Phenotypic expression of a family with multiple endocrine neoplasia type 2A due to a RET mutation at codon 618

Background

Multiple endocrine neoplasia type 2A (MEN2A) is caused by missense mutations in the RET proto-oncogene on chromosome 10. This paper reports the phenotypic expression of a family with MEN2A, in which serine substitutes for cysteine at codon 618 in exon 10 of the RET gene. It was first claimed that medullary thyroid cancer (MTC) with this rare mutation led to mild disease; this has recently been updated to intermediate–high risk, based on stratified genetic information.

Methods

The family was mapped over six generations. In 1971 family members were invited to join a screening programme. Genetic testing was started in 1994.

Results

Twenty-two individuals with MTC were identified, 16 by the screening programme. One screened patient had a phaeochromocytoma and four had hyperparathyroidism. At surgery for MTC 12 patients had local tumour metastases and two young patients also had liver metastases. No screened patient died from MTC during a mean observation time of 19 years. Six other family members were diagnosed with MTC by signs and symptoms, five of whom died from MTC.

Conclusion

Because of the great interindividual differences in tumour aggressiveness within the family it is impossible to predict whether an individual gene carrier will have an aggressive MTC or not. This unpredictability is an additional argument, besides those obtained in stratified genetic studies, for operating on gene carriers at young age.

Clinical, histopathologic, and genetic investigation in two large families with dentinogenesis imperfecta type II

Dentinogenesis imperfecta (DI) type II, an inherited disorder affecting dentin, has been linked to mutations in the dentin sialophosphoprotein ( DSPP) gene on chromosome 4q21. The gene product is cleaved into two dentin-specific matrix proteins, dentin sialoprotein (DSP) and dentin phosphoprotein. The aim of this investigation was to study genotypes and phenotypes in two affected families with special reference to clinical, radiographic, and histopathologic manifestations. Seven affected members of Family A and five of Family B were documented clinically and radiographically; 14 and 10 teeth, respectively, were available for histopathologic investigation and prepared for ground sections, which were assessed semiquantitatively for dysplastic manifestations in the dentin according to the scoring system, dysplastic dentin score (DDS). Venous blood samples were collected from six affected and ten unaffected members of Family A, and from eight affected and six unaffected members of Family B. Genomic DNA was extracted and used for sequence analyses. The two families presented with different missense mutations. An Arg68Trp missense mutation in the DSP part of the gene was revealed in all six analyzed affected individuals in Family A. This mutation was not present in any of the ten healthy members. In Family B, an Ala15Val missense mutation involving the last residue of the signal peptide was found in all eight affected but in none of the six healthy members. The clinical and radiographic disturbances and DDS were more severe in Family B. The data indicate the presence of a genotype-phenotype correlation in DI type II.

[Phenotypic expression of a mutation in MEN 2A documented in a family in the western part of Sweden]

A missense mutation at codon 618 of the RET proto-oncogene is a rather unusual cause of multiple endocrine neoplasia 2A. We report the phenotypic expression of this specific RET mutation in a large Swedish family. The family was mapped back to the 18th century. Since 1971 the family has been included in a biochemical screening program, and since 1994 has undergone genetic screening. Twenty-seven individuals were found to have medullary thyroid carcinoma (MTC). Eighteen were detected by screening. The incidence of pheochromocytoma (4%) and hyperparathyroidism (7%) was low. Five individuals died of MTC, but of these none had been included in the screening program. One patient underwent prophylactic thyroidectomy after positive genetic screening. MTC tumor aggressivity differed markedly between gene carriers. The screening program shows that the clinical aggressivity of MTC can be mitigated by early and adequate surgical intervention.

A clinical histologic study of bovine hydroxyapatite in combination with autogenous bone and fibrin glue for maxillary sinus floor augmentation. Results after 6 to 8 months of healing

Biopsies were taken from 16 out of 20 consecutive referral patients 6 to 8 months after maxillary sinus floor augmentation with a mixture of bovine hydroxyapatite (BH), autogenous bone particles and fibrin glue. Four days prior to biopsy retrieval the patients were given a single dose of tetracycline to label bone forming sites. Fluorescence microscopy of 100 microm thick sections revealed active bone formation in conjunction with the BH particles in 14 of 15 specimens analysed. Light microscopy and morphometry of ground sections from 16 patients showed various amounts of mineralised bone tissue in all except one specimen. In the latter case, the BH particles were encapsulated by a dense fibrous connective tissue. Sections from the augmented areas were occupied by non-mineralized tissue (54.1+12.6%), lamellar bone (21.2+24.5%), BH particles (14.5+10.3%) and woven bone (10.2+13.4%). The non-mineralized tissue seen in bone forming areas consisted of a loose connective tissue, rich of vessels and cells, and in the periphery of a more dense fibrous connective tissue. Woven bone with large and scattered osteocyte lacunae was bridging between the BH particles and the lamellar trabecular bone. There were no signs of resorption of the BH particles. The lamellar bone appeared to have originated from the recipient site and was seldom in contact with the BH particles. It is concluded that the tested implant material has bone conducting properties. The bone associated with the BH particles after 6 to 8 months of healing was mainly woven.

Characterization of carbonic anhydrase from Neisseria gonorrhoeae

We have investigated the steady state and equilibrium kinetic properties of carbonic anhydrase from Neisseria gonorrhoeae (NGCA). Qualitatively, the enzyme shows the same kinetic behaviour as the well studied human carbonic anhydrase II (HCA II). This is reflected in the similar pH dependencies of the kinetic parameters for CO(2) hydration and the similar behaviour of the kinetics of (18)O exchange between CO(2) and water at chemical equilibrium. The pH profile of the turnover number, k(cat), can be described as a titration curve with an exceptionally high maximal value of 1.7 x 10(6) s(-1) at alkaline pH and a pK(a) of 7.2. At pH 9, k(cat) is buffer dependent in a saturable manner, suggesting a ping-pong mechanism with buffer as the second substrate. The ratio k(cat)/K(m) is dependent on two ionizations with pK(a) values of 6.4 and 8.2. However, an (18)O-exchange assay identified only one ionizable group in the pH profile of k(cat)/K(m) with an apparent pK(a) of 6.5. The results of a kinetic analysis of a His66-->Ala variant of the bacterial enzyme suggest that His66 in NGCA has the same function as a proton shuttle as His64 in HCA II. The kinetic defect in the mutant can partially be overcome by certain buffers, such as imidazole and 1,2-dimethylimidazole. The bacterial enzyme shows similar K(i) values for the inhibitors NCO(-), SCN(-) and N(3)(-) as HCA II, while CN(-) and the sulfonamide ethoxzolamide are considerably weaker inhibitors of the bacterial enzyme than of HCA II. The absorption spectra of the adducts of Co(II)-substituted NGCA with acetazolamide, NCO(-), SCN(-), CN(-) and N(3)(-) resemble the corresponding spectra obtained with human Co(II)-isozymes I and II. Measurements of guanidine hydrochloride (GdnHCl)-induced denaturation reveal a sensitivity of the CO(2) hydration activity to the reducing agent tris(2-carboxyethyl)phosphine (TCEP). However, the A(292)/A(260) ratio was not affected by the presence of TCEP, and a structural transition at 2.8--2.9 M GdnHCl was observed.

Cloning, expression and some properties of alpha-carbonic anhydrase from Helicobacter pylori

The alpha-carbonic anhydrase gene from Helicobacter pylori strain 26695 has been cloned and sequenced. The full-length protein appears to be toxic to Escherichia coli, so we prepared a modified form of the gene lacking a part that presumably encodes a cleavable signal peptide. This truncated gene could be expressed in E. coli yielding an active enzyme comprising 229 amino acid residues. The amino acid sequence shows 36% identity with that of the enzyme from Neisseria gonorrhoeae and 28% with that of human carbonic anhydrase II. The H. pylori enzyme was purified by sulfonamide affinity chromatography and its circular dichroism spectrum and denaturation profile in guanidine hydrochloride have been measured. Kinetic parameters for CO2 hydration catalyzed by the H. pylori enzyme at pH 8.9 and 25 degrees C are kcat=2.4x10(5) s(-1), KM=17 mM and kcat/KM=1.4x10(7) M(-1) x s(-1). The pH dependence of kcat/KM fits with a simple titration curve with pK(a)=7.5. Thiocyanate yields an uncompetitive inhibition pattern at pH 9 indicating that the maximal rate of CO2 hydration is limited by proton transfer between a zinc-bound water molecule and the reaction medium in analogy to other forms of the enzyme. The 4-nitrophenyl acetate hydrolase activity of the H. pylori enzyme is quite low with an apparent catalytic second-order rate constant, k(enz), of 24 M(-1) x s(-1) at pH 8.8 and 25 degrees C. However, with 2-nitrophenyl acetate as substrate a k(enz) value of 665 M(-1) x s(-1) was obtained under similar conditions.

A clinical study of root surface conditioning with an EDTA gel. II. Surgical periodontal treatment

The objective of the present trial was to assess the effect of an EDTA gel applied during surgical periodontal therapy on probing depth reduction and periodontal attachment gain, allowing for the influence on healing of smoking as well as postsurgical oral hygiene. For comparison, citric acid treatment and control surgery only were included. The investigation was performed in one study center involving one clinical investigator and 68 patients. The patients were selected from a consecutive referral material on a voluntary basis. No statistically significant differences between treatment groups concerning attachment gain or pocket depth reduction could be seen after 3 and 6 months. A subgroup of the sample--21 patients who scored zero on the bleeding index at 3 and 6 months postsurgery and did not smoke--had a borderline significantly higher attachment gain in response to experimental treatment as well as a significant pocket depth reduction 6 months postsurgery when controlling for age, gender, Plaque Index at baseline, and treatment in multiple regression analyses. However, this was true not only for EDTA treatment but for citric acid and control treatment as well.

A clinical study of root surface conditioning with an EDTA gel. I. Nonsurgical periodontal treatment

The present study was undertaken to investigate if subgingival administration of an EDTA gel has any adjunctive effect to subgingival and supragingival root debridement. The investigation was performed in one study center involving 6 clinical investigators and 91 patients. The patients were selected from 2 patient populations: 41 were included from a consecutive referral material on a voluntary basis, and 50 were included from a maintenance care material at the clinic. No significant differences were found between the EDTA-treated and control groups with respect to clinical attachment gain or probing pocket depth reduction. The referral patients showed a significant improvement of pocket depth and attachment gain compared to maintenance care patients at the clinic. In multiple regression analyses, it was found that patients with small attachment losses at baseline responded better to treatment than patients with severe periodontitis. Also, in multivariate analyses, referral patients responded better than maintenance patients when controlling for other predictors.

Enhancement of catalytic efficiency by the combination of site-specific mutations in a carbonic anhydrase-related protein

A single mutation, involving the replacement of an arginine residue with histidine to reconstruct a zinc-binding site, suffices to change a catalytically inactive murine carbonic anhydrase-related protein (CARP) to an active carbonic anhydrase with a CO2-hydration turnover number of 1.2 x 104 s-1. Further mutations, leading to a more 'carbonic anhydrase-like' active-site cavity, results in increased activity. A quintuple mutant having His94, Gln92, Val121, Val143, and Thr200 (human carbonic anhydrase I numbering system) shows kcat = 4 x 104 s-1 and kcat/Km = 2 x 107 M-1.s-1, greatly exceeding the corresponding values for carbonic anhydrase isozyme III and approaching those characterizing carbonic anhydrase I. In addition, a buffer change from 50 mM Taps/NaOH to 50 mM 1, 2-dimethylimidazole/H2SO4 at pH 9 results in a 14-fold increase in kcat for this quintuple mutant. The CO2-hydrating activity of a double mutant with His94 and Gln92 shows complex pH-dependence, but the other mutants investigated behave as if the activity (kcat/Km) is controlled by the basic form of a single group with pKa near 7.7. In a similar way to human carbonic anhydrase II, the buffer behaves formally as a second substrate in a ping-pong pattern, suggesting that proton transfer between a zinc-bound water molecule and buffer limits the maximal rate of catalysis in both systems at low buffer concentrations. However, the results of isotope-exchange kinetic studies suggest that proton shuttling via His64 is insignificant in the CARP mutant in contrast with carbonic anhydrase II. The replacement of Ile residues with Val in positions 121 or 143 results in measurable 4-nitrophenyl acetate hydrolase activity. The pH-rate profile for this activity has a similar shape to those of carbonic anhydrase I and II. CD spectra of the double mutant with His94 and Gln92 are variable, indicating an equilibrium between a compact form of the protein and a 'molten globule'-like form. The introduction of Thr200 seems to stabilize the protein.

Lingual BDNF and NT-3 mRNA expression patterns and their relation to innervation in the human tongue: similarities and differences compared with rodents

Brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3) mRNAs are expressed in developing and adult rodent tongue and are important for the proper development of lingual gustatory and somatosensory innervation in rodents. Here, we wished to determine whether the findings in rodents apply to humans. By using in situ hybridization histochemistry, distinct, specific, and in some instances overlapping patterns of BDNF and NT-3 mRNA expression were found in the developing and adult human tongue, gustatory papillae, and taste buds. BDNF mRNA was expressed in the superior surface epithelium of the developing fungiform papillae (i.e., developing taste buds), in the epithelium covering the circumvallate papillae, and in the subepithelial mesenchyme. Interestingly, BDNF mRNA was expressed in the lingual epithelium before nerve fibers reached the epithelium, indicating a prespecialization of the gustatory epithelium before the arrival of nerves. In the adult fungiform papillae, BDNF mRNA labeling was found in taste buds and in restricted areas in the non-gustatory lingual epithelium. NT-3 mRNA was found in the developing lingual epithelium and gustatory papillae. NT-3 mRNA labeling was observed in the adult fungiform taste buds, overlapping with BDNF mRNA labeling, in contrast to what was seen in rodents. NT-3 mRNA was additionally found in restricted areas in filiform papillae. Protein gene product 9.5 (PGP) antibodies were used to investigate a possible correlation between lingual innervation and sites of neurotrophin gene activity. Adult human tongue innervation differed from that of rodents, possibly in part due to a different neurotrophin expression pattern in the human tongue. Based on these findings, we suggest that BDNF and NT-3 are important for the initiation and maintenance of the gustatory and somatosensory innervation also in humans. The broader and somewhat overlapping expression patterns of BDNF and NT-3 mRNAs, compared with rodents, suggest additional and possibly somewhat overlapping roles for BDNF and NT-3 in the human tongue and also indicate differences between species. It is important that interspecies differences be taken into consideration.

Hypothermic insult to the periodontium: a model for the study of aseptic tooth resorption

The aim of the current investigation was to define an animal model for the study of hard tissue resorption by examining the responses of the periodontal ligament (PDL) to both single and multiple episodes of hypothermic injury to the crowns of rat teeth. A group of 12 male rats weighing 200-250 g were anesthetized, and pellets of dry ice (CO2) were applied once to the crowns of the right first maxillary molars for continuous periods of 10 or 20 min. Animals were sacrificed at 2, 7, 14 and 28 days and tissues were processed for routine histological examination. A second group of eight animals and a third group of 12 animals were subjected to three applications of dry ice over a period of 1 week and sacrificed at 2 and 14 days respectively after the final application. In addition to thermal insult, the periodontium of teeth from a fourth group of six rats was subjected to mechanical trauma. Examination of the sections from the group undergoing a single freezing episode revealed that, by 1 week, shallow resorption lacunae had appeared on the root surface. These became more extensive after 14 days. At the same time hyaline degeneration was evident in the PDL. Within this group, teeth subjected to the longer 20-min application times generally showed more extensive injuries. By 28 days, evidence of repair was observed with reparative cementum beginning to line the resorption lacunae in the root dentin. Sections from animals subjected to multiple episodes of thermal trauma and those subjected to additional mechanical insult showed more extensive external root resorption than those from single-injury animals. It was concluded that low temperature stimuli applied to the crowns of rat molars were capable of eliciting a sterile degenerative response in the PDL which, in turn, resulted in external root resorption. Furthermore, the degree of this tissue injury was commensurate with the duration and number of exposures to the trauma. The results also indicated that progression of the resorptive process required periodic exposure to the injury, in the absence of which repair to the damaged root occurred.

Palatal growth and chemotherapy: effects of cyclophosphamide on bone formation in the intermaxillary suture in growing rats

OBJECTIVE

To study the effect of cyclophosphamide (Cy) on bone formation in the maxillary median suture of young rats.

STUDY DESIGN

Doses of 30 mg/kg body weight of Cy were administered to 12 experimental rats at 10 and 13 days of age. A corresponding amount of 0.9% sodium chloride was given to 6 control rats at the same ages. At 31 days, the median maxillary suture was studied histologically in the experimental and control rats.

RESULTS

Structural changes of the osteogenic layers and cartilage components of the suture could be seen in the experimental rats. The thickness of the palatal bone was only 66% of that of the control rats, and the experimental rats also exhibited significantly reduced width of the suture.

CONCLUSION

This study shows that Cy by itself can cause disturbances in bone formation in rats.

Efficacy of Carisolv-assisted caries excavation

As a possible alternative to conventional techniques for excavating caries chemomechanical methods have been developed. Caridex has so far been the dominating product. However, a new system, Carisolv, was recently introduced. The purpose of the present study was to evaluate the caries-dissolving efficacy of Carisolv in vitro. After excavation with Carisolv all dentin surfaces were caries free. However, 6 of the 10 cavities showed residual caries in the dentinoenamel junction. The dentin and enamel surfaces were covered by smear and debris. Since there may be a risk of leaving caries in the dentinoenamel junction proper case selection appears to be of importance to ensure a successful result.

Skin-prick test for severe marginal periodontitis

The present study tested the hypothesis that treatment-resistant periodontitis patients present with a more intense inflammatory response to marginal bacterial plaque as a sign of an inflammatory overreaction. Patients with severe marginal periodontitis (Gingival Index > 20%) who had not responded to treatment showed almost no positive response to lipid A in a skin-prick test, which was significantly different from the results from patients with severe marginal periodontitis who had responded to treatment and from healthy control individuals without marginal periodontitis. This finding can be interpreted as an impaired inflammatory reactivity to periodontitis pathogens in treatment-resistant patients, rejecting the hypothesis.

Proliferative activity in the juxtaradicular human periodontal ligament

The aim of the present study was to evaluate cell proliferation, assessed by MIB 1, with respect to the type and the distribution of proliferating cells in the healthy juxtaradicular periodontal ligament (PDL) from completely formed human teeth. Immunohistochemical markers against vimentin, CD68 and S-100 were used to characterize cell type. The applicability of the immunohistochemical method on explants of human PDL was also evaluated. The results indicated that under physiological conditions, the majority of the proliferating cells in the PDL were mesenchymal cells predominantly located paravascularly in the middle third of the PDL. Furthermore, MIB 1 reacting with the Ki-67 antigen together with the avidin-biotin-complex technique was proved to be an efficient marker of cell proliferation in explants of human PDL.

Effect of a chemo-mechanical caries removal system (Carisolv) on dentin topography of non-carious dentin

The purpose of the present study was to examine the morphology of healthy dentin surfaces after treatment with Carisolv followed by conditioning with phosphoric acid and EDTA, since surface morphology may be of interest for dentin bonding. Another purpose was to evaluate the effect of treatment with Carisolv on healthy non-carious dentin surfaces with exposed collagen fibers. Scanning electron microscopy was utilized to carry out a detailed morphological examination of the dentin surfaces with regard to presence or absence of both smear layer and collagen fibers. Twelve premolars extracted for orthodontic reasons from young adults were used. The two etchants appeared to have produced two distinctly different surfaces. Etching with phosphoric acid following Carisolv treatment resulted in a porous dentin surface, while EDTA etching without prior Carisolv treatment appeared to have uncovered an intact collagen network. In contrast, the surfaces treated with Carisolv prior to EDTA etching displayed smooth intertubular surfaces with only occasional fibers. Apparently, the ability of EDTA to expose collagen in the dentin surface is counteracted or inhibited by the Carisolv treatment. Furthermore, it cannot be excluded that the Carisolv treatment in itself may have dissolved collagen fibers. Since most bonding systems claim bonding to the collagenous component of dentin, the question arises which of the etched surfaces is preferable and to what degree the collagenous component contributes to bonding strength. Further studies are thus needed to evaluate the micromechanical retention of a restoration to the different surfaces described in the present study.

Changing the efficiency and specificity of the esterase activity of human carbonic anhydrase II by site-specific mutagenesis

Rates of hydrolysis of 4-, 3-, and 2-nitrophenyl acetate and 4-nitrophenyl propionate catalyzed by wild-type and mutant forms of human carbonic anhydrase II have been measured. The results show that the mutations Tyr7-->Phe and Ala65-->Leu lead to activity enhancements with all the investigated substrates, but there is no significant effect on the specificity. In contrast, some mutations at sequence position 200 have large effects on specificity. For example, while the mutation Thr200-->Gly results in a threefold increase of the rate of hydrolysis of 4-nitrophenyl acetate, the activity is enhanced 10 times with the meta-substituted substrate and 380 times with the ortho-substituted substrate. These results are interpreted in terms of the removal in the mutant of a steric interference between the 2-NO2 group, in particular, and the side chain of Thr200. Mutants involving residues lining a hydrophobic pocket near the catalytically essential zinc ion have also been investigated. The most pronounced effect on specificity was found for the Val143-->Gly mutant. This mutation leads to a sixfold decrease of the rate of hydrolysis of 4-nitrophenyl acetate but a 20-fold increase of the activity with the propionyl ester as substrate. These results suggest that the side chain of Val143 interferes sterically with the acyl moiety of 4-nitrophenyl propionate. Based on these results, we have constructed a hypothetical model of the location of these ester substrates in the enzymic active site.

Crystal structure of carbonic anhydrase from Neisseria gonorrhoeae and its complex with the inhibitor acetazolamide

The crystal structure of carbonic anhydrase from Neisseria gonorrhoeae has been solved to a resolution of 1.78 A by molecular replacement using human carbonic anhydrase II as a template. After refinement the R factor was 17.8% (Rfree=23.2%). There are two molecules per asymmetric unit (space group P21), but they have essentially identical structures. The fold of the N. gonorrhoeae enzyme is very similar to that of human isozyme II; 192 residues, 74 of which are identical in the two enzymes, have equivalent positions in the three-dimensional structures. This corresponds to 85% of the entire polypeptide chain of the bacterial enzyme. The only two cysteine residues in the bacterial enzyme, which has a periplasmic location in the cell, are connected by a disulfide bond. Most of the secondary structure elements present in human isozyme II are retained in N. gonorrhoeae carbonic anhydrase, but there are also differences, particularly in the few helical regions. Long deletions in the bacterial enzyme relative to human isozyme II have resulted in a considerable shortening of three surface loops. One of these deletions, corresponding to residues 128 to 139 in the human enzyme, leads to a widening of the entrance to the hydrophobic part of the active site cavity. Practically all the amino acid residues in the active site of human isozyme II are conserved in the N. gonorrhoeae enzyme and have similar structural positions. However, the imidazole ring of a histidine residue, which has been shown to function as a proton shuttle in the catalytic mechanism of the human enzyme, interacts with an extraneous entity, which has tentatively been identified as a 2-mercaptoethanol molecule from the crystallization medium. When this entity is removed by soaking the crystal in a different medium, the side-chain of His66 becomes quite mobile. The structure of a complex with the sulfonamide inhibitor, acetazolamide, has also been determined. Its position in the active site is very similar to that observed in human carbonic anhydrase II.

Preneoplastic oral lesions: the clinical value of image cytometry DNA analysis, p53 and p21/WAF1 expression

BACKGROUND

Various mucosal lesions are frequently encountered in the oral cavity. Neither macroscopic nor microscopic evaluation of these lesions gives any reliable information concerning the risk of cancer development.

MATERIAL AND METHODS

From 21 patients, 29 mucosal lesions were found to precede development of invasive squamous cell carcinoma or carcinoma in situ at the same location. The lesions were matched to 29 control lesions, with the same grade of dysplasia and from exactly the same locations but without subsequent cancer during a mean follow up of 112 months (46-194). The specimens were evaluated using Image Cytometry DNA analysis and immunohistochemical analysis of p53 and p21/WAF1 expression.

RESULTS

Lesions prior to carcinomatous development displayed a higher degree of DNA aberration as compared with the control lesions. p53 and p21/WAF1 evaluation did not reveal any differences between cases and controls.

CONCLUSION

Image Cytometry DNA analysis is an useful adjunct to histopathological evaluation of oral mucosal lesions for prediction of risk of malignant transformation.

Chlorhexidine as a root canal medicament for treating inflammatory lesions in the periodontal space

The purpose of the present study was to investigate the therapeutic effect of intra-canal application of chlorhexidine on inflammatory root resorption. Dental pulps from monkey incisors were infected and resealed prior to extraction of the teeth. Root dentin was mechanically exposed and the teeth were replanted under aseptic conditions. After 4 weeks, the experimental teeth were dressed with chlorhexidine gel and resealed. Animals were sacrificed 4 weeks later, and their jaws prepared for histologic examination. Results showed that both marginal and apical periodontal inflammation and resorption were reduced in the chlorhexidine-treated teeth. It was concluded that the use of intra-canal chlorhexidine may be a useful adjunct in the treatment of inflammatory root resorption, but further human trials need to be undertaken before its clinical use can be recommended.

Effect of 3-O-methylglucose on insulin secretion in the perfused dog and rat pancreas

We recently reported that the nonmetabolizable glucose analogue, 3-O-methylglucose, stimulates somatostatin secretion in the perfused dog pancreas. In this study, we report that 3-O-methylglucose also stimulates insulin secretion in the dog pancreas. The effect was present at 5.5 mM glucose (p < 0.001) but not at O or 2.7 mM glucose. The inhibitor of glucose metabolism, mannoheptulose, blocked the insulinotropic action of 3-O-methylglucose. In contrast, 3-O-methylglucose had no effect on insulin secretion in the perfused rat pancreas. We conclude that 3-O-methylglucose stimulates insulin secretion in the dog and that the effect requires the presence of stimulatory concentrations of D-glucose.

Ultrasonic subgingival root planing and EDTA etching in a one-step procedure

The purpose of the present study was to investigate if ultrasonic debridement and EDTA etching could be combined in a ore-step procedure. Tap water was exchanged for a 24% EDTA solution as irrigation agent during root planing with a piezo scaler. 24 human teeth extracted due to severe periodontal disease were used and the results were evaluated with scanning electron microscopy. Results indicate that synergistic effects (smear removal and exposure of collagen fibers) were negligible with conventional application of the irrigation fluid to the working area of the scaling tip while a marked effect was evident when the EDTA solution was applied directly to the working area of the piezoelectric scaler through a customized tip.

Cervical root resorption associated with guided tissue regeneration: a case report

Root surface resorption, ankylosis (replacement resorption) and alveolar bone resorption are not uncommon sequelae to periodontal healing in both animal and human trials whether the treatment objective is regenerative, preventive, or conservative. The present report describes a case with progressive cervical root resorption in a patient who received periodontal regenerative treatment with guided tissue regeneration (GTR). A 46-year-old woman was referred for treatment of severe periodontitis. Remaining radiographic attachment was less than 50%. Following a period of 18 months, during which non-surgical and surgical therapies were performed, angular defects were diagnosed on radiographs and recurrent bleeding periodontal pockets (6 mm) were found in the proximal areas of 24 and 25. Root caries was not present. Periodontal surgery with GTR was performed in this area. No immediate postsurgical complications were noted. Two years later, clinical and radiographic examinations revealed gingival recession with bleeding periodontal pockets (6 mm) which had partly uncovered severe proximal cervical resorptions in 25. Root surface caries was not present. Following surgical inspection, the root of 25 was removed. The root was subsequently prepared for histological analysis. Resorption cavities covered almost the entire cervical proximal surface of the root above intact infracrestal cementum and were covered by numerous CD68+, both mononuclear and multinucleated cells. In a central area as indicated on the radiographs, the cavities penetrated into the root canal. There was no evidence of root caries.

Periodontal healing in horizontal and vertical defects following surgical or non-surgical therapy

The aim of the present study was to investigate any relationship between the level of oral hygiene and probing pocket depth reduction over time after periodontal treatment in sites with either vertical or horizontal destructions. The investigation was conducted as a retrospective study on a 3-year consecutive referral population of periodontitis-prone patients based on full-mouth oral radiographic examinations, probing pocket depth registrations and plaque scores. The analyses were performed on a final sample of 3064 sites in 107 patients with regression analysis after adjusting for dependence within the patient. Probing pocket depth was significantly less reduced over time in sites with vertical destructions compared to sites with horizontal destructions following non-surgical treatment. Furthermore, the difference in probing pocket depth reduction between vertical and horizontal defects following non-surgical treatment increased over time in sites with plaque compared to sites without plaque, thus reflecting the importance of the patient's plaque control, especially in sites with vertical destructions. However, the difference in probing pocket depth reduction between vertical and horizontal defects did not increase over time for surgically treated teeth, a finding which probably can be attributed to a more thorough debridement of vertical defects during surgery and/or osteoplasty/osteoectomy limiting the surface area upon which a long junctional epithelium can form, which may facilitate recurrence of a periodontal pocket.

Cellular expression of neurotrophin mRNAs during tooth development

Target-derived neurotrophins support and sustain peripheral sensory neurons during development. In addition, it has been suggested that these growth factors could have developmental functions in non-neuronal tissues. To further elucidate the possible roles of neurotrophins in tooth morphogenesis and innervation, we have used in-situ hybridization to determine the specific sites of neurotrophin gene activity in pre- and postnatal rat jaws from E16 to P7. All four neurotrophins were expressed during tooth development with specific temporospatial patterns. Nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) mRNAs were mainly detected in the dental papilla/pulp in postnatal animals, and the pattern of expression correlated with the onset of dental innervation. In contrast, neurotrophin 3 (NT3) and neurotrophin 4 (NT4) mRNA expression patterns were predominantly epithelial and were strongest during early developmental stages when teeth are not yet innervated. Dental papilla NGF-mRNA expression was first seen in both epithelium and mesenchyme and later shifted to the odontoblast layer and the subodontoblast zone. BDNF-mRNA labeling was present in low levels in the early dental organ, but increased in the pulp and in the odontoblast cell layer of the developing teeth at later developmental stages. Both NT3 and NT4 mRNA were observed in the prenatal oral epithelium and the inner dental epithelium. NT3-mRNA labeling was seen mainly in the cervical loop region, fissure system depressions and cuspal tops, while NT4 mRNA was more evenly distributed in the dental epithelium. At P7, NT3-mRNA labeling was below detection level and NT4 mRNA expression was lower than at prior stages. Complementary to reports on the presence of low-affinity neurotrophin receptor (LANR), trkB and trkC mRNA in the developing teeth, our results suggest that neurotrophins may have multiple functions during tooth morphogenesis. Neurotrophins might participate in epithelial-mesenchymal interactions in early tooth morphogenetic events such as proliferation and differentiation of epithelial and mesenchymal cells. In addition, based on mRNA localization in postnatal animals, we also suggest that NGF and BDNF (beside glial cell line-derived neurotrophic factor) might participate in establishing and maintaining the innervation of the teeth, thus acting as classical neurotrophic factors.

Structure and mechanism of carbonic anhydrase

Carbonic anhydrase (CA; carbonate hydro-lyase, EC 4.2.1.1) is a zinc-containing enzyme that catalyzes the reversible hydration of carbon dioxide: CO2+ H2O<-->HCO3(-)+H+. The enzyme is the target for drugs, such as acetazolamide, methazolamide, and dichlorphenamide, for the treatment of glaucoma. There are three evolutionarily unrelated CA families, designated alpha, beta, and gamma. All known CAs from the animal kingdom are of the alpha type. There are seven mammalian CA isozymes with different tissue distributions and intracellular locations, CA I-VII. Crystal structures of human CA I and II, bovine CA III, and murine CA V have been determined. All of them have the same tertiary fold, with a central 10-stranded beta-sheet as the dominating secondary structure element. The zinc ion is located in a cone-shaped cavity and coordinated to three histidyl residues and a solvent molecule. Inhibitors bind at or near the metal center guided by a hydrogen-bonded system comprising Glu-106 and Thr-199. The catalytic mechanism of CA II has been studied in particular detail. It involves an attack of zinc-bound OH- on a CO2 molecule loosely bound in a hydrophobic pocket. The resulting zinc-coordinated HCO3- ion is displaced from the metal ion by H2O. The rate-limiting step is an intramolecular proton transfer from the zinc-bound water molecule to His-64, which serves as a proton shuttle between the metal center and buffer molecules in the reaction medium.

Effect of different concentrations of EDTA on smear removal and collagen exposure in periodontitis-affected root surfaces

The purpose of the present study was to explore the possibility of obtaining an acceptable smear-removing and collagen-exposing effect following EDTA etching with concentrations lower than supersaturation (24%). A flat dentin surface was created on human teeth extracted due to severe periodontitis. The teeth were etched with the following concentrations of EDTA for 2 min: 1.5% (group I), 5% (group II), 15% (group III) and 24% (group IV), and evaluated with scanning electron microscopy with respect to smear layer removal and exposure of root-associated collagen fibers. It was found that neither 1.5% nor 5% EDTA etching was sufficient to dissolve the smear layer to any higher degree. Etching with 15% EDTA dissolved the smear more effectively than the lower concentrations and collagen fibers were sparsely found. Following etching with 24% EDTA (group IV), significantly less smear was seen on the dentin surfaces than in any of the other groups and collagen fibers were seen covering the entire intertubular dentin surfaces. Based on these findings, the concentration of EDTA should be somewhere between 15 to 24% in order to obtain an acceptable smear removing and collagen-exposing effect within a clinically acceptable time period.

Prognosis and mortality of root-resected molars

The purpose of the present study was to compare tooth mortality of root-resected molars with that of root-filled, single-rooted teeth. Survival rates were 68% for root-resected molars and 77% for root-filled single-rooted teeth over a 10-year period. This difference was not statistically significant. Ten-year survival of root-resected molars in patients with radiographic attachment loss in single-rooted teeth of greater than 6 mm was 56% while survival was as high as 89% for root-resected molar patients with radiographic attachment loss in single-rooted teeth less than or equal to 6 mm. In conclusion, the prognosis of root-resection is not poorer than the prognosis of single-rooted teeth with an equal susceptibility to periodontitis, if endodontic conditions and maintenance care are optimal.

Galanin exerts dual action on inositol-specific phospholipase C activity in isolated pancreatic islets

The intracellular mechanism whereby the neuropeptide galanin inhibits insulin secretion is not establish, since the peptide affects several signal pathways, including intracellular messengers such as calcium and cyclic AMP. In this study, we have assessed the effect of galanin on the inositol-specific phospholipase C (iPLC) activity in isolated rat pancreatic islets. The iPLC activity was measured as the generation of inositol 1,4,5-trisphosphate and its metabolite inositol 1,3,4-trisphosphate from the hydrolysis of polyphosphoinositides. Inositol phosphates were measured by anion-exchange fast protein liquid chromatography (FPLC) analysis of extracts from islets prelabelled with myo-3H-inositol. Galanin (1 to 100 nM) significantly increased the glucose-induced (12 mM) accumulation of inositol 1,4,5-trisphosphate after 2 min, but this stimulation of iPLC activity was followed by a significant suppression after 15 min. In the absence of extracellular calcium, both the stimulatory and inhibitory effects of galanin on the iPLC activity vanished. We therefore conclude that galanin initially stimulates iPLC in a calcium-dependent manner, followed by a secondary inhibitory effect. The secondary inhibition of iPLC activity might contribute to the insulinostatic action of the neuropeptide.

The complete sequence, expression in Escherichia coli, purification and some properties of carbonic anhydrase from Neisseria gonorrhoeae

The complete nucleotide sequence of the carbonic anhydrase gene from Neisseria gonorrhoeae has been determined. The gene encodes a 252-residue polypeptide with a molecular mass of 28085 Da. The gene has been cloned and overexpressed in Escherichia coli, and the enzyme has been purified. A 26-residue signal peptide is cleaved off by the E. coli processing machinery. Thus, the isolated enzyme contains 226 amino acid residues with a molecular mass of 25314 Da. Most of the enzyme seems to be produced as a soluble protein located in the periplasm of E. coli. The enzyme is homologous to carbonic anhydrases from the animal kingdom; it is an alpha-carbonic anhydrase. A comparison with the amino acid sequences of human carbonic anhydrases I and II suggests that the secondary structures are essentially intact in the bacterial enzyme but that several loops are much shorter than in the human forms. Most of the active-site residues are identical to those found in the high-activity human isozyme II. The bacterial enzyme has a high CO2 hydration activity with a k(cat) of 1.1 x 10(6) s(-1) and Km of 20 mM at pH 9 and 25 degrees C. The enzyme also catalyzes the hydrolysis of 4-nitrophenyl acetate. The pH/rate profile can be described as a titration curve with pKa of 6.7 and a maximal value of the catalytic second-order rate constant, k(enz), of 130 M(-1) x s(-1).

Two point mutations convert a catalytically inactive carbonic anhydrase-related protein (CARP) to an active enzyme

A murine carbonic anhydrase-related protein (CARP) has been expressed in Escherichia coli and purified to near homogeneity. The polypeptide chain consists of 290 amino acid residues and has a calculated molecular mass of 32,950 Da. By introducing two mutations, Arg117 --> His and Glu115 --> Gln, we created a metal-binding center homologous to that in the carbonic anhydrases from the animal kingdom. In contrast to unmodified CARP, this double mutant was isolated as a 1:1 zinc-protein complex. While unmodified CARP is catalytically inactive, the mutant catalyzes CO2 hydration with a significantly higher efficiency than the mammalian low-activity carbonic anhydrase isozyme III. The activity is strongly inhibited by the powerful and selective carbonic anhydrase inhibitor, acetazolamide.

Tissue response to space closure in monkeys: a comparison of orthodontic magnets and superelastic coil springs

Interest in using magnets for generating orthodontic forces started with the widespread availability of rare earth magnetic alloys. In vivo studies have indicated that a static magnetic field and/or corrosion products from the magnetic materials may induce biological effects when in close contact with cells or tissues. In the clinical situation, orthodontic magnets are often situated some distance away from the gingiva and bone. Consequently, the previously observed biological effects may not be found in an experimental situation mimicking the clinical setting. Thus, the present experimental study was undertaken to test this hypothesis using commercially available cobalt-samarium magnets for orthodontic treatment in comparison to treatment with Sentalloy closed coil springs with respect to possible side effects on alveolar bone growth, gingival epithelial thickness as well as rate of space closure. Corrosion of the uncovered areas of the magnets was already evident after 6 weeks. No statistical differences were found between the magnet and coil spring specimens with respect to rate of space closure, bone formation or epithelial thickness. The only two variables that differed significantly between magnet and coil spring specimens was that there were more resorption and more tetracycline labelled osteocyte lacunae under the magnets. In conclusion, although some marginal statistical differences were found between the magnet and coil spring specimens with respect to cell and tissue reactions, the near lack of cell and tissue effects of the magnets in the present clinical experimental situation compared to previous studies in which the magnets were positioned in close contact with the tissue under study, indicate limited adverse clinical effects.

Cellular expression of GDNF mRNA suggests multiple functions inside and outside the nervous system

Glial-cell-line-derived neurotrophic factor (GDNF) is a distant member of the transforming growth factor-beta family and has potent neurotrophic effects on several classes of neurons including dopamine neurons and motoneurons. Here, we have used in situ hybridization to describe the development of the cellular expression of GDNF mRNA pre- and postnatally. Consistent with dopaminotrophic activity, GDNF mRNA is expressed in the developing basal ganglia and the olfactory tubercle. It is also found in a thalamic nucleus, in neurons of the substantia innominata, in the developing Purkinje neurons and the developing locus coeruleus area, and in trigeminal brainstem nuclei. In the spinal cord, neuronal expression is found in Clarke's column. GDNF mRNA is also expressed in the dorsal horns during development. Additional GDNF mRNA expression in the head region includes the carotid body, the retina, the vibrissae, the inner ear, the ear canal, and epithelium in the nasal cavity. Prominent expression is also found in the developing teeth. The widespread expression of GDNF in developing skeletal muscle is consistent with trophic activity on alpha-motoneurons. The smooth muscle layers of the gastrointestinal tract are also strongly positive. A very strong signal is found in the outer mesenchyme of the developing metanephric kidney. We conclude that GDNF mRNA is expressed in many different cellular systems inside and outside the central nervous system during development, suggesting multiple functions of GDNF in the developing organism.

Stimulation of somatostatin secretion by 3-O-methylglucose in the perfused dog pancreas

CONCLUSION

3-O-methylglucose stimulates somatostatin secretion from the dog pancreas by a glucose-dependent and glucose-like effect. Therefore, it is possible that 3-O-methylglucose-stimulated somatostatin secretion is dependent on glucose metabolism.

BACKGROUND

Somatostatin secretion from the endocrine pancreas is stimulated by glucose, glyceraldehyde, and dihydroxyacetone but not affected by fructose, galactose, or ribose. Whether the nonmetabolizable glucose analog, 3-O-methylglucose affects somatostatin secretion is, however, not known.

METHOD

We therefore, examined whether the glucose analog affects somatostatin secretion in the perfused dog pancreas.

RESULTS

We found that when added to a medium containing 2.7 mM or 5.5 mM D-glucose, 3-O-methylglucose (10 mM) stimulated somatostatin secretion to the same extent as did an equivalent dose of D-glucose. The same stimulation was observed also with arginine at 2.5 mM in the perfusion medium. In contrast, 3-O-methylglucose did not stimulate somatostatin secretion in the absence of glucose in the perfusion medium. Mannoheptulose (5 mM), which inhibits glucose metabolism, completely blocked the secretion to both hexoses.

Healing of the root surface-associated periodontium: an immunohistochemical study of orthodontic root resorption in man

The purpose of the present investigation was to study resorption and regeneration of periodontal tissues incident to orthodontic tooth movement, in particular cells resorbing the root surface and the subsequent regeneration of the periodontal epithelial network and forming reparative cementum. The study was carried out using a select number of immunohistochemical markers on extracted human teeth which had been treated orthodontically. The most striking finding in the resorbing areas was the presence of what appeared to be two populations of KP 1+ mononuclear cells located at a distance of 50-100 microns from the root surface and multinucleated cells in resorption lacunae in close contact with the root surface. KP 1+ has previously not been reported for odontoclasts. The mononuclear KP 1+ cells in the periodontal ligament may represent either precursors to odontoclasts or phagocytic scavenger cells of the macrophage lineage. The subsequent healing of the resorption lacunae was characterized by re-establishment of nervous, vascular and epithelial tissues as evidenced by S-100+ filamentous delicate structures, factor VIII+ vessels and cytokeratin+ clusters of cells, respectively. However, cytokeratin+ single cells in close contact with the unresorbed cementum did not re-appear within the healing period. Although the present results are not quantitative in nature, cementoblasts located in the vicinity of resorption lacunae, especially healing ones, appeared to show an up-regulation of epidermal growth factor (EGF) receptors. It may be suggested the intense positive staining for EGF receptors may be an expression of an auto- or paracrine stimulatory pathway increasing the rate of reparative cementum formation.

Effects of glucagon-like peptide-I on glucose turnover in rats

The influences of glucagon-like peptide-I-(7-36) amide (GLP-I; 15 mumol. kg-1.min-1) on glucose turnover were studied in freely moving Wistar rats. In fed rats, GLP-1 reduced plasma glucose (from 7.3 +/- 0.2 to 5.6 +/- 0.3 mmol/l; P = 0.017), increased plasma insulin (from 20 +/- 3 to 89 +/- 11 mU/l; P = 0.002), and reduced plasma glucagon (from 44 +/- 1 to 35 +/- 2 pg/ml; P = 0.009) and glucose appearance rate (Ra; from 3.9 +/- 0.2 to 1.7 +/- 0.7 micromol.min-1. 100 g-1 after 30 min; P = 0.049) without affecting glucose disappearance rate (Rd). The glucose clearance rate (MCR) was increased (P = 0.048). In 48-h-fasted rats, GLP-I reduced plasma glucose (from 5.0 +/- 0.2 to 4.4 +/- 0.3 mmol/l; P = 0.035) and increased plasma insulin (from 4 +/- 1 to 25 +/- 10 mU/l; P = 0.042) and plasma glucagon (from 43 +/- 3 to 61 +/- 7 pg/ml; P = 0.046). Ra and Rd were not significantly affected, although Ra was lower than Rd after 15-30 min (P = 0.005) and MCR was increased (P = 0.049). Thus GLP-I reduces Ra in fed rats and increases MCR in fed and fasted rats. The reduced Ra seems mediated by an increased insulin-to-glucagon ratio; the increased glucose clearance seems dependent on insulin and a peripheral effect of GLP-I.

Root surface etching at neutral pH promotes periodontal healing

The purpose of the present investigation was to examine whether an etching agent operating at neutral pH (EDTA) can enhance healing compared to a low pH etching agent (citric acid) in an animal model. Maxillary molars and premolars, in total 32 teeth, in 4 monkeys were divided between test (EDTA or citric acid treatment) and matched control groups. Periodontal surgery on both palatal and buccal roots using the dehiscence model was performed with or without root surface etching. Healing results were evaluated histomorphometrically after 8 weeks. The statistically significant differences between EDTA treated surfaces (n=15) and control surfaces (n=11) were approximately 10% less failure (gingival recession and periodontal pocket), 10 to 15% more total histological attachment (long epithelial junction, connective tissue and reparative cementum), approximately 20% less long epithelial junction and approximately 20% more connective tissue in roots etched with EDTA. The statistically significant differences between citric-acid-treated surfaces (n=14) and control surfaces (n=11) were approximately 10% more connective tissue and 15% less long epithelial junction in the citric acid etched roots. Thus, etching with EDTA appeared to improve healing, avoiding the superficial necrotizing effect on exposed periodontal tissues by citric acid documented in previous studies. Although etching at present is not routinely applied in conventional periodontal therapy, future potential applications of etching at neutral pH may include exposure of the collagenous matrix of dentin for retention of biologically active substances, such as growth factors. Such treatment may be argued to produce a biocompatible surface more conducive to periodontal membrane cell colonization after removal of root-surface- associated smear without compromising the vitality of the surrounding periodontium.

Spatial and temporal repair patterns of orthodontically induced surface resorption patches

Root resorption appears to be an inevitable sequel to orthodontic tooth movement, occurring either apically or along surfaces in and around the pressure zones. However, there is uncertainty as to the location of initial cementum repair in resorbed areas as well as the time of onset of repair. The aim of the present study was to map the spatial and temporal patterns of cementum repair in orthodontically induced areas of surface resorption following maxillary expansion. Two spatial patterns of repair of orthodontic surface resorption patches were observed with cementum deposition proceeding either from the periphery or starting somewhere in the center of the resorbing areas, although the deposition starting centrally was argued to be artifactual. Furthermore, onset of reparative cementum mineralization appeared to follow within 2 wk after release of the force, involving initially only acellular cementum formation. However, the pattern of formation changed gradually, favouring a slow deposition of cellular cementum at more advanced stages of healing.

The influence of endodontic infection on progression of marginal bone loss in periodontitis

The purpose of the present investigation was to determine magnitude and rate of proximal radiographic attachment loss in relation to endodontic infection in periodontally involved teeth. The investigation was conducted as a retrospective longitudinal study on a periodontitis-prone randomly selected referral population, including 175 single-rooted, root-filled teeth in 133 patients. An observation period of at least 3 years was required. Periapical conditions of the selected sample at baseline and re-examination were evaluated on radiographs, independently by 3 investigators. Each single-rooted, root-filled tooth of the sample was given a score according to the combined registrations. Radiographic attachment level was measured as the distance between the most coronal point of the alveolar bone and the apex at the mesial and distal sides of the tooth, and expressed as relative radiographic attachment level (RRAL) (radiographic attachment level at baseline/root length) at proximal sites for every tooth. Multiple regression analysis was used to study change in RRAL over time. Teeth in periodontitis-prone patients with progressing periapical pathology indicating a continuous root canal infection were found to lose comparatively more radiographic attachment than teeth with no signs of periapical pathology or teeth with an established periapical destruction which subsided during the observation period. An approximate 3-fold amplification of the rate of marginal proximal radiographic bone loss by endodontic infection in periodontitis-prone patients was found with an average 0.19 mm/year, while 0.06 mm/year was lost for teeth without endodontic infection or subsiding endodontic involvement.

Endodontic pathogens: propagation of infection through patent dentinal tubules in traumatized monkey teeth

Periapical pathology indicating endodontic infection, when present in marginal periodontitis-affected teeth, has recently been shown to be an aggravating factor in progression of marginal destruction. This has been associated with patency of dentinal tubules in the tooth cervix, an area normally devoid of cementum following periodontal therapy. These studies are, however hampered by that only circumstantial evidence such as presence of periapical destruction have been applied as criteria of endodontic infection. The purpose of the present investigation was to study to what extent a predefined selection of endodontic pathogens inoculated in the root canal can influence periodontal pathology and healing in areas of the root covered by or devoid of cementum, using root resorption as a histomorphometric marker. Exposed dentine surfaces, in the present study showed significantly larger areas of resorption in infected roots compared to non-infected roots, while cementum surfaces showed an almost identical distribution of tissue reactions regardless of root canal infection or not. It was concluded that endodontic pathogens or their products were not able to penetrate the cementum barrier. The significantly larger areas of resorption on exposed dentine surfaces in infected roots compared to non-infected roots indicated that endodontic pathogens or their products could spread through dentinal tubules to a root surface void of cementum. Extrapolated to the marginal situation this indicated that endodontic pathogens in the root canal might be able to aggravate marginal infection in areas of root devoid of cementum.

Effects of galanin on proinsulin mRNA and insulin biosynthesis in normal islets

Whether the potent insulinostatic neuropeptide galanin also inhibits insulin production in normal islets is not known. Therefore, isolated mouse islets were incubated for 90 min in 2.8 or 16.7 mmol/l glucose and 3H-labelled leucine with addition of mouse galanin at 1, 10 or 100 nmol/l. Galanin potently inhibited glucose-stimulated insulin secretion at both 10 and 100 nmol/l (P < 0.05), and proinsulin biosynthesis was slightly inhibited at 100 nmol/l (P < 0.05). Also, mouse islets were incubated for 48 h at 5 or 16.7 mmol/l glucose with galanin at 1, 10 or 100 nmol/l and proinsulin mRNA was determined by hybridisation of extracted RNA with digoxigenin-labelled oligonucleotide insulin probe. Proinsulin mRNA levels were approximately doubled by glucose at 16.7 mmol/l compared at 5 mmol/l (P < 0.05). Galanin did not affect islet proinsulin mRNA levels. Therefore, galanin seems to mainly regulate insulin secretion without any important role in the regulation of insulin availability in normal islets.

Effects of orthodontic magnets on cutaneous epithelial thickness and tibial bone growth in rats

The use of permanent magnets in orthodontic treatment has increased significantly over the past years, triggered by the introduction of rare earth magnetic alloys. Concerns about possible side effects have been expressed relating to their use in orthodontic treatment. In previous experimental studies evidence of a reduction in bone formation and epithelial turnover close to rare earth magnets has been presented. The aim of the present study was twofold: to confirm earlier results and to study whether the observed changes are reversible. One hind leg in each of 45 rats was fitted with aluminum rings with Co5Sm magnets, whereas the other hind leg was fitted with sham rings. After 8 weeks 25 rats were killed, and the rings in the remaining rats were removed. The latter group was killed after another 11 weeks. The epithelial and bone reactions were evaluated histomorphometrically. Previous results showing thinner epithelium and retarded rate of bone formation close to Co5Sm magnets were confirmed. These effects were also shown to be largely reversible. It was concluded on the basis of this and the magnitude of the effects that any local side effects from orthodontic rare earth magnets appear negligible when extrapolated to the clinical situation.

Effects of GLP-1 and 2,5-anhydro-D-mannitol on insulin secretion and plasma glucose in mice

The truncated glucagon-like peptide-1 (GLP-1(7-36)amide or GLP-1) stimulates insulin secretion, enhances glucose elimination and is of potential interest in diabetes treatment. We studied the hypoglycemic action of GLP-1 in normal mice when given alone or together with the fructose analogue, 2,5-anhydro-D-mannitol (2,5-AM), which inhibits glycogenolysis and gluconeogenesis. GLP-1 (32 nmol/kg iv) lowered plasma glucose levels after 25 min to 4.6 +/- 0.2 mmol/l compared with 7.3 +/- 0.4 mmol/l in controls (P < 0.001). Also 2,5-AM (0.5 mumol/kg iv) reduced plasma glucose levels, to 5.6 +/- 0.3 mmol/l (P < 0.01). When given together, the glucose lowering action of GLP-1 and 2,5-AM was additive, since the 25 min glucose level was 2.8 +/- 0.2 mmol/l. At 5 min after injection, GLP-1 had increased plasma insulin levels to 693 +/- 68 pmol/l compared with 342 +/- 42 pmol/l in controls (P < 0.01). 2,5-AM abolished this increase. Furthermore, GLP-1 (32 nmol/kg) did not affect the glycogen content, neither in the liver nor in the gastrocnemic muscle in samples taken at 30 min after injection. Moreover, in isolated islets incubated at 3.3 and 8.3 mmol/l glucose, 2,5-AM at 75 mmol/l inhibited glucose-stimulated insulin secretion (P < 0.05) showing that 2,5-AM inhibits insulin secretion both in vivo and in vitro. We conclude that GLP-1 may reduce plasma glucose levels also to levels below the basal levels under normal conditions, and that an insulin- and liver-independent action of the peptide contributes to its hypoglycemic action in normal animals.