[Segmental Caroli's disease].
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Biomedical subjects
Publications and source records attributed to A Albaladejo.
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INTRODUCTION: Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal-crecessive or sporadic disorder, characterized by repeated episodes of unexplained cholestasis followed by prolonged asymptomatic periods. CASE REPORT: We present two male patients aged 12 and 15 years old who initially presented cholestasis and who had no family history of liver or biliary disease. Typically, alkaline phosphatase and bilirubin levels were elevated, with a slight increase in transaminases and gamma-glutamyltransferase. In both patients biliary tract disease was ruled out by endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiography while no significant abnormalities of the liver parenchyma were found on liver biopsy. Early treatment with ursodeoxycholic acid (UDCA) reduced the duration of the cholestasis episode compared with that of other episodes in which the patient had received other treatment or the treatment was late (1 or 2 months vs 4 months in patient 1 and 1-3 months vs 5 months in patient 2, respectively). DISCUSSION: Consensus is lacking on the treatment of BRIC although several treatment have been used. UDCA could be effective in increasing bile acid secretion and in reducing serum bilirubin levels. In the two patients described, the initial dosage was 15 mg/kg/day, which was subsequently maintained at 6 mg/kg/day, which was subsequently maintained 6 mg/kg/day until biochemical parameters returned to normal. Nevertheless, larger studies are required to confirm that UDA shortens episodes of cholestasis in BRIC.
OBJECTIVE: To evaluate the effect of mechanical loading on the microtensile bond strength (MTBS) of five adhesive systems to dentin. METHODS: Flat dentin surfaces from human molars were divided into five groups and bonded with total-etch self-priming adhesives (Single Bond, Prime&Bond NT and Prime&Bond XP), two-step self-etching primer (Clearfil SE Bond) and an all-in-one adhesive (Etch&Prime 3.0), according to the manufacturers' instructions. Composite build-ups were constructed incrementally with Tetric Ceram. After 24 hours of water storage, half the specimens were load cycled (5000 cycles, 90 N). The teeth were then sectioned into beams of 1.0 mm2 cross-sectional area. Each beam was tested in tension in an Instron machine at 0.5 mm/minute. Data were analyzed by two-way ANOVA and Student Newman Keuls multiple comparisons tests (p<0.05). RESULTS: Clearfil SE Bond and Single Bond attained higher MTBS than the other three adhesives. Prime&Bond NT and Prime&Bond XP performed equally, and Etch&Prime 3.0 resulted in the lowest MTBS. After mechanical loading, MTBS decreased in all groups except Prime&Bond XP. Clearfil SE Bond, Single Bond and Prime&Bond XP obtained higher MTBS than Prime&Bond NT. Specimens bonded with Etch&Prime 3.0 resulted in premature failures and MTBS could not be measured. CLINICAL RELEVANCE: When using Etch&Prime 3.0, bond structures did not withstand mechanical loading, which may have an influence on the long-term success of restorations. If dentin is acid-etched, alcohol-based adhesive systems showed higher bond strength after mechanical loading.