A biochemical and immunological comparative study on Trypanosoma equiperdum and Trypanosoma evansi.

Trypanosoma equiperdum and Trypanosoma evansi were purified by three or four cycles of low-speed centrifugation and final filtration through DEAE cellulose. The purified trypanosomes were used in comparative biochemical and immunological studies. Comparative polypeptide pattern analysis revealed that T. equiperdum showed 21 polypeptide bands, whose Mr ranged from >200 to 14.8 kDa. T. evansi showed 25 polypeptide bands in the Mr range 97-14.8 kDa. The main differences were associated with the presence of secondary bands, relative intensity and the number of bands. Both species gave seven glycoprotein bands; those of 97 and 68 kDa were present in T. equiperdum but absent in T. evansi. Bands of 61 and 28 kDa were present in T. evansi but not in T. equiperdum. Anti-T. equiperdum sera recognized four homologous antigens and cross-reacted with three antigens of T. evansi. Anti-T. evansi sera recognized three homologous antigens and cross-reacted with four T. equiperdum antigens. Four identical proteolytic protease bands were present for both species, while only one surface protein was detected for each species: 66 kDa for T. equiperdum and 62 kDa for T. evansi.

Complications associated with cesarean section in HIV-infected patients.

OBJECTIVE: To document complications associated with cesarean section in HIV-infected women. METHOD: A cross-sectional study was done on 307 women who delivered by cesarean section. All these patients, irrespective of their HIV-status, were managed according to the same preset protocol. RESULT: Of the 307 women, 59 (19%) were HIV-positive. The only significant differences were a higher prevalence of positive serology for syphilis (32% vs. 12%, P=0.0014) as well as more cases of post-operative endometritis in the HIV-positive group (24% vs. 7%, P=0.0003). Post-operative endometritis was documented in 44% of HIV-infected patients with a CD4 count below 400. However, the severity of endometritis, measured by antibiotic treatment and duration of hospital stay, was similar in the two groups. Overall, there was no difference in the duration of hospital stay, post-operative anemia, wound infection, birth weight and perinatal mortality between the two groups. CONCLUSION: HIV-infected patients undergoing cesarean section are at increased risk for post-operative endometritis, but the severity of the infection is not different from that in HIV-negative patients.

Alveolar distraction before implantation: a report of five cases and a review of the literature.

This work describes the author's experience with the treatment of alveolar vertical bone atrophy using the distraction osteogenesis technique. Five patients with localized vertical atrophy of the alveolar ridge (loss of one to four teeth) were treated using two different types of distractor devices. All the patients were operated on under local anesthesia without needing hospitalization. The surgical technique used in one of these cases and the results of all of the cases treated are reported in this study. Distraction osteogenesis may be a valid alternative to guided bone regeneration in selected cases for the treatment of vertical atrophy of the alveolar ridge, with a substantial reduction in implantation time.

[Clinical evaluation, radiologic and histologic analysis in mandibular alveolar distraction procedures. Preliminary study]. / Valutazioni cliniche, analisi radiologiche ed istologiche nelle procedure di distrazione alveolare mandibolare. Studio preliminare.

BACKGROUND: Alveolar distraction osteogenesis is a process to form new alveolar bone to correct alveolar deformities in ridge height and width. Aim of this work is to study the bone processes to optimize the implantoprosthetic rehabilitation. METHODS: Alveolar distraction osteogenesis was applied in 7 patients with ridge deformities to obtain the desired ridge augmentation. Clinical and radiological evaluations were performed during the following 12 weeks, before implant insertion. Biopsies at 40, 60 and 88 days were studied after general, specific and histochemical staining of slides; microradiographs were analyzed to evaluate the trabecular bone volume. RESULTS: Forty days after the end of distraction, soft callus shows the start of ossification. Sixty days after the end of distraction, soft callus was widely converted into a network of trabecular woven bone; osteogenic activities were low; trabecular bone volume was about 50%. Eighty-eight days after the end of distraction bone amount appeared reduced, with a more ordered structure, further reduction of bone formation activity, whereas osteoclast erosion was active. CONCLUSIONS: Results show an almost steady-state bone deposition processes 60 days after the end of distraction and a regress with longer time. The results suggest the possibility of an early implant insertion to avoid bone loss due to mechanical unloading.

Neutrophil migration, oxidative metabolism and adhesion in early onset periodontitis.

The aim of this study was to evaluate neutrophil function in patients suffering from the generalized form of early onset periodontitis (EOP). We investigated neutrophil migration in vivo and neutrophil superoxide production and adhesion in response to a variety of compounds; neutrophils were isolated both from blood and a skin experimental exudate of 15 patients with EOP and of 15 sex- and age-matched normal control subjects. No difference was found in neutrophil migration in vivo (71.2+/-16.4x10(6) and 68.8+/-10.7x10(6) PMN/cm2/24 h in patients affected by early onset periodontitis and normal subjects respectively) and in adhesion. The superoxide production in response to STZ and PMA was similar between the 2 groups, while superoxide production in response to fMLP was markedly lower in patients than in control subjects both in circulating neutrophils (5.6+/-2.2 versus 10.4+/-2.3 nmoles O2-/10(6) cells, p<0.0001) and in exudate neutrophils (16.3+/-4.3 versus 22.3+/-4.7 nmoles O2-/10(6) cells, p<0.005). In general, neutrophil function in patients suffering from early onset periodontitis does not differ from control subjects, suggesting that the overall defence function of these cells is normal. The only parameter that we have found to be different between the 2 groups is the low superoxide production after fMLP stimulation. The stimulus- and function-specificity of this defect in neutrophils from patients indicates the existence of a dysregulation of the signal transduction pathway distal to fMLP receptor and proximal to NADPH oxidase activation.

Distraction osteogenesis to achieve mandibular vertical bone regeneration: a case report.

In this case report a surgical technique for vertical ridge augmentation is presented. The procedure, performed in a 30-year-old woman with an atrophied alveolar ridge in the anterior portion of the mandible, is based on the biologic concept of osteogenesis distraction previously introduced in orthopedic and maxillofacial surgery. After elevation of a full-thickness flap a horizontal osteotomy was performed 7 to 8 mm from the top of the ridge. Two vertical osteotomies were prepared with drills of increasing diameter (2, 2.8, and 3.25 mm), tapping was performed for the first 5 to 6 mm, and two distractor base plugs were placed at the base of the osteotomies with a repositioning tool. An intraosseous distraction implant was then inserted and 2 inward vertical cuts were made in the bone to allow proper distraction to take place. Correct functioning of the device was checked by distracting the bone fragment 1 mm using the axial distraction screw. A latency distraction healing screw was inserted in each of the distraction implants and the area was left to heal for 5 days. Once primary healing had occurred, the distraction of the newly formed bone callus was activated each day for 10 days (1 mm per day). At the end of the distraction period a final distraction screw was left in place and a final healing screw was inserted. During this time there were no complications and the patient on no occasion complained of discomfort. The distractor device was removed 30 days later, leaving the base plugs in place. One month later a vertical augmentation of 7 mm had been achieved; the base plugs were removed, 3 intraosseous implants were inserted, and a biopsy of the newly formed tissue was obtained. Histologic evaluation of the biopsy specimen showed woven bone formation approximately 75 days after the initial procedure.

Localized ridge augmentation with chin grafts and resorbable pins: case reports.

Six block grafts harvested from the mandibular symphysis were used to augment partially atrophied ridges. Three maxillary defects and three mandibular defects were treated in five patients. Autologous bone grafts from the chin were stabilized in the recipient sites with resorbable pins and no membranes were used over the grafts. Healing proceeded without complications. At 3 to 4 months the external cortical surface of the grafts progressively resorbed and the profiles of the pins protruded from underneath the buccal tissue that covered the augmented areas. However, the pins never perforated the tissue and they were resorbed macroscopically within 4 to 6 months. At 6 months the areas treated showed successful ridge augmentation and when exposed for stage 2 surgery, remnants of the pin holes on the external surface of the repaired defects were detected. Radiographic evaluation of the block grafts was performed at 3 and 6 months and histologic specimens were obtained at 6 months; the specimens demonstrated incomplete pin resorption and encapsulation. A severe foreign-body reaction was detected in one case. The presence of an acellular bone matrix in certain sections and a normal bone pattern with a cellular component in others was a consistant finding. ITI endosseous Implants were placed with excellent primary stability in all treated cases.

Clinical results with exposed polyglactin 910 resorbable membranes for guided tissue regeneration.

Three cases are presented where early exposure of a resorbable membrane occurred during guided tissue regeneration therapy. An antimicrobial regimen was selected to determine whether infection of exposed membranes could be controlled to the point of achieving acceptable clinical results without membrane removal. The results suggest that with the use of the antimicrobial regimen: (1) exposure is compatible with successful clinical results, and (2) removal is not necessary.

Regenerative periodontal therapy in mucogingival surgery for root coverage.

This article illustrates the potential benefits of regenerative periodontal therapy in mucogingival surgery and esthetic dental treatment. Cases are described in which the treatment of soft-tissue recessions and root exposures are treated with surgical procedures where both clinical soft-tissue augmentation and the regeneration of periodontal attachment are obtained. Cases are also presented to illustrate the clinical application of guided tissue regeneration. Resorbable and nonresorbable barriers are placed over the root surface and bone and covered by the overlying flap, which allows the selective repopulation of the lesion by progenitor cells and the inhibition of a long junctional epithelium. Emphasis is placed on regenerative procedures in soft-tissue augmentation, particularly with respect to rationales, techniques, and indications.

[Effect of saliva on resorption time of some resorbable membranes]. / L'influenza della saliva sul tempo di riassorbimento di alcune membrane riassorbibili.

Since resorbable membranes have been introduced their resorption time has been always an important topic of discussion. The current literature does not cover very accurately the contributing factors associated with this biologic process in the oral cavity. The clinical experience shows that the influence of saliva may be an important factor during the resorption of synthetic resorbable membranes. Six experiments are described in this article in which four synthetic resorbable membranes are tested (Vicryl periodontal mesh, Vicryl collagene, Guidor and Resolut). The membranes are plated in Petri dishes precoated with Agar in contact with saliva. Experiment number 1 and 2 demonstrated that saline solution and Agar do not alter the resorption time of the membranes. Experiment 3 and 4 showed that a dilution of saliva to 1:10 and a non diluted saliva accelerate their resorption time of two of the tested membranes. The Vicryl periodontal mesh and the Vicryl collagene disappeared respectively after 7 and 9 days of contact with the not diluted saliva and after 10 and 12 days of contact with the 1:10 diluted saliva. The experiment 5 and 6 indicated that both salivas (diluted and not diluted) deprived of bacteria do not alter the resorption time of the membranes. In conclusion the pattern of resorption of the synthetic membranes, in this in vitro study, is recognized in the contact between the membrane and the bacterial enzymes present in saliva, and in the mechanical structure of the membrane design.

Surgical correction of gingival recessions associated with radicular carious lesions.

In this clinical report, six cases are presented in which radicular carious lesions and gingival recessions were treated concurrently. The combined treatment included the removal of caries, radicular planing, and various surgical techniques for root coverage. Traditional procedures, as well as newer procedures, such as guided tissue regeneration, showed successful results.

Digital subtraction angiography for arteriovenous malformations in stereotactic radiosurgery.

Images coming from digital subtraction angiography (DSA) are affected by a perspective distortion due to the use of image intensifiers. As a result, DSA cannot be used for the accurate definition of stereotactic coordinates. A correction method has been developed to enable the use of DSA for the radiosurgery of arteriovnous malformations. A software program and a special phantom tool were employed. The phantom is made by a computer-controlled drilling machine which makes holes in a Plexiglas plate. It has 865 calibration steel spheres with coordinates determined with a precision of 0.01 mm. A calibration image is acquired by a personal computer, and the software calculates the transformation algorithm to superimpose the image on the known positions of the phantom. This algorithm is saved and then recalled to transform the diagnostic images.

Experimental administration of 19-nortestosterone and dexamethasone in cattle: elimination of the two drugs in different biological matrices.

19-Nortestosterone (19-NT) is one of the mostly recurrent anabolic agents on the black market of illicit drugs. Dexamethasone (DEXA) is licensed for therapy in veterinary practice but its misuse, although often suspected, has seldom been demonstrated. The excretion of 19-NT and DEXA is well documented when the compounds are administered independently but poor information is available in literature for instances when both drugs are administered as a mixture. To evaluate a radioimmunoassay (RIA) for anabolic residues in urine, blood and faeces, the effect of the simultaneous administration and the subsequent elimination of the two drugs, two animals were injected (4 times) with 19-NT and another two (4 times) with 19-NT-DEXA. After preparation and a sequential clean-up on C18 and alumina columns, the samples were analysed by means of a specific 19-NT radioimmunoassay kit and an anti-DEXA antibody. Detection limits for both drugs were 0.5 ppb in blood samples and 2.0 ppb in urine and faecal samples. After the final treatment, positive 19-NT results were recorded at 14 and 21 d in urine and faecal samples, respectively. In the same matrices, positive DEXA values were found at 11 and 28 d, respectively. In the same matrices, positive DEXA values were found at 11 and 28 d, respectively. Urinary excretion was the main metabolic path both for 19-NT and DEXA; only 30% of the residues were excreted via the faeces. The simultaneous injection of DEXA and 19-NT increased the urinary excretion of 19-NT; however, the excretion of 19-NT via faecal matter was similar for both groups.

Cyclosporin in Behçet's disease: results in 16 patients after 24 months of therapy.

The aim of this study was to evaluate the usefulness of cyclosporin in Behçet's disease. Sixteen subjects (10 males and 6 females; mean age 25.2 years) affected by the complete type of Behçet's syndrome received 5 mg/kg/day of cyclosporin for 24 months. A marked improvement of the symptoms was observed after three months of therapy. Within 6 to 12 months of treatment 14 of the 16 patients obtained a complete clinical remission. Biochemical and immunological parameters were controlled periodically to evaluate the clinical response and the possible side-effects. Two patients dropped out of the study because of anaemia and renal dysfunction, which returned to normal when cyclosporin was withdrawn. Our results confirm the efficacy of cyclosporin in the treatment of Behçet's disease.

[Microbiological contamination in the dental office and its possible decrease]. / L'inquinamento microbiologico nell'ambulatorio odontoiatrico ed il suo possibile abbattimento.

A microbiological analysis of the environment after dental work is presented in this paper. Detection of oral streptococci in the air is used as an index of the presence of salivary aerosol in consequence of the use of dental tools at high spin. This salivary aerosol may be considered a very important cause for the transmission of infectious diseases in the dental surgery. The real efficacy of a tool for the production of a dry aerosol of phenols or clorexidine with the purpose of environmental disinfection, is evaluated. Among possible parameters has been considered both the spray ability of the tool and the bactericidal activity of the aerosol at variable length from the source. Data here presented demonstrate the real utility of such an instrument for the disinfection of the dental surgery to be applied daily at the end of the work, not only in reducing environment microbial counts but also in totally eliminating salivary microorganisms.

[The efficacy of cyclosporin for topical use in oral lichen planus]. / Efficacia della ciclosporina per uso topico nel lichen planus orale.

Oral lichen planus is a disease characterized by long symptomatic phases unresponsive to the usual therapy. Many groups have used different drugs in the treatment of lichen planus: topically applied retinoic acid, temarotene, antimycotic agents corticosteroids and immunosuppressive agents, with unsatisfactory results. Recently it has been suggested that topical cyclosporine might improve the lesions of oral lichen planus. The aim of this study was to evaluate the usefulness of this therapy in our patients. Fourteen patients, 6 males and 8 females, mean age 47 years, with oral lichen planus were enrolled in the study. All the patients were instructed to swish 5 ml of solution (500 mg) of cyclosporine in the mouth three times a day for three months. Clinical evaluation was performed before therapy and every two weeks afterwards. At each visit serum levels of cyclosporine, creatinine, total and direct bilirubin and complete blood count were performed. No side effects or blood test alterations were detected in any patient and cyclosporine serum level was always undetectable. Symptoms and oral lesions had a beneficial effect already after one month of therapy. Our results confirm that cyclosporine is useful in the treatment of oral lichen planus.

[In vivo and in vitro experimentation with the effects of chlorhexidine in patients who have undergone a periodontal intervention]. / Sperimentazione in vivo ed in vitro degli effetti della clorexidina in pazienti sottoposti ad intervento parodontale.

The periodontal pack is often used to cover the surgical site after surgery, even when associated with local applications of preparations containing chlorexidine, in order to obtain an antiseptic protection. However many people question whether the drug effectively succeeds in penetrating the pack, or if the presence of the pack itself doesn't obstruct the action of the medication. The aim of this work is to evaluate the efficiency of the clorexidine in the surgical area with and without a periodontal pack. In a first stage, a case was chosen and contemporary operated on in two different but anatomically similar sites at the same time. One of the two sites was covered with a chlorexidine gel for the following week, whilst the other was left without medication. After seven days the stitches removed from the two different sites were placed in culture mediums to number and classify the bacterial strains present. In the second stage of the experiment, another eight patients were operated on in the same way, and the two sites covered with periodontal packs. In one of the two sites a layer of chlorexidine gel was positioned under the pack, and the chlorexidine above and on the sides of the pack was continually renewed throughout the week following the operation. The other site was not treated. The results obtained show that the pack partially reduces the action of the drug medication, probably because an insufficient amount reaches the site. The activity and efficiency of chlorexidine against the strains of bacteria found in vivo were tested in vitro. The chlorexidine destroyed all of them.(ABSTRACT TRUNCATED AT 250 WORDS)

[The possibility of orthodontic therapy in transplanted teeth]. / Possibilità di terapia ortodontica nei denti trapiantati.

The paper reports four cases of tooth transplant: two teeth were transplanted once they were fully mature (completely formed roots) and two were transplanted as germs. Having documented the clinical and radiological recovery for all four teeth, orthodontic braces were applied for a variety of reasons. In the two cases of teeth transplanted once the roots had completely formed it was impossible to move the teeth, whereas in the case of the germ transplants the teeth were quickly moved to a correct occlusal position. On the basis of these different reactions, the author assesses the possibility of histological recovery of the tooth transplant. Repeated radiographic controls showed anomalies in radicular formation and of the camera pulposa. Lastly, the paper discusses the optimal time to transplant a tooth germ.

[Dehiscence and fenestration: study of distribution and incidence in a homogeneous population model]. / Deiscenze e fenestrazioni: studio sulla distribuzione ed incidenza su un modello omogeneo di popolazione.

Ninety crania of Italian and Austrian males, 25-32 years old, coming from the ossurary of Custoza have been examined, (in all 2205 teeth) to determinate the presence and the frequency of dehiscences and fenestrations. All the crania presenting signs of serious stomatologic pathology have been rejected. Dehiscences are more frequent than fenestrations (7.30% vs 6.98%); dehiscences are more frequent in the mandible than in the maxilla (11.55% vs 1.86%), while fenestrations are more frequent in the upper alveolar arch than in the lower one (13.23% vs 2.10%); the upper right first molar is resulted to be the tooth showing the greatest number of defects (8.13% dehiscences and 49.69% fenestrations).