[Accidents of anticoagulant agents].
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Anticoagulants↗
Biomedical subjects
Michael Frank
Publications and source records attributed to Michael Frank.
Immediate loading versus immediate provisionalization of maxillary single-tooth replacements: a prospective randomized study with BioComp implants.
PURPOSE: The aim of this prospective randomized study was to evaluate the clinical outcome of immediately loaded solid plasma sprayed (TPS) BioComp (BioComp Industries BV, Vught, The Netherlands) implants versus immediate provisionalized but non-loaded BioComp implants in the anterior and premolar region of the maxilla. MATERIALS AND METHODS: Forty-eight patients (31 females and 17 males) with a mean age of 42.3+/-13.1 years (range 19 to 78 years) were included in the study. Fifty threaded TPS implants were placed and provisionalized within 24 hours after surgery. The patients were randomly assigned to 2 groups. In the immediate loaded (IL) group (n=24) the occlusion of the provisional was designed with normal contacts in centric relation and at lateral excursions, while in the non-immediate loaded (IP) group (n=24) the provisional restoration was adjusted to clear all occlusal contacts or contacts at lateral excursions. Patients were instructed to eat a soft diet and to avoid placing food in the area of the provisional crown during the first 6 weeks. Regular clinical and radiographic controls were performed and the survival rate and implant stability quotient (ISQ) values were evaluated at delivery of the definitive restoration at 6 months. At 1 year, radiographic coronal bone defects and gingival esthetics between the 2 groups were assessed. RESULTS: Of the IL group, 2 fixtures were lost, while 3 implants were lost in the IP group. The failing implants showed increasing mobility at 2 to 3 weeks after insertion, and were removed. The remaining 45 implants were stable at every subsequent follow-up examination, and 6 months after implant placement, ISQ values were measured. The mean ISQ value in the IL group was 63.7+/-5.8 versus 63.2+/-4.3 for the IP group (P=.78). The mean mesial marginal bone loss after 12 months in the IL group was 0.27+/-0.2 mm versus 0.28+/-0.22 mm in the IP group (P=.9). The mean distal marginal bone loss after 12 months in the IL group was 0.19+/-0.15 mm versus 0.2+/-0.11 mm in the IP group (P=.87). All implants of the IL group had an ideal gingival buccal margin, versus 91% of the IP group. Full regeneration of the mesial interdental papilla was observed in 70% of the IL group versus 91% of the IP group, while full regeneration of the distal papilla was observed in 91% of both the IL and IP implants. CONCLUSION: No significant differences in ISQ mean values in radiographic bone loss and gingival esthetics were found between immediate non-loaded provisionalization and immediately loaded BioComp implants in the maxilla.
Adult↗
Lactobacillus endocarditis: case report and review of cases reported since 1992.
Lactobacillus is a rare cause of endocarditis with only 78 reported cases in the literature. We report a case of Lactobacillus endocarditis and review reported adult cases since the introduction of the Duke's criteria for endocarditis. An analysis is presented with a focus on outcomes. Mortality from reported cases of Lactobacillus endocarditis was found to have substantially improved since 1992. Surgical rates for persistent disease remain the same. Possible reasons for this improvement include better antibiotics, earlier recognition of cases, and more aggressive treatment regimens.
Bacteremia↗
Estimation of the number of nerve fibers in the human vestibular endorgans using unbiased stereology and immunohistochemistry.
The objective of this study was to obtain estimates of the number of nerve fibers in the human crista ampullaris and utricular macula from normal individuals using unbiased stereology and immunohistochemistry. Vestibular endorgans with the attached vestibular nerve stump were microdissected from the temporal bones. Specimens were divided into two groups. The first group (group 1, N = 8, age range, 68-98 years old, mean = 87 years) was fixed with paraformaldehyde and post-fixed with osmium tetroxide. The second group (group 2, N = 5, age range, 80-98 years old, mean = 86.6 years) was fixed with paraformaldehyde, immunoreacted with monoclonal antibodies against neurofilaments, and post-fixed with osmium tetroxide. The endorgans of both groups were embedded in resin and 2-mum thick sections were made. Estimates of the number of nerve fibers were obtained using an unbiased stereological method, the fractionator. The diameter distribution of nerve fibers was also obtained. The average number of fibers in the horizontal, posterior and superior cristae of individuals in group 1 (N = 14 cristae) was 1424+/-320 (CV = 0.22). The average percentage of small (less than 3 microm), medium (between 3 and 5 microm) and large (more than 5 microm) size fibers was 22.4%, 51.5% and 26.1%, respectively. In group 2 (N = 12), there was an average of 1792+/-99 (CV = 0.05) nerve fibers. The average percentage of small, medium and large size fibers was 22%, 51.2% and 26.8%. In the macula utricle from group 1, there was an average of 3026 nerve fibers (N = 2, ages 80 and 96 years old). There was an average 30.75% small, 56% medium and 13.2% large size fibers. In the utricular macula from group 2 (N = 3, ages 84, 92 and 96 years old), there was an average of 3715 nerve fibers. The average percentage of small, medium and large size fibers was 33.2%, 51.7% and 15.1%. The nerve fiber number in both groups is within the range of previous studies, however, the number of fibers in group 2 was significantly higher than that in group 1 (p = 0.01). This difference is likely due to increased sensitivity gained by the immunohistochemical staining of the axoplasm of nerve fibers in group 2. Results from the present study demonstrate the use of unbiased stereology and immunohistochemistry in human vestibular endorgans, as a reliable and efficient method to estimate the number of nerve fibers. These methods can be applied for studies of normal aging and pathological conditions of the vestibular periphery.
Aged↗
Custom chemical microarray production and affinity fingerprinting for the S1 pocket of factor VIIa.
The goal of this study was to explore the applicability of surface plasmon resonance (SPR)-based fragment screening to identify compounds that bind to factor VIIa (FVIIa). Based on pharmacophore models virtual screening approaches, we selected fragments anticipated to have a reasonable chance of binding to the S1-binding pocket of FVIIa and immobilized these compounds on microarrays. In affinity fingerprinting experiments, a number of compounds were identified to be specifically interacting with FVIIa and shown to fall into four structural classes. The results demonstrate that the chemical microarray technology platform using SPR detection generates unique chemobiological information that is useful for de novo discovery and lead development and allows the detection of weak interactions with ligands of low molecular weight.
Chemistry, Pharmaceutical↗
Highly selective palladium catalyzed kinetic resolution and enantioselective substitution of racemic allylic carbonates with sulfur nucleophiles: asymmetric synthesis of allylic sulfides, allylic sulfones, and allylic alcohols.
We describe the highly selective palladium catalyzed kinetic resolutions of the racemic cyclic allylic carbonates rac-1 a-c and racemic acyclic allylic carbonates rac-3 aa and rac-3 ba through reaction with tert-butylsulfinate, tolylsulfinate, phenylsulfinate anions and 2-pyrimidinethiol by using N,N'-(1R,2R)-1,2-cyclohexanediylbis[2-(diphenylphosphino)-benzamide] (BPA) as ligand. Selectivities are expressed in yields and ee values of recovered substrate and product and in selectivity factors S. The reaction of the cyclohexenyl carbonate 1 a (>/=99 % ee) with 2-pyrimidinethiol in the presence of BPA was shown to exhibit, under the conditions used, an overall pseudo-zero order kinetics in regard to the allylic substrate. Also described are the highly selective palladium catalyzed asymmetric syntheses of the cyclic and acyclic allylic tert-butylsulfones 2 aa, 2 b, 2 c, 2 d and 4 a-c, respectively, and of the cyclic and acyclic allylic 2-pyrimidyl-, 2-pyridyl-, and 4-chlorophenylsulfides 5 aa, 5 b, 5 ab, 6 aa-ac, 6 ba and 6 bb, respectively, from the corresponding racemic carbonates and sulfinate anions and thiols, respectively, in the presence of BPA. Synthesis of the E-configured allylic sulfides 6 aa, 6 ab, 6 ac and 6 bb was accompanied by the formation of minor amounts of the corresponding Z isomers. The analogous synthesis of allylic tert-butylsulfides from allylic carbonates and tert-butylthiol by using BPA could not be achieved. Reaction of the cyclopentenyl esters rac-1 da and rac-1 db with 2-pyrimidinethiol gave the allylic sulfide 5 c having only a low ee value. Similar results were obtained in the case of the reaction of the cyclohexenyl carbonate rac-1 a and of the acyclic carbonates rac-3 aa and rac-3 ba with 2-pyridinethiol and lead to the formation of the sulfides 5 ab, 6 ab, and 6 bb, respectively. The low ee values may be ascribed to the operating of a "memory effect", that is, both enantiomers of the substrate give the substitution product with different enantioselectivities. However, in the reaction of the racemic carbonate rac-1 a as well as of the highly enriched enantiomers 1 a (>/=99 % ee) and ent-1 a (>/=99 % ee) with 2-pyrimidinethiol the ee values of the substrates and the substitution product remained constant until complete conversion. Similar results were obtained in the reaction of the cyclic carbonates rac-1 a, ent-1 a (>/=99 % ee) and ent-1 c (>/=99 % ee) with lithium tert-butylsulfinate. Thus, in the case of rac-1 a and 2-pyrimidinthiol and tert-butylsulfinate anion as nucleophiles the enantioselectivity of the substitution step is, under the conditions used, independent of the chirality of the substrate; this shows that no "memory effect" is operating in this case. Hydrolysis of the carbonates ent-1 a-c, ent-3 aa and ent-3 ba, which were obtained through kinetic resolution, afforded the enantiomerically highly enriched cyclic allylic alcohols 9 a-c (>/=99 % ee) and acyclic allylic alcohols 10 a (>/=99 % ee) and 10 b (99 % ee), respectively.
Alcohols↗
Effects of fertilizer and soil components on pesticide photolysis.
An environmental fate study was performed analyzing the effects of soil composition on the soil photolysis of a chemical. The study was conducted in two phases in which both moist and air-dried soils were fortified with either the common fertilizer sodium nitrate or the natural soil components iron or humic acid and dosed with niclosamide. The soils were photolyzed under a xenon lamp for 7 days. Increasing concentration of sodium nitrate did not affect the degradation pattern but did produce a lower concentration of aminoniclosamide. Soils fortified with iron displayed an unknown, which was not observed in other experiments, and the degradation of niclosamide from these soils was slower than from the sodium nitrate-fortified soils. There were no extractable degradates from any of the soils fortified with humic acid. In irradiated moist soils, the half-life of niclosamide increased when sodium nitrate was present at 20 ppm, and the half-lives of niclosamide in iron- and humic acid-fortified soil were increased slightly over that in unfortified soil. The effect of the nitrate and iron on the half-lives in dark control moist soils was minimal, but humic acid increased the dark control half-life from 420 to 611 h. No transformation of niclosamide was observed in the dark control air-dried soils. Soils with higher organic or iron contents or exposed to fertilizers do not affect as dramatically the half-life of pesticides as does the presence of moisture in the soil. Soil photolysis samples that were not maintained with moisture exhibited differences in half-life and degradation pattern. The maintenance of moisture was found to be more crucial to the reliability of soil photolysis studies than soil composition.
Fertilizers↗
Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?
STUDY OBJECTIVES: To investigate the frequency of microarousals (MA) associated with pressure changes during auto-CPAP therapy (APAP) for obstructive sleep apnea (OSA). DESIGN: Patients with OSA were studied by polysomnography during APAP therapy (Somnosmart). The MA were classified on the basis of concomitant changes in APAP pressure. SETTING: Sleep laboratory of a university hospital PARTICIPANTS: 30 patients with moderate to severe OSA. MEASUREMENTS AND RESULTS: The mean AHI during APAP was 4.7+/-4.7, the mean arousal index was 14.5+/-6.6 per hour. During epochs with a pressure variation greater than 0.5 mbar, significantly more MA occurred (0.30+/-0.17 MA per epoch) than in epochs with constant treatment pressure (0.10+/-0.054 MA per epoch; p<0.001). There were more MA during pressure-increase epochs than during pressure-decrease epochs (0.42+/-0.24 vs. 0.16+/-0.12 MA per epoch; p<0.001). 82.5 percent of the MA were not preceded by a significant change in pressure (at least 0.5 mbar within 30 sec.), 10.6% were associated with a significant prior increase and 6.9% with a significant prior decrease in pressure. The percentage of MA preceded by a significant pressure variation varied between 2.3% and 61%, with a mean of 18.9%. CONCLUSIONS: The overall frequency of MA was low, and in most individuals the relative amount of "pressure-associated MA" was not significant. However in some individuals it cannot be excluded that some additional MA may have been induced by pressure variations. Should it prove possible to prevent such "pressure-associated MA" by optimizing the regulation of APAP pressure, the overall clinical effect of APAP treatment may be improved.
Adult↗
Selective epimerization of L-chiro-inositol to L-muco- and D-chiro-inositol derivatives.
In a one step procedure, L-1-O-benzyl-2-O-methyl-chiro-inositol (1) was acetalized to the L-muco-inositol derivatives 2, 3 and D-2-O-benzyl-3-O-cyclohexylcarbamoyl-4-deoxy-4-(N,N'-dicyclohexylureido)-1-O-methyl-5,6-O-trichloroethylidene-chiro-inositol (4). Complete conversion of L-1-O-benzyl-6-O-cyclohexylcarbamoyl-3-O-formyl-2-O-methyl-4,5-O-trichloroethylidene-muco-inositol (3) into L-1-O-benzyl-6-O-cyclohexylcarbamoyl-2-O-methyl-4,5-O-trichloroethylidene-muco-inositol (2) is feasible by deformylation in boiling methanolic triethylamine. Furthermore, stepwise deprotection of 2 and 4 is described. Thus, compounds 5, 10, and 7 were obtained by decarbamoylation of 2, 4, and 6, respectively, with boiling methanolic sodium methoxide. The trichloroethylidene group of L-1-O-benzyl-2-O-methyl-4,5-O-trichloroethylidene-muco-inositol (5) was removed in a two step procedure (hydrodechlorination-deacetalization) via the ethylidene acetal 7 to give L-1-O-benzyl-2-O-methyl-muco-inositol (9). On refluxing D-chiro-inositol derivative 4 with 99% acetic acid, the ureido moiety was cleaved generating D-2-O-benzyl-4-cyclohexylamino-3-O-cyclohexylcarbamoyl-4-deoxy-1-O-methyl-5,6-O-trichloroethylidene-chiro-inositol (11). By contrast, cleavage of the ureido moiety of 10 was relatively difficult. The corresponding D-2-O-benzyl-4-cyclohexylamino-4-deoxy-1-O-methyl-5,6-O-trichloroethylidene-chiro-inositol (12) was only formed in small amounts. The structures of 1, 3 and 10 were confirmed by X-ray analysis.
Acetylation↗