Elevated plasma il-8 concentration is related to severity of systemic inflammation in chronic spontaneous urticaria.

Chronic spontaneous urticaria (CSU) is associated with activation of acute phase response. Questions arise regarding its association with other inflammatory mediators. To determine plasma IL-8 concentration in CSU patients and its association with C-reactive protein (CRP) concentration, a nonspecific inflammatory marker of the disease activity, concentrations of plasma IL-8 and serum CRP were measured in CSU patients and compared with healthy controls. IL-8 and CRP concentrations were significantly higher in CSU patients as compared with the healthy subjects. In addition, there were significant differences in IL-8 and CRP concentrations between CSU patients with moderate-severe symptoms and the healthy subjects. Plasma IL-8 and serum CRP concentrations showed a significant correlation with urticaria activity score (UAS). Additionally, a significant positive correlation was observed between IL-8 and CRP concentrations. Up-regulations of IL-8 and its association with the marker of clinical and inflammatory activity suggest a role of this cytokine in the pathogenesis of CSU.

Important research questions in allergy and related diseases: 3-chronic rhinosinusitis and nasal polyposis - a GALEN study.

Chronic rhinosinusitis is one of the most common health care challenges, with significant direct medical costs and severe impact on lower airway disease and general health outcomes. The diagnosis of chronic rhinosinusitis (CRS) currently is based on clinical signs, nasal endoscopy and CT scanning, and therapeutic recommendations are focussing on 2 classes of drugs, corticosteroids and antibiotics. A better understanding of the pathogenesis and the factors amplifying mucosal inflammation therefore seems to be crucial for the development of new diagnostic and therapeutic tools. In an effort to extend knowledge in this area, the WP 2.7.2 of the GA(2)LEN network of excellence currently collects data and samples of 1000 CRS patients and 250 control subjects. The main objective of this project is to characterize patients with upper airway disease on the basis of clinical parameters, infectious agents, inflammatory mechanisms and remodeling processes. This collaborative research will result in better knowledge on patient phenotypes, pathomechanisms, and subtypes in chronic rhinosinusitis. This review summarizes the state of the art on chronic rhinosinusitis and nasal polyposis in different aspects of the disease. It defines potential gaps in the current research, and points to future research perspectives and targets.

Effect of duodenal glucose infusion on blood glucose concentration in endotoxin-treated calves.

The effect of endotoxemia on the intestinal absorption of glucose was evaluated in nine experiments performed on seven 3- to 5-week-old calves fitted with a duodenal cannula. An intraduodenal glucose load trial (infusion of 2 g glucose/kg b.w. as a 10% aqueous solution through the cannula over 60 min) was conducted in a group of 5 calves three times during the 4-day period: 48 h before and at 2 and 24 h after i.v. injection of E. coli 0111:B4 endotoxin (LPS) at a dose of 0.1 microgram/kg b.w. Control calves were treated similarly but instead of glucose they were infused intraduodenally with deionised water at a volume of 20 ml/kg b.w. In trial with glucose load performed 48 h before LPS administration, blood glucose concentration increased during the absorptive phase from 4.32 +/- 0.32 mmol/l to 11.45 +/- 0.87 mmol/l at 60 min and then decreased to a minimum value of 3.16 +/- 0.51 mmol/l at 240 min. During the initial phase of endotoxemia, blood glucose concentration did not change from baseline values in both groups of calves. Glucose concentration in control calves started to decrease at 165 min reaching a minimum value of 1.39 +/- 0.17 mmol/l at 210 min and then increased to 2.44 +/- 0.11 mmol/l at 480 min after LPS administration. The intraduodenal infusion of glucose at 2 h after LPS administration resulted in an increase in blood glucose concentration during the absorptive phase only in one calf. Blood glucose concentration in this calf increased between 30 and 90 min reaching a maximum value of 7.19 mmol/l at 60 min, and then decreased to a minimal value of 0.94 mmol/l at 180 min after glucose load. In the remaining four calves in this group, blood glucose concentration ranged from 3.89 +/- 0.37 mmol/l to 4.48 +/- 0.45 mmol/l up to 120 min, and then steadily decreased to a minimal value of 2.41 +/- 0.41 mmol/l at 300 min. In trial with glucose load performed 24 h after LPS administration, the rate of entry of glucose into the circulation during the absorptive phase was similar to that observed in the trial performed 48 h before LPS administration. In conclusion, these results indicate that endotoxemia impairs the intestinal absorption of glucose in calves. The magnitude of the absorption disturbance may vary in individual calves, and the inhibitory effect of LPS on the intestinal glucose absorption lasts less than 24 h.

Tumor necrosis factor and interferon activity in the circulation of calves after repeated injection of low doses of lipopolysaccharide.

The effect of two intravenous (i.v.) injections of low doses of lipopolysaccharide (LPS)(0.1 microgram/kg of body weight) administered at 7-day intervals on the systemic release of tumor necrosis factor (TNF) and interferon (IFN), on the rectal temperature, breathing and heart rate, and on packed cell volume (PCV), plasma glucose concentration, white blood cell (WBC) counts in 3-week-old calves, was estimated. The first injection of LPS caused a significant increase in breathing and heart rate, rectal temperature, prolonged hypoglycemia and leukopenia, but no significant changes in PCV were observed. TNF and IFN activity peaked at 2 h after LPS injection and disappeared from circulation by 4 h and 5 h, respectively. After the second injection of LPS, the reaction of calves was similar to that observed after the first injection, however, the breathing rate and TNF systemic production were significantly reduced. The results obtained indicate that a low dose of LPS leads to the development of 'late' tolerance manifested by hyporeactivity to TNF production but with maintained responsivity to IFN production, pyrogenic, hypoglycemic and leukemic response to the second injection of LPS. In conclusion, these results demonstrate that the tolerance response is not universal to all hematologic and immunologic parameters, and that the response needs to be evaluated with respect to the specific variable.

Interferon and tumor necrosis factor production during endotoxemia in sheep.

In humans endotoxemia has often been associated with the development of adult respiratory distress syndrome (ARDS). Sheep have an abundant population of pulmonary intravascular macrophages, therefore they are a popular animal model for ARDS. In this study we characterized the temporal sequence and duration of the release of two cytokines: tumor necrosis factor (TNF) and interferon (IFN) and evaluated the effect of lipopolysaccharide (LPS) dose. Rectal temperature and white blood cell (WBC) count were also measured. Twenty four adult sheep were given E. coli endotoxin at a dose of 0 (saline solution) 0.05, 0.1 and 1.0 microg/kg of body weight by intravenous (i.v.) bolus. In all groups, TNF-alpha was produced earlier (3-4.5 h) after injection than IFN (4-5 h). No correlation between increased rectal temperature, the magnitude of leukopenia and time course of both cytokines production was observed. No straight relationship between LPS dose and the titer of cytokines was seen, but lower doses of LPS-induced delayed cytokine response in comparison to the dose 1 microg/kg of LPS. As IFN, present in the circulation of sheep, was mainly alpha/beta type, the role of this class of IFN in endotoxemia is discussed.

Removable partial denture production in western Germany.

Removable partial denture production in western Germany was studied by analyzing 1,082 photographs taken in consecutive series at five large dental laboratories. The photographic technique was standardized, enabling evaluation of the casts as well as the design of the dentures. Of the casts, 47.2% were maxillary and 52.8% were mandibular. The mean number of teeth present was 6.29 in the maxilla and 6.57 in the mandible. In the maxilla, 52.9% of the molar regions were edentulous; i.e., they had distal-extension free-end spaces. The corresponding figure for the mandibles was 72.7%. Most of the maxillary removable partial dentures had a palatal strap or a palatal plate, and most of the mandibular dentures had a lingual bar. Of the removable partial dentures, 53.1% were retained by telescopic crowns, 15.3% had precision attachments, and 36.1% were retained by clasps only.

[The mechanical loading capacity of new all-ceramic crown and bridge materials]. / Die mechanische Belastbarkeit neuer vollkeramischer Kronen- und Brückenmaterialien.

The present contribution presents the fracture toughness KIc, the bending strength and the splitting tensile strength of the recently developed all ceramics Cerec, Dicor, Duceram, IPS-Empress, Flexo-Ceram, Hi-Ceram, In-Ceram, LFC, Mirage (I, II), Optec HSP, Syntho-Ceram and Vitadur. The toughness of those materials suitable for crowns and bridges were also tested with the help of the "Normkronentest" on incisor and canine abutments made from natural teeth or Wiron alloy. As a consequence of our investigations we propose a differentiation into three classes of toughness: class I (fracture toughness up to 2.0 MPa*m1/2, fracture stress up to 100 MPa) consists of the leucite, mica or whisker strengthened ceramics Cerec, Dicor, Duceram, IPS-Empress, Flexo-Ceram, LFC, Mirage (I, II), Optec HSP and Vitadur Alpha, N. Dicor and Optec HSP are at the upper boundary. Class II (fracture toughness up to 3.0 MPa*m1/2, fracture stress up to 150 MPa) consists of the aluminium oxid strengthened ceramics Hi-Ceram, Syntho-Ceram and Vitadur N Kern. Class III (fracture toughness more than 3.0 MPa*m1/2, fracture stress more than 150 MPa) up to now consists only of the infiltration ceramics In-Ceram.

Bacterial foci in the teeth, oral cavity, and jaw--secondary effects (remote action) of bacterial colonies with respect to bacteriospermia and subfertility in males.

Bacteriospermia requiring medical treatment were diagnosed in more than 70% of the subfertile patients who had since 1988 attended the gynecological clinic at the RWTH hospital in Aachen. In 23% of all cases specific treatment with antibiotics did not reduce the concentrations of bacteria in sperma. Thirty-six patients with bacteriospermia resistant to antibiotic therapy were then subjected to dental examination. A high incidence of potential dental foci was found in all patients. In a test group of 18 patients these sources of potential infection were eliminated. Between dental operations and therapy swabs were taken to determine bacterial levels and bacteriological composition. It could be demonstrated that the bacterial spectrum of the intraoral samples was almost identical with the spermiograms. Six months following completion of dental treatment a further spermiogram analysis was carried out. In the test group about two thirds of the spermiograms proved sterile. Spermatological parameters, such as motility, density and morphology, had also clearly improved. In the control group the findings of the spermiogram remained poor. This study indicates that a direct causal relationship exists between bacterial colonies (dental foci) and therapy-resistant bacteriospermia which probably leads to subfertility.

[System for intraoral repair of ceramic blends--an in vitro study of adhesive strength]. / Systeme zur intraoralen Reparatur von keramischen Verblendungen--eine in-vitro Studie der Haftfestigkeit.

We investigated composite repair systems for crown facings which consisted in principle of a silane primer, of an unfilled Bis-GMA bonding agent and of a filled Bis-GMA resin. The in vitro investigations revealed that under oral conditions the longterm durability of the bond strength is still unsufficient, unless care is taken that the debris layer which is caused by mechanical treatment has been removed.

[The role of dental implantology--statistical considerations]. / Zahnärztliche Implantologie--eine statistische Standortbestimmung.

Endosseous implantation procedures are used in dentistry with ever increasing frequency. For an assessment of the role of dental implantology within the specialities of dentistry, 2000 physicians and dentist in the FRG were surveyed. The article reports data on physicians/dentists involved in implantology, the frequency of insertions of endosseous implants, the popularity of implant systems, implantological methods applied, successes, failures and indications.

[Prosthetic care of reduced dentition]. / Die prothetische Versorgung des reduzierten Restgebisses.

The treatment of replacing missing functional teeth (due to various schools of concepts), as well as the extensive possibilities of gaps, that may occur in the oral cavity makes it often extremely difficult for the dentist in the practice, to decide which form of prosthesis is right. In this study 996 laboratory work procedures from 5 laboratories in Germany were photographed after completion and evaluated for construction faults. Although a large percentage of the work was extensure prosthesis (more than 50% combined fixed--removable and telescopic procedure) 33.4% showed construction faults, whereas 65% of the work was rated acceptable.

[Prophylaxis programs in the dental office--evaluation of a survey of dentists]. / Prophylaxe-Massnahmen in der zahnärztlichen Praxis. Analyse einer Umfrage unter Zahnärzten.

Questionnaires on dental prophylaxis were sent to one thousand West German dentists. 457 of them were returned. 61.7% of the dentists interviewed were working in urban, 38.8% in rural areas. The results revealed that the importance of dental prophylaxis is still underestimated today.

[Algipore--new material for repair of bony periodontal pockets]. / Algipore--ein neues Material zur Auffüllung parodontaler Knochentaschen.

Intrabony periodontal lesions of three minipigs received surgical debridement followed by site implantation of synthetic and phycogenic hydroxylapatite graft material. Histologic examination of the sites treated with Algipore showed limited ossification of these implants. Lesions treated with the phycogenic material showed increased ossification of the implant pores and the implant periphery. These results suggest that Algipore has no clinical indication, while the phycogenic material could have a limited indication in intrabony periodontal lesions.

[Male subfertility and oral bacterial diseases]. / Männliche Subfertilität und orale bakterielle Erkrankungen.

More than 70% of the husbands consulting the Dept. of Gynecology and Obstetrics of the RWTH Aachen for sterility since June 1987 needed treatment for bacteriospermia with germ concentrations greater than 10(4) cfu/ml ejaculate. In 23% of the treated men however, no convincing reduction of germ concentration were achieved. 36 patients with therapy-resistant bacteriospermia were sent to the Dept. of Dentistry of the RWTH Aachen. A lot of intra-oral foci were found, which got eliminated. Intra-operational bacterial specimens were taken and evaluated by a special diagnostic technique in the Dept. of Microbiology. It was shown that the bacterial spectrum of the intraoral specimens and the spermiograms were identical. Six months after completion of the dental therapy a new andrological examination was performed. Two thirds of the spermiograms now were already sterile. There was an improvement of the spermparameters as well as motility, morphology and density. It can be concluded from these results that there is a direct causal relationship between a symptomatic dental primary disease and bacteriospermia which probably leads to subfertility.

[New construction principles for Silicoater-cast maxillary prosthesis]. / Neue Konstruktionsprinzipien für Silicoater-Modellgussprothesen im Oberkiefer.

A problem often seen in the dentist's practice is the relining of a removable Cr-Co-prosthesis in the reduced maxillary arch. For this reason we have developed a prosthesis that has its base completely surrounded with acrylic. This modification is nearly as stable as a total Cr-Co-prothesis. The results on 15 patients restored with this new prosthesis were very positive.

[Comparative studies on different full and veneer-ceramic crowns]. / Vergleichende Untersuchungen an verschiedenen Voll- und Verblendkeramikkronen.

Under quasi-clinical conditions, Dicor, Hi-Ceram, Ceraplatin and PFM (porcelain butt margin) crowns with ceramic shoulders manufactured by commercial laboratories for the same metal master die were examined for marginal defects under the electron microscope. With equal cementing conditions and points of measurement for all crowns, the PFM crowns were found to be significantly superior to the other crown types. However, this result becomes relativistic in view of the great statistical variances involved.

[Animal experimental studies of periodontal implants of compact macroporous and phycogenic HA-ceramic granules]. / Tierexperimentelle Untersuchungen zur parodontalen Implantation von kompakten, makroporösen und phykogenen HA-Keramikgranulaten.

Four different macro- and microporous, compact bone implant materials were used in minipigs for the periodontal treatment of infrabony defects. The results showed, that the compact materials had minimal osteogenic potential, where as the macroporous materials, especially the phycogenic HA-granules with connecting microporosities showed an intensive osteointegration and appositional reaction.

Minimal andrological requirements for in-vitro fertilization.

The ejaculate used for in-vitro fertilization of human oocytes must fulfil minimum requirements. Based on the results of experimental investigations, total concentrations of spermatozoa must be greater than 5 million spermatozoa/microliters with progressive motilities of at least 30% and also a normal morphology of at least 30%. Furthermore, in sperm preparations used for inseminating human oocytes, the concentration of pathogenic microorganisms must not be less than 10(4). If there are positive bacteriological findings, the treatment of both partners is mandatory according to the antibiogram. According to the information gathered to date, the hamster oocyte penetration test can only provide additional information if it is positive, but acceptance into an IVF programme should not depend on this test. According to the results presented so far, the swell test developed by Jeyendran shows quite good correlation with the fertilization of human oocytes.

[Studies on marginal fit of Dicor crowns]. / Histologische und rasterelektronen-mikroskopische Untersuchungen zur marginalen Passform von Dicor-Kronen.

Dicor crowns may present marginal defects, among other reasons because they require preparation of a circular ledge with rounded internal line angles. In studying this problem, 21 teeth that could no longer be saved were prepared in vivo and provided with Dicor crowns in our hospital. After remaining in place for 3 months these teeth were extracted. Subsequently their marginal areas were studied by SEM and histological preparations were made and measured. The marginal defects of Dicor crowns revealed slightly less favorable values than the Hi-Ceram crowns investigated one year ago, but these values are still within the range of clinical acceptability.

[Temporary acrylic crowns and bridges--particular considerations of the periodontium]. / Provisorische Kronen und Brücken aus Kunststoff unter besonderer Berücksichtigung des Parodonts.

Dentists generally fail to recognize the importance of the correct construction and finishing of acrylic temporary restorations from the periodontologic point of view. The potential traumatic effect of these restorations on the gingiva is rarely considered. A survey of 1000 dentists in Western Germany revealed some common errors. The results are compared with the clinical requirements for temporary restorations.