Double-lumen tube tracheal intubation using a rigid video-stylet: a randomized controlled comparison with the Macintosh laryngoscope.

BACKGROUND: Despite an increasing need, there is limited experience of double-lumen endobronchial tube (DLT) placement using video laryngoscope. We evaluated DLT intubation using an OptiScope, a rigid video-stylet with a malleable tip derived from the Clarus Video System, in comparison with a Macintosh laryngoscope. METHODS: After airway evaluation and anaesthetic induction, Cormack and Lehane (C and L) grade was initially assessed in all patients using a Macintosh laryngoscope before tracheal intubation. The trachea was then intubated using either a Macintosh laryngoscope (n=200) or an OptiScope® (n=200). Success rate, intubation time, number of attempts at intubation, vocal cord view during intubation, need for external manipulation, and the incidences of oral mucosal or dental injury were compared between the two devices. RESULTS: Data were analysed for 397 patients. Intubation time with the OptiScope® was faster [median (inter-quartile range): 15 (12-19) s] than with the Macintosh [18(12-28) s] {mean difference [95% confidence interval (CI)}: 5.5 (3.8-13.2) s, P=0.010]. The success rate of the first intubation was higher with the OptiScope® than with the Macintosh [80.4% vs 89.9%, odds ratio (95% CI): 2.2 (1.22-3.87), P=0.036]. Initial view of the vocal cords was also better, although the final success rate was not different between devices. The need for external laryngeal manipulation, oral mucosal, or dental injury was lower with the OptiScope® compared with the Macintosh laryngoscope (all P<0.01). CONCLUSIONS: The OptiScope® provides faster tracheal intubation and a higher success rate for the first intubation with less trauma and a better vocal cord view than the Macintosh laryngoscope.

Secretion of CXC chemokine IP-10 by peripheral blood mononuclear cells from healthy donors and breast cancer patients stimulated with HER-2 peptides.

CXC chemokines play an important role in recruitment of T cells to the site of activation and regulation of angiogenesis. CXC chemokines are secreted by T cells stimulated with cytokines or by established cytotoxic T lymphocyte (CTL) lines at recognition of conventional antigen (Ag), but the activation requirements and the relationship of interferon-gamma (IFN-gamma) inducible protein (IP-10) secretion with IFN-gamma induction in lymphocytes are still unclear. We studied the induction of IP-10 from nonadherent peripheral blood mononuclear cells (PBMC) by IFN-gamma, interleukin-12 (IL-12), and the HER-2 peptide E75, which forms a CTL-defined antigen. We found that IFN-gamma alone was a weak inducer of IP-10 in these cells, whereas IL-12 was a significantly stronger inducer of IP-10. In the presence of IL-12, the tumor peptide E75 (HER-2, 369-377) was a stronger inducer of IP-10 than was IL-12 alone. E75 and its variants mutated at position 5 could also induce IP-10 in the absence of exogenous IL-12 or IFN-gamma. IP-10 induction by E75 required HLA-A2 presentation and B7-CD28 interactions and was partially inhibited by blocking of CD40-CD40L interactions. These results indicate that presentation of tumor peptides to peripheral T cells can induce a fast chemokine response, which in its early phase may be higher than the IFN-gamma response. This shows that the IP-10 response was independent of any early-phase IFN-gamma response in peripheral T cells. This may be important for understanding the regulation of the balance between chemoattractant chemokines (CC) and CXC chemokines by tumor Ag and may have implications for understanding the mechanisms of polarization of T cells and conditioning of antigen-presenting cells (APC) by tumor antigens.

Lifetime-limiting strength degradation from contact fatigue in dental ceramics.

The hypothesis under examination in this paper is that the lifetimes of dental restorations are limited by the accumulation of contact damage during oral function; and, moreover, that strengths of dental ceramics are significantly lower after multi-cycle loading than after single-cycle loading. Accordingly, indentation damage and associated strength degradation from multi-cycle contacts with spherical indenters in water are evaluated in four dental ceramics: "aesthetic" ceramics-porcelain and micaceous glass-ceramic (MGC), and "structural" ceramics-glass-infiltrated alumina and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). At large numbers of contact cycles, all materials show an abrupt transition in damage mode, consisting of strongly enhanced damage inside the contact area and attendant initiation of radial cracks outside. This transition in damage mode is not observed in comparative static loading tests, attesting to a strong mechanical component in the fatigue mechanism. Radial cracks, once formed, lead to rapid degradation in strength properties, signaling the end of the useful lifetime of the material. Strength degradation from multi-cycle contacts is examined in the test materials, after indentation at loads from 200 to 3000 N up to 10(6) cycles. Degradation occurs in the porcelain and MGC after approximately 10(4) cycles at loads as low as 200 N; comparable degradation in the alumina and Y-TZP requires loads higher than 500 N, well above the clinically significant range.

Longitudinal monitoring for disease progression of localized juvenile periodontitis.

The present study was performed to investigate the factors associated with disease progression in localized juvenile periodontitis (LJP) patients by longitudinal monitoring of microbiological changes. Following a 9-month period, 9 LJP patients were divided into 2 groups based upon attachment loss, progressing and non-progressing. Both groups received scaling, root planing, and modified Widman flaps. Clinical and microbiological data were obtained at baseline, following the observation period, and at 6 and 12 months post-treatment. At 6 and 12 months post-treatment significantly more cocci were persistent in the non-progressing group than in the progressing group. Actinobacillus actinomycetemcomitans was also more frequently isolated in the progressing group than in the non-progressing group initially and following the 9-month observation period. Also after treatment, A. actinomycetemcomitans recolonized earlier in the progressing group than in the non-progressing group. These studies suggest that A. actinomycetemcomitans may play a role in disease progression in LJP; however, they do not eliminate the possibility that other organisms may also play a role, since A. actinomycetemcomitans was not detected in all of the patients in whom disease progressed.

Nevoid basal cell carcinoma syndrome: a retrospective analysis of 33 affected Korean individuals.

This article describes a pooled analysis of Korean individuals with nevoid basal cell carcinoma syndrome (NBCCS). The data upon which this review is based has been retrieved from published case reports in Korean dental and medical literature between the years 1981 to 2002. We found 33 subjects who met the diagnostic criteria for NBCCS. Relative frequencies of associated complications are presented and compared with those of the English literature. Odontogenic keratocyst (OKC) and palmar and/or plantar pits, and hypertelorism were the most frequently observed anomalies. OKCs are often the first signs of NBCCS and can be detected in patients younger than 20 years of age. However, the incidence and clinical manifestations of NBCCS in Korean individuals were found to be rather different from those of other countries. The relatively low frequency of basal cell carcinomas and falx calcification among the major criteria were two major differences. The frequencies of the minor criteria concur in general with the ranges given by some others. It is concluded that these differences may be attributed to genetic and geographic differences.

[Study on the shape and depth of the occlusal central fissure in permanent molar teeth].

The purpose of this study was to operation the efficient pit and fissure sealing among the caries preventive methods. The authors examined the shape and depth of occlusal fissure in 48 extracted molar teeth and the following conclusions were obtained. 1. The percentages on the occlusal fissure type were 58.0% in I type, 21.0% in U type, 15.0% in K type, 6.0% in V type. 2. In each type, the average mean depth of the occlusal fissure were 1.15mm in I type, 0.53mm in U type. 1.11mm in K type, 0.56mm in V type.

Synchronous delivery systems composed of Au nanoparticles and stimuli-sensitive diblock terpolymer.

A method to construct synchronous delivery systems via direct self-assembly of Au nanoparticles on the poly[(N-isopropylacrylamide-r-acrylamide)-b-L-lactic acid] (PNAL) nanospheres has been presented in this paper. To achieve amphiphilic diblock terpolymer, hydrophobic poly (L-lactic acid) (PLLA) block was added to poly(N-isopropylacrylamide- r-acrylamide) (PNA) block via Michel-type addition reaction. Lower critical solubility temperature (LCST) was modulated at 35.6 degrees C which is close to the body temperature, but higher than poly(N-isopropylacrylamide) (PNIPAAm) homopolymer by controlling the ratio between isopropylacrylamide (IPAAm) monomers and acrylamide (AAm) monomers. Using this amphiphilic diblock terpolymer, PNAL nanospheres were fabricated by emulsion/evaporation technique followed by direct self-assembly of Au nanoparticles on the PNAL nanospheres due to the high affinity of amino groups donated from PNA block. The 'core' site of Au@PNAL nanospheres can load various lyphophilic drugs. Moreover, Au nanoparticles in the 'shell' domain of PNAL nanospheres give optimal environment to conjugate various biomolecules. Therefore, it is expected that Au@PNAL hybrid nanospheres can be utilized in synchronous delivery of both biomolecules in the 'shell' domain and various therapeutic drugs in the 'core' domain.

Hypertrichosis universalis congenita: a separate entity, or the same disease as gingival fibromatosis?

Hypertrichosis universalis congenita is an extremely rare disorder characterized by generalized hypertrichosis. It is generally accepted as being inherited as an autosomal dominant trait with varying expression. Many aspects of this disease are still unknown. Several reports associating hypertrichosis and gingival fibromatosis raise the question of whether they are separate entities or the same disease with different expressions of the underlying process. Hypertrichosis universalis congenita occurred in a 6-year-old girl without known family history. Her facial features were simian-like and her gingiva was moderately hyperplastic. We pose the question of whether or not these phenomena are related.

Mechanical properties of a Ti-6A1-4V dental implant produced by electro-discharge compaction.

Cylindrical, porous-surfaced implants were fabricated from Ti-6A1-4V atomized powders by an electro-discharge compaction technique (EDC). Input energy (1-2.5 kJ/g powder) was used to produce implant compacts having a solid core surrounded by a porous layer. The solid core size, neck size between core and particle, neck size between particles, and pore size in the porous layer varied as input energy was changed. Compression tests were carried out to evaluate the mechanical properties of the EDC compacts. The yield strength ranged from 270 to 530 MPa and the ultimate compressive strengths ranged from 390 to 600 MPa. The yield strengths for solid core, core-particle and particle-particle interfaces remained constant at 755 MPa regardless of input energy. The endurance limits estimated from these results were 190-310 MPa, which were higher than the reported values for sintered titanium implants. Microhardness testing revealed that hardness was independent of input energy and the position where the testing indentation was applied. The average hardness of the compacts was 3430 MPa.

Physical characteristics of Ti-6A1-4V implants fabricated by electrodischarge compaction.

Physical characteristics of a Ti-6A1-4V implant were evaluated following fabrication using a new electrodischarge compaction technique. Ti-6A1-4V atomized powders were loaded into Pyrex tubes (3.3 mm ID) and subjected to a high-voltage, high-current-density pulse in air for a period of less than 300 microseconds. Single pulses (1.0, 1.5, 2.0 and 2.5 KJ/grampowder) were applied from a capacitor bank (240, 480 or 720 microF) to produce solid core implants with porous surface layers. Implants were evaluated microscopically for core size, neck size, pore size, grain structure, and incorporated oxide film. Hardness was also evaluated. Implants were compared with Ti-6A1-4V commercial powders. Core size increased and pore size decreased with increases in energy and capacitance. The cores were composed of equiaxed grains which were free of oxide at the grain boundary. Porous layers, consisting of particles connected in three dimensions by necks, were free of oxide films at the connecting interfaces. Neck size increased with increases in input energy and capacitance. Hardness readings of the core, necks, and porous particles resulted in readings higher than or similar to control materials. Electrodischarge compaction did not alter the physical characteristics during compaction.

Diverse roles of the tumor necrosis factor family member TRANCE in skeletal physiology revealed by TRANCE deficiency and partial rescue by a lymphocyte-expressed TRANCE transgene.

Tumor necrosis factor-related, activation-induced cytokine (TRANCE), a tumor necrosis factor family member, mediates survival of dendritic cells in the immune system and is required for osteoclast differentiation and activation in the skeleton. We report the skeletal phenotype of TRANCE-deficient mice and its rescue by the TRANCE transgene specifically expressed in lymphocytes. TRANCE-deficient mice showed severe osteopetrosis, with no osteoclasts, marrow spaces, or tooth eruption, and exhibited profound growth retardation at several skeletal sites, including the limbs, skull, and vertebrae. These mice had marked chondrodysplasia, with thick, irregular growth plates and a relative increase in hypertrophic chondrocytes. Transgenic overexpression of TRANCE in lymphocytes of TRANCE-deficient mice rescued osteoclast development in two locations in growing long bones: excavation of marrow cavities permitting hematopoiesis in the marrow spaces, and remodeling of osteopetrotic woven bone in the shafts of long bones into histologically normal lamellar bone. However, osteoclasts in these mice failed to appear at the chondroosseous junction and the metaphyseal periosteum of long bones, nor were they present in tooth eruption pathways. These defects resulted in sclerotic metaphyses with persistence of club-shaped long bones and unerupted teeth, and the growth plate defects were largely unimproved by the TRANCE transgene. Thus, TRANCE-mediated regulation of the skeleton is complex, and impacts chondrocyte differentiation and osteoclast formation in a manner that likely requires local delivery of TRANCE.

Biological effects of drug-loaded biodegradable membranes for guided bone regeneration.

The biological effects of drug-loaded biodegradable novel membrane for guided bone regeneration (GBR) was evaluated. The membranes were polyglycolic acid mesh coated with poly-L-lactic acid containing flurbiprofen, tetracycline or PDGF-BB. Porous structure was generated in the membranes by using a phase inversion method. The membrane was less toxic, nicely biodegradable and biocompatible for 8 wk after implantation in the dorsal skin of the rat. The drugs released from the membranes were shown to be effective for new bone formation. Tetracycline, flurbiprofen or PDGF-BB loaded membrane was markedly effective for osteoid tissue and new bone formation in the bony defect prepared in rat calvaria to compare with that by unloaded membrane. These results suggested that drug-loaded biodegradable barrier membrane might be a potential tool for GBR in periodontal therapy.

Cytotoxic polyacetylenic alcohols from the marine sponge Petrosia species.

New polyacetylenic alcohols (1-5) have been isolated as cytotoxic principles from the marine sponge Petrosia sp. The compounds were particularly cytotoxic against a human melanoma cell line (SK-MEL-2). The gross structures were established on the basis of NMR and MS data, and the absolute configuration was determined by the modified Mosher's method.

Preferential expression of L-type amino acid transporter 1 in ameloblasts during rat tooth development.

Certain amino acid transport systems play an important role in supplying organic nutrients to each cell and for cell proliferation during tooth development. However, the mechanisms responsible for such actions are unclear. This study demonstrated for the first time that LAT1 and 4F2hc are expressed during tooth development in prenatal and postnatal rats, and that the transporters show cell-specific expression in ameloblasts, which are the epithelium-derived dental cells. LAT1 and 4F2hc expression was not observed in other dental cells of the developing teeth such as odontoblasts and cementoblasts. Overall, these results suggest that LAT1 and 4F2hc might play an important role in enamel formation.

Identification of multiple forms of membrane-associated neutral sphingomyelinase in bovine brain.

Many different stimuli such as bioactive agents and environmental stresses are known to cause the activation of sphingomyelinase (SMase), which hydrolyzes sphingomyelin to generate ceramide as a second messenger playing a key role in differentiation and apoptosis in various cell types. Here we identified multiple forms of the membrane-associated neutral SMase (N-mSMase) activity in bovine brain. They could be classified into two groups according to extracting agents: group T-mSMase, extracted with 0.2% Triton X-100, and group S-mSMase, extracted with 0.5 M (NH(4))(2)SO(4). Group T-mSMase: alpha, beta, gamma, and delta, which were extensively purified from 40,000-g pellets of bovine brain homogenates by 3,150-, 5,275-, 1,665-, and 2,556-fold over the membrane extracts, respectively, by sequential use of several column chromatographies. On the other hand, S-mSMase was eluted as two active peaks of S-mSMase epsilon and zeta in a phenyl-5PW hydrophobic HPLC column and further purified by 1,119- and 976-fold over 40,000-g pellets of the homogenates, respectively. These highly purified N-mSMase enzyme preparations migrated as several bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and showed many different features in biochemical properties such as pH dependence, Mg(2+) requirements, and effects of detergents. Taken together, our data strongly suggest that mammalian brain N-mSMase may exist as multiple forms different in both its chromatographic profiles and biochemical properties.

New cytotoxic polyacetylenes from the marine sponge Petrosia.

New polyacetylenic alcohols with a C(45) carbon skeleton (2) and with an enone moiety in the alkyl chain (C(46), 1) were isolated from the marine sponge Petrosia sp. The gross structures of 1 and 2 were established by spectral methods, and the absolute stereochemistry was determined by the modified Mosher's method. Compounds 1 and 2 displayed considerable cytotoxicity against a small panel of human solid tumor cell lines. Significant inhibitions on DNA replication by 1 and 2 were also observed which could be explanative of their cytotoxicity.

Intraperitoneal gene delivery mediated by a novel cationic liposome in a peritoneal disseminated ovarian cancer model.

We have previously synthesized a new cationic liposome that displays high efficiency and low toxicity, 3 beta[l-ornithinamide-carbamoyl] cholesterol (O-Chol), using solid-phase synthesis. In this study, O-Chol was applied to in vitro and in vivo models of ovarian cancer. Intraperitoneal gene delivery for peritoneal disseminated ovarian cancer in nude mice was achieved using a stable chloramphenicol acetyl transferase (CAT)-expressing ovarian cancer cell line (OV-CA-2774/CAT), which allowed us to quantify the exact tumor burden of organs. When luciferase and beta-galactosidase genes were used as reporter genes, O-Chol showed better efficiency than other commercial transfection reagents such as lipofectin, lipofectAMINE, DC-Chol, and FuGENE 6, both in vitro and in vivo. Moreover, the transfection efficiency of this new cationic lipid reagent remained high in serum-containing medium and under serum-free conditions. Furthermore, in vivo transfection with O-Chol showed high levels of gene expression specific to peritoneal tumor cells. Consequently, the O-Chol:DNA lipoplex appears to offer potential advantages over other commercial transfection reagents because of (1) its higher level of gene expression in vitro and in vivo; (2) its reduced susceptibility to serum inhibition; and (3) its highly selective transfection into tumor cells. These results suggest that the O-Chol:DNA lipoplex is a promising tool in gene therapy for patients with peritoneal disseminated ovarian cancer.