Biomedical subjects

W K Chang

Publications and source records attributed to W K Chang.

At least 19 recordsLinked to original sources

PubMed2006

The feasibility study of using non-woven MBR for reduction of hydrolysed biosolids.

In this study, non-woven MBR was used to treat hydrolysed biosolids wasted from a biological treatment plant. The concentration of SS of hydrolysed biosolids in influent was 10,000 mg/L and the concentration of SS in effluent was less than 200 mg/L with/without discharging wasted sludge depending on different HRTs, i.e. 20, 15 and 10 d. The results indicated that the percentage of biosolids reduction in terms of SS removal efficiency in non-woven MBR was around 65, 60 and 35%, respectively, depending on different HRTs. Meanwhile, the ratio of VSS/SS was decreased from 0.78 to 0.50 and the number of smaller inorganic particle sizes increased due to extended SRT. The initial flux in the non-woven MBR was set at 0.02, 0.04 and 0.06 m3/m2/day and trans-membrane pressure (TMP) was less than 10 kPa. The permeate flux could be maintained quite stably due to lower TMP. The proposed non-woven MBR could be used to achieve the reduction of biosolids in the wastewater treatment plant.

Bioreactors↗

PubMed2004

Prediction of the distance from skin to epidural space for low-thoracic epidural catheter insertion by computed tomography.

BACKGROUND: It may be clinically useful to predict the depth of the epidural space. METHODS: To investigate the accuracy of preoperative abdominal computed tomography (CT) in prediction of the distance for low-thoracic epidural insertion, a single group observational study was conducted in 30 male patients undergoing elective major abdominal surgery requiring epidural analgesia for postoperative pain relief. Using the paramedian approach, low-thoracic epidural insertion at T10-11 interspace was performed with a standardized procedure to obtain an actual insertion length (AIL). According to the principles of trigonometry, an estimated insertion length (EIL) was calculated as 1.26 times the distance from skin to epidural space measured from the preoperative abdominal CT. RESULTS: The mean (SD) EIL and AIL were 5.5 (0.7) and 5.1 (0.6) cm, respectively, with a significant correlation (r=0.899, P<0.01). The EIL tended to have a higher value than the AIL (0.4 (0.3) cm). There were significant correlations of both EIL and AIL with weight (P<0.01), BMI (P<0.01), and body fat percentage (P<0.01), but not with height (P>0.05). CONCLUSIONS: We conclude that the preoperative abdominal CT is helpful in prediction of the distance for low-thoracic epidural insertion using the paramedian approach.

Abdomen↗

PubMed2003

Welded tracheal stent removal in a child under cardiopulmonary bypass.

Metallic tracheal stents have been used in the treatment of paediatric tracheomalacia for more than a decade. We describe a case in which critical airway obstruction occurred during removal of a welded tracheal stent using a rigid bronchoscope under general anaesthesia. Life-saving cardiopulmonary bypass was instituted urgently, and the welded stent was then removed successfully by directly opening the trachea.

Airway Obstruction↗

PubMed2003

Differences in embryonic development in sensitive and resistant matings to pregnancy block stimuli in mice.

Pregnancy block from exposure to foreign male mouse pheromones is sensitive to both male and female mating strain, as well as the foreign male pheromone-producing strain. Incidence of pregnancy block by male pheromones in mice is different depending on the combination of females, stud males and stimulus males. BALB/cA females mated with BALB/cA males showed a 100% pregnancy block when exposed to males of the DDK strain (Chung et al., 1997). In contrast, BALB/cA females mated with males of dissimilar strain show high rates of pregnancy even if they are exposed to DDK males; this difference is thought to be due to the difference in viability of embryos (Chung et al., 1999). The present study investigated how development of BALB/cA and F1 embryos differ under the influence of pregnancy block stimuli. F1 embryos had significantly higher numbers of cells than did the BALB/cA embryos (P<0.05) at day 3 of pregnancy after exposure to DDK males or after bromocriptine (dopamine agonist, 4 mg kg(-1), i.p.) treatment. Histological observation after bromocriptine treatment revealed that: (i) on day 4 of pregnancy, BALB/cA embryos tended to form a large blastocoel, but showed abnormalities such as degeneration of primitive endoderm and depression of the outer trophoblast-distal endoderm layer at the periphery of the inner cell mass (ICM) or detachment of the ICM from the outer layer. In contrast, 60-70% of F1 embryos were normal late blastocysts and incipient egg cylinders, but 28-40% of early blastocysts were degenerating; and (ii) day 5 BALB/cA embryos were in the range from incipient egg cylinder with a large proamniotic cavity to ectoplacental cone only, but their proximal endoderm and trophoblast-distal endoderm layer were degenerating. In contrast, the F1 embryos were mostly at the egg cylinder stage and maintained normal structure except for occasional enlargement of the developing yolk sac cavity. These results indicate that the lining of the inner surface of trophoblast by distal endoderm layer may be more firmly established and that the inner environment for development of F1 embryos may be more effectively maintained, thereby making them more resistant to deleterious influences due to pregnancy block stimuli than are BALB/cA embryos.

Animals↗

PubMed2001

Typical demethylation events in cloned pig embryos. Clues on species-specific differences in epigenetic reprogramming of a cloned donor genome.

We investigated whether a genomic demethylation process occurs in pig preimplantation embryos produced by either normal fertilization or somatic cell nuclear transfer. The methylation status of the centromeric satellite and the PRE-1 short interspersed element (SINE) sequences was characterized using bisulfite-sequencing technology. Typical demethylation processes were identified in these repetitive sequences of the cloned donor genome during cleavage, the patterns of which were similar to the ones detected in fertilized counterparts. These findings are different from previous observations with cloned bovine embryos where various repeated regions of the donor genome exhibited aberrant methylation patterns. Our results indicate that species-specific differences exist in modifying the epigenetic status of cloned donor genomes.

Animals↗

PubMed2001

Association between Helicobacter pylori infection and the risk of gastric cancer in the Korean population: prospective case-controlled study.

BACKGROUND: Gastric cancer is still the most common malignant tumor in Koreans. Although many reports have supported the association of Helicobacter pylori infection and the development of gastric cancer, few studies have been adjusted by variable factors such as age. sex, education, and economic status. Furthermore, most results from areas with a high incidence of gastric cancer, such as China and Korea, have failed to document any relationship between H. pylori infection and gastric cancer. We conducted a prospective case-controlled study, with controls matched for and adjusted by age, sex, education, and economic status, to evaluate the causal relationship between H. pylori infection and gastric cancer in Korean people. METHODS: From March 1997 to October 1998, 136 consecutive patients with gastric cancer, diagnosed by endoscopic histology, and 136 age- and sex-matched control subjects, confirmed to be free of gastric cancer by endoscopy during the same period, were enrolled in the study. The presence of H. pylori infection was determined by enzyme immunoassay (EIA) serology test. RESULTS: Seventy-two of the 136 gastric cancer patients (53%) were positive for H. pylori infection and 54 of the 136 control subjects (40%) were positive for H. pylori infection. The odds ratio (OR), adjusted by variable risk factors, such as age, sex, education, and economic status, for gastric cancer in H. pylori-infected patients was 1.82 (95% confidence internal [CI], 1.10-3.00; P = 0.019). The age- and sex-matched OR by conditional logistic regression was 1.6 (95% CI., 1.01-2.53; P = 0.043). CONCLUSIONS: H. pylori infection may be one of the important risk factors for the development of gastric cancer in Korea, an area of high prevalence of H. pylori infection and a high incidence of gastric cancer.

Adult↗

PubMed2001

Bilateral pulmonary edema after endoscopic sympathectomy in a patient with glucose-6-phosphate dehydrogenase deficiency.

Transaxillary endoscopic sympathectomy of thoracic ganglia (T2-T3) has recently gained wider acceptance as the treatment of choice for palmar hyperhidrosis. It requires one-lung ventilation to facilitate the surgery. One-lung ventilation, however, is not without complications, among which acute pulmonary edema has been reported. In this case report, we present a patient with palmar hyperhidrosis complicated by glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, who received bilateral endoscopic sympathectomy under alternate one-lung anesthesia, and developed acute pulmonary edema immediately after recruitment of the successive collapsed lung. The effects of hypoxemia, G-6-PD deficiency and sympathectomy might all add to the development of acute pulmonary edema secondary to reexpansion of each individual lung after alternate one-lung ventilation. The possibilities of the inferred causes are herein discussed.

Acute Disease↗

PubMed2000

Bacterial morphotypes and early cellular responses in clinically infected and non-infected sites after combination therapy of guided tissue regeneration and allograft.

OBJECTIVES: To compare the bacterial morphotypes and early cellular responses in periodontally treated sites with and without pus formation after a combination of guided tissue regeneration (GTR) and allograft therapy. METHODS: 45 subjects with 80 sites having periodontal lesions with moderate to deep pockets and angular bone defects participated. 28 treated sites in 25 patients were included in the studies. 14 sites suffered from symptoms and signs of infection with pus formation during the healing period were assigned to the pus (P) group. Another 14 sites had asymptomatic healing and were assigned to the non-pus (NP) group. The GTR membranes were retrieved 4-6 weeks after surgery and processed for SEM examination. The bacterial morphotypes on the membranes were observed and photographed. Bacterial adhesion score (BAS, 0-5) and the presence of leukocytes and fibroblasts were estimated from photographs. RESULTS: The results showed that large numbers of bacteria (high BAS) were present on both sides of the coronal 2/3 of the membrane in both groups, irrespective of clinical conditions. At the apical 1/3 of the membrane, moderate numbers of bacteria were still found on the outer side in the P group. The BAS of rod-shaped bacteria were significantly higher in the P group than that of the NP group on the outer coronal 2/3 of the membrane. The frequency of the presence of fibroblasts (18.5%) at the apical 1/3 of the inner (tooth facing) side of the P group was much lower than that of the same location (28.6-29.6%) in the NP group. The presence of leukocytes and fewer numbers of fibroblasts on the GTR membrane were associated with greater BAS for rod- and filament-shaped bacteria. CONCLUSIONS: GTR membranes are commonly colonized by oral bacteria during retention, even on uncomplicated and tissue covered portions. The overt infection clinically (pus group) of the membrane-allograft treated sites is associated with a significantly elevated BAS of rod-shaped bacteria, and may be closely related to the occurrence of its adverse early healing responses (inflammation, pus formation, fewer fibroblasts and greater accumulation of leukocytes).

Adult↗

PubMed2000

Iatrogenic trigeminal sensorimotor neuropathy resulting from local anesthesia: a case report.

Trigeminal neuropathy resulting from local anesthetic injection has not been reported in the literature. We present a 49-year-old man with 8 months of unilateral facial sensorimotor deficits in the distribution of the trigeminal nerve, following a local anesthetic injection. His medical history was significant for resection of an ipsilateral tongue carcinoma 4 years earlier with only postsurgical dysarthria and no other neurologic deficits. Magnetic resonance imaging of the head and face showed postsurgical changes and ipsilateral atrophic muscles of mastication without evidence of infection or tumor recurrence. Electrodiagnostic evaluation revealed prolonged ipsilateral R1, ipsilateral and contralateral R2 responses of the blink reflex, and neurogenic electromyographic changes in ipsilateral masseter and temporalis muscles, consistent with ipsilateral trigeminal nerve injury. Although trigeminal neuropathies from various etiologies have been reported, this unique case offers another etiology to consider: iatrogenic trigeminal neuropathy secondary to local anesthetic injection.

Anesthesia, Local↗

PubMed2000

In vitro development of reconstructed porcine oocytes after somatic cell nuclear transfer.

This study was designed to examine the developmental ability of porcine embryos after somatic cell nuclear transfer. Porcine fibroblasts were isolated from fetuses at Day 40 of gestation. In vitro-matured porcine oocytes were enucleated and electrically fused with somatic cells. The reconstructed eggs were activated using electrical stimulus and cultured in vitro for 6 days. Nuclear-transferred (NT) embryos activated at a field strength of 120 V/mm (11.6 +/- 1.6%) showed a higher developmental rate as compared to the 150-V/mm group (6.5 +/- 2.3%) (P: < 0.05), but the mean cell numbers of blastocysts were similar between the two groups. Rates of blastocyst development from NT embryos electrically pulsed at different times (2, 4, and 6 h) after electrofusion were 11.6 +/- 2.9, 6.6 +/- 2.3, and 8.1 +/- 3.3%, respectively. The mean cell numbers of blastocysts developed from NT embryos were gradually decreased (30.4 +/- 10.4 > 24.6 +/- 10.1 > 16.5 +/- 7.4 per blastocyst) as exposure time (2, 4, and 6 h) of nuclei to oocyte cytoplast before activation was prolonged. There was a significant difference in the cell number between the 2- and 6-h groups (P: < 0. 05). Nuclear-transferred embryos (9.4 +/- 0.9%) had a lower developmental rate than in vitro fertilization (IVF)-derived (21.4 +/- 1.9%) or parthenogenetic embryos (22.4 +/- 7.2%) (P: < 0.01). The mean cell number (28.9 +/- 11.4) of NT-derived blastocysts was smaller than that (38.6 +/- 10.4) of IVF-derived blastocysts (P: < 0. 05) and was similar to that (29.9 +/- 12.1) of parthenogenetic embryos. Our results suggest that porcine NT eggs using somatic cells after electrical activation have developmental potential to the blastocyst stage, although with smaller cell numbers compared to IVF embryos.

Animals↗

PubMed2000

Effect of oral clonidine premedication on perioperative hemodynamic response and postoperative analgesic requirement for patients undergoing laparoscopic cholecystectomy.

BACKGROUND: To investigate the clinical efficacy of oral clonidine premedication in anesthesia and analgesia in patients undergoing laparoscopic cholecystectomy (LC). METHODS: One hundred and ten patients, scheduled for elective laparoscopic cholecystectomy, were recruited for the prospective, randomized, single-blind, comparative study. They were randomly allotted to either of the placebo or clonidine group. Patients of the placebo group (n = 65) were premedicated with oral antacid (alugel hydroxide 300 mg), while those in the clonidine group (n = 45) were premedicated with oral clonidine 150 micrograms prior to anesthesia. The premedication was given 60 to 90 min before the anticipated time of induction of anesthesia. Normocapnia was maintained throughout the perioperative period. Mass spectrometer was used to assess the inspired and expiratory concentrations of isoflurane, the anesthetic used for maintenance of anesthesia. Postoperative pain intensity, sedation scores, adverse events, time to the first dose of postoperative analgesic and cumulative analgesic requirement in 24 hours were recorded. Data were expressed as mean +/- SD. RESULTS: Patients in the clonidine group displayed greater hemodynamic stability perioperatively and the isoflurane requirement was also reduced (30% less). The postoperative analgesic requirement was less (1.5 +/- 1.3 vs. 2.2 +/- 1.3 dose, P < 0.05) and the time for the first dose of analgesic was prolonged (411 +/- 565 vs. 264 +/- 441 min) in comparison with the placebo group but no statistic difference was found. CONCLUSIONS: Oral clonidine premedication helped to provide perioperative hemodynamic stability, spared the use of isoflurane and reduced the requirement of postoperative analgesia so as to smoother the way to recovery in patients undergoing LC.

Administration, Oral↗

PubMed1999

Effect of glutamine on Th1 and Th2 cytokine responses of human peripheral blood mononuclear cells.

Decreased glutamine concentrations are found in patients with catabolic stress and are related to susceptibility to infections. In this study, we evaluated the role of glutamine in Th1/Th2 cytokine responses. Peripheral blood mononuclear cells were stimulated with phytohemagglutinin (PHA), live attenuated bacillus Calmette-Guérin (BCG), or measles virus in the presence of different glutamine concentrations. We found that glutamine at an optimal concentration (0.6 mM) significantly enhanced PHA-stimulated lymphocyte proliferation as well as Th1 [interferon-gamma (IFN-gamma) and interleukin-2 (IL-2)] and Th2 cytokine (IL-4 and IL-10) production. In the absence of glutamine, BCG and measles virus elicited minimal lymphocyte proliferation, whereas BCG enhanced Th1 cytokine response and measles virus promoted Th2 cytokine response. Interestingly, addition of glutamine promoted the BCG-elicited Th1 cytokine response (IFN-gamma), but suppressed the measles-induced Th2 cytokine response (IL-10). These results suggest that appropriate glutamine levels may influence host responses to different antigens and microorganisms. Furthermore, predominately Th1, but not Th2, cytokine responses required the presence of optimal concentrations of glutamine.

BCG Vaccine↗

PubMed1999

Interleukin 1beta-secreting cells in inflamed gingival tissue of adult periodontitis patients.

Interleukin 1beta (IL-1beta) is a cytokine with a wide range of biological activities. It is produced by various cell types including macrophages, fibroblasts, and neutrophils. The inflammatory responses mediated by IL-1beta play an important role in periodontal tissue destruction. The purposes of this study were: (1) to determine the location of IL-1beta in inflamed human gingival tissues by the immunofluorescence method; and (2) to correlate this location to the concomitant presence of macrophage or neutrophils by immunohistochemistry. Five patients with moderate to advanced adult periodontitis receiving periodontal phase I therapy were included in this study. One month after phase I therapy, 15 sites with a probing pocket depth >/=5 mm and gingivitis index >/=1 were arranged for modified Widman flap operation. Another three sites with a probing pocket depth </=3 mm and gingivitis index=0 from two gingival healthy subjects who received crown-lengthening operation were also chosen as a control group. After clinical parameter recording, a biopsy of gingival tissues from all sites was obtained during the operation. The gingival specimens were frozen immediately for further immunofluorescent examination of IL-1beta and immunocytochemical localization of macrophages and neutrophils. The macrophages were found to be widely distributed in inflamed gingival connective tissue and near-by pocket wall tissue. The neutrophils were aggregated in pocket wall and were sparsely seen in connective tissue. IL-1beta immunofluorescent reaction was detected with high intensity in gingival connective tissue especially at the subepithelial region. IL-1beta immunofluorescence with low intensity was only occasionally seen in pocket wall tissue. There was a strong association between the presence of macrophages and IL-1beta expression. Similarly, there was a positive association between neutrophils and IL-1beta immunofluorecence. These results suggested that large amounts of IL-1beta are present in inflamed gingival tissues, and that both macrophages and neutrophils are predominate in IL-1beta production in inflamed gingival tissues.

Adult↗

PubMed1999

Lymphocyte proliferation modulated by glutamine: involved in the endogenous redox reaction.

Decreased glutamine concentrations are found during catabolic stress and are related to susceptibility to infections. However, little is known about the mechanism of glutamine modulation of lymphocyte functions. Glutamine is not only an important energy source in mitochondria, but is also a precursor of glutamate, which is used for cellular glutathione (GSH) biosynthesis in lymphocytes. In this study, we investigated the effects of glutamine on the redox reaction during lymphocyte proliferation. Peripheral blood mononuclear cells, obtained from healthy adult volunteers, were cultured and stimulated by phytohaemagglutinin (PHA) in the presence of different glutamine concentrations. Cells were harvested and prepared for analysis of lymphocyte proliferation, cell cycle propagation, intracellular glutathione levels and reactive oxygen species (ROS) production. We found that glutamine supplementation significantly enhanced PHA-stimulated lymphocyte proliferation and propagation of the cell cycle from the G1 to S and G2/M phases. Glutamine also enhanced production of both intracellular ROS and GSH levels in PHA-stimulated lymphocytes. Flow cytometric analysis by the mercury orange staining method showed that glutamine significantly enhanced intracellular non-protein thiols in PHA-stimulated CD4+, but not CD8+ lymphocyte subsets. Furthermore, intracellular GSH detected by monochlorobimane dye probe showed that glutamine enhanced GSH both in PHA-stimulated CD4+ and CD8+ lymphocyte subsets. Inadequate glutamine supplementation resulted in decreased lymphocyte proliferation in association with decreased levels of intracellular GSH. Addition of exogenous GSH significantly enhanced lymphocyte proliferation, whereas blockade of GSH synthesis enhanced ROS production and suppressed lymphocyte proliferation. These results suggest that the modulation of PHA-stimulated lymphocyte proliferation by glutamine is closely related to the maintenance of appropriate intracellular redox status.

Adult↗

PubMed1999

Relationship of the subgingival microbiota to a chairside test for aspartate aminotransferase in gingival crevicular fluid.

BACKGROUND: The aim of the present study was to evaluate the association between the occurrence of certain specific periodontal pathogens and aspartate aminotransferase (AST) levels in gingival crevicular fluid (GCF). METHODS: Thirty systemically healthy subjects with moderate to advanced periodontitis were selected. Within each subject, the AST contents of GCF from sites with probing depth between 5 mm and 7 mm were measured using a chairside colorimetric test. AST-positive site refers to one that had an AST level > or = 800 microIU. Subgingival plaque samples from one AST-positive and one negative site were collected for microbiological examination. One site with probing depth < or = 3 mm and no gingival inflammation was selected as a healthy control. Clinical parameters of the chosen sites, including the plaque index and gingival index scores, probing depth, and clinical attachment level were measured. Culture and immunofluorescence (IF) were used for detecting common periodontal pathogens, including Actinobacillus actinomycetemcomitans, Peptostreptococcus micros, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Capnocytophaga species, Prevotella intermedia, Prevotella melaninogenica, and Porphyromonas gingivalis. Logistic regression was used to analyze the correlation between the AST test and certain specific pathogens. RESULTS: The GCF scores and total cultivable bacterial counts were higher in AST-positive sites than either AST-negative or healthy sites. The prevalence and proportions of specific periodontal pathogens such as C rectus, E. corrodens, F. nucleatum, Capnocytophaga species, P. intermedia, and P. gingivalis were significantly higher in positive than in negative sites. In analyzing the correlation of the proportion of 6 pathogens with the AST test by logistic regression, only P. gingivalis showed a significant positive correlation. The odds ratio of having a high proportion of P. gingivalis in the presence of a positive AST test was 1.21. CONCLUSIONS: The present study showed that at AST-positive sites, there is a higher prevalence and higher proportion of certain periodontal pathogens. Although only the correlation of P. gingivalis and AST values was statistically significant, the results imply that certain periodontal pathogens may be associated with elevation of AST levels in GCF.

Adult↗

PubMed1999

Unexpected transurethral resection of prostate syndrome complicated with acute myocardial infarction during transurethral incision procedure--a case report.

Transurethral incision (TUI) is a simple and safe procedure. We, herein, present a case undergoing transurethral incision procedure during which he developed transurethral resection of prostate syndrome (TURP syndrome) and hypothermia precipitating an acute perioperative myocardial infarction attack. The potential risk of development of TURP syndrome in settings other than TURP surgery as well as its prevention are reviewed and discussed.

Aged↗

PubMed1999

Clinical implication of atypical squamous cells of undetermined significance with or without favoring high-grade squamous intraepithelial lesion on cervical smears.

BACKGROUND: The cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) on a cervical smear usually makes clinicians unsure of how to manage the patient and follow-up on her condition. We attempted to define the clinical implication of qualifying the cytologic diagnosis of ASCUS as either favoring a high-grade squamous intraepithelial lesion (HSIL) or not in an effort to provide management guidelines. METHODS: From January through May 1997, 65 of 5792 women who had cervical/vaginal smears taken at Kaohsiung Chang Gung Memorial Hospital were diagnosed as having ASCUS. Thirteen of the 65 cases of ASCUS favored an HSIL, based on nuclear abnormalities in atypical metaplastic and parakeratotic-type squamous cells. All these 65 patients were evaluated in our outpatient clinic by a second cervical smear, colposcopy, and colposcopically directed biopsies and/or endocervical curettage. The median length of the follow-up period was 19 months (range, 16 to 21 months). RESULTS: Of the 52 patients evaluated for ASCUS smears without favoring HSIL, 6 (11.5%) had a low-grade SIL (LSIL), 1 (1.9%) had cervical intraepithelial neoplasia grade II (CIN II), and 1 (1.9%) had invasive squamous carcinoma. Of the 13 patients with a cervical cytologic diagnosis of ASCUS favoring HSIL, 1 (7.6%) had immature metaplasia, 2 (15.4%) had LSIL, 2 (15.4%) had CIN II, 6 (46.2%) had CIN III, and 2 (15.4%) had invasive squamous carcinoma. CONCLUSION: For patients with a cytologic diagnosis of ASCUS favoring HSIL, more aggressive interventions, such as colposcopy-directed biopsy, endocervical curettage, or even conization, should be performed promptly. However, those without features favoring HSIL may be evaluated with regularly repeated smears.

Female↗

PubMed1998

Clinical response of localized recurrent periodontitis treated with scaling, root planing, and tetracycline fiber.

The purpose of this study was to compare the clinical efficacy of scaling and root planing alone versus tetracycline fiber therapy used adjunctively with scaling and root planing in the treatment of nonresponsive active periodontitis in patients under supportive periodontal therapy. Thirty patients who were receiving supportive treatment and had at least two nonadjacent periodontitis sites with a probing depth of between 4 and 8 mm and bleeding on probing, or had aspartate aminotransferase (AST) levels above 800 microIU in the gingival crevicular fluid in separate quadrants participated in this study. For each patient, the test sites were treated with scaling and root planing plus tetracycline fibers while the control site was treated with scaling and root planing only. Probing depths, clinical attachment levels, gingival recession, AST levels, and bleeding on probing were recorded and subgingival plaque samples were collected at baseline and 1, 3, and 6 months following treatment. At 3 months after treatment, there was a reduction of bleeding on probing and probing depth, and a gain of clinical attachment in both test and control sites. The mean reduction in probing depth of the test sites was 1.38 mm and the attachment gain was 0.8 mm after 6 months. The clinical response obtained at 3 months following therapy was maintained throughout the 6-month follow-up period. However, there were no statistically significant differences between sites treated with scaling and root planing alone and those treated with combined tetracycline therapy. Most of the reductions of probing depths in the fiber group were attributed to gingival recession. The present study did not confirm the efficacy of adjunctive tetracycline fibers in treating nonresponsive sites in maintenance subjects with regard to probing depth reduction or clinical attachment gain. Reinfection of the pockets from untreated sites and extra-crevicular regions may explain the insignificant response to local tetracycline therapy.

Adult↗