Immunhistochemical analysis for expression of calpain 1, calpain 2 and calpastatin in endometrial cancer.

BACKGROUND: Calpains (CAPN) are intracellular, non-lysosomal cytoplasmic cysteine endopeptidases and they are expressed ubiquitously. Their endogenous specific inhibitor is calpastatin. When calcium is present, calpastatin and calpain attach to each other, inhibiting the protease. The calpain system plays an important role in many processes including apoptosis, necrosis, ischaemia and exocytosis. The role of calpains in pathogenesis or further tumour progression has been proved in related studies. This study focused on the expression of the enzymes calpain 1, calpain 2 and the inhibitor calpastatin in normal and malignant endometrial tissue. MATERIALS AND METHODS: Immunohistochemical stainings were performed on paraffin slices and staining intensity, percentage of positive cells and international ratio score were evaluated. RESULTS AND CONCLUSION: The endometrial carcinoma showed a higher expression of calpastatin than benign endometrial tissue.

The cinnamon-derived dietary factor cinnamic aldehyde activates the Nrf2-dependent antioxidant response in human epithelial colon cells.

Colorectal cancer (CRC) is a major cause of tumor-related morbidity and mortality worldwide. Recent research suggests that pharmacological intervention using dietary factors that activate the redox sensitive Nrf2/Keap1-ARE signaling pathway may represent a promising strategy for chemoprevention of human cancer including CRC. In our search for dietary Nrf2 activators with potential chemopreventive activity targeting CRC, we have focused our studies on trans-cinnamic aldehyde (cinnamaldeyde, CA), the key flavor compound in cinnamon essential oil. Here we demonstrate that CA and an ethanolic extract (CE) prepared from Cinnamomum cassia bark, standardized for CA content by GC-MS analysis, display equipotent activity as inducers of Nrf2 transcriptional activity. In human colon cancer cells (HCT116, HT29) and non-immortalized primary fetal colon cells (FHC), CA- and CE-treatment upregulated cellular protein levels of Nrf2 and established Nrf2 targets involved in the antioxidant response including heme oxygenase 1 (HO-1) and gamma-glutamyl-cysteine synthetase (gamma-GCS, catalytic subunit). CA- and CE-pretreatment strongly upregulated cellular glutathione levels and protected HCT116 cells against hydrogen peroxide-induced genotoxicity and arsenic-induced oxidative insult. Taken together our data demonstrate that the cinnamon-derived food factor CA is a potent activator of the Nrf2-orchestrated antioxidant response in cultured human epithelial colon cells. CA may therefore represent an underappreciated chemopreventive dietary factor targeting colorectal carcinogenesis.

Neoadjuvant therapy for breast cancer: assessing treatment progress and managing poor responders.

There is no clear consensus regarding the most effective management of poor responders to neoadjuvant chemotherapy. Intensifying or changing primary systemic treatment has not been shown to offer any benefit. There is a paucity of trials testing the utility of adjuvant chemotherapy in this setting. Adjuvant hormonal treatment significantly decreases relapse rates in patients with estrogen receptor-positive breast cancer, regardless of initial response to chemotherapy. Neoadjuvant hormonal therapy is usually reserved for patients who are not candidates for chemotherapy or surgery. In patients with HER-2-overexpressing tumors who are candidates for chemotherapy, trastuzumab improves outcomes when administered in the preoperative or postoperative setting. This article examines issues related to the assessment of response to preoperative therapy and the clinical use of these assessments. It reviews important clinical evidence related to the utility of further treatment in patients with breast cancer that has responded poorly to neoadjuvant treatment.

Correlation of intercondylar notch cross sections to the ACL size: a high resolution MR tomographic in vivo analysis.

INTRODUCTION: To correlate cross sections of the intercondylar notch to cross sections of the anterior cruciate ligament (ACL) and to analyze gender-related differences in notch and ACL morphometry with an attempt to explain the observation that a small intercondylar notch and the female gender predispose to a rupture of the ACL. MATERIAL AND METHODS: High resolution MR imaging was performed on a 1.5 T magnet using a dedicated extremity-coil in ten left and ten right knee joints of 20 volunteers (10 male, 10 female, mean age 25 years) with no history of knee abnormalities. Continuous axial T2-weighted MR images perpendicular to the longitudinal axis of the ACL were acquired. Cross-sectional areas of the ACL midsubstance at the contact area to the posterior cruciate ligament were measured. For imaging and evaluation of the osseous limits of the intercondylar notch a 3D-dataset of the knee was acquired. Anterior, middle and posterior planes of the intercondylar notch were calculated and analyzed for measurement of the notch area AN and notch width index NWI. The ratio of the ACL cross-sectional area of the ACL and the cross-sectional area of the notch was defined as the ACL notch index (ANI) and used as a standardized tool for evaluation. For statistical evaluation, linear regression analysis was performed. Mean values between male and female were compared using a t test. In addition, five matched pairs of male and female volunteers of same height were analyzed. RESULTS: Mean cross-sectional size of the ACL at the crossing with the PCL was 54.4 +/- 20.4 mm2. Regression analysis showed a significant correlation (P < 0.05) of the ACL cross-sectional area to the notch areas on all three planes and NWI, respectively. Comparison between the sexes revealed that female participants had significantly smaller cross-sectional areas of the ACL, the notch areas, the NWI and ANI. This difference was found for both the complete study group and the matched pairs of same height. CONCLUSIONS: The smaller the intercondylar notch the smaller the cross-sectional area of the ACL midsubstance. In addition to the impingement of the ACL at the anterior and posterior roof of the notch, a biomechanically weaker ACL may be the reason for disposition to an ACL rupture in patients with a small intercondylar notch. Women have a thinner ACL midsubstance than men of the same height which may be one of the critical etiologic factors that predispose women to an ACL rupture.

Increased expression of monocytic angiotensin-converting enzyme in dialysis patients with cardiovascular disease.

BACKGROUND: Patients with chronic renal disease suffer from accelerated atherogenesis, which is promoted by inflammation and oxidative stress. Tissue angiotensin converting enzyme (ACE) exerts proinflammatory and prooxidative effects by producing angiotensin II. Monocytes are strongly involved in the pathogenesis of atherosclerosis. They express ACE, which might contribute to their atherogenic potency. We hypothesize that dialysis patients have increased monocytic ACE expression, and that ACE expression on circulating monocytes is associated with prevalent cardiovascular disease. METHODS: In 74 dialysis patients, ACE expression on total monocytes and monocyte subsets was measured flow-cytometrically in a whole-blood assay. A subpopulation of 22 dialysis patients was compared to an age- and gender-matched control group with intact renal function. Cardiovascular risk factors and the prevalence of cardiovascular disease were assessed. In a subgroup of patients (n = 8), monocytic ACE activity was measured in vitro and correlated with monocytic ACE expression. RESULTS: Dialysis patients had an increased expression of monocytic ACE compared to controls. Monocytic ACE expression was higher in dialysis patients with prevalent cardiovascular disease than in those without cardiovascular disease. This association remained significant after correction for classical cardiovascular risk factors. Among monocyte subsets, CD14++CD16+ monocytes had the highest ACE expression. Monocytic ACE activity correlated with ACE surface expression. CONCLUSIONS: The finding of increased ACE expression on monocytes of dialysis patients with cardiovascular disease links monocytes to the activated renin-angiotensin system. ACE expression was found highest among CD14++16+ monocytes, which is in accordance with a prominent role of these proinflammatory cells in atherogenesis.

Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study.

BACKGROUND AND AIMS: Persons with a familial risk of colorectal cancer (CRC) account for about 25% of all CRC cases. The adenoma prevalence in relatives of CRC patients 50-60 years of age is 17-34%; data on younger individuals are scarce. Our aim was to prospectively define the adenoma prevalence in 40- to 50-year-old first-degree relatives of CRC patients compared to controls. PATIENTS AND METHODS: CRC patients were identified via the regional cancer registry, and their 40- to 50-year-old first-degree relatives (risk group) were invited for screening colonoscopy. Additional probands and controls of the same age were recruited by newspaper articles and radio or television broadcastings. Using high-resolution video colonoscopy, each detected polyp was removed and histopathologically assessed. Each participant completed demographic and epidemiological questionnaires. RESULTS: Of 228 subjects in the risk group 36.4% had polypoid lesions compared to 20.9% of 220 controls (p<0.001). Forty-three (18.9%) subjects in the risk group had adenomas compared to 18 (8.2%) in the control group (p=0.001). High-risk adenomas (>10 mm and/or of villous type) were found in 12 persons in the risk group compared to 5 controls (not significant). In the risk group most lesions (52%) were located proximal to the sigmoid colon compared to 29% in controls. CONCLUSIONS: Subjects between 40-50 years with first-degree relatives with CRC demonstrate a significantly higher prevalence of adenomas than controls, with a tendency towards a more proximal location. These data support a screening colonoscopy in persons with familial risk already between 40 and 50 years.

Cost-benefit analysis of screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer.

BACKGROUND AND AIMS: As shown previously, 40- to 50-year-old first-degree relatives of patients with colorectal cancer (CRC) have significantly more colorectal adenomas than controls of the same age. Screening colonoscopy of these persons at risk between 40 and 50 years might be cost beneficial. METHODS: We prepared a detailed cost-benefit analysis of screening colonoscopy and possible repeat endoscopies according to current expenditures for endoscopic procedures in Germany. Since screening colonoscopy is generally offered and reimbursed from 55 years on in Germany, we analysed the period between 45 and 55 years, taking an annual interest rate of 5% into account. Costs were analysed based on the results of a former study [11] depending on various participation rates in a general screening programme. FINDINGS: Based on the available 1994 figure of about 20,000 euros for diagnosis and treatment of one cancer case, screening colonoscopy is cost beneficial when participation is high. Under a more realistic assumption of currently about 40,000 euros per cancer case, screening colonoscopy is cost beneficial in any case. INTERPRETATION: Our data support that systematic screening colonoscopy in first-degree relatives of patients with CRC by the age of 45 years most likely demonstrates an economic benefit.

25-hydroxyvitamin D deficiency in renal transplant recipients.

CONTEXT: Bone disease after kidney transplantation is a common problem. The serum levels of the active vitamin D metabolite 1,25-dihydroxyvitamin D(3) [1,25(OH)(2)D] have been studied extensively. In contrast, there has not been much concern about the serum levels of 25-hydroxyvitamin D(3) [25(OH)D]. However, it is well recognized that serum levels of 1,25(OH)(2)D are often normal in vitamin D-deficient patients. Moreover, inadequate serum 25(OH)D may limit the extrarenal production of 1,25(OH)(2)D that could lead to increased risk of many chronic diseases. OBJECTIVE: We analyzed whether renal transplant patients were at a higher risk of 25(OH)D deficiency because of the consequence of their need to protect themselves from sun exposure. DESIGN, SETTING, AND PATIENTS: We hypothesized that renal transplant recipients are at high risk to develop 25(OH)D deficiency. Serum 25(OH)D levels were analyzed in renal transplant patients with adequate renal function and in an age- and gender-matched control group (n = 31) at the end of winter. All renal transplant patients practiced solar UV-protection after transplantation. 25(OH)D levels were compared using a nonparametrical test (Wilcoxon rank sum test). RESULTS: Serum 25(OH)D levels were significantly lower in renal transplant patients compared with controls (P = 0.007). Geometric mean (with 95% confidence interval) in renal transplant patients was 10.9 ng/ml (8.2-14.3) compared with 20.0 ng/ml (15.7-25.5) in the control group. CONCLUSIONS: Renal transplant recipients are at high risk to develop 25(OH)D deficiency. Treatment with vitamin D is recommended to correct their vitamin D deficiency, which may help protect them from serious vitamin D deficiency-related health problems that include an increased risk for internal malignancies.

Circulating big endothelin-1: an active role in pulmonary thromboendarterectomy?

BACKGROUND: Pulmonary thromboendarterectomy is an effective treatment for patients with chronic thromboembolic pulmonary hypertension. The early postoperative course may be associated with pulmonary vasoconstriction and profound systemic vasodilation. We investigated the potential involvement of endothelins in these hemodynamic alterations. METHODS: Seventeen patients with chronic thromboembolic pulmonary hypertension (pulmonary vascular resistance, 1015 +/- 402 dyne x s x cm(-5) [mean +/- SD]) underwent pulmonary thromboendarterectomy with cardiopulmonary bypass and deep hypothermic circulatory arrest. Peripheral arterial blood samples were drawn before sternotomy, during cardiopulmonary bypass before and after deep hypothermic circulatory arrest, and 0, 8, 16, and 24 hours after surgery and were analyzed for big endothelin-1. The patients were divided into 2 groups according to whether their preoperative big endothelin-1 plasma level was above or below the cutoff point of 2.1 pg/mL, as determined by receiver operating characteristic curve analysis (group A, big endothelin-1 <2.1 pg/mL, n = 8; group B, big endothelin-1 > or =2.1 pg/mL, n = 9). RESULTS: Patients in group B, with higher preoperative big endothelin-1 levels (3.2 +/- 1.0 pg/mL vs 1.5 +/- 0.4 pg/mL; P < .001), were poorer operative candidates (preoperative mean pulmonary artery pressure, 51.3 +/- 7.1 mm Hg vs 43.6 +/- 6.2 mm Hg; P = .006) and had a poorer outcome (mean pulmonary artery pressure 24 hours after surgery, 32.6 +/- 9.5 mm Hg vs 21.8 +/- 6.2 mm Hg; P < .001). Positive correlations were found between preoperative big endothelin-1 levels and preoperative mean pulmonary artery pressure (r = 0.56; P = .02) as well as postoperative mean pulmonary artery pressure at 0 hours (r = 0.70; P = .002) and 24 hours (r = 0.63; P = .006) after surgery. Preoperative big endothelin-1 levels predicted outcome (postoperative mean pulmonary artery pressure at 24 hours after surgery) after pulmonary thromboendarterectomy (area under the receiver operating characteristic curve, 0.85). Peak big endothelin-1 levels also correlated with maximal vasopressor dosage (r = 0.65; P = .004). CONCLUSIONS: Preoperative big endothelin-1 levels seem to correlate with the hemodynamic alterations observed in pulmonary thromboendarterectomy and may be used to predict hemodynamic outcome after pulmonary thromboendarterectomy.

Fixation stability following high tibial osteotomy: a radiostereometric analysis.

Fifteen patients with varus gonarthrosis underwent high tibial osteotomy and internal fixation with an L-shaped rigid plate. In 9 patients, an average wedge size of 7.1 degrees was resected leaving the medial cortex of the proximal tibia intact (group 1). In 6 patients, the medial cortex of the proximal tibia was unintentionally fractured during surgery when an average 10.7 degrees wedge was resected (group 2). Postoperatively, patients were monitored with serial radiostereometric analysis (RSA), conventional radiographs, and clinical evaluation for 1 year. In group 2, RSA revealed a 1.3-mm increase in lateral displacement of the distal tibial segment within 3 weeks following surgery. Twelve weeks after surgery, micromotion between tibial segments was below the precision of the RSA setup in 14 of 15 patients. These findings indicate that in cases with larger wedge sizes (>8 degrees), fracture of the medial cortex of the proximal tibia was frequent and resulted in significant lateral displacement of the distal tibia relative to the tibial plateau. In such cases, prophylactic additional medial fixation rather than lateral L-plate fixation alone is advised to minimize the propensity for lateral displacement of the distal tibia and to avoid subsequent loss of correction.

Assessing the risk of mortality in paediatric cancer patients admitted to the paediatric intensive care unit: a novel risk score?

UNLABELLED: Intensive front-line protocols have improved survival in children with malignancies; however, intensive multimodal therapy of paediatric malignancies can be associated with a significant risk of serious adverse events. Common risk scores (PRISM, PRISM III, APACHE-II) fail to predict mortality in these patients. A retrospective chart analysis of 32 paediatric cancer patients admitted to the Paediatric Intensive Care Unit (PICU) at the University Hospital of Saarland between January 2001 and December 2003 for life-threatening complications was performed. The aim of this study was to assess risk factors for short-term outcome (survival vs. non-survival when leaving the PICU) and to develop a risk score to estimate outcome in these patients. Overall survival was good (25 of 32 patients). Mortality rate was significantly related to leukaemia/lymphoma ( P = 0.029), to the number of organ failures ( P < 0.0001), neutropenia ( P = 0.001), septic shock ( P = 0.025), mechanical ventilation ( P = 0.01) and inotropic support ( P = 0.01). Employing multiple logistic regression, the strongest predictor for poor outcome was the number of organ failures ( P < 0.05). A risk score (cut-off value: >3 points for non-survival) which included the following risk factors (non-solid tumour, number of organ failures ( n > 2), neutropenia, septic shock, mechanical ventilation, and inotropic medication) yielded a sensitivity of 7/7 (95% CI: 4.56-7.00), a specificity of 23/25 (95% CI: 18.49-24.75), a positive predictive value of 23/23 (95% CI: 19.80-23.00), and a negative predictive value of 7/9 (95% CI: 3.60-8.74) for the time of admission to the PICU. CONCLUSION: Although our risk of mortality score is of prognostic value in assessing short-term outcome in these patients, prospective validation in a larger study cohort is mandatory. Furthermore, it must be emphasised that this risk score must not be used for decision-making in an individual patient.

Housekeeping gene variability in normal and cancerous colorectal, pancreatic, esophageal, gastric and hepatic tissues.

Careful normalization is essential for the accurate quantitation of mRNA levels in biopsy-sized tissue samples. Commonly, normalization of the target gene with an endogenous standard, mainly housekeeping genes (HKGs), is applied. However, differences in the expression levels of endogenous reference genes have been reported between different tissues and pathological states. Therefore, we were challenged to identify a set of endogenous reference genes whose mRNA expression levels would not change significantly between normal and cancerous tissues. Quantitative real-time PCR (Q-RT-PCR) analysis was applied to evaluate the variability in gene expression among 21 classical housekeeping genes in colorectal, pancreatic, esophageal and gastric cancer as well as in liver metastases in comparison to the corresponding normal tissue. Our results indicated that some housekeeping genes were candidates with relatively stable gene expression in several of the investigated tissues but for most of the HKGs under investigation our data have revealed distinct differences in the extent of variability in gene expression between the different tissues and pathological states. However, for each of the five tissues investigated we found a group of genes that were expressed at a constant level thus representing a panel of candidates that we can recommend as housekeeping genes in the respective tissue types. In summary, our results can be used as guidance for other scientists studying various carcinomas for tissue-specific selection of the optimal housekeeping gene (HKG) to be used in normalizing target gene expression.

Clinical evaluation of an Er:YAG laser for nonsurgical treatment of peri-implantitis: a pilot study.

The aim of this controlled, parallel design clinical study was to compare the effectiveness of an Er:YAG laser (ERL) to that of mechanical debridement using plastic curettes and antiseptic therapy for nonsurgical treatment of peri-implantitis. Twenty patients with moderate to advanced peri-implantitis lesions were randomly treated with either (1) an ERL using a cone-shaped glass fiber tip at an energy setting of 100 mJ/pulse and 10 pps (ERL), or (2) mechanical debridement using plastic curettes and antiseptic therapy with chlorhexidine digluconate (0.2%) (C). The following clinical parameters were measured at baseline, 3 and 6 months after treatment by one blinded and calibrated examiner: Plaque index (PI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). At the baseline examination, there were no statistically significant differences in any of the investigated parameters. Mean value of BOP decreased in the ERL group from 83% at baseline to 31% after 6 months (P < 0.001) and in the C group from 80% at baseline to 58% after 6 months (P < 0.001). The difference between the two groups was statistically significant (P < 0.001, respectively). The sites treated with ERL demonstrated a mean CAL change from 5.8 +/- 1 mm at baseline to 5.1 +/- 1.1 mm (P < 0.01) after 6 months. The C sites demonstrated a mean CAL change from 6.2 +/- 1.5 mm at baseline to 5.6 +/- 1.6 mm (P < 0.001) after 6 months. After 6 months, the difference between the two groups was statistically not significant (P > 0.05). Within the limits of the present study, it was concluded that (i) at 6 months following treatment both therapies led to significant improvements of the investigated clinical parameters, and (ii) ERL resulted in a statistically significant higher reduction of BOP than C.

Value of F-18-fluorodeoxyglucose positron emission tomography after induction therapy of locally advanced bronchogenic carcinoma.

OBJECTIVES: Induction therapy is an important treatment option in locally advanced non-small cell lung cancer. F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) has an important role in initial staging. The aim of this study was to assess the value of FDG-PET in restaging after induction therapy and in analyzing tumor viability, nodal status, distant metastases, and prognosis. METHODS: Forty-seven patients with locally advanced non-small cell lung cancer accepted for resection after induction therapy underwent FDG-PET. Images were interpreted visually for mediastinal nodal status and metastatic spread. The FDG accumulation in the tumor site was measured by using the maximum standardized uptake value. RESULTS: Unexpected metastases were detected by means of FDG-PET in 9 patients. Surgical intervention was not performed in 8 patients with confirmed metastases. The rate of unexpected findings increased from complete radiologic remission (0%) over partial remission (9%) to no change (67%). The standardized uptake value was higher in tumors with (n = 26) than in those without (n = 11) histologic proof of viability (6.4 +/- 5.3 vs 2.9 +/- 1.6, P = .006). All patients with standardized uptake values of greater than 5.8 had viable tumors. Sensitivity, specificity, and negative predictive value were 81%, 64%, and 58% for tumor viability and 50%, 88%, and 85% for persistent mediastinal disease. Median survival after resection was greater than 56 months for patients with tumor standardized uptake values of less than 4 and 19 months for patients with standardized uptake values of 4 or greater ( P < .001). CONCLUSION: FDG-PET helps in the selection of patients for resection after induction therapy. It can be used to detect unexpected distant metastases, especially after poor response to induction therapy. Its high negative predictive value in mediastinal restaging allows for omission of repeat mediastinoscopy. Tumor standardized uptake value after induction is a prognostic factor.

MRI of the brainstem in patients with major depression, bipolar affective disorder and normal controls.

Structural imaging studies of bipolar affective disorder or major depression have shown a spectrum of abnormal findings. However, a characteristic pattern of abnormality for either disease has not yet emerged. While the majority of studies focused on brain atrophy and the volumes of supratentorial cerebral structures, little attention has been paid to infratentorial structures. This MRI study focused on the pontomesencephalic area including the region of the raphe nuclei. The raphe nuclei are of special interest in affective disorders as they are the origin of the major serotonergic projections in this region. MRI scans of 10 bipolar I patients, 10 patients with major depression and 10 age-matched healthy control subjects were studied. The brain stem and the fourth ventricle areas as well as T2-relaxation times in the area of the raphe nuclei were evaluated. A difference between patients with major depression and control subjects for T(2)-relaxation times was found in a region of interest located along the midline of the pons. No difference was found between patients with bipolar disorder and control subjects. This finding needs to be replicated in a larger sample with more elaborated MRI techniques (multi-echo sequences) for the determination of T2-relaxation times.

Comparison of the influence of volume-oriented training and high-intensity interval training on serum homocysteine and its cofactors in young, healthy swimmers.

BACKGROUND: Since homocysteine (Hcy) is a risk factor for cardiovascular and other diseases, it is important to know how exercise can modify it. Previous studies have suggested that endurance training influences Hcy. However, little is known about the effect of training intensity on Hcy. MATERIALS AND METHODS: We investigated Hcy, vitamin B12, vitamin B6, folate and methylmalonic acid (MMA) before and after 3 weeks of volume-oriented training (VOL) (30 km/week) and high-intensity interval training (HIT) (20 km/week) in 20 young swimmers (16 +/- 2 years). Afterward, the athletes completed 5 days of recovery training. RESULTS: The training induced a Hcy increase in HIT and VOL (6.47 +/- 0.95 micromol/l vs. 7.44 +/- 1.17 micromol/l and 7.33 +/- 1.92 micromol/l vs. 8.28 +/- 1.42 micromol/l, respectively) that persisted during the recovery period (8.02 +/- 1.69 micromol/l and 8.00 +/- 1.81 micromol/l, respectively). Vitamin B12 was unchanged after the training (539 +/- 166 ng/l vs. 556 +/- 192 ng/l and 480 +/- 144 ng/l vs. 491 +/- 124 ng/l, respectively) but decreased during the recovery period (459 +/- 134 ng/l and 451 +/- 116 ng/l, respectively). Folate showed an increase during the training (9.07 +/- 2.01 microg/l vs. 11.71 +/- 4.08 microg/l and 10.34 +/- 2.32 microg/l vs. 11.13 +/- 4.64 microg/l, respectively), which was reversible by the end of the recovery training (8.57 +/- 1.98 microg/l and 9.60 +/- 2.38 microg/l, respectively). Vitamin B6 and MMA did not change. For none of the measured parameters were there significant differences between HIT and VOL. CONCLUSION: Three weeks of strenuous swimming caused a prolonged Hcy increase, which was accompanied by changes in vitamin B12 and folate. The magnitude of these effects was not influenced by the training intensity.

In vivo effects of an Er:YAG laser, an ultrasonic system and scaling and root planing on the biocompatibility of periodontally diseased root surfaces in cultures of human PDL fibroblasts.

BACKGROUND AND OBJECTIVES: The aim of the present study was to investigate the in vivo effects of an Er:YAG laser (ERL), an ultrasonic system and scaling and root planing (SRP) on the biocompatibility of periodontally diseased root surfaces in cultures of human periodontal ligament fibroblasts (PDL). STUDY DESIGN/MATERIALS AND METHODS: Forty single rooted teeth, considered for extraction due to severe periodontal destruction, have been randomly assigned to the following groups: (1) ERL at 160 mJ/pulse and 10 Hz, or (2) Vector ultrasonic system (VUS), or (3) SRP using hand instruments, or (4) untreated control (C). Immediately after instrumentation, all test and control teeth were extracted and root specimens (4 mm2) were prepared from all mesial and distal surfaces (n=80). Following the prescribed treatments, the root specimens were incubated with human PDL fibroblast cultures. Adherent cells were stained with methylene blue and counted using a reflected light microscope and the cell density per mm2 was calculated. Additionally, the cell morphology was investigated using SEM (n=8 teeth). RESULTS: Cell counts within each group yielded the following means and standard deviations (cells/mm2): ERL, 111+/-27; VUS, 75+/-25; SRP, 41+/-17; control, 25+/-11. Analysis of variance (ANOVA) revealed significant differences in the number of attached cells between the test and control groups (P<0.001, P<0.001, P<0.01, respectively). ERL and VUS treated specimens showed significantly higher numbers of cells/mm2 than the SRP group (P<0.001, respectively). The difference between the ERL and VUS group was statistically significant (P<0.001). CONCLUSIONS: The results of the present study indicate that (i) ERL, VUS, and SRP promote the attachment of PDL fibroblasts on previously diseased root surfaces, (ii) periodontally diseased root surfaces inhibit the adherence of PDL fibroblasts, and (iii) the surface structure of ERL and VUS instrumented roots seem to offer better conditions for the adherence of PDL fibroblasts than SRP.

Periodontal treatment with an Er:YAG laser or scaling and root planing. A 2-year follow-up split-mouth study.

BACKGROUND: Non-surgical periodontal treatment with an Er:YAG laser has been shown to result in significant clinical attachment level gain; however, clinical results have not been established on a long-term basis following Er:YAG laser treatment. Therefore, the aim of the present study was to present the 2-year results following non-surgical periodontal treatment with an Er:YAG laser or scaling and root planing. METHODS: Twenty patients with moderate to advanced periodontal destruction were treated under local anesthesia, and the quadrants were randomly allocated in a split-mouth design to either 1) Er:YAG laser (ERL) using an energy level of 160 mJ/pulse and 10 Hz, or 2) scaling and root planing (SRP) using hand instruments. The following clinical parameters were evaluated at baseline and at 1 and 2 years after treatment: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). Subgingival plaque samples were taken at each appointment and analyzed using dark-field microscopy for the presence of cocci, non-motile rods, motile rods, and spirochetes. The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline. Power analysis to determine superiority of ERL treatment showed that the available sample size would yield 99% power to detect a 1 mm difference. RESULTS: The sites treated with ERL demonstrated mean CAL change from 6.3 +/- 1.1 mm to 4.5 +/- 0.4 mm (P < 0.001) and to 4.9 +/- 0.4 mm (P < 0.001) at 1 and 2 years, respectively. No statistically significant differences were found between the CAL mean at 1 and 2 years postoperatively. The sites treated with SRP showed a mean CAL change from 6.5 +/- 1.0 mm to 5.6 +/- 0.4 mm (P < 0.001) and to 5.8 +/- 0.4 mm (P < 0.001) at 1 and 2 years, respectively. The CAL change between 1 and 2 years did not present statistically significant differences. Both groups showed a significant increase of cocci and non-motile rods and a decrease in the amount of spirochetes. However, at the 1- and 2-year examination, the statistical analysis showed a significant difference for the CAL (P < 0.001, respectively) between the 2 treatment groups. CONCLUSION: It was concluded that the CAL gain obtained following non-surgical periodontal treatment with ERL or SRP can be maintained over a 2-year period.

[First steps with the Zeiss IOLMaster: A comparison between acoustic contact biometry and non-contact optical biometry]. / Erste Erfahrungen mit dem Zeiss-IOL-Master: ein Vergleich zwischen akustischer Kontaktbiometrie und kontaktfreier optischer Biometrie.

BACKGROUND: After having received an IOL-Master (Zeiss, Jena), we compared our actual standard method with this new device. PATIENTS, MATERIALS AND METHODS: From March to June 2002, we examined 175 consecutive cataractous eyes with the IOL-Master as well as with the acoustic biometry (Tomey AL-1000) combined to the Javal-Keratometer (Haag-Streit, Bern). The results were compared and analysed statistically. In all eyes, the intraocular lens to be implanted was chosen by means of the SRK/T formula, based on the measurements conducted with our standard method. The achieved postoperative refraction of 153 eyes obtained, at least six weeks after surgery, by the treating ophthalmologists, was communicated to us. RESULTS: Comparison of eye lengths as well as of the keratometric measurements showed good correspondence between the obtained measurements by both methods, acoustic biometry yielding significantly (p < 0.001) shorter axial lengths than the IOL-Master, and the Javal yielding significantly (p < 0.001) higher mean corneal refraction power than the IOL-Master. For both measurements, regression lines showed good coherence of the results over the refraction sample of our patients. Surprisingly, the accuracy of the refraction obtained postoperatively compared to the preoperative aim was better with our standard method compared to the IOL-Master. CONCLUSIONS: The predicted systemic differences in measurement results could be verified. No improvement in accuracy of our postoperative refraction prediction was achieved so far. The current advantage of the IOL-Master in our clinic is the substantial gain in time, as well as the fact that performance of the measurements may be delegated.