Risk comparison of osteonecrosis of the jaw in osteoporotic patients treated with bisphosphonates vs. denosumab: a multi-institutional retrospective cohort study in Taiwan.

In this multi-institutional retrospective cohort study, we compared the long-term risk of osteonecrosis of the jaw following the use of denosumab vs. bisphosphonates in osteoporotic patients. After 2-year use, the likelihood of osteonecrosis of the jaw is lower with denosumab compared to bisphosphonates, and the difference increases with time. PURPOSE: To compare the long-term risk of osteonecrosis of the jaw (ONJ) between osteoporotic patients treated with bisphosphonates (BPs) and denosumab. METHODS: This multi-institutional retrospective cohort study included patients aged > 40 years with osteoporosis between January 2010 and December 2018. Patients who met the eligibility criteria were divided into BPs and denosumab groups by propensity score matching (PSM). The risk of ONJ of denosumab vs. BPs was estimated using a Cox proportional hazards model and was described by the cumulative incidence rate using the Kaplan-Meier method. RESULTS: A total of 84,102 patients with osteoporosis were enrolled, among whom, 8962 were eligible for inclusion based on their first-line drug use (denosumab, n = 3,823; BPs, n = 5,139). Following PCM matching (1:1), the BPs and denosumab groups included 3665 patients each. The incidence density of ONJ in the denosumab and BPs matching groups was 1.47 vs. 2.49 events (per 1000 person-years), respectively. The hazard ratio of ONJ in the denosumab vs. BPs group was estimated as 0.581 (95% confidence interval: 0.33-1.04, p = 0.07). The cumulative incidence rates of ONJ in both groups were similar for the first and second years of drug use (p = 0.062), but significantly different from the third year onwards (p = 0.022). The severity of ONJ was not significantly different between the two groups. CONCLUSION: In osteoporotic patients, after 2 years of use, the likelihood of ONJ being induced by denosumab is lower than that of BPs, and the difference increases with time.

Probable sporadic Creutzfeldt-Jakob disease mimicking focal epilepsy.

Creutzfeldt-Jakob disease (CJD) presents with seizures as an early symptom in only approximately 3% of cases. These seizures often present as nonconvulsive status epilepticus (NCSE) or epilepsia partialis continua (EPC). Here, we describe a case of probable sporadic CJD (sCJD) in an 83-year-old man whose manifest an unusual presentation of left-hand tonic seizures without evolution to EPC, as well as brain MRI findings interpreted as peri-ictal changes, which led to an initial misdiagnosis of focal epilepsy.

Regulatory effects of root pruning on leaf nutrients, photosynthesis, and growth of trees in a closed-canopy poplar plantation.

A plantation of 5-year-old poplar Populus × euramericana cv. 'Neva' was used to study the regulatory effects of root pruning on nutrients, photosynthetic characteristics, and water-use efficiency (WUE) of leaves and growth rates of diameter at breast height (DBH; 1.3 m), tree height, and volume. Six root-pruning treatments were conducted with different combinations of intensity (at a distance of six, eight or ten times DBH from the trunk) and orientation (on two or four sides of the trees). Results showed that the N, P, K, photosynthetic rate, transpiration rate, and stomatal conductance of leaves were all significantly decreased by root pruning over the initial period following root pruning (30 days), but increased in the subsequent investigations. The values of the above indexes peaked in 8-2 treatment (i.e., eight times DBH distance on two sides). The leaf WUE in 8-2 treatment, and average growth rates of DBH, tree height and volume, were the highest among all treatments within 3 years of root pruning. The results indicated that the root pruning based on the appropriate selection of intensity and orientation had significant positive effects on leaf nutrients, photosynthesis, and growth of trees in a closed-canopy poplar plantation.

Effects of root pruning on the physicochemical properties and microbial activities of poplar rhizosphere soil.

This study aimed to determine the effects of root pruning on the physicochemical characteristics and microbial activities of poplar rhizosphere soil. The root systems of 5-year-old poplar (Populus×euramericana cv. 'Neva') trees were manually pruned at 6, 8, or 10 times diameter at breast height (DBH) from the trunk (severe, moderate, and light, respectively) along both inter-row sides. Moderate root pruning significantly increased the concentrations of amino acids, organic acids, and total sugars in the root exudates and decreased the pH of rhizosphere soil. This treatment also increased the contents of available nitrogen, phosphorus, potassium, and total organic carbon as well as high-, medium-, and low-activity organic carbon in rhizosphere soil. Moreover, moderate pruning increased the contents of microbial biomass carbon and nitrogen, and enhanced basal respiration, in addition to decreasing the metabolic quotients in rhizosphere soil by 8.9%, 5.0%, and 11.4% compared with control, light, and severe root pruning treatments, respectively. Moderate pruning increased the growth rates of DBH, tree height, and volume to the highest levels. Furthermore, these indices were not significantly different between the light root pruning and control groups, but varied significantly between severe and moderate root-pruning treatments. Thus, root pruning, depending on the distance from the trunk, significantly influences the physicochemical properties and microbial activities in poplar rhizosphere soil.

Interference factors regarding the path of insertion of rotational-path removable partial dentures.

BACKGROUND: The aims of this study were to evaluate the effect of the location of the rotational center and the morphology of teeth resulting in interference with the rotational path of insertion and to estimate when an interference test should be performed. METHODS: A total of 400 dental radiograms of maxillary and mandibular first and second molars (100 for each position) were selected. The radiograms were used to hand-sketch the outlines on tracing paper. Then, an interference test was simulated using calipers. Mesial long occlusal rest seats with three different lengths were designed. A curve-simulated rotational path was drawn on the tracing paper showing the outline of a molar. If the curve was intersected by the mesial outline, interference was occurred. A total of 1200 tests were performed. RESULTS: A significant number of interference cases (18.5%, N = 400) occurred when the rotational center was placed at the most distal margin of the occlusal surface. The interference was reduced (2.75%, N = 400) but still present at the distal fourth of the occlusal surface. At the distal one-third of the occlusal surface, interference did not occur (0%, N = 400). There was a significant difference between the results of the three rotational centers (p < 0.0001). CONCLUSIONS: The interference test was not required for a rotational center at the distal third to half of the occlusal surface. However, if the length of the long occlusal rest extends beyond the distal third, an interference test is recommended before final impression.

The Abundance of Epicardial Adipose Tissue Surrounding Left Atrium Is Associated With the Occurrence of Stroke in Patients With Atrial Fibrillation.

Epicardial adipose tissue (EAT) is positively associated with risk factors for cardiovascular disease, but the role of EAT in the development of atrial fibrillation (AF)-related stroke and its association with the anatomical and functional remodeling of the left atrium (LA) have not been elucidated.This was a comparative cross-sectional study. Twenty-seven patients with paroxysmal or persistent AF and cardioembolic stroke were selected and compared with 68 age- and sex-matched AF patients without stroke. In addition, 20 controls without a history of AF or stroke were included. The periatrial EAT and the structural and functional properties of the LA and left ventricle were evaluated using contrast-enhanced 64-slice multidetector computed tomography during sinus rhythm. Total EAT around the LA was significantly increased across the groups (control vs AF vs AF-related stroke, P < 0.001). The volumes of the LA and the LA appendage (LAA) were also significantly increased across the 3 groups (P < 0.001 for each). The emptying fraction of the LA and LAA and the booster-pump function of the LA and LAA were all reduced across the 3 groups (P < 0.001 for all). In addition, the Hounsfield unit (HU) ratio of the LAA to the ascending aorta (LAA/AA) was also decreased in patients with stroke (P < 0.001). Furthermore, EAT had a negative correlation with the dynamic function of the LA, LAA, and the HU ratio. After a multivariate analysis, increased EAT (P < 0.001) was shown to be independently associated with the occurrence of AF-related stroke.Periatrial EAT was increased and was correlated with atrial dysfunction in patients with AF-related stroke. Hence, EAT assessment may potentially offer an incremental value for grading the risk of cardioembolic stroke in patients with AF.

[Effects of gel made by super absorbent polymers and urea on fine root growth and nitrogen use efficiency of Platycladus orientalis bareroot seedlings.] / 保水剂-å°¿ç´ å‡èƒ¶å¯¹ä¾§æŸè£¸æ ¹è‹—ç»†æ ¹ç”Ÿé•¿å’Œæ°®ç´ åˆ©ç”¨çŽ‡çš„å½±å“.

A pot experiment including five treatments, i.e., CK (neither fertilizer nor super absorbent polymers), U (urea alone), S [super absorbent polymers (SAP) alone], SUM (SAP mixed with urea) and SUG (gel made of SAP and urea) was conducted to evaluate their effects on fine root morphological characteristics, fine root absorption area, fine root nitrogen metabolism and nitrogen use efficiency of Platycladus orientalis bareroot seedlings. Results showed that compared with U treatment, the SUG treatment significantly increased the biomass, length, specific root length, surface area and volume of fine root. The total absorption area and active absorption area of fine root were also increased remarkably under the SUG treatment. The specific root length in the SUG treatment was increased by 34.7%, 37.9%, 41.1% and 12.4% compared with the treatments of CK, U, S and SUM, respectively. Compared with the U treatment, the activities of nitrate reductase, glutamine synthase, glutamate synthase and glutamate dehydrogenase in fine root of the SUG treatment was improved by 41.2%, 76.6%, 30.7% and 125.8%, respectively, while the ratio of GS to GDH decreased. Not only the ground diameter and plant height, but also the dry matter accumulation of aboveground and underground parts was remarkably enhanced under the SUG treatment. The nitrogen use efficiency was 40.7% in the SUG treatment, being 118.8% and 44.5% higher than the U and SUM treatments, respectively. Gel made of SAP and urea was able to significantly increase the nitrogen use efficiency, promote the growth and enhance the ability of drought resistance by improving the morphological characteristics, enhancing the absorption area and key enzymes activities of nitrogen metabolism in the fine root of P. orientalis bareroot seedlings.

All-on-4 concept implantation for mandibular rehabilitation of an edentulous patient with Parkinson disease: A clinical report.

Parkinson disease (PD) is a progressive neurologic disorder. Compromised voluntary and involuntary muscle control of the orofacial-pharyngeal muscles of patients with PD may lead to difficulty in mastication, dysphagia, and tremor of the mouth and chin. All of these problems represent major challenges for the clinician with respect to the oral rehabilitation. This clinical report describes the use of the All-on-4 concept implantation for mandibular rehabilitation with a fixed detachable dental prosthesis in an edentulous patient with PD. The treatment steps, outcome, and limitations are discussed.

A Novel Application of Multiscale Entropy in Electroencephalography to Predict the Efficacy of Acetylcholinesterase Inhibitor in Alzheimer's Disease.

Alzheimer's disease (AD) is the most common form of dementia. According to one hypothesis, AD is caused by the reduced synthesis of the neurotransmitter acetylcholine. Therefore, acetylcholinesterase (AChE) inhibitors are considered to be an effective therapy. For clinicians, however, AChE inhibitors are not a predictable treatment for individual patients. We aimed to disclose the difference by biosignal processing. In this study, we used multiscale entropy (MSE) analysis, which can disclose the embedded information in different time scales, in electroencephalography (EEG), in an attempt to predict the efficacy of AChE inhibitors. Seventeen newly diagnosed AD patients were enrolled, with an initial minimental state examination (MMSE) score of 18.8 ± 4.5. After 12 months of AChE inhibitor therapy, 7 patients were responsive and 10 patients were nonresponsive. The major difference between these two groups is Slope 2 (MSE6 to 20). The area below the receiver operating characteristic (ROC) curve of Slope 2 is 0.871 (95% CI = 0.69-1). The sensitivity is 85.7% and the specificity is 60%, whereas the cut-off value of Slope 2 is -0.024. Therefore, MSE analysis of EEG signals, especially Slope 2, provides a potential tool for predicting the efficacy of AChE inhibitors prior to therapy.

[Effects of inoculating plant growth-promoting rhizobacteria on the biological characteristics of walnut (Juglans regia) rhizosphere soil under drought condition].

Effects of four plant growth-promoting rhizobacteria (PGPR) , namely Pseudomonas sp. YT3, Bacillus subtilis DZ1, B. cereus L90 and B. fusiformis L13 on the biological characteristics of walnut (Juglans regia) rhizosphere soil under drought stress were investigated. Results showed that drought stress had little effect on available nutrients of walnut rhizosphere soil, but significantly decreased the activity of organic carbon by 18.4% and increased the pH from 7.34 to 7.79. Under drought stress condition, the inoculation of Bacillus cereus L90 significantly increased high-labile organic carbon in walnut rhizosphere by 14.5% relative to the un-inoculated control, and decreased the pH to 7.41. Compared with the irrigated control, the total microbial populations, root exudates, microbial biomass carbon, and microbial biomass nitrogen in walnut rhizosphere soil were significantly decreased by 36.0%, 20.7%, 33.5% and 30.7%, respectively, because of drought stress. However, L90 inoculation decreased these deficits to 14.1%, 10.3%, 12.1% and 12.7%, respectively. Some terminal restriction fragments (T-RFs) disappeared under the drought condition and PGPR inoculation had great influence on T-RFs according to Terminal Restriction Fragment Length Polymorphism profiles. The Margalef index and the Shannon index of walnut rhizosphere soil significantly decreased, but the Simpson index increased relative to the irrigated control. Compared with the un-inoculated control, the Margalef index significantly increased from 0.42 to 0.99, as well as the Shannon index increased from 0.52 to 0.98. However, the Simpson index de- creased from 0.60 to 0.39. Inoculating YT3, DZ1 and L13 had weaker effects on the biological characteristics of walnut rhizosphere soil compared to inoculating L90, suggesting L90 inoculation could interfere with the suppression of drought stress to the biological characteristics of walnut rhizosphere soil.

Family-wide expression characterization of Arabidopsis beta-carbonic anhydrase genes using qRT-PCR and Promoter::GUS fusions.

Carbonic anhydrases (CAs, EC 4.2.1.1) are metalloenzymes found throughout the phylogenetic tree. The ß-class carbonic anhydrases (ß-CAs) are the predominating class of CAs in plants. Growing evidence underscores the importance of ß-CAs in plant immunity and environmental adaptation in addition to their roles in photosynthesis. However, many fundamental problems in Arabidopsis ßCAs expression remain unsolved. Here we examined the transcript abundance of AtßCAs in different tissues of Arabidopsis thaliana, and the accumulation of mRNA in response to CO2 and darkness. Histochemical analysis was performed to study the promoter activity of AtßCAs during post-germination seedling growth and in mature plants. All six members of the AtßCA subfamily showed a response to changed CO2 level and darkness, but each member showed a specific dynamic pattern. Although expression of each AtßCA was unique, in general most AtßCAs were synchronously expressed in green leaves since 5 days after germination until flowering. AtßCA1 and AtßCA2 were most highly expressed in leaves but AtßCA2 displayed weaker expression in roots. The level of AtßCA3 transcripts was highest in flowers, while AtßCA5 was most widely expressed and might be involved in more processes than other members. AtßCA6 was unique for increased expression in darkness and no expression in either the anther or pistil. The present study provides useful information for further functional investigation.

[Effects of drought stress on the growth, photosynthetic characteristics, and active oxygen metabolism of poplar seedlings].

A pot experiment was conducted to study the effects of different water treatments (normal irrigation, light drought, moderate drought, and severe drought) on the growth, gas exchange, chlorophyll fluorescence characteristics, and active oxygen metabolism of poplar ( Populus x euramericana cv. 'Neva') seedlings in the experimental nursery of Shandong Forestry Academy from April to October, 2011. As compared with those under normal irrigation, the growth of the seedling' s basal diameter under light, moderate, and severe drought stress decreased by 12.8%, 44.5%, and 65.6%, and the height growth decreased by 12.2%, 43.1%, and 57.2%, respectively. With the increasing extent and duration of drought stress, the maximal photochemical efficiency of PS II , quantum yield, photochemical quenching coefficient, net photosynthetic rate, and stomatal conductance of the seedling leaves decreased gradually under light drought stress, while decreased rapidly under both moderate and severe drought stress. The non-photochemical quenching coefficient increased significantly under light drought stress, but decreased after an initial increase under moderate and severe drought. The leaf superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) activities under drought stress decreased after an initial increase, but definite differences existed in the responses of the three enzymes to drought stress and reactive oxygen. The leaf relative electric conductivity and malondialdehyde (MDA) content under drought stress increased significantly, plasma membrane was damaged, and massive ions leaked out. The most serious damage of plasma membrane was found under severe stress. Under light drought stress, the seedlings had higher photosynthetic efficiency and stronger oxidative enzyme defense system; under moderate and severe drought stress, the photosynthetic efficiency decreased significantly, and the oxidative enzyme defense system was damaged remarkably.

Connective tissue disorders in patients with spontaneous intracranial hypotension.

OBJECTIVE: Spontaneous intracranial hypotension (SIH) is caused by spinal cerebrospinal fluid (CSF) leakage. An underlying connective tissue disorder has been hypothesized to cause dural weakness and predisposition to CSF leak. We conducted a case-controlled study to investigate the role of connective tissue disorders in SIH patients. METHODS: We recruited 55 consecutive SIH patients (38 F, 17 M; mean age, 40.8 ± 9.8 years) and 55 age- and sex-matched control individuals (mean age, 38.0 ± 8.9 years) for this study. The connective tissue disorders were evaluated by: (i) Beighton hypermobility scores and revised diagnostic criteria for benign joint hypermobility syndrome; (ii) skin and skeletal manifestations of Ehlers-Danlos syndrome (EDS); and (iii) skeletal features of Marfan syndrome. RESULTS: The frequencies of joint hypermobility according to Beighton scores >4/9 (SIH 23.6% vs controls 16.4%, P = 0.48) and revised benign joint hypermobility syndrome criteria (SIH 23.6% vs controls 34.5%, P = 0.29) did not differ between SIH patients and controls. Sixteen patients and 16 controls had one or more skin features of EDS (P = 1.0). Nine SIH patients (16.4%) demonstrated the skeletal features of Marfan syndrome; this frequency did not differ from that of the control group (9.1%; P = 0.262). Only dolichostenomelia (disproportionately long limbs) was more prominent in SIH patients than in controls (34.5% vs 9.1%; P = 0.002). CONCLUSION: Compared with Western studies, the frequencies of connective tissue disorders were higher in our SIH patients. However, these frequencies did not differ between SIH patients and control individuals, except for dolichostenomelia.

[Nitrate nitrogen leaching and residue of humic acid fertilizer in field soil].

To elucidate the potential influence of humic acidfertilizer on groundwater and soil quality in clay soil (CS) and sandy soil (SS), nitrate nitrogen leaching and residue of different fertilizers in field soil were studied using a self-made leaching field device. Nitrate nitrogen concentration in leaching water of fertilizer treatments was 28.1%-222.2% higher than that of non-nitrogen treatment in different times, but humic acid fertilizer could prevent nitrate nitrogen leaching both in CS and SS, especially in CS. Nitrate nitrogen concentration of leaching water in CS was 41.2%-59.1% less than that in SS and the inhibiting effect in CS was greater than that in SS. Nitrate nitrogen could be accumulated in soil profile by fertilizer application. The residue of nitrate nitrogen retained in 0-40 cm soil layer of humic acid fertilizer treatment was 59.8% and 54.4% respectively, higher than that of urea and compound fertilizer treatments. Nitrate nitrogen amount of humic acid, urea and compound fertilizer treatments in SS was significantly less than that in CS, being 81.7%, 81.1% and 47.6% respectively. Compared with the conventional fertilizer, humic acid fertilizer treatment improved the contents of organic matter, available nitrogen, phosphorus, and potassium of upper layer soil as well as cation exchange capacity. Besides, total amount of water-soluble salts in humic acid fertilizer treatment was decreased by 24.8% and 22.5% in comparison to urea and compound fertilizer treatments in CS, respectively. In summary, the application of humic acid fertilizer could improve physical and chemical properties of upper layer soil and reduce the risk of potential pollution to groundwater.

Modified split-cast technique: a new, timesaving clinical remount technique.

Interocclusal discrepancies can be eliminated by a clinical remount procedure, but most practitioners avoid it because of the time involved. This article introduces a new timesaving method, the modified split-cast technique. It uses a semi-adjustable articulator, tin foil as plaster separator, and an addition-type, silicone bite-registration material. The technician does most of the remounting procedures before the denture delivery appointment, so the dentist spends very little time chairside to complete the clinical remount procedure. Compared with the conventional and two other remounting techniques, the new technique is faster and easier to manipulate.

Symptomatic trigeminal autonomic cephalalgia associated with allodynia in a patient with multiple sclerosis.

A patient with symptomatic trigeminal autonomic cephalalgia (TAC) provides a chance to understand the pathophysiology and anatomic correlates of TAC. A 28-year-old woman experienced intermittent sharp and excruciating pain over her right temporal, ear and neck regions for 3 days. The headaches lasted 10-20 minutes each, occurred 1-2 times a day, and were accompanied by prominent ipsilateral lacrimation and conjunctival injection. The patient had hiccups, 4-limb numbness and impaired visual acuity in both eyes. She had also had 3 episodes of left-side optic neuritis in the past half year. Neurologic examination showed brushing allodynia over the right face and scalp during the headache attacks. The visual acuity of her right eye was 6/60 and that of the left eye was 1/60. Brain magnetic resonance imaging showed non-enhancing lesions on the right lateral tegmentum of the lower pons where the spinal trigeminal nucleus is located and the floor of the 4th ventricle. The patient was diagnosed as having multiple sclerosis with symptomatic TAC. Her headaches, autonomic signs and allodynia subsided 3 days after pulse therapy and gabapentin treatment were given. We suggest that the spinal trigeminal nucleus lesion was responsible for the symptomatology of TAC and cutaneous allodynia in our patient.