A long-term ecstasy-related change in visual perception.

RATIONALE: The present study provides the first evidence of the long-term consequences of ecstasy use on visual processes thought to reflect serotonergic functions in the occipital lobe. Methylenedioxymethamphetamine ("ecstasy") is known to cause lasting changes to the serotonin system in animals, and convergent evidence suggests that similar changes occur in human ecstasy users. Other research suggests that serotonin may be involved in lateral inhibition between orientation sensitive neurons in the occipital lobe, and that disruption to the serotonin system causes an increase in the magnitude of the tilt aftereffect illusion that is known depend on those neurons. OBJECTIVES: The aim of the present study was to determine if ecstasy users have detectable changes in occipital lobe behavioural functioning, as revealed by the tilt aftereffect illusion. MATERIALS AND METHODS: Thirty ecstasy users and 34 non-drug using controls were compared on the magnitude of the tilt aftereffect illusion following adaptation to stimuli oriented at 15 and 40 degrees from vertical. RESULTS: Ecstasy users who had not used amphetamines for 115 days or more had a larger average tilt aftereffect than non-drug using controls after adaptation to 40 degrees stimuli but not after adaptation to 15 degrees stimuli. Additionally, there was no difference between non-drug using controls and ecstasy users who had used amphetamines within the last 61 days at either adaptation angle. CONCLUSIONS: The results were consistent with the proposal that ecstasy-related damage to the serotonin system causes behavioural changes on tests of visual perception processes that are thought to reflect serotonergic functions in the occipital lobe.

Trends in morphine prescriptions, illicit morphine use and associated harms among regular injecting drug users in Australia.

This paper examines population trends in morphine prescriptions in Australia, and contrasts them with findings from annual surveys with regular injecting drug users (IDU). Data on morphine prescriptions from 1995 to 2003 were obtained from the Drug Monitoring System (DRUMS) run by the Australian Government Department of Health and Ageing. Data collected from regular IDU as part of the Australian Illicit Drug Reporting System (IDRS) were analysed (2001 - 2004). The rate of morphine prescription per person aged 15 - 54 years increased by 89% across Australia between 1995 and 2003 (from 46.3 to 85.9 mg per person). Almost half (46%) of IDU surveyed in 2004 reported illicit morphine use, with the highest rates in jurisdictions where heroin was less available. Recent morphine injectors were significantly more likely to be male, unemployed, out of treatment and homeless in comparison to IDU who had not injected morphine. They were also more likely to have injected other pharmaceutical drugs and to report injection related problems. Among those who had injected morphine recently, the most commonly reported injecting harms were morphine dependence (38%), difficulty finding veins into which to inject (36%) and scarring or bruising (27%). Morphine use and injection is a common practice among regular IDU in Australia. In some cases, morphine may be a substitute for illicit heroin; in others, it may be being used to treat heroin dependence where other pharmacotherapies, such as methadone and buprenorphine, are perceived as being unavailable or undesirable by IDU. Morphine injection appears to be associated with polydrug use, and with it, a range of problems related to drug injection. Further research is required to monitor and reduce morphine diversion and related harms by such polydrug injectors.

Evaluation of an ultrasonic technique to remove fractured rotary nickel-titanium endodontic instruments from root canals: an experimental study.

The use of nickel-titanium rotary instruments in endodontic practice is increasing. One frequently mentioned problem is fracture of an instrument within the root canal. To date, there is no consistently safe and successful technique for removing these fractured instruments. This study evaluates the use of an ultrasonic technique to remove fractured rotary nickel-titanium instruments from narrow, curved canals in both simulated (resin blocks) and mesiolingual canals of extracted mandibular first molars. A technique using ultrasonic tips, combined with the creation of a "staging platform" and the use of the dental operating microscope, was consistently successful and safe at removing fractured rotary nickel-titanium instruments from curved root canals, when some part of the fractured instrument segment was located in the straight portion of the canal. When the fractured instrument segment was located entirely around the curve, the success rate was significantly decreased and major canal damage often occurred.

Evaluation of an ultrasonic technique to remove fractured rotary nickel-titanium endodontic instruments from root canals: clinical cases.

The removal of fractured rotary nickel-titanium instruments from small, curved root canals is one of the most complex operative procedures in endodontics. There have been many different devices and techniques developed to remove fractured instruments, but none are consistently successful and all show a high incidence of canal damage such as perforation. A technique using a staging platform and the use of modern ultrasonic tips with direct visualization through a dental operating microscope has recently been evaluated. The use of this technique in clinical practice is described in 24 cases and illustrated by 3 cases.

Vital pulp therapy in cariously exposed permanent teeth and its limitations.

Vital pulp therapy for cariously exposed permanent teeth remains one of the most controversial areas in dentistry. Because a vital, functioning pulp is capable of initiating several defence mechanisms to protect the body from bacterial invasion, it is beneficial to preserve the vitality and health of an exposed pulp rather than replace it with a root filling material following pulp exposure. There is no consensus on the survival rate of formerly cariously exposed pulps. Observation time, judgement criteria, pulpotomy/pulp capping technique and, most importantly, pulpal status at the time of treatment, vary to a great extent amongst studies. In mature teeth, a pulp exposed by caries is usually removed and the root canals are cleaned, shaped and filled. Amongst the methods for preservation of a cariously exposed pulp, partial pulpotomy has yielded a markedly high success rate in young teeth. Major limitations in the success of vital pulp therapy in cariously exposed permanent teeth exist. The lack of predictability and long-term success greatly influence decision-making. The decision-making itself is unreliable primarily due to the difficulty of accurately diagnosing the ability of the pulp to repair. While there are indications for vital pulp therapy in young permanent molars, it must be remembered that ultimately, none of these procedures enjoy the long-term success of complete root canal therapy.

Intentional replantation of a lower premolar.

Intentional replantation is the purposeful extraction of a tooth to perform extraoral endodontic treatment, curettage of apical soft tissue when present and the replacement of the tooth in its socket. This paper demonstrates the use of intentional replantation as a technique to successfully treat a case where conventional endodontic retreatment and apical surgery were considered unfeasible.

The use of an ultrasonic technique to remove a fractured rotary nickel-titanium instrument from the apical third of a curved root canal.

The frequency of use of nickel-titanium rotary instruments in endodontic practice is increasing. One occasionally mentioned problem is fracture of an instrument within the root canal. The broken instrument may prevent access to the root apex, impeding optimal cleaning and shaping procedures. A case report is presented which uses a modern technique, utilising a staging platform and the use of newly designed ultrasonic tips with direct visualisation through a dental operating microscope, to remove a fractured rotary nickel-titanium instrument from the apical third of a curved root canal.

Deficits of long-term memory in ecstasy users are related to cognitive complexity of the task.

RATIONALE: Despite animal evidence that methylenedioxymethamphetamine (ecstasy) causes lasting damage in brain regions related to long-term memory, results regarding human memory performance have been variable. This variability may reflect the cognitive complexity of the memory tasks. However, previous studies have tested only a limited range of cognitive complexity. Furthermore, comparisons across different studies are made difficult by regional variations in ecstasy composition and patterns of use. OBJECTIVES: The objective of this study is to evaluate ecstasy-related deficits in human verbal memory over a wide range of cognitive complexity using subjects drawn from a single geographical population. MATERIALS AND METHODS: Ecstasy users were compared to non-drug using controls on verbal tasks with low cognitive complexity (stem completion), moderate cognitive complexity (stem-cued recall and word list learning) and high cognitive complexity (California Verbal Learning Test, Verbal Paired Associates and a novel Verbal Triplet Associates test). Where significant differences were found, both groups were also compared to cannabis users. RESULTS: More cognitively complex memory tasks were associated with clearer ecstasy-related deficits than low complexity tasks. In the most cognitively demanding task, ecstasy-related deficits remained even after multiple learning opportunities, whereas the performance of cannabis users approached that of non-drug using controls. Ecstasy users also had weaker deliberate strategy use than both non-drug and cannabis controls. CONCLUSIONS: Results were consistent with the proposal that ecstasy-related memory deficits are more reliable on tasks with greater cognitive complexity. This could arise either because such tasks require a greater contribution from the frontal lobe or because they require greater interaction between multiple brain regions.

Hepatic gene expression in rainbow trout (Oncorhynchus mykiss) exposed to different hydrocarbon mixtures.

Traditional biomarkers for hydrocarbon exposure are not induced by all petroleum substances. The objective of this study was to determine if exposure to a crude oil and different refined oils would generate a common hydrocarbon-specific response in gene expression profiles that could be used as generic biomarkers of hydrocarbon exposure. Juvenile rainbow trout (Oncorhynchus mykiss) were exposed to the water accommodated fraction (WAF) of either kerosene, gas oil, heavy fuel oil, or crude oil for 96 h. Tissue was collected for RNA extraction and microarray analysis. Exposure to each WAF resulted in a different list of differentially regulated genes, with few genes in common across treatments. Exposure to crude oil WAF changed the expression of genes including cytochrome P4501A (CYP1A) and glutathione-S-transferase (GST) with known roles in detoxification pathways. These gene expression profiles were compared to others from previous experiments that used a diverse suite of toxicants. Clustering algorithms successfully identified gene expression profiles resulting from hydrocarbon exposure. These preliminary analyses highlight the difficulties of using single genes as diagnostic of petroleum hydrocarbon exposures. Further work is needed to determine if multivariate transcriptomic-based biomarkers may be a more effective tool than single gene studies for exposure monitoring of different oils.

Temporal patterns in the transcriptomic response of rainbow trout, Oncorhynchus mykiss, to crude oil.

Time is often not characterized as a variable in ecotoxicogenomic studies. In this study, temporal changes in gene expression were determined during exposure to crude oil and a subsequent recovery period. Juvenile rainbow trout, Oncorhynchus mykiss, were exposed for 96 h to the water accommodated fractions of 0.4, 2 or 10 mgl(-1) crude oil loadings. Following 96 h of exposure, fish were transferred to recovery tanks. Gill and liver samples were collected after 24 and 96 h of exposure, and after 96 h of recovery for RNA extraction and microarray analysis. Fluorescently labeled cDNA was hybridized against matched controls, using salmonid cDNA arrays. Each exposure scenario generated unique patterns of altered gene expression. More genes responded to crude oil in the gill than in the liver. In the gill, 1137 genes had altered expression at 24 h, 2003 genes had altered expression levels at 96 h of exposure, yet by 96 h of recovery, no genes were significantly altered in expression. In the liver at 10 mgl(-1), only five genes were changed at 24 h, yet 192 genes had altered expression after 96 h recovery. At 2 mgl(-1) in the liver, many genes had altered regulation at all three time points. The 0.4 mgl(-1) loading also showed 289 genes upregulated at 24 h after exposure. The Gene Ontology terms associated with altered expression in the liver suggested that the processes of protein synthesis, xenobiotic metabolism, and oxidoreductase activity were altered. The concentration-responsive expression profile of cytochrome P450 1A, a biomarker for oil exposure, did not predict the majority of gene expression profiles in any tissue or dose, since direct relationships with dose were not observed for most genes. While the genes and their associated functions agree with known modes of toxic action for crude oil, the gene lists obtained do not match our previously published work, presumably due to array analysis procedures. These results demonstrate that changes in gene expression with time and dose may be complicated, and should be characterized in controlled laboratory settings before attempts are made to interpret responses in field-collected organisms. Further, processes for analyzing microarray data need to be developed such that standardized gene lists are developed, or that analysis does not rely on lists of significantly altered genes before arrays can be further evaluated as a monitoring tool.

Patterns of memory dysfunction in current and 2-year abstinent MDMA users.

The popular recreational drug MDMA or "ecstasy" is a selective serotonin neurotoxin in many species and has been found to be associated with memory dysfunction in human beings. Recent studies suggest that this impairment persists after cessation of use for periods up to at least one year. However, there is no clear indication as yet concerning which stage of memory processing is impaired as a result of MDMA use. In the current study, 31 current MDMA users and 30 MDMA users who had been abstinent for more than two years were compared with 30 controls on the WMS-III. The results suggest that MDMA use is associated with memory dysfunction and that this dysfunction persists for up to two years after cessation of use. Importantly, the findings suggest that this memory dysfunction may be due to interference at the encoding stage of memory processing.