Serial extraction: Precautions, limitations, and alternatives.
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Serial endothelial photographs were taken preoperatively and postoperatively in 200 eyes; 111 eyes contained a Rayner iris clip lens, 54 eyes contained a Fyodorov Sputnik lens, and 35 eyes had no lens. Central endothelial cell density was changed in all instances, with counts in implanted eyes declining 25 to 30%, and in nonimplanted eyes 10 to 15%. In both instances, the decline essentially ceased at about three months. The cause of the greater decline in implanted eyes appeared to be mechanical and subsequent cell loss after the 90-day period was virtually equal for the two groups. Methods that may be used to alter the difference in cell density occurring with implantation are best analyzed by using the 90-day period data for comparison.
Three trials involving 184 male Sprague Dawley rats were conducted to identify the biologically active fraction of endophyte-infected tall fescue seed. In trial 1, seed infected (greater than 95%) with the endophytic fungus Acremonium coenophialum and shown to be toxic to cattle, was serially extracted with hexane, ethylacetate, and methanol, respectively. A second sample of this seed was extracted with chloroform only. Controls included a solvent treatment (spraying the various solvents on endophyte-free seed and carrying the mixture to dryness), the seed post-extraction, endophyte-infected seed and endo-phyte-free seed. Laboratory chow was mixed with all diets to provide 50% of the mix. Trial 2 examined the same treatments as trial 1 except that the chloroform treatment was omitted. Dosages 3 times (equivalent to 22.5 g seed) those used in trial 1 were applied to endophyte-free seed (7.5 g) in an attempt to accentuate any differences. Trial 3 examined the methanol fraction extracted serially, a methanol fraction extracted batchwise, and a water fraction extracted batchwise. Controls included seed residues post-extraction, solvent residue from methanol sprayed on endophyte-free seed, and endophyte-infected seed. Lowered feed intake and weight gains, and depressed serum prolactin concentrations were used as indicators of toxicity. Feed intake was lower in all three trials for rats fed the methanol fraction. In all three trials mean serum prolactin concentrations in rats fed the methanol extracts were not different from those fed endophyte-infected fescue seed. Rats fed the water extract in trial 3 had lower feed intakes than rats fed endophyte-free seed. However, rats fed the seed, post-water extraction, had serum prolactin concentrations similar to that of the negative control. Results suggest that the toxic factor(s) may be concentrated in the methanol extract.
A study was made on 27 cases where enucleation of four first premolars was performed simultaneously without introduction of mechanical devices to influence space closure. The results suggested that: 1. Enucleation of premolars can be used to minimize the severity of crowding in arch-length deficiency cases. 2. There is no damage to the remaining teeth and alveolar process when enucleation is accomplished with good surgical technique. 3. The average amount of lingual tipping of the mandibular incisors in approximately four years subsequent to the enucleation procedure was 4.1 degrees. 4. This amount of lingual tipping compares quite favorably with the amount of lower incisor uprighting experienced during growth and could not be considered excessive. 5. The mandible does tend to rotate in a counterclockwise manner following enucleation of four first premolars without appliance therapy. This rotation was considered significant in comparison with the amount of rotation that could be expected from an untreated sample. 6. If orthodontic treatment is planned, the enucleation of the manddibular second premolars in borderline extraction cases to avoid excessive lingual tipping of the mandibular incisors would seem to be questionable. 7. Various combinations of enucleation and tooth extraction may be helpful in treatment planning. 8. With judicious timing the enucleation of four first premolars can minimize the severity of the malocclusion simplifying appliance therapy if proper diagnosis and good surgical technique are employed. 9. Although conventional serial extraction may accomplish similar ends, it would appear that enucleation would offer some advantages in terms of autonomous adjustment of the mandibular incisors and root positioning of mandibular cuspids. 10. Enucleation cases usually require fewer traumatic surgical procedures and less supervision by the orthodontist. 11. The parents should be informed that serial extraction procedures including enucleation may simplify but will not eliminate the need for appliance therapy.
Immunoreactive oxytocin and neurophysin were identified and measured by radioimmunoassay in human thymus extracts. Serial dilutions of extracts paralleled the appropriate standard curves. Thymus-extracted oxytocin and neurophysin eluted in the same positions as reference preparations on Sephadex G-75. Authenticity of oxytocin was confirmed by biological assay and high-performance liquid chromatography analysis. In most instances, thymus contents of oxytocin and neurophysin were far greater than those expected from known circulating concentrations and declined with increasing age. The molar ratio of oxytocin to neurophysin in thymus was similar to that found in the hypothalamo-neurohypophyseal system, which strongly suggested with the other data a local synthesis of oxytocin. These findings indicate the presence of neurohypophyseal peptides in the human thymus and further support the concept of a neuroendocrine function integrated in an immune structure.
The female in this case was 9 years and 9 months old at the initial visit with a dental stage of III B. The chief complaint was anterior cross bite. Diagnosis revealed a class III angle at the right side and class I at the left. The ANB angle was -3.0 degrees with mandible shifting to the left side. Tooth size was large, and a lack of space, observed, and 2 was congenitally missing. A chin cap was used for treatment to retract and inhibit mandibular growth. The anterior cross bite was corrected within two months when class I angle molar relationship was achieved and the extraction of midline was also corrected. Since the lack of space in the upper arch was about 10 mm, extraction of 5 was decided, although the assigned ANB angle improved to be -0.5 degree within one year of treatment. 3 was to replace the position of the congenitally missing 2. At the age of 11 years and 1 month, 4 was extracted to guide the eruption of 3. 4 and E were extracted guide the eruption of 3 and 5. Then 5 was extracted. As a result of these serial extractions, space closing and leveling were automatically achieved without use of the multibracket system. Good stable occlusion has been maintained up to the present age of 15 years and 8 months.
Immunoreactive corticotropin-releasing factor (CRF) was identified and measured by radioimmunossay in rat thymic extract. Serial dilutions of thymic extract paralleled hypothalamic extract and synthetic CRF standard curves. CRF extracted from rat thymus eluted in the position of synthetic rat CRF on Sephadex G-25 column. Thymus-derived CRF was biologically active as demonstrated by stimulating adrenocorticotropic hormone secretion in dispersed rat anterior pituitary cells. These findings indicate the presence of authentic CRF in rat thymus, further supporting the concept of an integrated regulation of the neuroendocrine-immune responses to environmental stimuli.
Matched controls are used to identify differences in facial morphology related to the severe crowding in patients treated with serial extraction or early extraction of bicuspids.