Do Current Asthma-Preventive Measures Appropriately Face the World Health Organization's Concerns: A Study Presentation of a New Clinical, Prospective, Multicentric Pediatric Asthma Exacerbation Cohort in Germany.

In summer 2017, the World Health Organization published 10 facts on asthma, which is known as a major non-communicable disease of high clinical and scientific importance with currently several hundred million people-with many children among them-suffering from air passages inflammation and narrowing. Importantly, the World Health Organization sees asthma as being underdiagnosed and undertreated. Consequently, much more efforts in clinical disease management and research need to be spent on reducing the asthma-related health burden. Particularly, for young approximately 6 months aged patients presenting recurrent bronchitic respiratory symptoms, many parents anxiously ask the doctors for risk prognosis for their children's future life. Therefore, we urgently need to reevaluate if the current diagnostic and treatment measures are in concordance with our yet incomplete knowledge of pathomechanisms on exacerbation. To contribute to this increasing concern worldwide, we established a multicentric pediatric exacerbation study network, still recruiting acute exacerbated asthmatics (children >6 years) and preschool asthmatics/wheezers (children <6 years) since winter 2018 in Germany. The current study that has a currently population comprising 176 study participants aims to discover novel holistic entry points for achieving a better understanding of the poorly understood plasticity of involved molecular pathways and to define biomarkers enabling improved diagnostics and therapeutics. With this study description, we want to present the study design, population, and few ongoing experiments for novel biomarker research. Clinical Trial Registration: German Clinical Trials Register (Deutsches Register für Klinische Studien, DRKS): DRKS00015738.

Craniometric measurements of artificial cranial deformations in Eastern European skulls.

Standardized lateral cephalograms of eleven skulls with artificial cranial deformations from Eastern Europe and twenty normal skulls from the same population were made, digitized and imported into the AutoCAD 2005 computer program. The x- and y-coordinates of defined measuring points were determined and angle measurements were made. The form difference of the skulls was tested with the Euclidean Distance Matrix Analysis (EDMA) and the difference of the angle measurements were compared statistically using the non-parametric Mann-Whitney test. All deformed skulls belonged to the tabular fronto-occipital type of deformation. The results of the EDMA and the angle measurements indicated significant differences for the neurocranium and the facial cranium in height between the normal and the deformed skulls, but not in the cranial length. It can be concluded that in Eastern Europe one method of cranial molding was used. The deformation of the neurocranium also affected the development of the facial cranium regarding facial height. This may indicate a dependency of the developmental fields of the neurocranium and facial cranium.

Comparative study of in vitro caries-like lesions and natural caries lesions at crown margins.

PURPOSE: Secondary caries at crown margins and the influence of preparation techniques are major clinical problems. It was therefore the aim of this study to compare natural caries lesions at crown margins with experimental caries lesions. MATERIALS AND METHODS: Five extracted caries-free human molars were restored with gold cast crowns and afterwards covered with wax leaving a 3 x 3 mm window at the crown margin. These teeth were then incubated in acidified gel (pH 4.7) for 50 days. After incubation these teeth and five other crowned extracted teeth exhibiting natural caries lesions were embedded in Technovit 9100. Serial sections with a thickness of 80 microm were cut through the lesions and investigated with polarized light microscopy (PLM) and scanning electron microscopy (SEM) combined with energy dispersive X-ray (EDX) analysis for quantitative element analysis of Ca, P, and C. The results of the quantitative element analysis were statistically evaluated using the nonparametric ANOVA test for repeated measurements. RESULTS: PLM of the experimental lesions showed homogeneous lesions with no transparent zone, or dead tracts. The natural caries lesions exhibited a demineralized zone, translucent zone, and dead tracts. Quantitative element analysis showed a statistically significant difference (p < 0.01) of Ca, P, and C between sound dentin and demineralized dentin in natural and experimental caries lesions. CONCLUSION: The experimental model reproduces the demineralization pattern of secondary caries but does not simulate the vital dentin reactions of peritubular and intratubular mineralization.

Micromorphological and micronanalytical characterization of stagnating and progressing root caries lesions.

Root caries is the predominant disease of the tooth tissues in the elderly population and differs in progression and micromorphology from coronal dentin caries. Therefore, different clinical concepts are needed for the treatment of these progressing and arrested lesions. It was the aim of this study to investigate the three-dimensional structure and volume of stagnating and progressing root caries lesions and to determine the mineral composition of the different lesion zones to achieve a better understanding of the natural history of root caries lesion formation. Of 21 extracted human teeth of patients between 42 and 77 years of age with stagnating and progressing root caries lesions serial sections were cut and investigated with polarized light and scanning electron microscopy. From the polarized light micrographs 3D reconstructions were made to determine the volumes of the lesion zones and their relations expressed in a demineralization index (DI). With increasing size of the demineralizing zone the DI increased indicating an increase in the size of the translucent zone. The 3D reconstructions showed distinct differences between stagnating and progressing root caries lesions. In the hypermineralized translucent dentin not all dentin tubules were obliterated by intratubular dentin and within the translucent dentin scattered dead tracts were found. Electron dispersive X-ray (EDX) analysis showed that the intertubular dentin of the translucent dentin was also demineralized to a certain extent. The results indicate distinct morphological differences between progressing and stagnating root caries lesions which may have consequences for treatment strategies.