Neutralizing antibodies in multiple sclerosis patients treated with 375 micrograms interferon-beta-1b.

BACKGROUND: Neutralizing antibodies (NAbs) to IFN-beta may have a detrimental effect on treatment response, but increasing IFN-beta dose could reduce their occurrence. The OPTimization of Interferon for MS (OPTIMS) study was a multicenter trial investigating clinical and MRI outcomes with the approved IFN-beta-1b dose (250 microg) and a higher dose (375 microg), s.c. every other day. OBJECTIVE: To analyze the occurrence of NAbs and their effect on clinical and MRI response over a long-term (4-year) follow-up using cross-sectional and longitudinal statistical analysis. METHODS: Relapses or disease progression was assessed open-label and MRI scans were performed serially during the first year of the study. Neutralizing antibodies were measured using the MxA protein production neutralization assay. RESULTS: A total of 145 patients with relapsing-remitting multiple sclerosis from 14 centers participated in the study. Neutralizing antibody frequency was negatively associated with MRI treatment response, but no detrimental effect of NAbs on the clinical response was observed. Results obtained using cross-sectional or longitudinal statistical approaches were similar. Over the 4-year period, NAb-positive patients treated with 375 microg had a significantly greater probability of NAb disappearance (hazard ratio: 3.41; 95% confidence interval: 1.78 - 6.43; p < 0.01). CONCLUSION: Use of an IFN-beta-1b dose higher than the currently approved 250-microg dose is associated with an increased probability of NAb disappearance. The OPTIMS study was registered at ClinicalTrials.gov: NCT00473213.

Terminal latency index in polyneuropathy with IgM paraproteinemia and anti-MAG antibody.

Criteria for the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) are met by the polyneuropathy associated with immunoglobulin M (IgM) paraproteinemia and anti-myelin-associated glycoprotein (MAG) antibody (MAG-CIDP). However, MAG-CIDP differs from other types of CIDP, mainly in its poorer response to treatment. The utility of terminal latency index (TLI) as an electrophysiological marker for MAG-CIDP has been debated. In this study we confirmed its diagnostic usefulness and evaluated TLI threshold values for motor nerves investigated in routine nerve conduction studies. Median, ulnar, peroneal, and tibial TLIs of 11 subjects with MAG-CIDP, 18 with CIDP, and 76 healthy controls were compared, and threshold values for MAG-CIDP evaluated as the lowest value with a likelihood ratio higher than 10. Mean TLI values and TLIs of all but the peroneal nerve were significantly lower in MAG-CIDP. Median nerve TLI of 0.26 and ulnar nerve TLI of 0.33 were identified as the threshold TLI values for MAG-CIDP.

Anti-GM1 and anti-sulfatide antibodies in polyneuropathies. Threshold titers and accuracy.

OBJECTIVES: To determine threshold titers and diagnostic accuracy of anti-GM1 and anti-sulfatide antibodies (Ab) for autoimmune polyneuropathies (PN) in overall and for particular subtypes of them. MATERIALS AND METHODS: In this study 84 PN patients, 120 epileptics and 93 healthy controls' sera were tested by enzyme-linked immunosorbent assay for autoAbs and results confirmed by thin-layer chromatography. Frequencies of positive patients at increasing cut-off were compared to determine threshold titers. Accuracy was determined by Receiver Operator Characteristic analysis. RESULTS: A 1:2,000 titer for IgM anti-GM1 and a 1:4,000 titer for IgM anti-sulfatide Ab resulted to be threshold titers for autoimmune PN in overall. IgM anti-GM1 and anti-sulfatide Ab had low discriminating capacity between autoimmune PN and other PN, but good discriminating capacity between motor neuropathy (for anti-GM1 Ab) or PN in IgM-paraproteinemia or chronic painful sensory axonal PN (for anti-sulfatide Ab) and other PN. CONCLUSION: Our results suggest that testing IgM anti-GM1 or anti-sulfatide Ab is useful only for diagnostic confirmation of specific subtypes of autoimmune PN.

Tensile bond strengths of hard chairside reline resins as influenced by water storage.

Due to gradual resorption of the edentulous ridge bone, removable prostheses often require denture base relines to improve fit and stability. This research evaluated the bond strength between one heat-cured acrylic resin (Lucitone 550(R)) and two hard chairside reline resins, after two different periods of storage in water (50 h and 30 days). The bond strength was evaluated using a tensile test. The mode of failure, adhesive or cohesive, was also recorded. The results submitted to the Kruskal-Wallis test indicated that the highest tensile strengths were achieved with intact Lucitone 550(R) denture base resin in both periods of storage in water. After 50 h of storage in water, Duraliner II(R) reline material exhibited the highest bond strength to the denture base resin. After 30 days of storage in water, Duraliner II(R) reline resin demonstrated a significant reduction in adhesion, showing lower tensile bond strength than Kooliner(R) material. Both hard chairside reline materials failed adhesively across Lucitone 550(R) denture base resin, in both periods of time.

Water sorption, solubility, and bond strength of two autopolymerizing acrylic resins and one heat-polymerizing acrylic resin.

STATEMENT OF PROBLEM: Because water sorption of autopolymerizing acrylic reline resins is accompanied by volumetric change, it is a physical property of importance. As residual monomer leaches into the oral fluids and causes tissue irritation, low solubility of these resins is desired. Another requirement is a satisfactory bond between the autopolymerizing acrylic resins and the denture base acrylic resin. PURPOSE: This study compared the water sorption, solubility, and the transverse bond strength of 2 autopolymerizing acrylic resins (Duraliner II and Kooliner) and 1 heat-polymerizing acrylic resin (Lucitone 550). MATERIAL AND METHODS: The water sorption and solubility test was performed as per International Standards Organization Specification No. 1567 for denture base polymers. Bond strengths between the autopolymerizing acrylic resins and the heat-polymerizing acrylic resin were determine with a 3-point loading test made on specimens immersed in distilled water at 37 degrees C for 50 hours and for 30 days. Visual inspection determined whether failures were adhesive or cohesive. RESULTS: Duraliner II acrylic resin showed significantly lower water sorption than Kooliner and Lucitone 550 acrylic resins. No difference was noted in the solubility of all materials. Kooliner acrylic resin demonstrated significantly lower transverse bond strength to denture base acrylic resin and failed adhesively. The failures seen with Duraliner II acrylic resin were primarily cohesive in nature. CONCLUSIONS: Autopolymerizing acrylic reline resins met water sorption and solubility requirements. However, Kooliner acrylic resin demonstrated significantly lower bond strength to denture base acrylic resin.

Composite occlusal surfaces for acrylic resin denture teeth.

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to a loss of chewing efficiency and a loss of vertical dimension of occlusion. The use of metal occlusal surfaces on the acrylic resin denture teeth will minimize occlusal wear. Several articles have described methods to construct metal occlusal surfaces; however, these methods are time-consuming, costly, and sometimes considered to be unesthetic. These methods also require that the patient be without the prosthesis for the time necessary to perform the laboratory procedures. This article presents a quick, simple, and relatively inexpensive procedure for construction of composite occlusal surfaces on complete and partial dentures.

Unrestricted linear dimensional changes of two hard chairside reline resins and one heat-curing acrylic resin.

The selection and use of hard chairside reline resins must be made with regard to dimensional stability, which will influence the accuracy of fit of the denture base. This study compared the dimensional change of two hard chairside reline resins (Duraliner II and Kooliner) and one heat-curing denture base resin (Lucitone 550). A stainless steel mold with reference dimensions (AB, CD) was used to obtain the samples. The materials were processed according to the manufacturer's recommendations. Measurements of the dimensions were made after processing and after the samples had been stored in distilled water at 37 degrees C for eight different periods of time. The data were recorded and then analyzed with analysis of variance. All materials showed shrinkage immediately after processing (p < 0.05). The only resin that exhibited shrinkage after 60 days of storage in water was Duraliner II; these changes could be clinically significant in regard of tissue fit.

[Resins for esthetic veneering of fixed dentures. 3. Simultaneous analysis of dimensional change variables and weight change as a function of materials, storage condition and time]. / Resinas para facetas estéticas de próteses fixas. III. Análise conjunta das variáveis alteração dimensional e alteração de peso em função de materiais, condição de armazenamento e tempos.

The authors analysed the simultaneous effects of the dimensional and weight alteration of resins utilized for esthetic facets submitted to warehousing conditions and periods of time. The resins showed different behaviour and a neat correlation between dimensional alteration and weight. The condition of immersion promoted dimensional alteration 50% lower and an alteration of weight three times higher.

[Fatigue of retentive clasps of removable partial dentures. Effect of alloys, thickness and casting techniques. 1]. / Fadiga de grampos de retenção em prótese parcial removível. Efeito de ligas, espessuras e técnicas de fusão. Parte I.

The authors looked for the verification of the fatigue of retentive clasps utilized on the removable partial denture. According to this, it was idealized and built on assay machine, that through movements, simulate the insertion and removal of the clasp for a pattern tooth, manufactured on cobalt-chromium which has all the preparation normally utilized to the correct confection of this type of prosthesis. It was utilized three different commercial alloys based on cobalt-chromium: L1-Biosil; L2-Steldent; L3-Duracron. It was utilized the T clasp of Roach, with was tested upon three different proportions among width and thickness: E1-1.7;E2-2.0 and E3-2.3 and was casted through two casting techniques: F1-oxygen-gas and F2-oxygen-acetylene. The clasps were tested on the machine, which allowed the reading of the number of insertion and removal cycles made until fatigue appeared. The obtained results were submitted to the statistic analysis and the authors concluded that: a) L3 (Duracrom) obtained the best results followed by L1 (Biosil) and finally L3 (Steldent); b) among the analyzed thickness, the best results were obtained by E3, followed by E2 and after this E1; c) form the casting techniques, F2 gave us the best results.

[Fatigue of retentive clasps of removable partial dentures. Effect of alloys, thickness and casting techniques. 2]. / Fadiga de grampos de retenção em prótese parcial removível. Efeito de ligas, espessuras e técnicas de fusão. Parte II.

The authors tested the T clasp of Roach in three differents proportions among width and thickness: E1-1.7; E2-2.0 and E3-2.3, with a constant length of 15 mm. These clasps were casted with three cobalt-chromium alloys (L1-Biosil; L2-Steldent and L3-Duracrom), through two casting techniques (F1-oxygen-gas and F2-oxygen-acetylene). The fatigue of the clasps were verified by using and assay machine, that through movements, simulate the insertion and removal of the clasps for a pattern which were obtained from a premolar, prepared in a surveyor. This machine detect the fatigue of the clasps and count the number of cycles of insertion and removal realized. The obtained results of the interaction between the analysed factors, were submitted to the statistic analysis and the authors concluded that: a) the interaction of factors, Alloy x Thickness, Alloy x Casting Technique and Thickness x Casting Technique did not change the order of effects that the factors showed separately but gave rise to effects of different magnitude for any observed sense; b) the simultaneous interaction of the factors Alloy x Thickness x Casting Technique confirmed the superiority of the L3 alloy, the thickness E3 and the F2 casting technique.

Different electrophysiological modes of action of oral quinidine in man.

The purpose of this study was to evaluate the effects of oral quinidine on the normal sinus node (SN) and A-V node and to determine if the drug exerts in man the same effects observed in cardiac tissue preparations (i.e. both direct and vagolytic action). Electrophysiological studies were performed twice in each of 16 patients (mean age: 57.7 +/- 12 years) with normal resting and intrinsic heart rates and normal A-H intervals. In the first study, the parameters of SN and A-V node were evaluated both in the basal state and following pharmacological autonomic blockade (AB), (propranolol 0.2 mg kg-1 and atropine 0.04 mg kg-1), Oral quinidine was administered for 3-4 days (1200 mg day-1) and the electrophysiological study was then repeated using the same methods. From the comparison of data obtained in the two studies in the basal state the overall effect of quinidine was evaluated, and by comparing those obtained following AB the direct action of the drug was assessed. The overall effect of quinidine on SN and A-V nodal functions was very slight since sinus cycle length, corrected SN recovery time, sino-atrial conduction time, A-H interval, A1-H1 interval at a cycle length of 600 ms and Wenckebach periods did not change significantly after the drug. On the contrary, following AB these measures increased significantly (P less than or equal to 0.01). These results provide evidence of dual effects of oral quinidine in man: a direct depressant action and an autonomically mediated opposing action, very probably vagolytic. The overall effect of the drug is very slight.

Changes in serum pancreatic enzymes after hormonal stimulation in chronic pancreatitis.

Eighteen patients with chronic pancreatitis and 12 healthy controls were subjected to hormonal stimulation by continuous secretin plus cerulein intravenous infusion or a rapid injection of secretin. In both tests total serum amylase, lipase, and TLI (trypsin-like immunoreactive substances) levels were measured. Continuous intravenous infusion does not bring about changes in the serum levels of the enzymes studied; rapid injection of secretin, however, induces changes in the serum levels of TLI and lipase (but not amylase) which makes it possible to distinguish patients with chronic pancreatitis in its early stages from advanced chronic pancreatitis but is of doubtful value in distinguishing healthy subjects from those suffering with chronic pancreatitis.

[Behavior of the functional reserve of the exocrine pancreas compared to its morphologico-echographic aspect in subjects recently recovered from acute pancreatitis]. / Comportement de la réserve fonctionnelle du pancréas exocrine comparé à son aspect morphologico-échographique, chez des sujets récemment gueris d'une pancréatite aiguë.

Fifteen patients, who recovered from acute pancreatitis approximately one month earlier, were subjected to rapid intravenous injection of secretin. Serum trypsin (or rather trypsin-like immunoreactive substances: TLI) and lipase levels were measured serially both before and after stimulation. At the time of the test, the patients' pancreatic ultrasonograms were normal. Results were compared to those in 13 healthy controls. Our findings show that restoration of a normal ultrasonographic image coincides with almost complete recovery of the exocrine function of the pancreas. In fact, though a very slight exocrine pancreatic deficiency persists, this has neither statistical significance nor clinical and/or ultrasonographical significance.

[Meaning and development of markers of acute hepatitis]. / Osservazioni sul significato e la evolutività dei markers delle epatiti acute.

The Authors analyse the results of their tryls about the markers of HBV and HAV acute hepatitis (HBsAg, anti-HAVAb) by R.I.Z. method. HAVAb was in 75% of the cases, its meaning was of post-contact with HAV. The title of HAVAb was effected in 18 patients with viral acute hepatitis; the results were 3 cases of HAV acute hepatitis and in other 7 cases no Ano B viral acute hepatitis. The 58.3% of acute viral hepatitis was HBsAg positive, the study of other markers of HBV and the title of HAVAb showed a viral acute hepatitis caused by HBV. We were not able to demonstrate the viruses which caused 7 HBsAg negative acute virale hepatitis, anti-HBcAg was in 97.8% of HBV acute hepatitis; its the most sensitive of HAV past-infection. The system c-anti-e was in 78.2% of HBsAg viral acute hepatitis. The persistence after 7th week of illness of HBeAg coincided with the hepatitis cronicity. On the contrary anti-HBeAg has not always a protective meaning.

[Hepatitis B and hepatitis A markers in 33 cases of acute hepatitis B surface antigen-negative, hepatitis A virus antibody-positive viral hepatitis. Importance of immune complexes]. / Studio dei markers dell'HBV, dell'HAV in 33 casi di epatiti virali acute HBsAg negativi, HAVab positivi. Importanza degli immunocomplessi.

The authors have looked for the markers of HBV by R.I.A. method (HBsAg, anti HBsAg, HBeAg, anti HBeAg, anti HBcAg), of HAV (by measurement on two samples of HAVab or by measurement of HAVab IgM), the immune-complexes (I.C.C.) by C1q solid-phase binding assay method with E.L.I.S.A. with determination after division I.C.C. of HBsAg by R.I.A. method in 33 cases of HBsAg negative acute viral hepatitis. The 9% (3 cases) were HAV acute hepatitis, the 42,4% (14 cases) no A no B acute hepatitis, the 36,3% (12 case) were HBV acute hepatitis, in 9 anti HBcAg positive cases the I.C.C. with HBsAg positive after division resulted positive, the 12,3% (4 cases) had a positivity for HAVab by stereoconversion (2 cases) or HAVab IgM (2 cases) with HBsAg positivity after division I.C.C. This result puts a nosologic problem about the 4 cases of acute viral hepatitis, which, from epidemiological and clinical point of the view are HAV acute hepatitis.