Relation between periodontal disease and arterial stiffness.

BACKGROUND AND OBJECTIVE: Periodontal disease has been described as playing a role in the atherosclerosis process, and its relation with intimal thickness and vascular endothelial function (EF) has been investigated. The present study sought to determine whether there are differences in parameters of arterial stiffness and EF between patients with and without severe periodontal disease (SPD). MATERIAL AND METHODS: Patients referred to the School of Dentistry University of Buenos Aires, were assessed. Demographic characteristics, atherogenic risk factors and concomitant pathologies were recorded. Patients with known cardiovascular pathology were excluded. Using carotid Doppler ultrasound an operator assessed arterial stiffness parameters: compliance, elastic modulus (EM), ß stiffness index (ßSI) and vascular EF by brachial artery flow-mediated dilatation. The patients were divided into two groups: with and without SPD. RESULTS: Forty patients were included; 60% were women; 15 were in the SPD group and 25 in the group without SPD. Respective results of the studied variables were: age 56.53 ± 17.58 vs. 51.12 ± 12.97 years (NS); probing depth 2.53 ± 1.30 (95% CI 1.81-3.25) vs. 1.25 ± 0.51 (95% CI 1.31-1.73) p = 0.02; clinical attachment level 4.80 ± 2.00 (95% CI 3.69-5.91) vs. 1.72 ± 0.93 (95% CI 1.33-2.11) p = 0.001; intimal thickness 0.10 ± 0.17 (95% CI 0.095-0.11) vs. 0.82 ± 0.18 (95% CI 0.074-0.98) (NS); EM 48.33 ± 12.53 vs. 38.86 ± 7.69 (p = 0.005); ßSI 4.21 ± 1.03 vs. 3.64 ± 1.02 (p = 0.004); EF 16.13 ± 5.02 vs. 22.76 ± 4.50 (p = 0.0003). Correlation between: EM and clinical attachment level r = 0.58 (p < 0.001), ßSI and clinical attachment level r = 0.66 (p < 0.001), EF and clinical attachment level 0.59 (p < 0.001). CONCLUSIONS: Parameters of arterial stiffness and EF were worse in patients with SPD and correlated moderately with clinical attachment level. Correlation with compliance and EF was negative.

One week of treatment with esomeprazole-based triple therapy eradicates Helicobacter pylori and heals patients with duodenal ulcer disease.

BACKGROUND: Proton pump inhibitor (PPI) monotherapy is commonly continued for 3 weeks after Helicobacter pylori eradication with PPI-based triple therapy regimens to ensure duodenal ulcer (DU) healing. This randomized, double-blind, multicentre study evaluated whether only 1 week of triple therapy with the new PPI esomeprazole was sufficient to ensure high rates of ulcer healing and H. pylori eradication. METHODS: A total of 446 H. pylori-positive patients with active DU received twice daily treatment with esomeprazole 20 mg (n = 222) or omeprazole 20 mg (n = 224) in combination with amoxicillin 1 g and clarithromycin 500 mg for 1 week (EAC and OAC, respectively). Patients in the OAC group then received 3 weeks' monotherapy with omeprazole 20 mg once daily; those treated with EAC received placebo. Ulcer healing was assessed by endoscopy on completion of therapy and H. pylori status was assessed by (13)C-urea breath testing and histology 4-6 weeks later. RESULTS: Ulcer healing rates (95% CI) for intention-to-treat and per-protocol populations were: EAC + placebo 91% (87-95%) and 94% (90-97%); OAC + omeprazole 92% (88-95%) and 96% (92-98%). Corresponding H. pylori eradication rates were: EAC + placebo 86% (81-90%) and 89% (84-93%); OAC + omeprazole 88% (83-92%) and 90% (85-93%). Both eradication regimens were well tolerated, and patient compliance was high. CONCLUSIONS: A 1-week regimen of esomeprazole-based triple therapy is sufficient for DU healing and H. pylori eradication in patients with DU disease.

Chlorine kinetic isotope effects on the haloalkane dehalogenase reaction.

We have found chlorine kinetic isotope effects on the dehalogenation catalyzed by haloalkane dehalogenase from Xanthobacter autotrophicus GJ10 to be 1.0045 +/- 0.0004 for 1,2-dichloroethane and 1.0066 +/- 0.0004 for 1-chlorobutane. The latter isotope effect approaches the intrinsic chlorine kinetic isotope effect for the dehalogenation step. The intrinsic isotope effect has been modeled using semiempirical and DFT theory levels using the ONIOM QM/QM scheme. Our results indicate that the dehalogenation step is reversible; the overall irreversibility of the enzyme-catalyzed reaction is brought about by a step following the dehalogenation.

Computing the relative gas-phase populations of C60 and C70: beyond the traditional delta H(fo),298 scale.

Computations and experiments have shown that the relative heat of formation (i.e., the heat of formation per carbon atom) of C70 is lower than of C60. Moreover, various computations suggest that this is actually a general trend among fullerene cages. The relationship is particularly important for gas-phase fullerenes. Experiments have shown that C60 is typically more populated than C70 when produced in high-temperature gas-phase synthesis. It is not immediately obvious how to reconcile those two terms, or whether the relative heats of formation and the relative populations are in conflict or in agreement. This article deals with this problem, treating it as a general task of relative stabilities of gas-phase clusters of different dimensions (i.e., nonisomeric clusters) under different types of thermodynamic equilibria. The results are then applied to C60 and C70 and point out that the conventional standard pressure of 1 atm is considerably different from actual fullerene-synthesis conditions. Apparently, we should expect considerably lower cluster pressures in carbon-arc synthesis. At 1 atm, C70 is more populated than C60, but at the conditions of a saturated carbon vapor the stability order is reversed in favor of C60 so that an agreement with experiment is obtained already within the thermodynamic treatment. The pressure effects are modeled using the MNDO, AM1, PM3, and SAM1 quantum-chemical semi-empirical methods as well as the available experimental data. The computations consistently show that, if the pressure effects are considered, C60 becomes more populated than C70. Relationships of the thermodynamic treatment to more sophisticated but impractical kinetic analysis are also discussed.

A new method of determining chlorine kinetic isotope effects.

Two methods have been used to measure the chlorine leaving group kinetic isotope effect for the S(N)2 reduction of benzyl chloride to toluene by sodium borohydride in DMSO at 30.000 °C. The reaction was monitored by titrating the unreacted borohydride ion. One method involved determining the chlorine isotope effect using the classical IRMS method, which requires the conversion of the chloride ions into gaseous methyl chloride that is analyzed in an isotope ratio mass spectrometric analyses (Hill, J. W.; Fry, A. J. Am. Chem. Soc. 1962, 84, 2763. Taylor, J. W.; Grimsrud, E. P. Anal. Chem. 1969, 41, 805.). Two different measurements using this method yielded isotope effects of k(35)/k(37) = 1.007 19 ± 0.000 19 and 1.007 64 ± 0.000 19. The second method was a new technique where the ratio of the chlorine isotopes was obtained by fast atom bombardment mass spectrometry on the silver chloride recovered from the reaction, i.e., from the first step in the classical procedure. Therefore, the new method is much simpler and avoids the time-consuming preparation, purification, and recovery of the gaseous methyl chloride. Although the experimental error is larger (k(35)/k(37) = 1.008 03 ± 0.00 10 and 1.008 02 ± 0.000 65) when the new technique is used to analyze the silver chloride samples from the same set of experiments that were used to measure the isotope effect by the classical method, the chlorine isotope effect found by the two methods is identical within experimental error. This large chlorine kinetic isotope effect indicates there is considerable C(α)-Cl bond rupture in the S(N)2 transition state.

Nasal response to allergen challenge in patients with immediate asthmatic reaction.

Ten patients with bronchial asthma and allergy to house-dust mite (HDM) and ten normal, nonatopic control subjects underwent a bronchial challenge with flour. Before and 24 hr after the allergen provocation with flour, the levels of eosinophil cationic protein (ECP) and myeloperoxidase (MPO) were determined in the serum and nasal lavage fluid. All allergics showed an isolated immediate asthmatic reaction (IAR). After the flour challenge only in asthmatic patients the increase was detected in the mean values of: 1) eosinophils (mean value before 16.7 x 103/mm3; mean after: 10 min 132.9 x 103/ml; 3 hr 183.6 x 103/mm3; 24 hr 110.6 x 103/mm3, p < 0.05), 2) basophils (mean before 1.2 x 103/mm3; mean after: 10 min 5.3 x 103/ml; 3 hr s 14.1 x 103/mm3 24 hr was 18.3 x 103/mm3, p < 0.05), 3) neutrophils (mean before 9.2 x 103/mm3; mean after 24 h 18.2 x 103/mm3, p < 0.05) in the nasal lavage fluid. In contrast to a group of normal subjects, asthmatics were found to have higher postchallenge levels of ECP and MPO in the nasal secretions as compared with the prechallenge levels (ECP-mean 3.85 ug/l compared with 32.17 ug/l, p < 0.05; MPO-mean 120-02 ug/l compared with 1313.2 ug/l, p < 0.05). The authors did not find any significant difference between pre- and postchallenge levels of ECP and MPO in the serum of asthmatics and controls. The higher levels of MPO as well as higher count of neutrophils observed in asthmatic patients 24 hr after allergen challenge support the neutrophil involvement in the allergic inflammation. Our results indicate that both neutrophils and eosinophils take part in allergic reaction in the mucosa.

Nasal response to allergen challenge in patients with immediate asthmatic reaction.

Ten patients with bronchial asthma and allergy to house-dust mite (HDM) and ten normal, nonatopic control subjects underwent a bronchial challenge with flour. Before and 24 h after the allergen provocation with flour, the levels of eosinophil cationic protein (ECP) and myeloperoxidase (MPO) were determined in the serum and nasal lavage fluid. All allergics showed an isolated immediate asthmatic reaction (IAR). After the flour challenge only in asthmatic patients the increase was detected in the mean values of: 1/eosinophils (mean value before 16.7 x 10(3)/mm3; mean after; 10 min 132.9 x 10(3)/ml; 3 hr 183.6 x 10(3)/mm3; 24 h 110.6 x 103/mm3, p < 0.05), 2/basophils (mean before 1.2 x 10(3)/mm3; mean after: 10 min 5.3 x 10(3)/ml; 3 h s 14.1 x 10(3)/mm3 24 h was 18.3/mm3, p < 0.05), 3/neutrophils (mean before 9.2 x 10(3)/mm3; mean after 24 h 18.2 x 10(3)/mm3, p < 0.05) in the nasal lavage fluid. In contrast to a group of normal subjects, asthmatics were found to have higher postchallenge levels of ECP and MPO in the nasal secretions as compared with the prechallenge levels (ECP-mean 3.85 ug/l compared with 32.17 ug/l p < 0.05; MPO-mean 120.02 ug/l compared with 1313.2 ug/l, p < 0.05). The authors did not find any significant difference between pre- and postchallenge levels of ECP and MPO in the serum of asthmatics and controls. The higher levels of MPO as well as higher count of neutrophils observed in asthmatic patients 24 h after allergen challenge support the neutrophil involvement in the allergic inflammation. Our results indicate that both neutrophils and eosinophils take part in allergic reaction in the mucosa.

[Chronic gastritis and ulcer disease in young men]. / Przewlekle zapalenie blony sluzowej zoladka, a choroba wrzodowa u mlodych mezczyzn.

Examination has been carried out on 34 young men (average age: 22 years) with chronic erosive gastritis. Chronic erosions were situated most frequently in the prepyloric part of the stomach (88.2%). Duodenal ulcer-was found in 14 patients (41.1%), gastric ulcer was found in 1 patient (2.9%). In 19 examined patients (56.0%) chronic erosive gastritis existed without any other disease of the gastrointestinal tract. Clinical picture, gastric secretion and histopatological examination were compared in two group: I-chronic erosive gastritis without any other changes within the gastrointestinal tract and group II-chronic erosive gastritis coexisting with duodenal ulcer in the clinical picture of the group I, pain usually occurred after a meal and was felt as a heaviness sensation in epigastrum, while in the group II patients felt suction, hunger pain night pain and heartburn. Gastric secretion in the two group did not differ much. Microscopic examination of the mucosa usually confirmed chronic active gastritis. A typical feature for both group was regenerative glandular hyperplasia of the gastric mucosa. Despite many common features, it is impossible to identify explicitly and univocally the relationship between chronic erosive gastritis and ulceration.

Chronic erosive gastritis on morphological analysis.

The present study was carried out to systematize the histopathological markers of chronic erosive gastritis referred to also as gastritis varioliformis (GV). The study population consisted of 74 patients aged 20 to 69 years with gastroscopic GV. The samples were obtained from the erosion site and representative areas of the prepyloric region and gastric body. In routine microscopic examinations we evaluated the severity, type and location of changes in the gastric mucosa. Helicobacter pylori in tissue samples was identified with Giemsa's staining. Gastroscopic GV is accompanied in 76% by microscopic gastritis. In the vicinity of GV the gastric mucosa shows inflammation signs but less severe. Regenerative glandular hyperplasia of the gastric pit layer is the most frequent microscopic marker of GV.

[Comparative evaluation of sucralfate (Venter) and cimetidine (Altramet) efficiency in treatment of chronic erosive gastritis]. / Porównawcza ocena skutecznosci sukralfatu (Venter) i cymetydyny (Altramet) w leczeniu przewleklego nadzerkowego zapalenia zoladka.

The results of patients with chronic erosive gastritis treated with sucralfate (Venter) and cimetidine (Altramet) were compared. 50 patients were treated with 4.0 g of sucralfate daily and 42 patients with 1000 mg of cimetidine daily. After 4 weeks of treatment endoscopic assessment of 13 patients (26.0%) treated with sucralfate and 5 patients (11.6%) treated with cimetidine was normal. It was possible to heal only the erosions of 33 (66.0%) and 17 (40.5%) patients respectively, while the mucosal elevations remained. The result of examinations indicate, that chronic erosive gastritis is difficult to be healed; sucralfate proved to be more efficient than cimetidine.

[Coexistence of acute intermittent porphyria and Crohn's disease]. / Wspólistnienie ostrej przerywanej porfirii oraz choroby Lesniowskiego i Crohna.

A very rare coexistence is described of acute intermittent porphyria and Crohn's disease in a 46-year-old woman. The diagnosis was made on the basis of the overall clinical picture confirmed by laboratory tests (porphyria) and histopathological examination (Crohn's disease).

[Gastric secretion in chronic erosive gastritis]. / Wydzielanie zoladkowe w przewleklym nadzerkowym zapaleniu zoladka.

In 50 patients with erosive gastritis the basic and the post-pentagastrin secretion of hydrochloric acid or glycoproteids has been studied. The results obtained have been compared with that in healthy subjects. No significant differences between the both groups investigated have been noted. It has been stated that chronic erosive gastritis could be associated with normal, elevated or lowered hydrochloric acid secretion. The results are of value with regard to the choice of treatment but remain without significance for diagnostics.

Massive hemoptysis.

Massive hemoptysis is an uncommon but life-threatening emergency. The loss of at least 600 mL of blood within a 48-hour period has been associated with a high mortality rate. Initial stabilization including airway and ventilation management, IV fluids, oxygen, and laboratory and radiographic studies should be done in the ED. Bronchoscopy and angiography are initial diagnostic manuevers that also may be therapeutic. Surgical therapy is reserved for patients with adequate pulmonary reserve and localized sources of bleeding.