[Root resection in the era of dental implants].

The treatment of furcation defects is one of the most challenging aspects of periodontal therapy. The periodontal therapist can utilize various treatment modalities, including: non surgical root debridement, local drug delivery, open flap surgery, tunneling, root resection, guided tissue regeneration and extraction. Each treatment method has its advantages and disadvantages. The dilemmas concerning tooth prognosis and prosthetic considerations in such cases are especially demanding, especially in comparison to implant therapy. The clinician's decision in these situations must comply with the objective condition in the particular case based on his abilities and knowledge and the patient expectations. In order to evaluate the relevancy of root resection procedures we reviewed the literature focusing on root resection therapy prognosis as well as the different therapeutic alternatives for furcated molar teeth. Root resection treatment guidelines, indications and contraindication are presented along with clinical examples. Root resection is currently a relevant treatment modality for furcation defects. By using proper case selection, good surgical technique, proper prosthetic treatment and good periodontal supportive care, a good 5 year prognosis can be achieved and complications can be minimized. In light of the growing literature concerning dental implants complications, extraction and dental implant placement should be recommended as the last option when all other conservative options cannot be used, or following their failure.

Suppression of human hepatoma in mice through adoptive transfer of immunity to the hepatitis B surface antigen.

BACKGROUND/AIMS: Adoptive transfer of immunity against hepatitis B surface antigen (HBsAg) has previously been shown to occur in mice and humans through transplantation of bone marrow cells from donors immunized against HBsAg (anti-HBs) to non-immune recipients. In the present study we evaluated the effect of adoptive transfer of immunity to HBsAg on the growth of HbsAg-secreting hepatocellular carcinoma (HCC) xenografts in athymic mice. METHODS: Immunocompetent mice were immunized with recombinant HBsAg. Bone marrow cells from anti-HBs+ mice were injected intravenously to irradiated athymic Balb/c mice which had been previously transplanted subcutaneously with Hep3B human hepatoma cells. Treatment groups included mice receiving bone marrow transplantation from HBV-immunized (anti-HBs positive) and non-immunized (anti-HBs negative) donors. RESULTS: At 9 weeks post bone marrow transplantation, tumor volume and serum alpha-fetoprotein levels in athymic mice receiving HBV-immune bone marrow cells were 11.5 mm3 and 363 ng/ml, respectively, as compared to 1579 mm3 and 19,000 ng/ml, in recipients of non-immune bone marrow transplantation (p<0.005). T-cell depletion of antiHBs+ immune bone marrow prior to transplantation decreased the anti-tumor effect but did not abolish it. A mild nonspecific, bone marrow-derived, graft versus tumor effect was observed in mice transplanted with human hepatoma cells that do not express HBsAg. CONCLUSIONS: Adoptive transfer of immunity to HBV facilitates suppression of experimental human HCC expressing HBsAg. This effect is the result of a combination of specific anti-viral surface antigen effect and a nonspecific graft versus tumor effect.

Alterations in human fecal flora, including ingrowth of Clostridium difficile, related to cefoxitin therapy.

To evaluate the effects of parenteral cefoxitin therapy on human fecal flora, we cultured fecal specimens obtained from six patients before, during, and after therapy and used standard methods to identify and quantify all microorganisms. The major changes (observed in at least three patients) included the acquisition or proliferation of group D Streptococcus species, coagulase-negative Staphylococcus species, cefoxitin-resistant members of the family Enterobacteriaceae, Pseudomonas species, and various species of the Bacteroides fragilis group. The most striking finding was ingrowth of Clostridium difficile, noted in five of the six patients. There was concomitant eradication or decrease of cefoxitin-susceptible Enterobacteriaceae family members, Bacteroides species other than the B. fragilis group, Clostridium species other than C. difficile, and Lactobacillus species. These marked alterations of fecal flora may have important clinical consequences.

Computerized tomographic findings in meningovascular syphilis: a case report.

Although angiographic findings of arterial narrowing have been detailed in several cases of meningovascular syphilis, very few descriptions of abnormal computerized tomographic (CT) findings have been reported. A case of multiple vascular infarcts detected on CT scan is described; syphilis is proposed as the probable cause of the vascular pathology.

Branhamella catarrhalis pneumonia.

The diagnosis of Branhamella catarrhalis pneumonia in five cases was established by culture of pulmonary secretions obtained by transtracheal aspiration. B catarrhalis caused an acute lobar pneumonia which usually responded promptly to appropriate antimicrobial therapy. Recognition that this organism may cause pneumonia in a nonimmunocompromised person should alert clinicians to consider it as a possible pathogen when Gramnegative diplococci are seen on smears of specimens from the lower respiratory tract.

Susceptibility of Clostridium septicum to 23 antimicrobial agents.

The in vitro susceptibility of Clostridium septicum was studied with a microtiter broth dilution method. Several antimicrobial agents demonstrated consistently good activity against the organism.

Flow rate, sodium and potassium concentration in mixed saliva of complete denture-wearers.

Flow rate, sodium and potassium concentrations in stimulated mixed saliva obtained from eleven elderly (mean age 63) inexperienced denture-wearers, were determined. Salivary samples were collected at four different dental stages: 1. Before tooth extraction. 2. After tooth extraction. 3. Three weeks after wearing newly constructed complete dentures. 4. Following one year of denture wearing. Plasma electrolytes were included for comparison. The salivary sodium and potassium concentrations varied from stage to stage without showing corresponding variations in sodium and potassium in the blood. This points to selective action and an active transport system in the salivary cells. The mean flow rate and salivary electrolyte concentration showed a definite significant rise following the wearing of new complete dentures as compared with the previous dentulous and edentulous stages (Period A, non-denture-wearers). The mean flow rate was 2 ml/min after denture-wearing compared to 0.75 ml/min at the dentulous and edentulous stage (Period A). The stimulant effect represented by the dentures was found to be even more pronounced after one year. Mean sodium and potassium concentration at Period A were at levels of 5.50 and 13.67 mequiv./l respectively, as compared to levels of 23.72 and 19.40 mequiv./l respectively, after insertion of dentures. The difference was significant at a level of P less than 0.005. Although sodium concentration correlated well with flow rate, potassium concentration did not show any correlation with variations during secretion, following the wearing of dentures.