maxwell model analogies. RESULTS Significant differences were found in the setting behavior of the autopolymerizing materials. The acrylic resin and fluoroethylene materials demonstrated viscoelastic properties and the silicone and polyolephin materials were found to be elastic. The acrylic resin materials exhibited the greatest changes in viscoelastic properties over time when compared with silicone, polyolephin, and fluoroethylene materials. CONCLUSIONS The results suggest that it is important to select denture liner materials according to clinical situations because of the wide ranges of setting behavior, viscoelastic properties, and durability over time.
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