[Therapeutic results in periodontal diseases with a primary immune defect and diabetes mellitus].
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Biomedical subjects
Publications and source records attributed to W Pfister.
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In a time period of 21 days an experimental gingivitis was induced in 8 volunteers. Four volunteers received a carbohydrate-reduced, the other 4 persons a carbohydrate-enriched diet. Clinical investigations on the development of plaque and gingivitis and bacteriological examinations of the supragingival microflora were performed simultaneously. The change in the composition of the supragingival plaque-microflora were nearly independent of the amount of food-carbohydrate. In the beginning of the experiment all volunteers had an almost pure streptococcal microflora but during the course of the experiment, the supragingival flora developed to a complex microflora with 50% anaerobes. The reduction of the number of streptococci was accompanied by an increase in the number of Gram-negative rods and actinomycetes. The development of gingivitis in persons with carbohydrate-enriched food was more rapid than in persons with carbohydrate-reduced food. It was striking that the occurrence of clinical symptoms correlated with the increase of the number of Actinomyces viscosus in the plaque material.
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Before and 4 weeks after a single course of local treatment, the composition of subgingival microflora of 15 patients with marginal periodontitis was determined by cultural and microscopical examination. A significant reduction in the number of gram-negative microorganisms could be achieved by this treatment. Anaerobic sporeless rods like Bacteroides and Fusobacteria but also Spirochetes, Eikenella and Capnocytophaga were involved in the inflammation. The number of Actinomyces in the subgingival flora was also significantly reduced by therapy. After treatment the number of gram-positive bacteria like Streptococci and Corynebacteria was significantly increased. The reduction in the number of these gram-negative bacteria in line with the reduction of periodontal inflammation is a criterion of their significance in the etiology of marginal periodontitis.
The proof of a chlorophyllous alga of the genus Prototheca from the blood of a tuberculous patient with brain damage is described. The pathogenetic importance of Protothecae in the field of human medicine is discussed. Although representatives of the genus Protothecae up to now are regarded as extraordinarily infrequent commensals, nevertheless occasionally their proof not only on the surface of the skin but also from the blood or the inner organs must be taken into account.
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In 34 patients without pre-existing infection of the urinary tract mostly a few days after insertion of an indwelling catheter a bacteriuria with 10(5) germs per ml urine developed. In 24 patients from the moment of the first proof of bacteriuria up to the removal of the catheter 1 to 10 days passed away. During this time in 6 patients a cylindruria, in no case, however, an antibody-coat of the bacteria could be established. In 10 patients who carried the catheter for a longer time, the excretion of antibody-coated germs in the urine began 11 to 18 days after the first proof of bacteriuria. A cylindruria was observed in 9 of these patients. Altogether the proof of cylinders in the early phase of the renal infection was more sensitive than that of antibody-coated bacteria in the urine. The probability of a provable participation of the kidneys in catheter-conditioned infections of the urinary tract consequently increases with increasing period of indwelling of the catheter.
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In patients with prostatovesiculitis the qualitative proof of microorganisms from experiment or ejaculate has only an insignificant diagnostic value on account of the lacking possibility of the recognition of contamination germs, It may be concluded to a prostatitis caused by bacteria, when the number of germs established in the exprimate is unequivocally larger than this one in the middle stream urine. In order to use successfully also the differences of the number of germs of ejaculate and middle stream urine for the differentiation between bacterial contamination and prostatovesiculitis, it must be presumed that bacteria of the physiological flora of the urethra may be cultivated in about the same quantity by investigations of the ejaculate as well as of the middle stream urine. Of 100 males without inflammatory disease in the region of the urogenital tract, therefore, middle stream urine and ejaculate or exprimate-containing urine were examined bacteriologically. Hereby was recognized that the number of germs in the different ejaculte specimens of healthy men considerably varied in comparison to the middle stream urine or the exprimate-containing urine and, consequently, is scarcely taken into consideration as diagnostic criterion for the prostatovesiculitis.