A Clinical Study on the Effect of Injection Sites on Efficacy of Anesthesia and Pulpal Blood Flow in Carious Teeth.

This randomized clinical trial evaluated the efficiency of maxillary infiltration anesthesia in carious teeth at two different injection sites and their impact on the laser Doppler recordings of pulpal blood flow (PBF) during a caries excavation procedure. The null hypothesis tested was that there are no differences in the efficiency of anesthesia and PBF reduction between maxillary infiltrations at the two injection sites. One hundred twenty patients were divided into three groups according to the degree of carious lesion of their maxillary left central incisors (moderate caries, deep caries, or no caries). Forty patients in each group randomly received infiltrations over the root apex of maxillary left central incisors (site X) or over the midpoint of the line connecting the root apexes of both maxillary left central and lateral incisors (site Y) using 0.9 mL 2% lidocaine with 1:100,000 adrenaline. Teeth were pulp tested at five-minute intervals after injection except for the period of cavity cutting, which was done 12 minutes after injection. The PBF changes after injection were monitored by laser Doppler flowmetry. The observation period in this study was 60 minutes. Success of anesthesia was defined as no or mild pain on cavity cutting by visual analog scale recordings. Deep caries group showed significantly higher baseline PBF ( p<0.05). All groups showed 100% success of anesthesia and similar duration time ( p>0.05). Subgroups that had the injection at site Y showed significantly less reduction of PBF ( p<0.05). Cavity-cutting procedures increased the amplitude of the PBF around the lowest value after injection. Independent of the cavity depth, carious anterior teeth anesthetized by infiltration further from the apex had significantly less reduction on the pulpal blood flow compared with teeth anesthetized by infiltration at the apex.

First Report of Powdery Mildew Caused by Podosphaera fusca on Herba eupatorii in China.

Herba eupatorii, one of the most important Chinese medicinal herbs, belongs to the Asteraceae family. In June 2012, a previously unknown disease, tentatively identified as powdery mildew, was observed on H. eupatorii growing in Shangqiu, in eastern Henan Province, China. Symptoms began as white mycelium partially covering upper leaf surfaces; as the disease progressed, it spread to cover entire leaf surfaces. The infected leaves became yellow and necrotic at advanced stages of infection. Specimens consisting of infected leaves were maintained at the Plant-Microbe Interaction Laboratory at Shangqiu Normal University. Microscopic observations of the morphology of the fungus revealed oval primary conidia measuring 18 to 27 × 15 to 22 µm. A long unbranched germ tube that germinated laterally from the ends of conidia was observed in some samples. Conidiophores were cylindrical, simple unbranched, and composed of a basal cell with a swollen base and three to six barrel-shaped conidia formed in chains, measuring 112 to 180 × 9 to 12 µm. Mycelial appressoria were nipple-shaped. Chasmothecia were not observed in the collected samples. To verify the identity of the fungus, the internal transcribed spacer (ITS) rDNA was amplified with ITS1 and ITS4 primers (3) and sequenced. The sequences were deposited as GenBank Accession No. JX546297. Comparison with sequences in the GenBank database revealed that the ITS sequence was 100% homologous with the sequence of Podosphaera fusca on Calendula officinalis (AB525914) (2) and Syneilesis palmata (AB040349) (1). The ITS sequence analysis verified that the causal agent was P. fusca, which is reported to be a cosmopolitan powdery mildew fungus, parasitic on numerous plant species in the Asteraceae family. Koch's postulates were completed by inoculating healthy H. eupatorii plants with a conidial suspension (prepared in distilled water) of 105 conidia/ml collected from infected plants. Five plants were sprayed until the suspension ran off the leaves, while five additional plants were sprayed with distilled water as a control. Plants were maintained in a climate cell under the following conditions: day, 24°C, 16 h; night, 20°C, 8 h; 85% humidity. After 10 days, inoculated plants developed symptoms similar to those observed in the field, whereas control plants remained healthy. Further examination showed that the inoculated plants were infected by P. fusca. To our knowledge, this is the first report of P. fusca affecting H. eupatorii in China. Because there are no fungicides labeled for use on this plant, the appearance of powdery mildew caused by P. fusca could result in substantial production loss of H. eupatorii. References: (1) T. Hirata et al. Can. J. Bot. 78:1521, 2000. (2) S. Takamatsu et al. Persoonia 24:38, 2010. (3) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, San Diego, CA, 1990.