Autotransplantation after primary bone repair of a recipient site with a large periradicular lesion: a case report.

AIM: To describe a case of autotransplantation nine weeks after the extraction of a hopeless tooth with a large periradicular lesion, which enabled the healing of the recipient site. SUMMARY: A 19-year-old male in generally good health was referred for evaluation of tooth 46. Clinically, there were class III mobility and sensitivity to percussion and palpation. There was a mesio-lingual swelling and a single narrow deep pocket of 15 mm at the disto-lingual aspect. CBCT imaging revealed a radiolucent area over 15 mm in diameter that extended from the mesial aspect of the mesial root of tooth 47 to the distal aspect of tooth 45. The radiolucent area was in proximity to the inferior alveolar canal and penetrated the buccal and the lingual cortical plates. The tooth was diagnosed with previously treated tooth, acute apical abscess and vertical root fracture. Tooth 46 was extracted, and a delicate curettage and drainage were performed. Nine weeks afterwards, a second surgery was performed: extraction of the impacted immature third molar (tooth 48). Immediately after the extraction, the tooth was replanted in the healing socket of tooth 46, and sufficient initial stability achieved. At a 1-year follow-up, the tooth had normal mobility, no sensitivity to palpation and percussion, and responded to thermal pulp testing. The soft tissue was normal, probing depths up to 3-mm, without swelling or sinus tract. Radiographically, periapical healing at the recipient site was observed. Compared to the post-operative periapical radiography immediately after the procedure, there was no change in the distal root dimensions. In the mesial root, development of the root length and a closed apex was demonstrated.

Digoxin quinidine interaction: a pharmacokinetic study in the isolated perfused rat liver.

Digoxin-quinidine interaction was studied in the experimental model of isolated perfused rat liver. Neither digoxin nor quinidine were toxic to the isolated rat liver. The clearance of digoxin and quinidine by the liver was directly related to the rate of bile flow and the size of the initial dose of digoxin. In the presence of quinidine, after initial doses of digoxin of 0.5 and 1 micrograms, the concentration of digoxin in the perfusate was increased 2.5 and 3-fold. Its excretion in the bile was reduced by 45% and 20.5%, respectively (all comparisons, p less than 0.01). Digoxin concentration in the liver tissue was calculated and found to be appreciably elevated in the presence of quinidine. A reduction of about 30% (p less than 0.05) in the excretion of quinidine in the bile was observed in the presence of digoxin. Thus, a competition of digoxin and quinidine for biliary excretion was demonstrated as an underlying cause for digoxin-quinidine interaction in the isolated perfused rat liver.

The formation of genotoxic metabolites of benzo[a]pyrene by the isolated perfused rat liver, as detected by the bioluminescence test.

The kinetics of the formation of mutagenic metabolites of benzo[a]pyrene (BP) in an isolated perfused rat-liver system have been studied. No genotoxic activity was detected in the perfusate using either the Ames test or the new bioluminescence test for genotoxic agents (BLT). The bile excretion showed strong genotoxic activity especially in the presence of the deconjugation enzymes beta-glucuronidase and arylsulfatase. The BLT was 1000-fold more sensitive than the Ames test in detecting the genotoxic activity in the bile excretion.

Subphrenic abscess following percutaneous liver needle biopsy.

A 65-yr-old diabetic woman had air in the bile ducts after a choledochoduodenostomy. Following a liver needle biopsy (LNB) she developed a subphrenic abscess with an air-fluid level. Presence of air in the bile ducts in a diabetic patient is a predisposing factor for infection and a contraindication for LNB.