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Biomedical subjects

E Knoll-Köhler

Publications and source records attributed to E Knoll-Köhler.

At least 19 recordsLinked to original sources

Short exposure of polymorphonuclear leucocytes to sodium fluoride suppresses the response to fMLP.

Fluoridated dental care products are used to prevent dental decay. Up to now, there are no data available on whether the fluoride (F-) component of these products affects the bactericidal activity of salivary polymorpho-nuclear leucocytes, which are involved in the protection of the oral mucosa against infection. Therefore, after determining the concentration/time profile of F- in mixed saliva of healthy subjects after topical application of 0.5 g of a 1.25% F- containing gel, unstimulated and fMLP-stimulated polymorphonuclear leucocytes (PMNs) were shortly exposed to these F- concentrations and the generation of superoxide and hypochloric acid were measured, as well as the liberation of lysomal enzymes, and correlated with the cellular Ca2+ and cAMP-levels. The results show that F-, at concentrations as retained in saliva, did not activate the oxidative burst in unstimulated PMNs. In fMLP-activated PMNs, F-suppressed the receptor-mediated increase in the oxidative burst and the liberation of fl-glucuronidase by reduction of the availability of extracellular Ca2+ and, thus, the influx of Ca2+ necessary to couple completely the fMLP signal to effector pathways. These F- concentrations neither altered the liberation of Ca2+ from internal stores nor induced a rise in cAMP. The possible clinical consequences of these results for xerostomic patients with respect to the generation of HOSCN/OSCN/SCN in saliva an important non-immune factor for oral health, are dicussed.

Adult↗

Metronidazole dental gel as an alternative to scaling and root planing in the treatment of localized adult periodontitis. Is its efficacy proved?

Eight randomized clinical trials, comparing the application of 25% metronidazole dental gel (Elzylol dental gel) once a week for two weeks with scaling and root planing in the "split-mouth" design for treating adult periodontitis, were evaluated and scored according to ANTCZAK et al. (1986) and BEGG et al. (1996). The aim of this investigation was to determine whether both treatment methods are of equal value. With a maximum of 1.0 in each case, the scores determined were (M +/- SD) 0.107 +/- 0.033 (range 0.072-0.168) for reporting the study protocol and 0.285 +/- 0.084 (range 0.120-0.400) for the data analysis, presentation and discussion. Though the study results show that both treatment modalities are of equal value, the quality of the trials does not allow a comparative therapy assessment at present. The state of the data is inadequate for applying local metronidazole dental gel as an alternative to mechanical instrumentation in adult periodontitis.

Adult↗

Activation of calcium signaling in isolated rat hepatocytes is accompanied by shape changes of microvilli.

Preceding studies using the hamster insulinoma cell line, HIT, and isolated rat hepatocytes have shown that two essential components of the Ca2+ signaling pathway, the ATP-dependent Ca2+ store and the store-coupled Ca2+ influx pathway, are both located in microvilli covering the surface of these cells. Microvilli-derived vesicles from both cell types exhibited anion and cation pathways which could be inhibited by anion and cation channel-specific inhibitors. These findings suggested that the microvillar tip compartment forms a space which is freely accessible for external Ca2+, ATP, and IP3. The entry of Ca2+ into the cytoplasm, however, is largely restricted by the microvillar core structure, the dense bundle of actin microfilaments acting as a diffusion barrier between the microvillar tip compartment and the cell body. Moreover, evidence has been presented that F-actin may function as ATP-dependent and IP3-sensitive Ca2+ store that can be emptied by profilin-induced depolymerization or reorganization [K. Lange and U. Brandt (1996) FEBS Lett. 395, 137-142]. Here we demonstrate the tight connection between microvillar shape changes and the activation of the Ca2+ signaling system in isolated rat hepatocytes. Using a combination of scanning electron microscopy (SEM) and fura-2 fluorescence technique, we confirmed a consequence of the "diffusion barrier" concept of Ca2+ signaling: Irrespective of the type of the applied stimulus, activation of the Ca2+ influx pathway is accompanied by changes in the structural organization of microvilli indicative of the loss of their diffusion barrier function. We further show that the cell surfaces of unstimulated hepatocytes isolated by either the collagenase or the EDTA perfusion technique are densely covered with microvilli predominantly of a short and slender type. Beside this rather uniformly shaped type of microvilli, a number of dilated surface protrusions were observed. Under these conditions the cells displayed the well known rather high basal [Ca2+]i of 200-250 nM as repeatedly demonstrated for freshly isolated hepatocytes. However, addition of the serine protease inhibitor, phenylmethanesulfonyl fluoride (PMSF), to the cell suspension immediately after its preparation reduced the basal cytoplasmic Ca2+ level to about 100 nM. Concomitantly, dilated surface protrusions disappeared, and cell surfaces exclusively displayed short, slender microvilli. Activation of the Ca2+ signaling pathway by vasopressin, as well as by the IP3-independent acting Ca2+ store inhibitor, thapsigargin, was accompanied by a conspicuous shortening and dilation of microvilli following the same time courses as the respective increases of [Ca2+]i induced by the effectors. Furthermore, the abundance of the large form of surface protrusions on isolated hepatocytes positively correlated with the size of a cellular Ca2+/Fura-2 compartment which is rapidly depleted from Ca2+ by extracellular EGTA. These findings support the postulated localization of the store-coupled Ca2+ influx pathway in microvilli of HIT cells also for hepatocytes and are in accord with the notion of a cytoskeletal diffusion barrier regulating the flux of external Ca2+ via the microvillar tip region in the cytoplasm.

Animals↗

Detection of the ATP-dependent nonmitochondrial calcium store in a cell surface-derived vesicle fraction from isolated rat hepatocytes.

In preceding studies, the IP3-sensitive Ca2+ store of the hamster insulinoma cell line, HIT, was detected in cell surface protrusions such as microvilli and related membrane structures [Lange, K., and Brandt, U. (1993) FEBS Lett. 320, 183-188; and (1993) FEBS Lett. 325, 205-209]. In this study, these experiments were extended on rat hepatocytes. We used the previously described shearing technique for isolating cell surface-derived vesicle fractions from freshly isolated and 48-h-cultured rat hepatocytes. As shown by Western blot analysis, these vesicles contained the hepatocyte-specific glucose transporter, GluT2, and actin, which are both typical microvillar components. Scanning electron microscopy revealed that a spherical vesicle population of uniform size (about 1 microm in diameter) originates from the hepatocyte microvilli. This vesicle fraction exhibited ATP-dependent and thapsigargin-sensitive Ca2+ storage activity with properties identical to those of the known microsomal systems and of HIT cell surface-derived vesicles, except that the ATP-dependent Ca2+ pool was insensitive to IP3. Like HIT surface vesicles, hepatocyte surface vesicles rapidly took up ATP via a 4,4'-diisocyanostilbene-2,2'-disulfonic acid (DIDS)-sensitive anion pathway. Inhibition of ATP influx into the vesicles by DIDS also completely inhibited ATP-dependent Ca2+ storage. Moreover, determination of efflux kinetics of Ca2+ from passively (in the absence of ATP) loaded vesicles revealed a La(3+)-sensitive but IP3-independent Ca2+ pathway which rapidly equilibrated intravesicular free Ca2+ with the external medium. Permeabilization of the vesicles with saponin (0.005%) opened an additional efflux pathway for Ca2+ which is not La(3+)-sensitive. However, saponin treatment of vesicles preloaded with Ca2+ in the presence of ATP did not affect the thapsigargin-sensitive vesicular Ca2+ store but only released a small portion (about 20%) of the vesicular Ca2+ that is not part of the thapsigargin-sensitive Ca2+ pool. Also, the size of the saponin-releasable Ca2+ pool was not affected by depletion of the thapsigargin-sensitive Ca2+ store. These findings indicate that hepatocyte surface vesicles are readily permeable for Ca2+ and ATP via cation and anion pathways. Consequently, Ca2+ storage into these vesicles does not occur by concentrative Ca2+ pumping but rather appears to be due to an internal, ATP-dependent mechanism of Ca2+ sequestration. The presented data are in accord with the previously reported colocalization of the ATP-dependent Ca2+ store and its functionally coupled, store-regulated Ca2+ influx pathway in special cell surface organelles, the microvilli.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗

[Is adrenaline in a 2% lidocaine solution after enoral injection hemodynamically effective?].

Adrenaline in local anesthetic solutions is thought to be the causative factor of acute exacerbations of preexisting cardiac diseases during dental anesthesia. This assumption presupposes the systemic effectiveness of adrenaline when coinjected with a local anesthetic drug. To test the above assumption, cardiovascular effects (PS, PD, dP/dTmax LVEP, CO, HR, EGG) and arterial drug concentrations were measured before and after injection of 1.0 ml/kg b.w. of a 0.9% NaCl, 1:300,000/1:100,000 adrenaline-HCl or 2% lidocaine-HCl alone and in combination into the mucobuccal fold of adrenalectomized rats. The transient increase in the cardiovascular parameters by adrenaline was abolished by lidocaine coinjection. The cardiodepressant effect of plain lidocaine was only reversed by the higher adrenaline dose, which however induced a small fall in PD, R and PM. Lidocaine increased the bioavailability of adrenaline from the intraoral depot. Inhibition of COMT activity by lidocaine may contribute to this effect. These findings demonstrate no cardiac response to adrenaline, up to 1:100,000 in a 2% lidocaine solution. In agreement with clinical findings the 1:100,000 adrenaline containing solution can be safely used in compromised cardiovascular patients. However, an interaction between a vasoactive comedication and lidocaine/adrenaline on the vascular system has to be taken into consideration.

Adrenalectomy↗

Pulpal anesthesia dependent on epinephrine dose in 2% lidocaine. A randomized controlled double-blind crossover study.

We studied the discrepancy in the results published on the dependence of the duration of pulpal nerve anesthesia on the concentration of epinephrine in 2% lidocaine. The increase in pain threshold of the pulpal nerve was measured before and after injection of lidocaine alone and lidocaine with epinephrine concentrations of 1:200,000, 1:100,000, or 1:50,000 into the mucobuccal aspect adjacent to the apex of the maxillary right incisor. The study was done in a random manner with a double-blind crossover design. The pulpal nerve was stimulated with negative rectangular electrical pulses of up to -167 V with 100 Hz and a pulse width of 0.6 msec. The results show a relationship between the 1:200,000 and 1:100,000 epinephrine concentrations and the success and duration of anesthesia. The onset of anesthesia was independent of the catecholamine content of the solution.

Anesthesia, Dental↗

[The beta-mimetic effects following the enoral injection of epinephrine with articaine].

A randomized, double-blind study was conducted to assess the influence of 1:200,000 or 1:100,000 epinephrine in a four percent articaine-HCl solution on the concentration-time profiles of epinephrine in the serum of patients during removal of an impacted lower wisdom tooth. In order to estimate the amount of endogenous epinephrine secretion during operation, volunteers were injected without subsequent operation. The heart rate (HR), the concentration of cAMP and norepinephrine were determined as indicators of beta-adrenoceptor stimulation and effective signal transduction. These parameters were correlated with the epinephrine serum concentration. HR measurements were done automatically using the Hewlett Packard monitor, cAMP and the catecholamins were determined immuno- and radioenzymatically. The results showed a dose-dependent absorption of epinephrine from the intraoral depot. The peak concentration and the velocity at which 50% of the epinephrine had been eliminated were affected by the operative manipulation that had induced an increase in endogenous epinephrine secretion. HR, cAMP and norepinephrine were linearly correlated with serum epinephrine.

Administration, Oral↗

Cardiohemodynamic and serum catecholamine response to surgical removal of impacted mandibular third molars under local anesthesia: a randomized double-blind parallel group and crossover study.

The aim of this study was to differentiate between the extent to which surgical stress and the epinephrine in local anesthetic solutions influence serum catecholamine, cAMP, and potassium levels, and contribute to changes in cardiohemodynamic parameters. One hundred sixty mg of articaine hydrochloride (4.0 mL of a 4% articaine hydrochloride solution) with two different epinephrine doses was injected into outpatients prior to removal of an impacted mandibular third molar in a randomized, double-blind parallel group and crossover design. The results showed that the amount of epinephrine absorbed from the intraoral injection site predominantly determined the serum epinephrine concentration. The anesthetic-induced increase in the serum epinephrine level did not correlate with changes in the cardiohemodynamic parameters under study at any time during the operative procedure. The serum cAMP changes correlated with those of epinephrine, whereas the serum potassium levels remained unchanged. The procedure of tooth extraction was a stressful event when the 1:200,000 epinephrine-containing anesthetic solution was used, showing that the risk of inducing a cardiovascular incident during oral surgery seems to be higher the greater the extent of operation and the lower the epinephrine dose in the anesthetic solution.

Adult↗

Cardiohaemodynamic and plasma level responses to intraoral submucosal injection of adrenaline.

Since knowledge of the bioavailability of adrenaline from the intraoral submucosal depot is a prerequisite for its safe use in dentistry, the time-dependent effects of adrenaline on the plasma adrenaline level and cardiohaemodynamic parameters were studied with invasive methods in adrenalectomized, anaesthetized rats after injection of adrenaline (4.0 micrograms/kg body wt) into the mucobuccal fold lateral to the upper right incisor. The absolute bioavailability of adrenaline from this intraoral submucosal depot was 16.8 per cent. Peak values for arterial plasma adrenaline and arterial blood pressure, maximal rate of rise of pressure in the left ventricle and heart rate were measured as early as 5 s after an injection period of 10 s. The different velocities at which the individual parameters returned to the basal state showed that the measurement of heart rate is an insensitive indicator of systemic adrenaline. Due to the absorption kinetics of adrenaline from intraoral tissue it may be concluded that the method of injection has a decisive influence on arterial adrenaline concentration and thus on cardiovascular response.

Adrenalectomy↗

[Possible causes of incidents during dental anesthesia].

Inadvertent intravascular injection of a local anaesthetic is the main cause of incidents during local dental anaesthesia. The composition of the local anaesthetic solution determines the clinical symptoms in dependence on the patient's pathophysiological condition and a possible drug therapy. Since an intravascular injection cannot be excluded with certainty slow injection of the anaesthetic solution and the knowledge of its composition are prerequisites.

Adjuvants, Anesthesia↗

[A comparative study of equimolar solutions of lidocaine and articaine for anesthesia. A randomized double-blind cross-over study].

Clinical experience has shown a greater anaesthetic efficiency of articaine over lidocaine. This could be confirmed by voltage measurements at the first maxillary incisor before and after injection of anaesthetic solutions containing equimolar concentrations of lidocaine and articaine supplemented with 1:100,000 and 1:200,000 epinephrine (EPI) in a randomized double-blind cross-over design. No significant differences in the anaesthetic profile between the 74 and 148 mM articaine solution with 1:100,000 EPI could be observed. The differences in the duration of pulpal anaesthesia at otherwise similar anaesthetic profiles imply that differences do exist in the indications for clinical use of these two anaesthetic substances during oral surgery.

Adult↗

Changes in plasma epinephrine concentration after dental infiltration anesthesia with different doses of epinephrine.

To define the cardiovascular risk as a result of epinephrine in local anesthetic solutions used in dental anesthesia, we measured the plasma epinephrine levels, the mean arterial brachial pressure (MAP), and heart rate for 15 min, after infiltration anesthesia in the area buccal to the upper permanent left lateral incisor and canine. For this purpose, 12 dental student volunteers received 2.0 mL 2% lidocaine with and without 20 or 80 micrograms epinephrine, in a double-blind cross-over trial. --Plain lidocaine solution cause no significant changes in the parameters under study when compared with the baseline values. --Lidocaine with 20 micrograms epinephrine caused a sustained doubling of the plasma epinephrine concentration two min after injection, and at the same time, a slight but significant (p less than 0.05) decrease in MAP. Two min and 45 s after injection, the heart rate increased by four beats/min when compared with the baseline rate. --Lidocaine with 80 micrograms epinephrine caused a doubling of the basal plasma epinephrine value as early as one min and 25 s after injection, and a ten-fold increase above the basal value at the end of the observation period (15 min). The heart rate increased significantly (p less than 0.01) by five beats/min above the baseline value starting two min after injection, and rose to a maximum of 13 beats/min until the end of the observation period. The time-point of the decrease in MAP was earlier, but the amount of the decrease equaled that measured after submucosal injection of 20 micrograms epinephrine with 40 mg lidocaine.

Adult↗

[Antibiotic therapy for odontogenic induced orofacial infections under office conditions].

Due to the dominance of anaerobics in dentogen-induced orofacial inflammations the possibility of their treatment is restricted to a few groups of substances of different chemical structure (penicillins, lincosamides, nitroimidazoles, tetracyclins and macrolide antibiotics) for ambulant patients. The order of application for these different substances is determined by the local diagnosis and the pathophysiological state of the patient. The general anamnesis of disease, drugs and allergy as well as the knowledge of pharmacodynamics and pharmacokinetics of the substances to be applied are, therefore, indispensible for an optimal antimicrobial therapy.

Anti-Bacterial Agents↗