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[Oral health of Brazilian elderly: a systematic review of epidemiologic status and dental care access].

Population aging and declining birth rate have significantly altered the Brazilian age structure pyramid. In parallel with demographic transition, epidemiological transition is altering morbidity-mortality profiles, without adequate health support for the elderly population group. By searching databases, the objective of this study was a systemic literature review from 1986 to 2004 concerning the most prevalent oral problems experienced by elderly Brazilians, aimed at revealing the main obstacles for accessing health services. Mean DMFT index values in this study ranged from 25 to 31. Most articles reported a high percentage of edentulism. The main barriers for access to dental services were poor education, low income, and scarcity of public oral health services. Brazilian elderly oral health is thus precarious, with high edentulism rates, periodontal problems, decayed teeth, and great need for prostheses, reflecting the historical inefficacy of public dental services, limited to serial extractions and emergency services, based on the curative model.

Aged↗

Human chorionic gonadotropin (hCG) beta-core fragment is produced by degradation of hCG or free hCG beta in gestational trophoblastic tumors: a possible marker for early detection of persistent postmolar gestational trophoblastic disease.

The present study was undertaken to investigate whether human chorionic gonadotropin (hCG) beta-core fragment (hCG beta cf) was directly produced by gestational trophoblastic tumors. Immunoreactivity of hCG beta cf was demonstrated in the extracts as well as in the culture media of hydatidiform mole tissues. It was also present in the extracts of choriocarcinoma tissues, and its molar concentration exceeded that of intact hCG. The presence of hCG beta cf was then confirmed by gel chromatography and Western blot analysis. Immunohistochemistry showed localization of hCG beta cf immunoreactivity to the syncytiotrophoblasts and scattered cells in the stroma of mole tissue, and to syncytiotrophoblastic cells in choriocarcinoma. Immunoreactivity of hCG beta cf was also detected in the sera of the patients with gestational trophoblastic disease, although the hCG beta cf/hCG ratio was less than one hundredth of that in the tissue extracts. Serial measurement of serum hCG beta cf levels after mole evacuation showed that they declined much more rapidly than those of hCG and became undetectable in the patients with subsequent spontaneous resolution, while hCG beta cf remained or became detectable before the rise of hCG was observed in the patients with subsequent persistent trophoblastic disease. Taken together, these results suggest that hCG beta cf is directly produced by gestational trophoblastic tumors, and monitoring of hCG beta cf in the serum after mole evacuation may be useful for early prediction of subsequent development of postmolar persistent trophoblastic disease.

Animals↗

A simplified time-series analysis for evaluating treatment interventions.

Time-series analysis procedures for analyzing behavior data are receiving increasing support. However, several authorities strongly recommend using at least 50-100 points per experimental phase. A complex mathematical model must then be empirically developed using computer programs to extract serial dependency from the data before the effects of treatment interventions can be evaluated. The present discussion provides a simple method of evaluating intervention effects that can be used with as few as 8 points per experimental phase. The calculations are easy enough to do by hand.

Behavior Therapy↗

Capillary electrophoresis study on DNA-protein complex formation in the polymorphic 5' upstream region of the dopamine D4 receptor (DRD4) gene.

DNA-protein interaction in the 5' upstream polymorphic region of the dopamine D4 receptor (DRD4) gene was analyzed by capillary electrophoretic mobility shift assay (CEMSA). The sequence of interest was amplified using a fluorescent primer and applied as a probe in the binding assays with HeLa nuclear extract. Serial dilution of the probe resulted in a concentration dependent DNA-protein complex formation. Sp 1 specific oligonucleotide competitor significantly inhibited the DNA-protein complex formation. A non-specific competitor, differing only in three base pairs, showed weaker effect pointing to the contribution of the Sp 1 recognition sequence in the complex. Polymorphic competitors were also prepared from homozygous individuals possessing either duplicated (2 x 120 bp) or single copy (1 x 120 bp) of the 120 bp repeat sequence and were used against the Sp 1 specific probe in competition assays. Our data provide experimental evidence for the binding of Sp 1 to the 120 bp duplicated sequence of the DRD4 5' upstream region and suggest enhanced binding capacity of the duplicated form.

5' Flanking Region↗

Circadian rhythms of melatonin release from chicken pineal in vitro: modified melatonin radioimmunoassay.

An improved and simplified radioimmunoassay for measuring pineal, serum, and in vitro cultured medium melatonin is described. Using 2-[125I]iodomelatonin as radiolabeled ligand and a polyclonal rabbit antimelatonin antiserum, melatonin concentrations were determined in all three types of samples by a 2-day direct equilibrium double-antibody assay method without prior extraction. Serial dilutions of pineal homogenates, serum, and cultured medium all gave parallel displacement curves. Cross-reactivity of the antisera with other indoles was negligible. Intraassay coefficients of variation (n = 3) were 5.09, 3.32, and 5.05% at 7.81, 62.5, and 500 pg/tube, respectively, and the interassay coefficients of variation (n = 20) were 12.18% at 62.5 pg/tube. A characteristic diurnal rhythm of melatonin was observed using this direct assay for measuring daytime and nighttime chicken pineal and serum samples. An in vitro incubation of chicken pineal glands with a lighting cycle of 12-hr light:12-hr dark showed that the diurnal rhythm of melatonin secretion into the cultured medium was maintained. The direct assay method described in this report for measuring chicken melatonin using 2-[125I]iodomelatonin as radiolabeled ligand coupled with the in vitro cultured chicken pineal gland clearly offers great potential for studying the chicken pineal circadian oscillator and its underlying mechanism.

Animals↗

An unexpected growth pattern: considerations in management.

A case study spanning 16 years is presented. Routine treatment with serial extraction and an edgewise appliance for a Class I crowded occlusion began when the patient was 8 years old. By the time the patient was 17, his dentition had evolved, because of unanticipated growth, into a Class III malocclusion with complete-arch crossbite. The question of whether it is most appropriate to treat this patient in one or two surgical procedures is discussed, and some controversial aspects and concerns are presented.

Adolescent↗

Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth.

PURPOSE: The aim of this study was to use clinical, radiographic, and histologic examinations to compare the relative success of gray mineral trioxide aggregate (MTA), white MTA, and formocresol as pulp dressings in pulpotomized primary teeth. METHODS: Twenty-four children, each with at least 3 primary molars requiring pulpotomy, were selected for this study's clinical and radiographic portion. An additional 15 carious primary teeth planned for serial extraction were selected for this study's histologic portion. All selected teeth were evenly divided into 3 test groups and treated with pulpotomies. Gray MTA was used as the pulp dressing for one third of the teeth, white MTA was the dressing for one third, and the remaining one third were treated with formocresol. The treated teeth selected for the clinical and radiographic evaluations were monitored periodically for 12 months. The treated teeth selected for histologic study were monitored periodically and extracted 6 months postoperatively. RESULTS: Four children with 12 pulpotomized teeth failed to return for any follow-up evaluations in the clinical and radiographic study. Of the remaining 60 teeth in 20 patients, 1 tooth (gray MTA) exfoliated normally and 6 teeth (4 white MTA and 2 formocresol) failed due to abscesses. The remaining 53 teeth appeared to be clinically and radiographically successful 12 months postoperatively. Pulp canal obliteration was a radiographic finding in 11 teeth treated with gray MTA and 1 tooth treated with white MTA. In the histologic study, both types of MTA successfully induced thick dentin bridge formation at the amputation sites, while formocresol induced thin, poorly calcified dentin. Teeth treated with gray MTA demonstrated pulp architecture nearest to normal pulp by preserving the odontoblastic layer and delicate fibrocellular matrix, yet few inflammatory cells or isolated calcified bodies were seen. Teeth treated with white MTA showed a denser fibrotic pattern, with more isolated calcifications in the pulp tissue along with secondary dentin formation. CONCLUSIONS: Gray MTA appears to be superior to white MTA and formocresol as a pulp dressing for pulpotomized primary teeth.

Aluminum Compounds↗

Isolation and partial characterization of prolactin from equine pituitary gland (hypophysis).

Highly purified equine prolactin was prepared from equine pituitary glands (hypophysis) by serial extractions with water at pH 5.5, 0.1 M (NH4)2SO4 at pH 4.0, and 0.25 M (NH4)2SO4 at pH 5.5 to remove other hormones, and then finally with 70% ethanol at pH 9.3 to 10.0 to extract prolactin. Preliminary purification of the extract involved salting out other substances with 0.1% NaCl at pH 9.0. Prolactin was precipitated out by adding three times the volume of 95% ethanol at 4 C. This prolactin preparation had a biological potency of 24 IU/mg. Further purification by isoelectric focusing on a pH gradient of 5 to 7 gave three prolactin components with the following characteristics: isoelectric point 5.8, 5.7, and 5.25; biological potencies (IU/mg) 35.6, 19.6, and 11.3. The major component had a molecular weight of 25,000, an isoelectric point of 5.8, and a biological potency of 35.6 IU/mg. Antiserum produced against this component did not cross-react with equine follicular stimulating hormone, luteinizing hormone, and growth hormone, but did cross-react with ovine and bovine prolactin. Human and murine prolactin had little cross-reactivity with the equine prolactin antiserum.

Animals↗

T lymphocytes and mast cells express messenger RNA for interleukin-4 in the nasal mucosa in allergen-induced rhinitis.

We have investigated the phenotype of interleukin-4 (IL-4) mRNA+ cells in the nasal mucosa of six subjects with allergic rhinitis before and 24 hr after local allergen provocation with grass pollen extract. Serial cryostat sections were cut from paraformaldehyde-fixed snap-frozen nasal biopsies, and immunocytochemistry (APAAP) followed by in situ hybridization performed on the same sections. For immunocytochemistry, antibodies against CD3, tryptase, major basic protein (MBP) and CD68 were used to identify T cells, mast cells, eosinophils and macrophages, respectively. Hybridization studies were performed using a digoxigenin-labelled IL-4 riboprobe. Nitroblue tetrazolium (NBT) and X-phosphate-5-bromo-4-chloro-3-indoly phosphate (BCIP) served as chromogens to detect hybridization IL-4 mRNA signals. Significant increases in T lymphocytes and eosinophils and in the number of IL-4 mRNA+ cells were observed after allergen challenge. Double immunocytochemistry/in situ hybridization demonstrated that the majority of IL-4 mRNA+ cells after allergen challenge were CD3+ (73.7% +/- 1.6). Lower numbers of IL-4 mRNA hybridization signals were co-localized to tryptase+ cells (26.0% +/- 1.6). In contrast, no IL-4 mRNA hybridization signals were co-localized to either eosinophils or macrophages. These results indicate that after allergen challenge T cells are the principal cellular source of IL-4 mRNA transcripts during human late nasal responses, with a lesser contribution from mast cells.

Adult↗

Quantitation and stability of fumonisins B1 and B2 in milk.

The well-documented presence of fumonisin mycotoxins B1 and B2 (FB1 and FB2) in corn raises the possibility that these toxins are carried over into the milk of animals fed with contaminated feed. The presence of FB1 and FB2 in milk has not been assessed because of the lack of sensitive analytical techniques for this matrix. Two methods, liquid chromatography (LC) and enzyme-linked immunosorbent assay (ELISA), were adapted for the analysis of milk. The ELISA, produced commercially for screening corn, required no sample preparation and was reproducible but was of low sensitivity [concentration that inhibits color development by 50% (IC50), 1200-1600 ng FB1/mL]. The more sensitive LC method involves serial extraction of milk with methanol-acetone and strong anion exchange followed by derivatization with naphthalene-2,3-dicarboxaldehyde. Recoveries of 50 ng FB1 and FB2/mL from unpasteurized and unhomogenized milk were 84 and 83%, respectively (limit of detection, 5 ng/mL). Recoveries of FB1 from whole homogenized milk (76%) were slightly lower. Heating milk for 30 min at 62 degrees C, to mimic pasteurization, did not significantly reduce FB1 or FB2 recovery, nor did storing milk for 11 days at 4 degrees C. The LC method was applied to 165 samples of milk, only 1 of which was positive. This finding suggests that exposure of humans to FB1 and FB2 from milk is low.

Animal Feed↗

Hereditary epidermolysis bullosa: oral manifestations and dental management.

Epidermolysis bullosa (EB) is a diverse group of disorders that have as a common feature blister formation with tissue separation occurring at variable depths in the skin and/or mucosa depending on the specific EB type. There may be marked oral involvement, potentially creating devastating alterations in the soft and hard tissues. Oral tissue fragility and blistering is common to all EB types. However, oral debilitation as a result of soft tissue scarring is primarily limited to the recessive dystrophic EB subtypes. Generalized enamel hypoplasia appears to be limited to junctional EB, although rampant dental caries is associated with many individuals having generalized recessive dystrophic EB. While systemic treatment remains primarily palliative, it is possible to prevent destruction and subsequent loss of the dentition through appropriate interventions and dental therapy. The majority of individuals with mild EB subtypes may receive dental treatment with only minor modifications in approach. Even the most severely affected individuals with EB can retain their dentition using general anesthesia and conventional restorative techniques. With aggressive preventive interventions and management of developing malocclusions using serial extraction, it also is possible to reduce the likelihood of rampant caries, achieve an acceptable occlusion without the need for active tooth movement or appliance therapy, and allow these individuals to benefit from maintaining a natural healthy dentition.

Anesthesia, Dental↗

Interference screw fixation of soft tissue grafts in anterior cruciate ligament reconstruction: part 1: effect of tunnel compaction by serial dilators versus extraction drilling on the initial fixation strength.

BACKGROUND: Compaction of the bone-tunnel walls by serial dilation is believed to enhance the interference screw fixation strength of the soft tissue grafts in anterior cruciate ligament (ACL) reconstruction. HYPOTHESIS: Serial dilation enhances the fixation strength of soft tissue grafts in ACL reconstruction over extraction drilling. STUDY DESIGN: Randomized experimental study. METHODS: Initial fixation strength of the doubled anterior tibialis tendon grafts (fixed with a bioabsorbable interference screw) was assessed in 21 pairs of human cadaver tibiae with either serially dilated or extraction-drilled bone tunnels. The specimens were subjected to a cyclic-loading test, and those surviving were then tested using the single-cycle load-to-failure test. RESULTS: During the cyclic-loading test, there were 3 fixation failures in the serially dilated and 6 failures in the extraction-drilled specimens but no significant stiffness or displacement differences between the groups. In the subsequent load-to-failure test, the average yield loads were 473 +/- 110 N and 480 +/- 115 N for the 2 groups respectively (P =.97) and no difference with regard to stiffness or mode of failure. CONCLUSIONS: Serial dilation does not increase the strength of interference fixation of soft tissue grafts in ACL reconstruction over extraction drilling. CLINICAL RELEVANCE: The results of this experiment do not support the use of serial dilators in ACL reconstruction.

Adolescent↗

The role of extraction in stability of orthodontic treatment.

Long-term postretention assessment of orthodontically treated cases has been of interest for 5 decades; however, extraction versus nonextraction follow-up studies are difficult to compare without regard to sample structure, therapy concept und different parameters. The results of selected studies- extraction of 1 or 2 incisors, of premolars and of second and third molars, early and late extraction therapy and serial extraction-showed that long-term postretention stability is not a realistic treatment goal. The Cologne long-term records allow optimistic prediction: relative stability has been found in the majority of former patients, irrespective of the kind of treatment and treatment time. Original anomaly, type (extraction/nonextraction) and amount of treatment, and end-of-treatment alignment were found to be major factors influencing dentoalveolar and skeletal post-treatment changes. The conclusion is that therapy-induced post-treatment changes can be reduced by having a treatment goal within the anatomic limits.

Bicuspid↗

Presence of atriopeptin-like immunoreactivity in human and rat milk.

Maternal milk is a significant source of hormones and other bioactive substances. They might be involved either in the control of mammary gland function or in the regulation of growth and development of the neonate. Atriopeptin (atrial natriuretic factor, ANF) is a peptide with strong diuretic, natriuretic and vasorelaxant actions, and it has been suggested to play an important role in the circulatory adaptation to extrauterine life. The aim of this study was to determine whether ANF is present in maternal milk, using radioimmunological analysis. The levels of ANF-like substance in human milk were found to be in the range of 0.3-3.0 pg/ml, those in rat milk between 37-117 pg/ml. The measured concentrations of ANF were proportional to the volume of the extracted milk. Serial dilutions of the extracts yielded curves which were not totally parallel to the human alpha-ANF standard curve. Our data indicate that, during the first days after delivery, ANF levels in human milk are higher than those in later periods of lactation. This pilot study provides the first description of the presence of atriopeptin in milk. Though a detailed characterization of milk ANF-like immunoreactivity is needed, a biological significance of present findings seems possible.

Adult↗

Stabilisation of refraction following extracapsular cataract extraction.

Regular serial refraction was used to determine the rate of stabilisation of refraction following routine extracapsular cataract surgery in 85 eyes. Patients were divided into four groups depending on wound closure technique: limbal section closed by interrupted 8-0 virgin silk, 9-0 polydioxanone or 10-0 nylon sutures, and corneal section closed by continuous 10-0 nylon suture. Stabilisation of refraction, sufficient to prescribe satisfactory glasses, occurred at three months except in the interrupted 10-0 nylon group, when stabilisation was delayed to between four and five months. The factors affecting stabilisation and the causes of the differences observed are discussed.

Aged↗

Formation of delta-Aminolevulinic Acid from Glutamic Acid in Algal Extracts : Separation into an RNA and Three Required Enzyme Components by Serial Affinity Chromatography.

Extracts from plant chloroplasts and algae catalyze the conversion of glutamate to delta-aminolevulinic acid (ALA) in the first committed step of the tetrapyrrole biosynthetic pathway leading to chlorophylls, hemes, and bilins. The conversion requires ATP, Mg(2+), and NADPH as cofactors. Soluble extracts from Chlorella vulgaris have now been resolved into four macromolecular fractions, all of which are required to reconstitute activity. One fraction contains a low molecular weight RNA which can be separated from the protein components in an active high-speed supernatant by treatment with 1 molar NaCl followed by precipitation of the proteins with (NH(4))(2)SO(4) at 70% saturation. The proteins recovered from the (NH(4))(2)SO(4) precipitate are reactivated by addition of a fraction containing tRNAs isolated from Chlorella by phenol-chloroform extraction and DEAE cellulose chromatography. Three required protein fractions were resolved from the RNA-depleted (NH(4))(2)SO(4) precipitate by serial affinity chromatography on Reactive Blue 2-Sepharose and 2',5'-ADP-agarose. Glycerol was found to stabilize the enzyme activity during the separation process. The majority of the glutamate:tRNA ligase activity was associated with the fraction which was retained by Blue-Sepharose and not retained by ADP-agarose, in agreement with the reported properties of the affinity ligands. The active material in the fraction not retained by Blue-Sepharose eluted as a single component on gel filtration chromatography, with an apparent molecular weight of 67,000. The active component in the RNA fraction also eluted as a single component on gel filtration chromatography.

Journal Article↗

Microcomputer-aided reconstruction: a system designed for the study of 3-D microstructure in histology and histopathology.

We have designed a microcomputer system to reproduce 3-D tissue structures graphically from serial microscopic sections. The system, based on a Hewlett-Packard model 310 desktop computer, comprises a floppy disc drive, a hard-disc that extends the available user memory by adding 40 Mbytes, a colour memory-mapped graphics display, a graphics tablet and a graphics printer. A set of serial 2-D images, manually extracted from serial sections using a microprojector, are digitized on the tablet by tracing the contours of the structure of interest; up to ten different structures can be inputted and reproduced using a 'hidden line' effect. The software, written mainly in HP-BASIC 4.0, produces 3-D pictures of a tissue structure either as a 'stack of slices' with or without being 'tiled' with triangular patches, or in 'wire framing'. Any angle of rotation around the x, y and z axes is assigned for the image to be reconstructed, allowing the operator to obtain the best perspective. The system also discloses the internal connectivity of an object by reducing the structure to a network diagram; this is especially useful in analysing the topological properties of tissue structure. It is shown how, in some examples, the system contributes to a better understanding of tissue microstructures and their morbid changes and how, as an effective tool in morphology, it will aid future studies of histology and histopathology.

Adenocarcinoma↗

Serum-free growth of human mammary epithelial cells: rapid clonal growth in defined medium and extended serial passage with pituitary extract.

A serum-free medium with bovine pituitary extract as the only undefined supplement has been developed for long-term culture of human mammary epithelial cells. This medium supports serial subculture of normal cells for 10-20 passages (1:10 splits) without conditioning or special substrates, and it supports rapid clonal growth with plating efficiencies up to 35%. It consists of an optimized basal nutrient medium, MCDB 170, supplemented with insulin, hydrocortisone, epidermal growth factor, ethanolamine, phosphoethanolamine, and bovine pituitary extract. Replacement of pituitary extract with prostaglandin E1 and ovine prolactin yields a defined medium that supports rapid clonal growth and serial subculture for three or four passages. Cultures initiated in these media from normal reduction mammoplasty tissue remain diploid and maintain normal epithelial morphology, distribution of cell-associated fibronectin, expression of keratin fibrils, and a low level of expression of milk fat globule antigen. Large cell populations can now be generated and stored frozen, permitting multiple experiments over a period of time with cells from a single donor. These media greatly extend the range of experiments that can be performed both conveniently and reproducibly with cultured normal and tumor-derived human mammary epithelial cells.

Animals↗