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Biomedical subjects

D M Aeppli

Publications and source records attributed to D M Aeppli.

At least 37 records · Page 2Linked to original sources
PubMed1992

Effect of gels containing stannous fluoride on oral bacteria--an in vitro study.

The purposes of this investigation were to evaluate and compare the antimicrobial effect of (1) twelve 0.4 per cent stannous fluoride (SnF2) commercial products and (2) different concentrations of SnF2 (range = 0.02 to 3.28 per cent). The antibacterial inhibitory effect of various SnF2 gels was evaluated as to their effectiveness against oral plaque bacteria including strains of S. mutans, S. sanguis, S. sobrinus, A. viscosus, A. actinomycetemcomitans, and B. intermedius. When twelve different commercial preparations of 0.4 per cent SnF2 were compared for inhibitory effect on plaque bacteria, several of the SnF2 preparations were significantly more effective in inhibiting oral bacteria (p < 0.05). With increasing concentration of SnF2, there was a comparable increase in the inhibitory effect on the oral bacteria tested (r2 ranged from 0.867 to 0.996). SnF2 at a concentration of 0.4 per cent had a similar antibacterial effect to 0.12 per cent chlorhexidine. This in vitro study demonstrated that certain SnF2 products are highly effective in inhibiting the growth of bacteria often found in plaque, and this inhibitory effect is directly related to the concentration of the SnF2.

Actinomyces viscosus↗
PubMed1992

Comparison of measurement variability in subjects with moderate periodontitis using a conventional and constant force periodontal probe.

This study compared the intra- and inter-examiner measurement error of the Florida Probe, Florida Disk Probe, and conventional periodontal probe in persons having moderate to severe periodontitis. Single pass measurements using the conventional probe were compared to both single and double pass (corrected) measurements using the Florida Probe and Florida Disk Probe. The mean intra-examiner standard deviations of differences in repeated site probing depth measurements ranged from 0.60 to 0.93 mm for the Florida Probe and from 0.52 to 0.89 mm for the conventional probe. Based on overall averages, the conventional probe measured deeper probing depths than the Florida Probe at the same sites. This difference was especially evident in pockets greater than or equal to 6 mm in depth. Based on sites, the mean intra-examiner standard deviations of differences in repeated relative attachment level measurements using the Florida Disk Probe ranged from 0.55 to 0.82 mm. The mean standard deviations of site measurements for attachment level obtained with the conventional probe ranged from 0.62 to 1.14 mm. Inter-examiner measurement error was greater than intra-examiner measurement error for each probing method. It was concluded that use of the Florida Probe and Florida Disk Probe may offer significant advantages in reducing measurement error for some clinical examiners. For other examiners, use of the Florida Probes do not necessarily result in less measurement error than use of conventional probing methods.

Calibration↗
PubMed1992

Lack of prognostic value of histopathologic parameters in Hodgkin's disease, nodular sclerosis type. A study of 123 patients with limited stage disease who had undergone laparotomy and were treated with radiation therapy.

The value of histopathologic parameters in predicting the long-term overall survival probabilities was studied in a series of 123 patients with pathologic stage IA, IB, IIA, IIB, or IIIA Hodgkin's disease, nodular sclerosis type who were treated with curative radiation therapy. The parameters that were studied included the relative proportion of atypical vs reactive cells, amount of eosinophils, presence of necrosis, degree of mitotic activity, intensity of different types of mesenchymal reactions, classification in three subtypes (ie, lymphocyte predominance, mixed cellularity, and lymphocyte depletion) or in two grades (ie, grades 1 and 2), and identification of the syncytial variant. For each parameter, the association with clinical risk factors was also analyzed. The results of this study show that there are no pathologic features that carry a significant predictive value of the overall survival.

Adolescent↗
PubMed1991

Spermatic vein occlusion with hot contrast material: angiographic results.

Spermatic vein occlusion by means of selective injection of boiling contrast material into the spermatic vein was attempted in 175 men with symptomatic varicoceles or infertility. Seventy-six patients (43%) returned for follow-up venography. Of 115 veins injected, 96 (83%) were totally occluded on the follow-up venogram obtained at 6 weeks to 2 years after injection. In the latter portion of the study, the technique was changed slightly, with injection of larger volumes of hot contrast material, resulting in a 91% occlusion rate. Each vein that was found patent on the follow-up venogram (19 of 115 [16%]) was assessed radiographically, and results were categorized as grade 1, a complete failure in which there was no change from the presclerotherapy appearance (nine of 19 [47%]); grade 2, a failure in which the treated vein was smaller but patent (five of 19 [26%]); or grade 3, a failure in which the treated vein was occluded with newly developed collateral vessels (five of 19 [26%]). The pretreatment size of the spermatic vein and the quantity of hot contrast material injected were both statistically significant factors in the treatment outcome.

Adolescent↗
PubMed1991

Fluorescence immunoassay for detecting periodontal bacterial pathogens in plaque.

A particle concentration fluorescence immunoassay has been modified into a bacterial concentration fluorescence immunoassay (BCFIA) to rapidly detect periodontopathic bacteria in human plaque samples. The BCFIA utilizes fluorescently tagged monoclonal antibodies (MAbs) directed against the lipopolysaccharide of selected gram-negative plaque bacteria. Microorganisms closely associated with periodontal disease that can be identified in plaque with the BCFIA include Porphyromonas gingivalis, Bacteroides intermedius, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Eikenella corrodens. Briefly, the procedure involved mixing a patient's plaque sample or other bacterial preparation with a species-specific fluorescein isothiocyanate-labeled MAb in a specialized microtiter plate. This mixture was incubated to allow binding of the MAb to its homologous bacteria. The bound and unbound fluorescent tagged MAbs were separated by filtration in the modified microtiter plate, and the total bacterial bound fluorescence was determined with a fluorimeter. The number of a specific bacterial species in a given plaque sample or other bacterial suspension was estimated by reference to a primary standard carried through the BCFIA. The lower detection limit of the BCFIA was 10(3) to 10(4) bacterial cells from single cultures of bacteria or 10(4) bacterial cells in mixed cultures. The coefficient of variation within and between plates for each of the five bacterium-specific MAbs in screening plaque for the periodontal pathogens was less than 10%. These results demonstrate that microbes in plaque can be used as the solid phase in the BCFIA to detect and quantitate MAbs associated with specific bacteria quickly and reliably.

Aggregatibacter actinomycetemcomitans↗
PubMed1990

Curative radiotherapy for laparotomy-staged IA, IIA, IIIA Hodgkin's disease: an evaluation of the gains achieved with radical radiotherapy.

Between 1970 and 1983, 179 patients with pathologically staged IA, IIA, and IIIA Hodgkin's disease were treated with curative radiotherapy. From 1970 to 1974, patients were treated with standard extended or total nodal field irradiation (Treatment Group 1). Since 1975, because of the high prevalence of recurrences in patients with large mediastinal mass and/or hilar disease and/or splenic involvement (LMM &/or H+ &/or S+), treatment was modified to include low-dose lung irradiation within the mantle field for those patients with LMM &/or H+ and low-dose liver irradiation within the infradiaphragmatic field for patients with S+ (radical XRT). Patients who did not have those characteristics were treated with standard radiotherapy (standard XRT). A total of 122 patients were treated from 1975 to 1983 (Treatment Group 2), of whom 61 received radical XRT and 61 received standard XRT. An analysis was done to evaluate whether the progressive-improvement in outcome since 1970 at the University of Minnesota Hospital resulted from the contribution of modified treatment or from progressive improvement in treatment overall. There was a statistical improvement in recurrence-free survival (RFS) in Treatment Group 2 (Tr Gr 2) compared to Treatment Group 1 (Tr Gr 1), with 10-year RFS of 80% versus 57% (p less than 0.001 for time to event). The improvement in RFS was attributed to treatment modification consisting of radical XRT for those patients with LMM &/or S+. There was no change in RFS for those patients without LMM &/or H+ &/or S+ who were treated in Tr Gr 1 and Tr Gr 2, with 10-year RFS of 78% versus 86% (p = 0.29), respectively. However, treatment results for patients with LMM &/or H+ &/or S+ improved considerably in the radical XRT group. Comparing standard versus radical XRT, 10-year RFS was 36% versus 78% (p = 0.001), and 10-year OS was 72% versus 92% (p = 0.034). Patterns of relapse also changed for patients with LMM &/or H+ &/or S+ who were treated with radical XRT. Rather than showing a high frequency of intrathoracic recurrence as was seen in those patients with LMM &/or H+ &/or S+ after standard XRT, the relapse pattern was similar to patients without LMM &/or H+ &/or S+. Salvage treatment was well tolerated for patients who failed after radical XRT. Delayed, life-threatening effects, such as pulmonary and cardiovascular complications and SMN, were equivalent for patients in Tr Gr 1 versus 2, and for those who received standard and radical XRT.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1990

Acyclovir treatment of varicella in otherwise healthy children.

STUDY OBJECTIVE: To determine whether acyclovir administered orally affects the duration and severity of varicella in otherwise normal children. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: Patients' residence and university hospital clinic. PATIENTS: One hundred five children between 5 and 16 years of age with laboratory-confirmed varicella entered the study. Of the 102 who were included in the final analysis, 50 received acyclovir and 52 received placebo. INTERVENTION: Placebo or acyclovir was given orally four times daily, for 5 to 7 days. The acyclovir dose was adjusted as follows: 5 to 7 years of age, 20 mg/kg; 7 to 12 years, 15 mg/kg; and 12 to 16 years, 10 mg/kg. MEASUREMENTS AND MAIN RESULTS: Acyclovir recipients, compared with the placebo group, defervesced sooner (median, 1 day vs 2 days; p = 0.001), experienced onset of cutaneous healing sooner, as reflected by a decrease in number of lesions (median, 3 days vs 2 days; p = 0.002), and had fewer skin lesions (median, 500 vs 336; p = 0.02). Acyclovir did not significantly change the rate of complications of varicella (10% in the acyclovir group vs 13.5% among placebo subjects). Adverse drug effects were not observed. Acyclovir recipients had lower geometric mean serum antibody titers to varicella-zoster virus than their placebo counterparts 4 weeks after the onset of illness, but antibody titers in both groups were similar 1 year later. CONCLUSIONS: These results provide evidence that acyclovir is useful and well tolerated for treatment of varicella in otherwise healthy children.

Acyclovir↗
PubMed1990

Comparison of plaque microflora between Chinese and Caucasian population groups.

This investigation was designed to compare the predominant plaque micro-organisms from a Chinese group of patients exhibiting periodontitis with an age-, sex- and periodontal disease-matched Caucasian group of patients. In addition to race, the 2 population groups differed with respect to diet and oral hygiene habits, or effectiveness at removing plaque. Clinical measurements were determined along with an evaluation for micro-organisms in supragingival and subgingival plaque. Although the Chinese and Caucasian population groups were similar with respect to composition of micro-organisms in subgingival plaque, notable differences were observed in supragingival plaque. The Chinese group had higher mean proportions of spirochetes, motile rods. Fusobacterium spp. and dark-pigmented Bacteroides species, while the Caucasian group had higher mean proportions of cocci, total Actinomyces spp., A. viscosus and total Streptococcus spp. in supragingival plaque. The microbial differences observed in supragingival plaque may be explained at least in part, if not totally, by the higher plaque index scores of the Chinese versus Caucasian population groups.

Actinobacillus↗
PubMed1990

The periodontal status of patients with Sjögren's syndrome.

Sjögren's syndrome (SS) is a chronic inflammatory disease characterized by xerostomia. Although a common observation in SS is increased susceptibility to caries, the level of periodontal disease has not been described in these individuals. The purpose of this study was to determine the periodontal status of 14 SS female subjects who had a mean age of 52.9 +/- 11.6 years. Plaque, gingival, and calculus indices as well as probing depth (PD) and attachment level (AL) were determined on 7 index teeth in each subject. Result indicated that individuals with Sjögren's Syndrome did not exhibit significant periodontal disease.

Dental Health Surveys↗
PubMed1989

Radiation dosimetry in specific area radiography.

An improved head-and-neck phantom was constructed from a human skull, cervical vertebrae, and Mix D, a mixture of wax, plastic, and metal oxides with x-ray absorbing and scattering properties similar to water and soft tissues. Lithium fluoride thermoluminescent dosimeters were calibrated and then exposed within the phantom. The doses at 17 anatomic sites were calculated for each of the 18 specific area radiographs in a complete intraoral radiographic survey.

Bone Marrow↗
PubMed1989

Detection of longitudinal change in periodontitis.

In any longitudinal study of periodontitis, it is important to determine when change in probing depth or clinical attachment level occurs as soon as possible. In this study, simulation was used to compare three statistical methods for detecting change in linear periodontal measurement under a variety of conditions including type of change, number of follow-up visits, magnitude of linear measurement and examiner variance. The statistical methods included: 1) testing the slope of a regression line, 2) a comparison of running medians and 3) the cumulative sum (cusum) method. Three types of change and random examiner error were imposed on baseline linear measurements. The types of change included a gradual change, a burst, and rapid loss followed by regeneration. The results indicated that all three methods yielded similar results when the change was gradual. However, the regression line was less sensitive to bursts of change than the other methods. Overestimation of examiner error for the running median and cusum methods increased specificity and decreased sensitivity. Underestimation of examiner variance decreased specificity and increased sensitivity of the cusum and running median methods, while the regression was unaffected by estimates of examiner variance. If preventive or therapeutic action does not need to be taken immediately, either the running median or the cusum would be a good choice for detecting change. If immediate intervention is needed, the cusum appears to be the method of choice for detecting change at specific sites in longitudinal periodontal studies.

Follow-Up Studies↗
PubMed1989

Four-year investigation of salt and peroxide regimen compared with conventional oral hygiene.

This study of 171 subjects compared the effectiveness of a patient-applied salt and peroxide oral hygiene regimen with the use of conventional oral hygiene methods on clinical measures of periodontal disease, and determined patient compliance with and acceptance of using these two oral hygiene regimens. Results indicated that both regimens, when combined with professional care, were effective in changing clinical measures of periodontal disease to a state favoring periodontal health.

Adult↗
PubMed1989

Effect of toothbrushing with 0.4% stannous fluoride and 0.22% sodium fluoride gel on gingivitis for 18 months.

This study determined the effect of brushing with 0.4% stannous fluoride (SnF2) or 0.22% sodium fluoride (NaF) on clinical and microbial parameters associated with gingivitis. The study included three groups of 281 subjects. Subjects in all three groups were instructed to brush twice daily with an ADA-accepted fluoride dentifrice, rinse their mouths with water, and subsequently brush with 0.4% SnF2, 0.22% NaF, or a fluoridefree placebo gel. More stain was detected in the SnF2 group than in the other two groups at all periods except at baseline. However, no differences were observed in gingivitis, bleeding, or mean proportions of microbial forms in the SnF2 or NaF groups when compared with the placebo group at 18 months. Results indicate that 0.4% SnF2, or 0.22% NaF is no more effective than a placebo in reducing gingivitis.

Adult↗
PubMed1989

The effect of professional and home subgingival irrigation with antimicrobial agents on gingivitis and early periodontitis.

The purpose of this investigation was to study the effect of a professionally applied subgingival antimicrobial agent (stannous fluoride) delivered at periodontal prophylaxis, combined with home personal subgingival delivery of an antimicrobial agent (iodine) on patients with gingivitis and early periodontitis. A control group of 32 individuals was instructed to use dental floss and a sulcular toothbrushing method as a regular oral hygiene regimen. The test group of 42 subjects received professional subgingival irrigation with a 1.64% stannous fluoride solution delivered after scaling. These subjects were also instructed in the home subgingival delivery of an iodine solution along with the use of dental floss and sulcular toothbrushing. Subjects were clinically evaluated at baseline and again after eight weeks. Individuals in the test group, when compared to the control group, had a significantly lower gingival index score at eight weeks. In addition, the test group had significantly lower bleeding and gingival index scores at eight weeks when compared to baseline. Professional subgingival irrigation with stannous fluoride, when combined with home subgingival delivery of an iodine solution, was effective in improving gingival health for patients with gingivitis and early periodontitis.

Adult↗
PubMed1988

Relation between serum digoxin concentration and the electrocardiogram.

The relation between serum digoxin concentration and the electrocardiogram was assessed by correlating computerized measurements of electrocardiographic parameters (PR, QRS, QT and QTc intervals, ST segment, and T-wave amplitude) with the serum digoxin concentration in 97 patients on digoxin maintenance therapy and in 40 nondigitalized control subjects. None of the patients had unstable ischemic heart disease, electrolyte disorders, medication known to influence the ST segment, and/or the presence of a bundle-branch block or ventricular hypertrophy. We found a trend toward lengthened PR interval and shortened QT and QTc intervals in digitalized versus nondigitalized patients. Increasing serum digoxin concentrations were associated with progressive depression of the ST segment and decreased T-wave amplitude (p less than 0.001). A normal ST segment in four leads (I, aVF, V5, V6) excluded the presence of a serum digoxin concentration greater than 1.3 ng/ml in our patients, whereas severe ST-segment depression with a J point of greater than or equal to 100 microV was a strong indicator for the presence of a serum digoxin concentration greater than 2.0 ng/ml in our selected patient population (specificity 99%, sensitivity 30%, predictive accuracy 85%). We conclude that computerized electrocardiographic analysis of the ST segment may provide clinically useful information for the management of selected patients on digitalis therapy and may therefore increase the diagnostic yield of the electrocardiogram in predicting the presence of higher serum digoxin concentrations in a small but significant percentage of patients.

Adult↗
PubMed1987

Survival of patients with acute renal failure requiring dialysis after open heart surgery: early prognostic indicators.

We analyzed pre- and postoperative data from 36 consecutive patients, who developed acute renal failure requiring hemodialysis after open heart surgery, to determine which factors predicted survival. Seventeen patients (47%) survived. Age, sex, preoperative renal dysfunction, severity of underlying heart disease, perioperative myocardial infarction, cardiopulmonary bypass time, and oliguria did not influence outcome (by univariate analysis). However, the number and type of postoperative complications, before the first hemodialysis and 48 hours thereafter, were found to be significant predictors of outcome. Univariate as well as multivariate analysis showed that the highest mortality rate was associated with the presence of respiratory failure, central nervous system dysfunction, hypotension, and infection (48 hours after first hemodialysis). Thirty-three (92%) of the 36 patients were correctly classified as survivors or nonsurvivors based on the presence or absence of any one of three prognostic indicators (three or more complications before the first hemodialysis and persisting 48 hours later; hypotension before the first dialysis and persisting 48 hours later; or central nervous system dysfunction 48 hours after hemodialysis was initiated). We conclude that an assessment of prognosis can be made in such patients as early as 48 hours after the first hemodialysis based on the number and type of complications.

Acute Kidney Injury↗
PubMed1987

Hodgkin's disease: a reassessment of prognostic factors following modification of radiotherapy.

Between 1970 and 1982, 175 patients with Stage IA, B, IIA, B, or IIIA Hodgkin's disease were treated with curative radiotherapy following surgical staging. The patients treated prior to 1975 received either regular extended or total nodal field treatments (Treatment Group 1, N = 65). Unsatisfactory results from this treatment program led to treatment modification in 1975. The modified protocols consisted of low-dose lung irradiation in patients having large mediastinal masses and/or hilar disease, and low-dose liver irradiation for Stage IIIAS+ patients (Treatment Group 2, N = 110). Recurrence-free survival rates improved significantly for various risk groups. Univariate analysis indicated that age, stage, symptoms, mediastinal mass size, number of sites involved, hilar disease, stage, and symptoms were significant risk factors in Treatment Group 1. In Treatment Group 2, only sex was a statistically significant risk factor. Stepwise Cox regression analysis for risk factors selected mediastinal mass size and stage as the most significant prognostic factors in Treatment Group 1. In Treatment Group 2, number of initial disease sites and sex were the most significant risk factors. The results of the study show significant improvement in recurrence-free survival rates in Treatment Group 2. It is concluded that these improvements are due to the modification in treatment.

Adolescent↗