Endodontics Program Directors', Residents', and Endodontists' Considerations About CBCT-Related Graduate Education.

Over the past decade, cone beam computed tomography (CBCT) has been increasingly used by endodontists. The aims of this study were to assess endodontic program directors', residents', and endodontists' considerations concerning CBCT-related graduate education, attitudes, and professional behavior. Survey data were collected from 31 of the 56 directors of U.S. endodontic graduate programs, 73 of 270 contacted residents, and 689 of 2,221 contacted endodontists (response rates 55%, 27%, and 31%, respectively). Ten of the 31 responding programs did not offer a CBCT-related class. Of the 21 programs that offered a CBCT class, 91% of the program directors and 85% of the residents agreed strongly that future endodontists need training to be able to use CBCT. Residents were less satisfied than directors with the way CBCT was taught (on a five-point scale with 1=most negative: 3.26 vs. 4.37; p<0.001) and the quality of their clinical CBCT-related education (3.75 vs. 4.62; p<0.001). Both groups strongly agreed that there is a need for CBCT training in endodontics (4.81 vs. 4.90). Endodontists reported being less well educated than residents about CBCT in classroom-based (2.02 vs. 2.70; p<0.001) and clinical graduate education settings (2.09 vs. 2.97; p<0.001) and wanted more CBCT-related education in endodontic programs (4.37 vs. 3.18; p<0.001). Yet, they reported being more confident than residents in interpreting CBCT scans (3.57 vs. 2.75; p<0.001) and rated themselves more positively as having sufficient clinical experience (3.76 vs. 2.92; p<0.001) to be competent in utilizing CBCT. These findings about residents' and practicing endodontists' CBCT-related considerations suggest that endodontic program directors should add more CBCT-related education.

Multiple simple bone cysts of the jaws: review of the literature and report of three cases.

OBJECTIVES: This study contributes three well-documented cases of multiple simple bone cysts (SBCs) of the jaws and reviews previously published cases. STUDY DESIGN: A comprehensive literature search of multiple SBCs was conducted using the PubMed database. Synonyms of SBC were used as search key words in combination with "mandible or jaw," "bilateral, multiple, multifocal, atypical, and unusual." RESULTS: A total of 34 cases of multiple SBCs (including two asynchronous cases) were identified, including the three new cases reported here. Multiple SBCs primarily occurred in the second decade (52.9%) and bilaterally in the posterior mandible. Lesions demonstrated female predominance (1.8:1) and were frequently accompanied by bony expansion (44.1%) and a multilocular radiolucent appearance (20.6 %). Recurrence was reported in three patients (mean age: 39.3 years old). CONCLUSION: Knowledge of the clinical and radiographic features of multiple SBCs is important in the diagnosis and management of this entity.

Impaired hepatocyte regeneration in toll-like receptor 4 mutant mice.

Multiple lines of evidence suggest a role for endogenous lipopolysaccharides in toxin-induced liver injury. Toll-like receptor 4 has recently been implicated as a cell surface receptor important for lipopolysaccharide responsiveness. In these experiments, we sought to determine the role of toll-like receptor 4 in acute liver injury by carbon tetrachloride by utilizing the naturally occurring toll-like receptor 4 mutant and wild-type mice strains. Mice were injected with either carbon tetrachloride or the carrier. Serum transaminase levels peaked at 24 hr after carbon tetrachloride administration for both wild-type and mutant mice, with no significant histological difference in initial liver injury between the two groups. However, an overall decrease in hepatocyte proliferation was found in the mutant mice. Examination of the liver tissue revealed significant decreases in intrahepatic expressions of proinflammatory mediators. In conclusion, our results suggest that toll-like receptor 4 is important in the hepatic regenerative response to CCl4 liver injury via its role in modulating the inflammatory response to hepatic injury.

Activation of human and mouse Kupffer cells by lipopolysaccharide is mediated by CD14.

Upregulation of CD14 in Kupffer cells has been implicated in the pathogenesis of several forms of liver injury, including alcoholic liver disease. However, it remains unclear whether CD14 mediates lipopolysaccharide (LPS) signaling in this specialized liver macrophage population. In this series of experiments, we determined the role of CD14 in LPS activation of Kupffer cells by using several complementary approaches. First, we isolated Kupffer cells from human livers and studied the effects of anti-CD14 antibodies on LPS activation of these cells. Kupffer cells were incubated with increasing concentrations of LPS in the presence and absence of recombinant human LPS binding protein (LBP). With increasing concentrations of LPS, human Kupffer cell tumor necrosis factor-alpha (TNF-alpha) production (a marker for Kupffer cell activation) increased in a dose-dependent manner in the presence and absence of LBP. In the presence of anti-human CD14 antibodies, the production of TNF-alpha was significantly diminished. Second, we compared LPS activation of Kupffer cells isolated from wild-type and CD14 knockout mice. Kupffer cells from CD14 knockout mice produced significantly less TNF-alpha in response to the same amount of LPS. Together, these data strongly support a critical role for CD14 in Kupffer cell responses to LPS.

Thermal injury induces expression of CD14 in human skin.

BACKGROUND: Skin is equipped with an array of immune mediators aimed at fighting invading microbes. CD14 has been shown to play a key role in modulating the activation of cells by LPS. Since LPS levels within burn wounds are often found to be elevated, we sought to examine the expression of CD14 within human skin following thermal injury. METHODS: Patients who sustained partial thickness burns, were recruited into the study (n=57). Total RNA was isolated from both burn and normal (control) skin. Northern blot analysis and TaqMan RT-PCR were used to determine skin CD14 mRNA levels. Immunohistochemistry was used to localize CD14 expression in burned and normal skin. RESULTS: Quantitative PCR showed significantly increased CD14 expression levels in the immediate post-burn period (P<0.05 burn versus non-burn). Immunohistochemistry revealed more pronounced CD14 staining 24 h after the injury, reaching normal levels approximately 5-7 days post-burn. CONCLUSION: CD14 expression peaks within the first week post-burn before declining, reaching normal levels after 14 days. This loss of supranormal CD14 expression locally within the wound may contribute to a weakened host defense response 5-6 days after injury, when patients become especially vulnerable to infection.