Subjective Evaluation of Denture Adhesives: A Multicenter Randomized Controlled Trial.

INTRODUCTION: Many reports show that denture adhesives improve the retention and stability of dentures. However, few randomized controlled trials have examined the effects of denture adhesives. OBJECTIVE: This 10-center randomized controlled trial with parallel groups involving 200 edentulous patients wearing complete dentures aimed to evaluate the effects of short-term use of cream and powder denture adhesives. METHODS: Patients were allocated into 2 cream- and powder-type adhesive groups and 1 control group. Intervention groups were treated with the 2 adhesives (1 each), and the control group received saline solution. Adhesive or control was applied to the denture-mucosal surface for 4 d, and data at baseline and after day 4 of intervention (i.e., 8 meals) were obtained. Patient satisfaction was evaluated with a 100-mm visual analog scale. Oral health-related quality of life was measured with the Japanese version of the Oral Health Impact Profile for Edentulous Patients. Perceived chewing ability was evaluated by a questionnaire regarding ease of chewing and swallowing food. Between-group comparisons were performed with Kruskal-Wallis tests with the Mann-Whitney U test adjusted by Bonferroni correction. Within-group comparisons of pre- and postintervention measurements were performed with the Wilcoxon signed-rank test. Intention-to-treat analysis was also performed. RESULTS: Between-group comparisons showed no significant differences for general satisfaction or Oral Health Impact Profile for Edentulous Patients. However, significant differences in satisfaction with various denture functions with cream- and powder-type adhesives were seen in pre- and postintervention comparisons (P < 0.05). Significant differences were also observed for perceived chewing ability of hard foods (P < 0.05). CONCLUSION: These results suggest that although denture adhesives do not invariably improve denture function, they do affect subjective evaluations and possibly chewing of hard foods. Therefore, the effects of denture adhesive use are insufficient to resolve any fundamental dissatisfaction with dentures ( ClinicalTrials.gov NCT01712802 ). KNOWLEDGE TRANSFER STATEMENT: The results of this study suggest that denture adhesives should be applied under certain conditions; however, an appropriate diagnosis is important before application. These practice-based data provide information to establish evidence-based guidelines for applying denture adhesives.

Effect of dentist's clinical experience on treatment satisfaction of a complete denture.

The relationship between the prosthodontic experience of dentists and satisfaction of complete denture wearers remains unknown. To investigate whether a prosthodontist's clinical experience affects treatment satisfaction of a complete denture wearer. From April 2004 to July 2006, we conducted a randomised controlled trial at two centres, including 74 edentulous patients; of these, 32 and 30 were randomly allocated to the ED or ID group, respectively. All the patients rated their satisfaction with dentures, including general satisfaction and satisfaction of chewing ability, speaking, cleaning, stability, retention, comfort and aesthetics. These satisfaction ratings were measured by a 100-mm visual analog scale (VAS). Perceived chewing ability to foods, divided into five grades, was measured using a questionnaire. The mastication index (MI) was calculated for each grade. General satisfaction and satisfaction of speaking, stability and retention were significantly higher in the ED than in the ID group (P = 0·049, 0·003, 0·019 and 0·041, respectively). No significant difference existed between the MI of the ED (71·3 ± 18·4) and ID group (64·1 ± 16·53). However, the perceived chewing ability of grade 5 food, whose texture was the hardest among all the grades, was significantly higher in the ED group than in the ID group. Within its limitations, this study showed that a clinician's prosthodontic experience affects a complete denture wearer's satisfaction ratings.

Leukocytes respiratory burst activity as indicator of innate immunity of pacu Piaractus mesopotamicus.

The present study evaluated the assay to quantify the respiratory burst activity of blood leukocytes of pacu as an indicator of the innate immune system, using the reduction of nitroblue tetrazolium (NBT) to formazan as a measure of the production of reactive oxygen species (ROS). In order to assess the accuracy of the assay, fish were challenged by Aeromonas hydrophila and sampled one week after challenge. The A. hydrophila infection increased the leukocyte respiratory burst activity. The protocol showed a reliable and easy assay, appropriate to determine the respiratory burst activity of blood leukocytes of pacu, a neotropical fish, in the present experimental conditions.

Diastereo- and enantioselective synthesis of 1'-C-branched N,O-nucleosides.

A synthetic approach towards 1'-C-branched N,O-nucleosides is reported, based on 1,3-dipolar cycloaddition of ethoxycarbonylnitrone. The asymmetric version of the process exploits the presence of a chiral auxiliary at the carbon atom of nitrone and leads to beta-D and beta-L nucleosides in good yields.

Reduction and fixation of sacroiliac joint dislocation by the combined use of S1 pedicle screws and the galveston technique.

STUDY DESIGN: This retrospective study was designed to analyze the results of the treatment with S1 pedicle screws and the Galveston technique of seven patients with sacroiliac dislocation. OBJECTIVES: To evaluate the effectiveness of the combined use of S1 pedicle screws and the Galveston technique for the treatment of sacroiliac dislocation. SUMMARY OF BACKGROUND DATA: Although several procedures for internal fixation of sacroiliac dislocation have been reported, there have been no reports discussing surgical treatment of sacroiliac dislocation by the combined use of S1 pedicle screws and the Galveston technique. METHODS: Seven patients with sacroiliac dislocation were treated with pedicle screws of S1 and iliac rod according to the Galveston technique. In the seven patients, the dislocation was associated with vertical displacement of the sacroiliac joint and rotational deformity of the pelvic ring. They were classified into Type-C pelvic disruption according to the Tile's classification. Three patients with disruption of the symphysis pubis underwent additional fixation of the symphysis using a dynamic compression plate. The remaining four patients were treated by the posterior procedure alone. RESULTS: The vertical displacement was completely reduced in five patients, and the rotational deformity was completely corrected in four patients. The reduction was maintained at the time of the final follow-up evaluation. There were no perioperative complications with the exception of late infection in one patient. CONCLUSIONS: The combined use of S1 pedicle screws and the Galveston technique provided immediate stability and sufficient reduction for sacroiliac dislocation in seven patients in this study. This hybrid internal fixation procedure is useful for reduction and fixation of sacroiliac dislocation associated with the vertical and rotational instability of the pelvic ring.

Cytokine synthesis of human monocytes stimulated by triple or single helical conformer of an antitumour (1-->3)-beta-D-glucan preparation, sonifilan.

It has been suggested that the immunopharmacological activity of soluble (1-->3)-beta-D-glucan depends on it's conformation in mice. In this study, we examined the relationship between the conformation of Schizophyllan (SPG), a high molecular weight (1-->3)-beta-D-glucan, and cytokine productivity in an in vitro human system. Monocyte-like human cell lines, THP-1 and U-937, and peripheral blood mononuclear cells (PBMC) were used. THP-1 and U-937 cells were differentiated by phorbol myristate acetate (PMA) before use. SPG usually has a triple helical conformation in water, but it was modified by treatment with aqueous sodium hydroxide to become a single helical conformer (SPG-OH). SPG or SPG-OH was added to the macrophage cell culture and gene expression and translation of several cytokines was analyzed by RT-PCR, ELISA, or bioassays. Differentiated THP-1 expressed high levels of cytokine genes, such as IL-8, in response to SPG-OH. High levels of IL-12 p70 were detected from THP-1 cells stimulated with SPG-OH. U-937 cells expressed high levels of IL-8 and TNF-alpha after SPG-OH treatment. Furthermore, PBMC isolated from healthy donors also strongly reacted with SPG-OH but not with SPG. High concentrations of TNF-alpha were detected in SPG-OH-stimulated PBMC cultures. These data suggest that the biological activities of SPG are strongly associated with its conformation in humans.

Cardiovascular and sympathetic effects of proadrenomedullin NH2-terminal 20 peptide in conscious rats.

Proadrenomedullin NH2-terminal 20 peptide (PAMP) and adrenomedullin (AM), which are derived from the same gene, are novel vasodilative peptides and have been shown to exhibit hypotensive action in anesthetized animals. To avoid the modification via anesthesia, we investigated the effects of intravenously administered PAMP on mean arterial pressure, heart rate (HR), and renal sympathetic nerve activity (RSNA) relative to those of AM in conscious unrestrained rats. We also examined whether the arterial baroreceptor reflex was altered with the two peptides. Intravenous injection of rat PAMP (rPAMP) (10, 20 and 50 nmol/kg) and rat AM (rAM) (0.3, 1.0 and 3.0 nmol/kg) similarly elicited dose-related hypotension accompanied by increases in HR and RSNA. However, the responses to rPAMP were less potent in magnitude and shorter in duration than those to rAM. Moreover, rAM facilitated baroreflex control, whereas rPAMP attenuated it. These findings indicate that although PAMP, as well as AM, may play an important role as a circulating hormone in the systemic circulation of conscious rats, the two peptides derived from an identical origin might have different mechanisms responsible for their cardiovascular and RSNA actions.

Abdominal vagotomy attenuates interleukin-1 beta-induced nitric oxide release in the paraventricular nucleus region in conscious rats.

Nitric oxide (NO) has recently been shown to modulate the hypothalamic-pituitary-adrenal axis response to interleukin-1 beta (IL-1 beta). We measured levels of nitrite (NO2-) and nitrate (NO3-) in the hypothalamic paraventricular nucleus (PVN) region using an in vivo brain microdialysis technique in conscious rats. Intraperitoneally administered IL-1 beta produced a significant increase in both NO2- and NO3- levels in the PVN region. We also examined the possible involvement of the abdominal vagal afferent nerves in this effect. In abdominal-vagotomized rats, the increase was significantly attenuated compared to that in sham-operated rats. Our results suggest that the abdominal vagal afferent nerves are involved in intraperitoneally administered IL-1 beta-induced NO release in the PVN region.

Central actions of adrenomedullin on cardiovascular parameters and sympathetic outflow in conscious rats.

Adrenomedullin (ADM) is reported to be a peripherally acting hypotensive peptide, but its central actions are unclear. We investigated the effects of centrally administered ADM on blood pressure (BP), heart rate (HR), and renal sympathetic nerve activity (RSNA) in conscious rats and sinoaortic-denervated (SAD) rats. We also investigated the receptors interacting with ADM using two putative antagonists. Intracerebroventricular administration of ADM in doses of 0.1 and 0.5 nmol/kg caused tachycardia and early inhibition of RSNA. Central ADM (1.0 nmol/kg) induced hypertension, tachycardia, and a decrease followed by an increase in RSNA. In SAD rats, increases in BP, HR, and RSNA at the late phase were enhanced by central ADM (1.0 nmol/kg), whereas the early decrease in RSNA remained. Thus the inhibition of RSNA via central ADM may be unrelated to the arterial baroreceptor reflex. Pretreatment with antagonists human calcitonin gene-related peptide-(8-37) and human ADM-(22-52) significantly suppressed the central actions of ADM. The findings suggest that ADM is involved as a neuropeptide in the receptor-mediated central regulation of the cardiovascular system and RSNA.

Occipitoatlantal instability associated with articular tropism.

The authors report the case of a patient with rotatory posterior subluxation of the occiput on the atlas associated with tropism of the O-C1 articulations. Lateral flexion-extension plain films demonstrated 5 mm of posterior translation of the occiput on the atlas. Tomographs revealed tropism of the O-C1 articulations, and CT scans on extension demonstrated posterior rotatory subluxation of the occiput on the atlas. The patient had no osseous abnormality caudally below the atlantoaxial joint, and underwent posterior occipitoatlantal fusion by wiring. At the 4-year follow-up, the grafted bone had been incorporated, and the patient was completely free from preoperative symptoms. In the present patient, occipitoatlantal instability is presumed to have derived from articular tropism.

Difference in water intake but not in renal sympathetic nerve activity in response to central salt-loading or angiotensin II in awake Dahl salt-sensitive and -resistant rats.

Experiments were conducted to examine whether renal sympathetic nerve activity (RSNA) and water intake in response to central salt-loading or angiotensin II (A II) differ between freely-moving Dahl salt-sensitive (DS) and -resistant (DR) rats maintained on a low-salt diet. Intracerebroventricular (i.c.v.) administration of hypertonic saline (0.3 M, 1 microl/min, 20 min) or A II (100 ng/1 microl) evoked water intake, pressor response and suppression of RSNA in both strains. The cumulative water intake in DS rats over a 60-min period after i.c.v. infusion of hypertonic saline or A II was significantly attenuated compared with that in DR rats. The RSNA response did not show a significant difference between the strains. These results demonstrate that water intake, but not RSNA response to acute central salt-loading or A II differ between awake DR and DS rats.

Effects of systemic interleukin-1beta administration on daily drinking and renal excretory function in conscious rats.

To elucidate the roles of interleukin-1beta (IL-1beta), a cytokine with several diverse actions, in the control of body fluid balance, its effects on daily drinking behavior and renal excretory function were examined in conscious rats. Administration of IL-1beta (4 microg/kg, I.P.) resulted in the suppression of both daily drinking and food intake and a decrease in daily urinary sodium and potassium excretion, but had no effect on urine volume. The IL-1beta-induced decrease in sodium excretion was abolished in renal-denervated rats. Kainic acid was then injected into the anteroventral third ventricle region, including the organum vasculosum of the lamina terminalis, to examine whether neurons in this region are involved in the IL-1beta-induced responses; the effects on daily drinking and urinary sodium and potassium excretion were abolished, whereas the effects on food intake, although attenuated, were still present. In contrast, electrical lesion of the subfomical organ did not affect the IL-1beta-induced responses. Thus, IL-1beta seems exert its effects on body fluid balance at several distinct sites in the central nervous system.

Inhibition of nitric oxide synthase attenuates osmotic thirst in the rat.

Changes in water intake after intraperitoneal injection of a nitric oxide synthase (NOS) inhibitor was studied in the rat. Administration of NW-nitro-L arginine methyl ester (L-NAME) at a dose of 50 mg/kg attenuated osmotic thirst induced by intraperitoneal injection of hypertonic saline, but did not affect spontaneous intake of water and thirst induced by subcutaneous injection of angiotension II. Pretreatment with L-arginine significantly attenuated the inhibition of osmotic thirst evoked with subsequent L-NAME. Administration of NW-nitro-D-arginine methyl ester (D-NAME) altered neither the spontaneous nor the osmotic drinking behavior. These findings suggest that NO may affect the osmotically induced drinking.

[Antinociceptive effects of counterirritants].

Counterirritants such as l-menthol, methyl salicylate, camphor, thymol and capsaicin are widely used in the treatment of mild pains and itches by topical application. However, little experimental research on counterirritants has been reported. In the present study, we investigated the antinociceptive effects and mechanisms of topically applied counterirritants, especially those of l-menthol. From the formalin test in mice, l-menthol (at a concentration of 1-30% in ethanol) showed a major effect in the early phase of pain response (0-5 min). In contrast, the antinociceptive effects of indomethacin (10 mg/kg, p.o.) were found only in the late phase of pain response (15-25 min). Furthermore, morphine (0.75-6 mg/kg, s.c.) dose-dependently inhibited both phases. l-Menthol-induced analgesia during the early phase was significantly blocked by naloxone and potentiated by bestatin. The antinociceptive effects of l-menthol were furthermore examined in dexamethasone-treated mice. l-Menthol also produced antinociceptive effects in the hot plate test of mice and hind paw pressure test of rats. l-Menthol showed mild surface and infiltrating anesthetic effects in guinea pigs. l-Menthol did not inhibit both carrageenin-induced paw edema of rats and the synthesis of prostaglandin E2 in vitro. Based on these findings, we proposed that l-menthol produces antinociceptive effects by activation of the endogenous opioid system and/or partially by local anesthetic actions without anti-inflammatory effects.

Inhibitory effect of prostaglandin E1 on laurate-induced peripheral vascular occlusive sequelae in rabbits: optimized topical formulation with beta-cyclodextrin derivative and penetration enhancer HPE-101.

Prostaglandin E1 (PGE1) and its inclusion complexes with beta-cyclodextrin (beta-CyD) and O-carboxymethyl-O-ethyl-beta-cyclodextrin (CME-beta-CyD) were made as topical preparations. The PGE1 preparations, when applied with a penetration enhancer, 1-[2-(decylthio)ethyl]azacyclopentane-2-one (HPE-101), markedly increased the regional blood flow in the ear of rabbits and were longer acting than when administered by the intravenous route. Topical application of the PGE1 preparations significantly protected rabbits against laurate-induced peripheral vascular occlusive sequelae; the protective potency increased in the order of PGE1 alone = beta-CyD complex < CME-beta-CyD complex preparation. The PGE1 preparations elicited skin reactions such as erythema and oedema depending on their vasodilating actions. These reactions disappeared gradually after removal of the preparations, and hence may not be serious obstacles for their safe use. These results suggest that combinations of CME-beta-CyD and HPE-101 work synergistically to facilitate the entry of PGE1 into the skin, and consequently enhance the therapeutic potential of PGE1 in the topical preparation tested.

Improved transdermal delivery of prostaglandin E1 through hairless mouse skin: combined use of carboxymethyl-ethyl-beta-cyclodextrin and penetration enhancers.

The optimal prescription of transdermal preparations of prostaglandin E1 (PGE1) for treatment of peripheral vascular diseases has been investigated. The chemical stability of PGE1 in fatty alcohol/propylene glycol (FAPG) ointment was markedly improved by carboxymethyl-ethyl-beta-cyclodextrin (CME-beta-CyD). Application of a PGE1 ointment containing the penetration enhancer, 1-dodecylazacycloheptane-2-one (Azone) or 1-[2-(decylthio)ethyl]azacyclopentane-2-one (HPE-101), onto the skin of hairless mice showed the increase of blood flow in the skin due to the vasodilating action of PGE1. In particular, the ointment containing a PGE1-CME-beta-CyD complex supplemented with HPE-101 showed the most prominent increase of the blood flow. Compared with other ointments, this ointment was found to show significantly greater transfer of HPE-101 into in-vitro preparations of the skin of hairless mice. Transfer of PGE1 into the skin was thought to be facilitated by this increased transfer of HPE-101. These results suggest that a combination of CME-beta-CyD and HPE-101 is useful for designing PGE1 ointments for topical application with good chemical stability and percutaneous permeability.

Effects of l-menthol and dl-camphor on the penetration and hydrolysis of methyl salicylate in hairless mouse skin.

Plasters containing methyl salicylate with and without l-menthol and dl-camphor were prepared and topically applied on hairless mouse skin to investigate the effects of l-menthol and dl-camphor on the skin penetration and hydrolysis of methyl salicylate in the skin. The in vitro hydrolysis of methyl salicylate was also investigated using the skin homogenate. It was found that l-menthol with dl-camphor enhanced the skin penetration of methyl salicylate, and they inhibited both the in vivo and in vitro hydrolysis of methyl salicylate to salicylic acid.

Clinical study on stability of combined distraction and compression rod instrumentation with posterolateral fusion for unstable degenerative spondylolisthesis.

The authors examined the stability of combined distraction and compression rod instrumentation with posterolateral fusion in 40 consecutive patients with unstable degenerative spondylolisthesis. All operations were performed by floating fusion of L3-4 or L4-5 after decompression procedures. Mobility at the fused level was checked every 4 weeks after operation by the disc space angle on the functional radiographic films without brace. The average period of postoperative follow-up was 26 months. In 30 patients, no mobility was found at any time. In six patients, any mobility disappeared within 24 weeks, and in three patients, within 1 year. Pseudoarthrosis was found in one patient. The solid fusion rate was 97.5%. The values of percent slippage and slip angle were slightly improved. Lumbar lordosis was in the normal range at follow-up.

Efficacy of emetic and United State pharmacopoeia ipecac syrup in prevention of drug absorption.

The efficacy of both the emetic syrup prepared in the previous report and the United States Pharmacopoeia (USP) ipecac syrup concerning the prevention of drug absorption was investigated in 4 beagle dogs using a randomized and cross-over design. In order to control the intragastric pH of the beagle dogs, the administration of pentagastrin or hydrochloric acid (HCl)-glycine buffer (pH 1.5) was tested. The intragastric pH changed from 7.2 to 1.8 with the intramuscular administration of pentagastrin, but the primary emesis occurred more slowly. On the other hand, the HCl-glycine buffer (pH 1.5) gave the appropriate emesis. Therefore, the HCl-glycine buffer (pH 1.5) was used to control the intragastric pH of the beagle dogs. Acetaminophen (AcA), salicylic acid (SA) and kanamycin (KM) as markers were administered orally after conditioning the intragastric pH at 1.5. The emetic syrup or the USP ipecac syrup was then administered. The recovery rate of AcA and KM from vomit was 42-65%. The emetic syrup and the USP ipecac syrup significantly reduced the absorption of AcA from the calculation of pharmacokinetic parameters compared to the control syrup. It was observed that the absorption of cephaeline (CP) in the emetic syrup was less than that of CP in the USP ipecac syrup.

[Renal failure associated with polyarteritis nodosa].

We reported 5 patients with renal failure associated with polyarteritis nodosa (PN). In all patients the renal dysfunction became apparent from 2 to 4 weeks after the onset of fever or neuromuscular symptoms with laboratory findings supporting marked inflammatory process and took the course of either acute or rapidly progressive renal failure. The clinical diagnoses on admission were variable; fever of unknown origin, peptic ulcer disease, polyneuritis multiplex, disseminated intravascular coagulation and Buerger's disease. Microscopic examination of the kidneys in 3 by renal biopsy and in 2 by autopsy revealed crescentic glomerulonephritis without immunoglobulin deposit, segmental necrotizing glomerulonephritis, marked inflammatory infiltrate around the glomeruli, granulomatous lesion, tubular necrosis and cortical necrosis other than necrotizing vasculitis. The outcomes were favorable with prednisolone monotherapy in two patients who had biopsy-proven diagnosis and treatment early in the course. Of all PN the prevalence of renal involvement is considered to be about 70%, the prognosis of which has been considered very poor. However it seems possible to alter fatal outcome of this disease by starting treatment with confident histological proof early in the disease process.