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Denture stomatitis: a review.

Denture stomatitis has been reported in 11-67% of complete denture wearers. It is more common on the palatal mucosa and in female patients. In Newton's type I denture stomatitis, where the inflammation remains focal, trauma seems to be responsible. In Newton's types II and III denture stomatitis, where the denture-bearing mucosa is diffusely involved, most workers assert that the aetiology is multi-factorial. Evidence is presented incriminating Candida albicans colonization of the fitting surface of the prosthesis in many cases of denture stomatitis promoted by continuous denture wearing. Allergic and primary irritant reactions to the denture base material, systemic predisposing factors including dietary deficiency and haematological disorders, also play a part. In most cases of denture stomatitis, elimination of denture faults, control of denture plaque and discontinuous denture wearing are sufficient treatment. The routine use of antiseptic or antimycotic drugs seems unnecessary.

Denture, Complete↗

Immune shaping and the development of Alzheimer's disease vaccines.

Given the emotional, social, and financial devastation wrought by Alzheimer's disease (AD), it is imperative that effective therapeutics be devised to ameliorate this presently incurable disorder. Vaccine-based approaches have been developed to target and eliminate amyloid beta (Abeta), a key peptide implicated in AD pathogenesis. Preclinical successes in AD mouse models created excitement and impetus for the clinical application of an Abeta-based vaccine. Eliciting immune responses against a self-peptide (that is, a peptide produced by the organism itself), such as Abeta, carries with it the potential to induce autoimmune and inflammatory conditions in the vaccinated individual, a caveat borne out in multiple patients enrolled as part of a recent clinical trial. These clinical adverse events seemingly overshadowed interesting behavioral stabilization and alterations of Abeta burden in these and other vaccinated patients, thus speaking to the potential of immunotherapy for AD. Understanding the mechanisms by which vaccines reduce Abeta burden in AD brain and the types of immune responses raised, as well as developing new modalities of vaccine delivery that facilitate the modulation of elicited immune responses, will undoubtedly lead to a new generation of efficacious Abeta immunotherapeutics with improved safety profiles.

Age Factors↗

PTF1 is an organ-specific and Notch-independent basic helix-loop-helix complex containing the mammalian Suppressor of Hairless (RBP-J) or its paralogue, RBP-L.

PTF1 is a trimeric transcription factor essential to the development of the pancreas and to the maintenance of the differentiated state of the adult exocrine pancreas. It comprises a dimer of P48/PTF1a (a pancreas and neural restricted basic helix-loop-helix [bHLH] protein) and a class A bHLH protein, together with a third protein that we show can be either the mammalian Suppressor of Hairless (RBP-J) or its paralogue, RBP-L. In mature acinar cells, PTF1 exclusively contains the RBP-L isoform and is bound to the promoters of acinar specific genes. P48 interacts with the RBP subunit primarily through two short conserved tryptophan-containing motifs, similar to the motif of the Notch intracellular domain (NotchIC) that interacts with RBP-J. The transcriptional activities of the J and L forms of PTF1 are independent of Notch signaling, because P48 occupies the NotchIC docking site on RBP-J and RBP-L does not bind the NotchIC. Mutations that delete one or both of the RBP-interacting motifs of P48 eliminate RBP-binding and are associated with a human genetic disorder characterized by pancreatic and cerebellar agenesis, which indicates that the association of P48 and RBPs is required for proper embryonic development. The presence of related peptide motifs in other transcription factors indicates a broader Notch-independent function for RBPJ/SU(H).

Animals↗

Current trends in ophthalmic anesthesia. The Second Walter S. Atkinson Lecture.

General anesthesia permits surgery involving large operative fields without limit to time. It is essential in children and uncooperative adults and provides an immobile, quiet patient who does not recall the operative procedure. Local and regional anesthesia re indicated when the surgical field is limited in size and extent. Neuroleptanesthesia in ophthalmology usually involves the administration of droperidol followed by fentanyl followed in intubation, sometimes using a muscle relaxant, and maintenance of anesthesia with nitrous oxide. The terrifying dreams produced by ketamine may be minimized by preoperative administration of diazepam and a quiet recovery period. Attempts to eliminate the oculocardiac reflex are unpredictable and unreliable and, with careful monitoring of anesthesia, elimination does not seem essential. Malignant hyperthermia is an autosomal dominant disorder occurring mainly with the administration of halogenated fluoroethane and depolarizing muscle relaxants. It is often signaled by sudden and prolonged muscle spasm following the injection of the muscle relaxant. Treatment must be directed toward hyperventilation using oxygen, correction of the metabolic respiratory acidosis, and reduction of fever.

Anesthesia, General↗

Primary prevention of occupational lung disease: a view from the United States.

Occupational lung diseases are an important source of preventable morbidity and mortality in the United States. A significant proportion of lung cancer, mesothelioma, asbestosis and the other pneumoconioses, asthma, and chronic obstructive pulmonary disease, is caused by well-established occupational agents, especially among selected subgroups of the general population. Primary prevention of this set of diseases requires identification and control of workplace hazards. In the United States, data from inspections undertaken by the Occupational Safety and Health Agency, and from periodic surveys conducted by the National Institute for Occupational Safety and Health, show that respiratory toxins are commonly found in the workplace. Workplace-based education, surveillance and exposure reduction and elimination are essential components of a strategy to prevent occupational lung disorders.

Health Surveys↗

[Status of the autonomic nervous system and reflexotherapy in children with vasomotor rhinitis].

Different variants of vegetative nervous system dysfunction were identified during the examination of 86 children with vasomotor rhinitis. Based on the findings of the examination a pathogenetically-based method of acupuncture was proposed for the management of this patients' group. Acupuncture with regard to vegetative dysfunction attenuated the latter's manifestations and corrected associated psychoemotional disorders. As a result the clinical manifestations of vasomotor rhinitis were eliminated.

Acupuncture Therapy↗

[Clinical characteristics of pulmonary tuberculosis detected in groups at risk].

It was established according to dispensarization data that more than a half of all patients with freshly detected pulmonary tuberculosis were revealed among the contingents of risk groups (54.6%), i.e. significantly more frequent than among other groups of the population diagnosed during prophylactic fluorography and characterized by larger extension, severity of clinical disorders, prevalence of infiltrative and disseminated forms and frequency of bacteria elimination and the clinical cure was essentially lower as compared with patients showing no aggravating factors. Cessation of bacteria elimination, healing of caverns of disintegration was similar in the groups.

Adult↗

An unusual presentation of temporal arteritis.

Serious ocular and systemic complications may result from inflammatory processes of the orbit. Temporal arteritis is one such process that can affect the eye. The patient described herein is unusual because she presented initially with signs and symptoms similar to orbital cellulitis. As her disease evolved, she displayed marked, hemorrhagic chemosis with some limitation of abduction and resistance to retropulsion on the involved side. Laboratory and radiologic findings eliminated orbital cellulitis, limited Wegener's granulomatosis, and other systemic inflammatory disorders and led to the diagnosis of temporal arteritis. To our knowledge, this complex of presenting signs has not been previously reported.

Aged↗

[Plasma exchange therapy in dermatologic diseases. Review of literature and personal experiences in psoriasis vulgaris].

High molecular pathogenic substances are eliminated from the blood by plasma exchange. Main indications are autoimmune disorders; the experiences with this therapy in dermatological disorders are reviewed. In psoriasis vulgaris immunoglobulins and antigen-antibody-complexes has been discussed as pathogenetic, too; we have therefore treated four patients with psoriasis by plasma exchange. Although we observed a surprising clinical improvement during the initial phase of therapy, the final results are not convincing.

Adult↗

Indican, ethereal and other forms of S eliminated in 24 hours urine by elderly Indian subjects.

Average daily excretion of Indican in urine of 42 healthy elderly men, av. age 69.9 +/- 5.0 years, (60 observations) was 60.7 +/- 17.4 mg/24 hrs. This is slightly higher than reported values for younger subjects. Average ethereal S elimination by Indian subjects has varied from 72-150 mg/day. Indican is the chief ethereal S eliminated in urine. Other forms of S excreted by elderly subjects were: Inorganic S 720 +/- 150 mg; Ethereal S 74 +/- 22 mg. Indican in them was 53.8 +/- 17.4 mg. This shows that the remaining 20 mg or about 1/4 of the ethereal S is eliminated in urine in other forms. Relationship with age, diet, common disorders along with findings in literature etc. are discussed.

Age Factors↗

[Medical or chirurgical treatment in transient cerebral ischemia? (author's transl)].

When a physician is faced by a patient suffering from transient ischemic attacks, the diagnosis is almost invariably determined by the clinical history. It becomes necessary to eliminate certain other medical conditions including migraine, focal epilepsy and cardiac disorders. Once he is satisfied with the diagnosis of TIA, then he must consider whether to employ medical or surgical therapy or a combination of both. It must be recognized that TIAs are not benign events since more than 50 p. 100 of individuals who develop completed strokes will have antecedent TIAs. Identification of the pathogenetic mechanism becomes important in choosing the specific therapy. Where the origin of the attacks is clearly thromboembolic, secondary to atherosclerosis, surgical intervention may be appropriate if the lesion is readily accessible. However, consideration of surgery is also determined by the risk of post-operative stroke or death at the hands of less experienced surgeons. The risk of stroke in a patient who is having frequent TIAs may be reduced initially by utilizing anticoagulants for a limited period. Long-term medical therapy requires the use of anti-platelet agents which have been shown to have a more beneficial effect in preventing strokes in men. The evidence for protection in females is less satisfactory. Surgical treatment should be followed by long-term medical therapy since it is very unlikely that only one lesion is present in a high-risk patient. It is still clear that the best way to manage cerebro-vascular accidents is to prevent them. This requires education of the public, as will as physicians, with respect to risk factors and the value of various modes of therapy.

Aged↗

Hypotony and aqueous humor dynamics in myotonic dystrophy.

A group of 26 subjects with myotonic dystrophy were studied with fluorophotometry to evaluate the relationship between aqueous humor dynamics and the hypotony found in this disorder. All 26 received topical fluorescein to determine the anterior chamber elimination coefficient; five received systemic fluorescein to evaluate the integrity of the blood-aqueous barrier. The group has a mean intraocular pressure of 7.1 mm Hg. The rate of clearance of fluorescein from the anterior chamber and the cornea-to-anterior chamber transfer coefficient for fluorescein were normal. An abnormally high level of fluorescence, three times normal, was observed in the anterior chambers of the myotonic subjects after oral administration of fluorescein. This finding could not be attributed to abnormal absorption and elimination of fluorescein or to abnormal plasma binding. This finding indicates that there is a defect in the blood-ocular barrier to fluorescein in myotonic subjects. Thus conclusions regarding aqueous humor flow cannot be made from the rate of clearance of topically applied fluorescein in myotonic subjects, since the clearance due to diffusion may represent a significantly large fraction of the total clearance.

Adolescent↗

Refining the position of Wilson disease by linkage disequilibrium with polymorphic microsatellites.

Wilson disease (WND) is an autosomal recessive disorder that is due to an inability of the liver to eliminate copper. Copper buildup in the liver, brain, kidney, and other tissues can result in liver cirrhosis, neurologic and psychiatric defects, and other problems. We have localized the disease-containing region to between D13S31 and D13S59, with > 70 multiply affected families, and have constructed a YAC contig of > 4.5 Mb that spans these loci and orders nine highly polymorphic microsatellites. Here we present an analysis of disequilibrium with markers in this interval and provide evidence for strong allelic associations between AFM084xc5 alleles and WND alleles in European, Middle Eastern, and East Asian populations. Significant but weaker allelic associations were also observed between WND alleles and alleles at D13S137 and D13S169. The strength of the association between AFM084xc5 and WND in all non-Sardinian populations combined (linkage-disequilibrium coefficient [phi] = .61) suggests that the number of mutations accounting for WND is less than expected on the basis of the variety of clinical symptoms that are observed.

Chromosomes, Human, Pair 13↗

Cardiac magnetic resonance imaging.

All four cardiac valves can be imaged using MRI. Gradient-echo imaging is the preferred mode of imaging. Valvular regurgitation seen as an area of signal loss in the more proximal chamber can be diagnosed with a high degree of accuracy when compared with 2-D Doppler echocardiography and catheterization angiography. Aortic and mitral stenosis can be semiquantitatively diagnosed, but no method for determining valve areas is currently available. Cardiac prosthetic valves can be imaged but appear only as localized signal loss. Prosthetic valve regurgitation can be diagnosed in the same way as native valve regurgitation. At present, MRI, though not a widely used modality, can contribute significantly to the diagnosis of cardiac valve disorders. With the addition of fast magnetic resonance scanning, which can eliminate the need for electrocardiographic gating, it will be possible for patients with cardiac rhythm irregularities to be scanned, thus broadening the base of patients with valve disease who can be diagnosed.

Heart Valve Diseases↗

[Drug-induced kidney damage].

Drug-related renal damage is manifold in its origin, clinical picture and prognosis. The disorder can manifest itself as a purely functional phenomenon with tubular elimination of amino acids, enzymes, protein, glucose and electrolytes, or it is due to reversible hemodynamic changes; on the other hand, it may be accompanied by cell necrosis and inflammation. Hemodynamic, toxic, immunologic, or mechanically obstructive mechanisms or a combination of these play a pathogenetic role. It is important to know the renal parameters before and monitor them during treatment with nephrotoxic drugs; to avoid concomitant administration of two or more nephrotoxic drugs; and to make the diagnosis as well as terminate exposure rapidly.

Analgesics↗

Participation of the Bcl-2 and Fas molecules in experimental apoptosis of spleen B lymphocytes.

BACKGROUND: Homeostasis in the immune system is based on equilibrium between rates of cell renewal and cell death. Failure of elimination of undesirable autoreactive B cell clones may lead to autoimmune disorders. OBJECTIVE: To assess the participation of the Bcl-2 and Fas molecules in the regulation of B lymphocyte death. METHODS: We used two strains of mice known to have deficient mechanisms of apoptosis, namely the transgenic C57BL/6-E mu-bcl-2-22 expressing the bcl-2 transgene on B cells, and the C57BL/6-lpr/lpr mutant, lacking the expression of a functional Fas molecule. Both strains develop a systemic lupus erythematosus-like disease with serum autoantibodies and splenomegaly. We induced apoptosis by three different treatments: dexamethasone,gamma irradiation and hyperthermia. The proportion of cells in apoptosis was determined with the TUNEL method. RESULTS: Radiation or hyperthermia induced apoptosis was inhibited more effectively by having the lpr mutation than the proto-oncogene bcl-2, but the latter conferred higher resistance to apoptosis by dexamethasone. CONCLUSIONS: Our findings suggest that the role of molecules regulating cell death may relate to the stimuli used to induced apoptosis, and that both the lpr mutation and the overexpression of the proto-oncogene bcl-2 protect B cells from apoptosis induced by the three treatments tested.

Animals↗

[Topographic mapping of electric activity of the brain].

Quantitated neurophysiology and topographic brain mapping are reviewed. Certain information on the electrical activity of the brain may be more easily comprehended with the aid of topographic visualization of EEG and evoked potentials. Quantitated neurophysiology promises to make an important contribution to research in several fields of neuroscience, e.g. cognitive processing, psychiatry, dementia, epilepsy, cerebrovascular disorders, auditory and visual electrophysiology, and migraine. Provided that careful attention is paid to the elimination of artefacts, such methods may also be used as supplementary diagnostic tools in the clinic.

Brain↗

Comparison of diet composition in women with and without functional bowel disorder.

Nurses are often involved in helping patients alleviate chronic distressing gastrointestinal symptoms such as those associated with irritable bowel syndrome or functional bowel disorder. One therapeutic strategy is to increase dietary fiber intake and to eliminate gastrointestinal (GI) irritants such as caffeine, alcohol, and tobacco smoking. However, little work has been done to establish a relationship between dietary factors and chronic GI symptoms. In this article, the authors: (a) describe and compare caloric and dietary constituent intake in symptomatic (n = 18) and asymptomatic (n = 37) women, and (b) examine the relationships among diet, GI symptoms, and stool characteristics in the two groups. In particular, total calories, fiber, fat, protein, and carbohydrates as well as alcohol and caffeine intakes were compared in women who do not smoke. Because menstrual cycle phase modulates both symptoms and appetite, women were studied during the follicular phase. Groups had similar caloric, fat, and protein intakes. Fiber intakes were similar and similar to national norms in both groups. When compared with asymptomatic women, the symptomatic women consumed more refined carbohydrates. Relationships were observed among dietary intake of refined carbohydrates, fiber, GI symptoms, and stool characteristics in women with functional bowel disorder.

Adult↗