THE EFFECT OF COMBINED ACTION OF ANTIBACTERIAL DRUGS WITH LOW-INTENSIVE LASER RADIATION ON CLINICAL STRAINS S. AUREUS AND S. SALIVARIUS IN THE ORAL CAVITY.

The oral mucosa is constantly contaminated by a large number of microorganisms that may cause diseases such as periodontitis and caries. The present paper aims to study the effectiveness of the antimicrobial effect of combined use of antibacterial drugs (AD) and low-intensity laser radiation (LLR) on S. aureus S. salivarius isolated from the oral cavity. The study included 20 individuals with dental caries, 20 individuals with periodontitis and 10 without any signs of dental disease. The material for the microbacterial study was collected from surfaces of the teeth, oral cavity with dental caries and periodontal pockets. The intensity of bacterial isolation was estimated by two factors: the frequency of isolation and percentage of other aerobic microorganisms. The obtained data demonstrated that the use of several antibacterial drugs had a different impact on the strains of S. salivarius and S. aureus, depending on the source of their collection. The collected isolates were used to determine the effect of a 5 minute laser radiation combined with antibacterial drugs. The simultaneous use of antibacterial therapy and laser radiation showed an increase in the therapeutic effect of all investigated antibiotics followed by the inhibition of the growth presentations in S. aureus and S. salivarius. The application of photodynamic therapy, e.g. LLR, combined with antibacterial drugs allowed to achieve a complete inhibition of the microbial growth.

Inner ear dysfunction in myotonic dystrophy type 1.

OBJECTIVES: Myotonic dystrophy type 1 is associated with various oculomotor, vestibular, and auditory abnormalities. However, auditory system investigation has been mainly performed with the subjective method of pure-tone audiometry. In this study, a detailed vestibular and audiological evaluation was undertaken, including the objective and more sensitive method of transiently evoked otoacoustic emissions (TEOAEs). MATERIALS AND METHODS: Twenty-four patients with genetically diagnosed myotonic dystrophy type 1 and 21 controls were studied. Audiological and vestibular investigations included pure-tone audiometry, tympanometry, auditory brainstem responses (ABRs), TEOAEs, and electronystagmography. RESULTS: Hearing impairment was evident in 15 (62.5%) patients and in nine of them (37.5%) ABR abnormalities were found. However, subclinical cochlear damage was found in all patients, as evidenced by absent emissions or lower otoacoustic emission amplitude. Vestibular hypesthesia was found in nine patients (37.5%), accompanied by spontaneous nystagmus in four of them (15.6%). CONCLUSIONS: Auditory and vestibular abnormalities are quite common in patients with myotonic dystrophy type 1. However, it appears that subclinical cochlear damage is an ubiquitous finding of the disease.

Huntington's disease in Greece: the experience of 14 years.

A large scale genetic and epidemiological study of Huntington's disease (HD) was carried out in Greece from January 1995 to December 2008. Diagnostic testing was carried out in 461 symptomatic individuals, while 256 were tested for presymptomatic purposes. The diagnosis of HD with a CAG expansion ≥ 36 was confirmed in 278 symptomatic individuals. The prevalence of HD in Greece was estimated at approximately 2.5 to 5.4:100,000, while the mean minimum incidence was estimated at 2.2 to 4.4 per million per year. The molecular diagnosis of HD was confirmed in the majority of patients (84.4%) sent for confirmation. The false-positive cases 15.6% were characterized by the absence of a family history of HD and the presence of an atypical clinical picture. The uptake of predictive testing for HD was 8.6%. A prenatal test was requested in six pregnancies. The findings of our study do not differ significantly from those of similar studies from other European countries despite the relative genetic isolation of Greece. Of interest is the identification of clusters of HD in Greece. The presence or absence of a family history of HD should be interpreted cautiously, during the diagnostic process.

Absence of aprataxin gene mutations in a Greek cohort with sporadic early onset ataxia and normal GAA triplets in frataxin gene.

Phenotype of patients with the aprataxin gene mutation varies and according to previous studies, screening of aprataxin gene could be useful, once frataxin gene mutation is excluded in patients with normal GAA expansion in frataxin gene. In the present study, we sought to determine possible causative mutations in aprataxin gene (all exons and flanking intronic sequences) in 14 Greek patients with sporadic cerebellar ataxia all but one without GAA expansion in frataxin gene (1 patient was heterozygous). No detectable point mutation or deletion was found in the aprataxin gene of all the patients. Our results do not confirm the previous studies. This difference may be attributed to the different populations studied and possible different genetic background. It is still questionable whether the screening for aprataxin mutation in Greek patients' Friedreich ataxia phenotype is of clinical importance; larger, multicenter studies are necessary to clarify this issue.

Central motor and sensory pathway involvement in an X-linked Charcot-Marie-Tooth family.

UNLABELLED: The aim of the present study was to investigate the subclinical involvement of the central nervous system (CNS) in an X-linked Charcot-Marie-Toth (CMTX) family. MATERIAL AND METHODS: Seven subjects, all members of one family with a C.462T > G connexin 32 (Cx32) mutation were investigated by Blink reflex, Somatosensory evoked potentials (SEP) and Transcranial magnetic stimulation (TMS). There were five clinically symptomatic for CMT neuropathy (four male and one female) and two asymptomatic (female) subjects. RESULTS: Subclinical CNS involvement was observed in all, symptomatic and asymptomatic subjects. CONCLUSION: This is the largest CMTX neuropathy family investigated for CNS involvement. Electrophysiological involvement of the CNS in every examined member of this family was observed, raising the question of a more systematic involvement of the CNS in CMTX disease.

Single-dose and multi-dose clindamycin therapy fails to demonstrate efficacy in preventing infectious and inflammatory complications in third molar surgery.

The goal of this study was to evaluate the efficacy of single- and multi-dose (5-day) clindamycin therapy for the prevention of inflammatory complications in patients undergoing lower third molar surgical extraction with bone removal. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into three groups: (1) single dose of oral clindamycin administered preoperatively (single-dose group); (2) clindamycin administered preoperatively with continued therapy for 5 days (5-day group); and (3) a placebo group. The following parameters were evaluated on the first, second and seventh days postsurgery: trismus, facial swelling, body temperature, lymphadenopathy, alveolar osteitis and subjective pain sensations. There were 86 patients (31 in the single-dose group, 28 in the 5-day group and 27 in the placebo group) enrolled in the study. There were no statistically significant differences in postoperative inflammatory complications in patients during the first and second days postsurgery. A statistically significant variation in body temperature was reported on the seventh day. Analysis of the postoperative analgesic intake did not show statistically significant differences between examined groups. Clindamycin applied in a single preoperative dose of 600 mg with or without subsequent 5-day therapy does not demonstrate efficacy in prophylaxis for postoperative inflammatory complications after third molar surgery.

Episodes of generalized weakness in two sibs with the C164T mutation of the connexin 32 gene.

Two sibs with Charcot-Marie-Tooth disease had repeated episodes of generalized weakness. The patients had distal weakness and atrophy as well as findings of CNS involvement on brain MRI. Both patients bear the C164T mutation of the connexin 32 gene but no mutations of the genes responsible for hyper- or hypokalemic periodic paralysis. It is possible that both patients have one disease with complex phenotype due to abnormal expression of the connexin 32 gene.

Apolipoprotein E and presenilin-1 genotypes in Huntington's disease.

Huntington's disease (HD) is an autosomal dominant degenerative disease of the central nervous system manifested by involuntary movements (chorea), psychiatric manifestations, and cognitive impairment with a variable age at onset. This variability is mainly attributed to genetic factors. The so-called aging genes [e.g., those for apolipoprotein E (APOE) and presenilin-1 (PS-1) have been implicated in determining the age at onset of Alzheimer's disease, a disease sharing common clinical features with HD. In 60 unrelated patients suffering from HD (mean age at onset 40.1 years, range 20-65) we determined number of CAG repeats and the distribution of the APOE alleles (epsilon2, epsilon3, epsilon4) and PS-1 alleles. The results showed that: (a) The age at onset was higher in the group of patients with the epsilon4 allele (51.6 vs. 38.0 P<0.002), (b) The correlation between the age at onset and the number of CAG repeats was strong in patients with the epsilon3/epsilon3 genotype while it was not detected in patients with epsilon3/epsilon4 genotype. (c) No correlation was found between age at onset and PS-1 alleles. In conclusion, APOE seems to be a significant factor influencing the age at onset of Huntington's disease.

Genotyping of presenilin-1 polymorphism in amyotrophic lateral sclerosis.

The mechanisms underlying motor neuron degeneration in amyotrophic lateral sclerosis are not fully understood. Recent studies suggest that apoptosis is involved in the abnormal neural death that occurs in this devastating disease. Presenilin-1, a transmembrane protein, seems to be implicated in apoptosis. To determine whether presenilin-1 intron 8 polymorphism has an influence in the course of amyotrophic lateral sclerosis, we examined this polymorphism genotypes in a large group of patients (n = 72) with amyotrophic lateral sclerosis and in a random sample of 213 healthy individuals. The results showed a significant difference in genotype (P < 0.04) and allele (P < 0.03) distribution between patients controls. These results suggest a possible intervention of presenilin-1 in the pathogenesis of amyotrophic lateral sclerosis.

Primary malignant melanoma of the oral cavity. A review of 20 cases.

Twenty patients with primary malignant melanoma of the oral cavity have been described. They formed 3.9 percent of the total number of patients with malignant neoplasms of the oral cavity. The upper gingiva was most commonly affected. In this series, there were 14 male patients and 6 female patients who ranged in age from 26 to 80 years (average 58 years). The first symptom of melanoma was hyperpigmentation of the mucosa in 10 patients, tumor in 7, and pain in 3 edentulous patients with prostheses. Radical surgery was performed in 13 patients, followed by chemotherapy and radiotherapy in 9 cases. Only 1 patient survived 9 years. The remaining 12 died 11 to 18 months after radical treatment. Palliative therapy was applied in three patients, two patients were treated symptomatically, and two patients refused treatment. Early detection of melanoma is an indication for radical treatment and may increase the survival rate of patients with this disease, which is still very low.

Squamous cell carcinoma arising in an odontogenic cyst. Report of three cases.

Primary intraosseous carcinoma of the jaws is an uncommon lesion. The majority of these develop in preexisting odontogenic cysts. Three cases of primary intraosseous squamous cell carcinomas of the mandible and maxilla, with evidence of origin in the odontogenic cysts are described. The recent literature on carcinomas arising in jaws cysts is reviewed.

[Role and duties performed by a toxicologic laboratory in diagnosis of acute poisoning]. / Rola i zadania laboratorium toksykologicznego w diagnostyce ostrych zatruc.

In late 1960's in Poland the problem of acute poisonings was separated from the others and found very important by itself. In consequence many toxicological centres were founded where toxicological laboratories were opened to make toxicological analyses. To make laboratory work more effective the analyst ought to enter into dialogue with the clinicist. Nowadays more often the analyst is expected to be an active not passive member of the team engaged in the process of treatment. Development of modern analytical methods enables improvement of clinical toxicological analytics. Toxicological analyst is obliged to fulfil many tasks which are imposed upon him by the clinicist; that is, to determine properly and as quickly as possible toxic substances especially in case of "complex poisoning", and to make qualitative and quantitative analyses which help to institute appropriate treatment. The analyst ought to choose proper analytical method very carefully and take also into account its purpose and usefulness. Economic approach to the method plays an important role too. Unfortunately, it is still underestimated in Poland. For toxicological analyst further development of analytical methods which can make his work easier, is of great importance. The same value for the analyst has close co-operation with the clinicist.

[Pharmacokinetic and toxicokinetic parameters of some drugs of abuse]. / Parametry farmakokinetyczne i toksykokinetyczne niektórych srodków uzalezniajacych.

This article outlines the main pharmacokinetic and toxicokinetic parameters of selected addicting compounds often being abused. Described parameters affect the way the compounds behave in the body. The article shows the usual dosage and "therapeutic", toxic and fatal concentrations. Knowledge of described parameters is important in the process of detoxication in patients poisoned with this group of psychoactive compounds.

[Use of different drug form identification systems]. / Zastosowanie systemów identyfikacji róznych postaci leków.

Since the foundation of the Department of Clinical Toxicology one of the unsolved problems is the identification of drugs which are often brought by the emergency service together with the patient. This problem is known to the personnel of Poison Centers and all first-contact physicians who deal with the patient at home or at the place of accident. Many years of observations and experiences allowed for creating Polish system of drugs identification based mainly on the catalogue containing data to be used in identification of an unknown form of a drug. The next step was to create a computer database system allowing for fast and accurate identification of drug forms. Created catalogue contains drug forms categorized by color and shape. The solution is constructed in a way that adding new and extending existing data is possible. The catalogue can be used in drug stores, by emergency services, family doctors and specifically in pediatrics since children are often exposed to the danger of unknown drug intake. The useful option is the color printout which can be obtained from the system. Search procedures enable setting range of criteria and, after initial list is produced, detailed search is possible with the color images on screen. The system was created using MS Access database. Department of Toxicology is the owner of the copyrights.

Development of toxicological information in the Department of Toxicology Collegium Medicum, Jagiellonian University.

The Poisons Information Centre at the Department of Toxicology gives toxicological information every day for full 24 hours. The information is based on the file of chemical compounds and substances. Each telephone enquiry is recorded and then analysed by the staff of Poisons Information Centre. The toxicological information covers children, adults and mass-poisonings cases, Most of the enquires concern consultation, then information and last consultation and information. During the regular telephone service most enquires are made about drug poisonings, ethanol, pesticides and mushrooms. Most of the enquiries are made by physicians. Private persons come next. Further activity of Poisons Information Centre depends on the access to the world literature and popularisation of toxicological knowledge among the people. This will contribute to higher rate toxicological enquires from private persons.

[Profile of chemical analyses of psychoactive substances in the Laboratory of the Department of Clinical Toxicology in the years 1990-1999]. / Profil analiz substancji psychoaktywnych wykonanych w latach 1990-1999 w Laboratorium Toksykologicznym Kliniki Toksykologii.

The chemical-toxicological Laboratory of the Department of Clinical Toxicology carry on the analyses of xenobiotics in biological fluid collected from poisoned patient leaving in Krakow and south-eastern Poland. The evaluation of frequency of performed analyses in the years 1990-1999 shown that among psychoactive substances, ethanol is the most common reason of acute poisoning, followed by psychotropic drugs and drugs of abuse. The level of ethyl alcohol above 2 g/L was observed in more than 40% of patients. In evaluated period the number of barbiturates analyses dropped, benzodiazepines stayed on the same level. During this time evident increase of illicit drugs (amphetamines, opiates and THC) analyses was observed.

The frequency of toxic methemoglobinemias in people living in the vicinity of refuse dumps in Barycz.

In the paper a thorough study of the influence of the methemoglobin levels and the occurrence of certain syndromes of clinical symptoms was made in the inhabitants living in the immediate vicinity of the large refuse dumps. During a 2.5-day clinical hospitalization the following examinations were done: general medical, specialistic and neuropsychological examinations, biochemical-analytical examination, EKG, chest X-ray, USG of the abdominal cave, spirometric tests, toxicological investigation of body fluids: carboxyhemoglobin, methemoglobin, lactates. The air pollution was measured and included: continuous measurement of the suspended particulate matter, carbon monoxide, sulfur dioxide, nitrogen oxide, nitrogen dioxide and the sum of nitrogen oxides. The evaluation of the refuse dumps gas showed that its main compounds were: carbon dioxide, methane in the amount of a few volume percent. Other pollutants were: carbon monoxide, hydrogen sulfide, methane homologues and aromatic hydrocarbons. The results of biochemical investigations were within normal limit. The elevated methemoglobin levels were found in 8 patients. The increased values of blood lactate concentration were found in 14 people and in 8 people the elevation of carboxyhemoglobin level was noted. The results of toxicological investigation do not unequivocally indicate the occurrence of toxic methemoglobinemia. However, the elevated levels of methemoglobin and lactates indicate a slight degree of oxygen deficiency in the body. In the examined people typical symptoms of methemoglobinemia were not observed, the only symptoms which may indicate their impact on the central nervous system were frequent headaches and neurovegetative disorders.