[Immediate full removable dentures. A clinical reality of oral medicine]. / Prothèse amovible complète immédiate. Une réalité clinique de la médecine bucco-dentaire.

The decision to extract the last teeth represents for the patient an aesthetic, functional and moral damage. The realization of an immediate complete removable denture is indicated to remedy these difficulties. This will make it possible to ensure a rational and efficient management of this transition to total edentulous. The restorations of aesthetics and functions as well as patient comfort constitute the essential therapeutic objectives to be achieved and this thanks to the immediate denture. This work presents, through clinical cases, the indications and the management of four patients who have never worn a removable denture.

[Transient removable dentures]. / Les prothèses amovibles transitoires.

Removable dentures are always transient current. The epidemiology and causes of tooth gaps demonstrate the need to master the different prosthetic treatment. This made whether to propose treatment plans that take into account psychological, physiological and technical support for this patient. Different situations may arise. A gradual transition may be considered or immediate passage to the total edentulous according to general criteria, local and desiderata of patients. After tooth extraction, the transitional prosthesis can control bone lysis thereby it is part of a complete treatment before prosthesis. It also facilitates a good psychological and physiological integration before the prosthesis use.

[Removable prosthesis insertion steps: controls-qualifications]. / Les étapes de i'insertion d'une prothèse amovible: contrôles-qualités.

Support a prosthetic edentulous patient aims to optimize the rudimentary functions of mastication and phonation. Knowing the routine procedures in dentistry is needed. These prostheses can be a source of criticism in terms of the quality of life they provide. Chronologically, several steps must be followed when delivered: Reception at the dental office of the prosthesis, with its technical specifications, Meticulous checks prosthetic surfaces, Introduction in the oral cavity of dentures smoothly, The stability of the prosthesis is tested initially, Second occlusion is checked, The esthetic of the prosthesis previously endorsed in the fittings, is popular again, Phonetic tests are performed to help verify the positioning of the teeth in relation to the lips, Tests for judging the ability to swallow, to incise and biting at the posterior teeth are made by the patient, Check alignment of mounting the entire face, Follow the recommendations for proper use of the prosthesis. The complementarily of these steps determines the integration of the prosthesis, but the patient must be informed early in the treatment of functional and aesthetic limits of its future prosthesis.

[Prosthetic rehabilitation after osteonecrosis of the jaws due to histiocytosis X and treatment with bisphosphonates apropos of a case]. / Réhabilitation prothétique après ostéonécrose des maxillaires due à une histiocytose X et un traitement aux bisphosphonates à propos d'un cas.

Bisphosphonates are involved in the occurrence of Osteonecrosis of Jaws (ONJ), which is a complication of these treatments. This osteonecrosis concern the alveolar bone and develops generally after an oral surgery. It can however occur spontaneously without preliminary dental extraction. Other risk factors could play potentiates the risk of ONJ. This osteonecrosis results in an osseous exposure in patient treated or having been treated by bisphosphonates, without any cervico-facial irradiation. Actually, no treatment has been the proof of its effectiveness. Preventives measures of ONJ in oral cavity are the best method before, during and after administration of bisphosphonates. In this article, we present the clinical case of a patient with histiocytois treated by bisphosphonates and having developed ONJ. The selection criteria of the prosthetic rehabilitation as well as the techniques used are detailed.

[Preferred zones of accumulation of prosthetic microbial plaque on removable complete dentures]. / Zones de prédilection d'accumulation de la plaque microbienne prothétique en prothèse amovible complète.

INTRODUCTION: Denture plaque (DP) is not visible with naked eye when it is not mineralized or not fully fixed. Describing and studying its qualitative and quantitative aspects in Complete Dentures (CD) require precisely-located sampling but selection criteria have not yet been well defined. In order to improve our treatment and preventive strategies for patients with CD, it is necessary to explore the various DP accumulation zones on CD fitting surfaces. PURPOSE: The aim of this study is to assess the DP accumulation on fitting surfaces of CD. MATERIAL AND METHODS: Distribution of DP accumulation zones was assessed by naked eye observation of the fitting surfaces on 31 maxillary and 31 mandibular CD. The prostheses were to be carried regularly since at least one year. The data were collected at the Prosthodontics department of the Annaba University Medical Center in Algeria. Prostheses were immersed for 24 hours in a plaque disclosing solution containing erythrosin 2% (Dento-Plaque Inava). The maxillary fitting surface was divided into five sectors: the post damming zone (1MaxFS), the top of the palate zone (2MaxFS), the incisor zone (3MaxFS), the maxillary tuberosity zone (4MaxFS), and the end of the canine and 1st premolar zone (5MaxFS). For mandibular fitting surfaces: trigonal and retromolar zone (1ManFS), canine and 1st premolar zone (2ManFS), and incisor zone (3ManFS). RESULTS: DP distribution was found to be homogeneous on the fitting surface of mandibular CD, however it was distributed in unequal way on the maxillary fitting surfaces. We noted a highly significant difference (p < 0.001) in the staining frequencies of the targeted zones. The most colored zone was the post damming one (1MaxFS), with a rate of 96.7%, whereas the least colored zone was the top of palate one (2MaxFS), with 35.5%. On the mandibular fitting surfaces, the rate of staining was 93.5% for the trigonal and retromolar zone (1ManFS) versus 83.8% on canine, 1st premolar (2ManFS) and incisor (3ManFS) zones. There was no significant difference (p = 0.422). CONCLUSION: The accumulation of DP was found to be homogeneous on mandibular fitting surfaces and no homogeneous on maxillary fitting surfaces. These results require further investigations in order to understand the causes of this difference. This will allow us to improve our treatment and preventive strategies for edentulous patients.

[Preferred sites of accumulation of microbial plaque as shown by the color of the exterior surface of complete dentures]. / Mise en évidence des sites préférentiels d'accumulation de la plaque microbienne prothétique par coloration des extrados des prothèses amovibles complètes.

PURPOSE: The observation of the denture plaque for complete dentures caused many clinical works and researches, since 30 years. Most of the studies were interested, by the prosthetic under-surface. New data show that the polished (exterior) surface on the denture palate is colonized more than hard palate. The aim of our study is to locate the favorite zones of the accumulation of the denture plaque on the level of the suction polished faces of the acrylic resin. MATERIAL AND METHODS: We proceeded by immersion during 24 hours of 62 used full dentures belongs to 33 patients, with mucous membranes of various clinical aspects in a plaque disclosing solution of erythrosine type. The suction faces were divided into several zones of marking. RESULTS: We record 100% of coloring of the interdental zones on the maxillary and mandibular prosthesis. On maxillary prosthesis: 100% of the former and posterior vestibular zones are colored. The bottom of the palate is colored to 67.74%, a rate equivalent to the zones of fractures. On mandibular prosthesis: retromolar and sublingual zones, are colored to 96.77%. The former hall is colored with a rate of 90.32%. The posterior vestibular zone seems the least colored with a rate of 80.64%. CONCLUSIONS: The former area of the hall carved in an aesthetic objective is generally colored as well on the maxillary and mandibular prosthesis. We point out that this zone should not be much carved on the level of the area simulating the attached gum. Patients should be always incited to practice a mechanical hygiene, which takes part largely in the evacuation of the denture plaque on prosthetic surfaces. This revealing plaque use should integrate a clinical attitude of good practice, to motivate a patient with prosthetic hygiene or to detect zones of cracks objectifying a mechanical weakness of a prosthesis to be taken again, as well as the checking of the quality of repair joint during a routine control.

Magnitude of effect and special approach to Ginkgo biloba extract EGb 761 in cognitive disorders.

In the early 70's, improvements in methodical procedures of extraction and standardization of ginkgo preparation allowed the production of a highly concentrated and stable extract (EGb 761) (definition see editorial) by the company Dr. Willmar Schwabe, which could be systematically tested in scientific programs. Consequently, numerous studies have been undertaken and provided replicable outcomes to demonstrate its efficacy in human population. EGb 761 is currently registered as an ethical drug in more than 50 countries around the world, and is prescribed for a range of neurological and vascular disorders including dementia, arterial occlusive disease, retinal deficit, and tinnitus. The following chapter will focus on the relevant data that support EGb 761 efficacy in the treatment of cognitive disorders in general, and dementia in particular. Besides the published data, the author will provide original results unveiling different factors that could interfere with EGb 761 efficacy and may be the source of the variations observed among studies in the EGb 761 literature. In the author's opinion, such factors should be taken into consideration when implementing the design of future research and optimizing individual EGb 761 response in the clinical practice. Within the framework of this new approach, the author will not only answer the question as to whether EGb 761 works over placebo in cognitive disorders, but also attempt to estimate how well it works in particular conditions.

Response patterns of EGb 761 in Alzheimer's disease: influence of neuropsychological profiles.

We conducted an exploratory analysis of the influence of baseline neuropsychological (NP) profiles on the effect of EGb 761 (definition see editorial) in Alzheimer's disease (AD). Using this perspective, we stratified the intent-to-treat data set collected during a 52-week, randomized, double-blind, placebo-controlled study with 120 mg EGb 761 based on cut-off points applied to naming and constructional praxis items of the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog). Mean changes over baseline and percentage of responders in each NP group and overall efficacy were analyzed, using the ADAS-Cog subscale as outcome measurements for assessing cognitive performance and the Geriatric Evaluation using the Relative's Rating Instrument (GERRI) to measure social functioning. Three subgroups were identified: (1) right AD (RAD) subgroup, including 83 patients with primarily visual-constructional impairment; (2) left AD (LAD) with 25 patients showing predominant verbal deficits; (3) general AD (GAD) including 60 patients impaired in both cognitive domains. At the endpoint, the EGb 761 group of RAD showed an improvement of 1.7 points according to ADAS-Cog and 0.15 points according to GERRI, while the placebo group worsened by 1.3 and 0.02 points, respectively. The LAD patients worsened regardless of treatment; however, to a lesser degree in those receiving EGb 761 as assessed by the increase of 4.7 ADAS-Cog points and 0.13 GERRI points compared to 6.8 points and 0.20 points, respectively, for placebo. In GAD, the EGb 761 group showed minimal changes, whereas the placebo group slightly worsened on both assessments, resulting in favorable treatment differences of 1.6 ADAS-Cog points and 0.23 GERRI points. Retrospective analysis of overall efficacy indicated that a quantitative treatment effect favorable to EGb 761 could be observed in cognitive performance (p = 0.04) and social functioning (p = 0.02), even taking NP differences and baseline severity into account. However, qualitative EGb 761 effects could greatly depend on NP profiles--improvement could be expected with RAD patients, while EGb 761 effect should be considered more in terms of stabilization for GAD and delayed worsening for LAD population.

Influence of the severity of cognitive impairment on the effect of the Gnkgo biloba extract EGb 761 in Alzheimer's disease.

OBJECTIVE: To explore the treatment effect of EGb 761((R)) (EGb) in Alzheimer's disease depending on baseline severity. METHODS: We applied stratification to the intent-to-treat data set collected during a 52-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter study with 120 mg of EGb, using cutoff points of 23 and 14 for the Mini-Mental State Examination (MMSE) score. Outcome measures used were the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog) and the Geriatric Evaluation by Relative's Rating Instrument (GERRI). RESULTS: In the severity stratum 1 (MMSE >23), the placebo group did not show significant changes, while the EGb group improved significantly by 1.7 points on the ADAS-Cog and by 0.09 points on the GERRI. In the severity stratum 2 (MMSE <24), the placebo group worsened by 4.1 points on the ADAS-Cog and 0.18 points on the GERRI, whereas the EGb group showed 60% less decline on the ADAS-Cog (treatment difference of 2.5 points) and no change on the GERRI (treatment difference of 0.25 points). The most severely impaired subgroup (MMSE <15) showed slightly more pronounced worsening for both treatment groups. However, in comparison to placebo, EGb induced virtually the same magnitude of effect as was observed in the entire stratum 2. CONCLUSIONS: The results of this retrospective analysis indicated that a treatment effect favorable to EGb could be observed with respect to cognitive performance (p = 0.02) and social functioning (p = 0.001) regardless of the stage of dementia, whether mild or moderately severe. However, the relative changes from baseline measured at endpoint depended heavily on the severity at baseline. Improvement was observed in the group of patients with very mild to mild cognitive impairment, while in more severe dementia, the mean EGb effect should be considered more in terms of stabilization or slowing down of worsening, as compared to the greater deterioration observed with placebo.

Immunohistochemical localization of type IV collagen and laminin (alpha1) in denture stomatitis.

Chronic clinical irritation of the palatal mucosa by dentures involves a series of histological changes in epithelial and connective tissues, inflammatory cells and the vasculature. No single change is pathognomic of this inflammatory process. The rupture of basement membrane associated with the development of denture stomatitis often marks an important stage. This study investigated modifications in basement membrane organisation, especially the distribution of type IV collagen and a specific laminin chain (alpha1), during denture stomatitis. Biopsies of palatal mucosa were obtained from 12 patients (8 with denture stomatitis and 4 with clinically healthy mucosa) who had worn removable dentures for more than 3 years. Immunohistochemical studies performed with specific antibodies to type IV collagen and a laminin (alpha1) revealed strong expression in the basement membrane of healthy palatal mucosa. In denture stomatitis, some discontinuities or disruptions in basement membrane were observed at the interface between connective tissue and epithelial cells. These findings suggest a relationship between the expression of laminin (alpha1) and type IV collagen and the development of denture stomatitis, a disorder involving modification of soft tissues in which initial inflammation of the palatal mucosa results from stress under the denture. These changes in basement membrane can be detected by histological studies.

Motor imagery in normal subjects and in asymmetrical Parkinson's disease: a PET study.

OBJECTIVE: To investigate, using PET and H2(15)O, brain activation abnormalities of patients with PD during motor imagery. To determine whether motor imagery activation patterns depend on the hand used to complete the task. BACKGROUND: Previous work in PD has shown that bradykinesia is associated with slowness of motor imagery. METHODS: The PET study was performed in eight patients with PD with predominantly right-sided akinesia, and in eight age-matched control subjects, all right-handed. Regional cerebral blood flow was measured by PET and H2(15)O while subjects imagined a predetermined unimanual externally cued sequential movement with a joystick with either the left or the right hand, and during a rest condition. RESULTS: In normal subjects, the prefrontal cortex, supplementary motor area (SMA), superior parietal lobe, inferior frontal gyrus, and cerebellum were activated during motor imagery with either the left or the right hand. Contralateral primary motor cortex activation was noted only when the task was imagined with the right (dominant) hand, whereas activation of the dorsolateral prefrontal cortex was observed only during imagery with the left hand. In patients with PD, motor imagery with the right ("akinetic") hand was characterized by lack of activation of the contralateral primary sensorimotor cortex and the cerebellum, persistent activation of the SMA, and bilateral activation of the superior parietal cortex. Motor imagery with the left ("non-akinetic") hand was also abnormal, with lack of activation of the SMA compared with controls. CONCLUSIONS: In patients with PD with predominantly right-sided akinesia, brain activation during motor imagery is abnormal and may appear even with the less affected hand. In normal subjects, brain activation during motor imagery depends on the hand used in the imagined movement.

A 26-week analysis of a double-blind, placebo-controlled trial of the ginkgo biloba extract EGb 761 in dementia.

This intent-to-treat (ITT) analysis was performed to provide a realistic image of the efficacy that could be expected after 26 weeks treatment with a 120-mg dose (40 mg t.i.d.) of EGb 761 (EGb). The data were collected during a 52-week, double-blind, placebo-controlled, fixed dose, parallel-group, multicenter study. Patients were mildly to severely impaired and diagnosed with uncomplicated Alzheimer's disease or multi-infarct dementia according to ICD-10 and DSM-III-R criteria. The primary outcome measures included the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Geriatric Evaluation by Relative's Rating Instrument (GERRI) and Clinical Global Impression of Change. From 309 patients included in the ITT analysis, 244 patients (76% for placebo and 73% for EGb) actually reached the 26th week visit. In comparison to the baseline values, the placebo group showed a statistically significant worsening in all domains of assessment, while the group receiving EGb was considered slightly improved on the cognitive assessment and the daily living and social behavior. Mean treatment differences favored EGb with 1.3 and 0.12 points, respectively, on the ADAS-Cog (p = 0.04) and the GERRI (p = 0.007). In the group receiving EGb, 26% of the patients achieved at least a 4-point improvement on the ADAS-Cog, compared to 17% with placebo (p = 0.04). On the GERRI, 30% of the EGb group improved and 17% worsened, while the placebo group showed an opposite trend with 37% of patients worsening for 25% improved (p = 0.006). Regarding safety, no differences between EGb and placebo were observed.

Efficacy and safety of a Ginkgo biloba extract.

This review of the literature documents the efficacy of a standard extract of Ginkgo biloba (EGb) in managing signs and symptoms associated with memory disorders and dementia. Analysis of the discrepant findings reveals that study outcomes may vary with the type of population studied, the outcome measurements selected, and the dosing tested. Overall, the efficacy of EGb was more frequently reported in trials enrolling dementia patients than healthy volunteers. In contrast to narrow memory tests, broad cognitive assessments were more likely to detect the treatment effect. Although a dose--response relationship is not yet established, 240 mg day(-1) EGb seems to show a higher rate of treatment response than does 120 mg day(-1). Regarding safety, in all trials reviewed the adverse event profile of EGb was not different from that of the placebo.

Evaluation of a fluorodensitometric method for analysis of ergosterol as a fungal marker in compound feeds.

Ergosterol is the principal sterol of fungi and plays an essential role as a component of the cell membrane and other cell constituents. This molecule is considered a good marker of fungal contamination in foods and feeds. This paper reports a rapid and sensitive method to test ergosterol content in compound feeds based on fluorodensitometry after thin-layer chromatography (TLC) separation. This method involves a thermal treatment of TLC plates that leads to the formation of a highly fluorescent ergosterol derivative. Such a dosage allows ergosterol testing in any naturally contaminated samples (limit of detection: 1 ppm of ergosterol) and gives results in close agreement with high-pressure liquid chromatography determination. Moreover, values obtained on mixed feeds for animals at different steps of fungal contamination are linked to quantitative development of storage fungi, evaluated by mycological technique, reinforcing the interest of a rapid method for measuring this fungal marker.

Correlation of desensitisation of platelet activating factor (PAF) receptors with intensity of inflammation and intestinal PAF content during experimental ileitis in guinea pig.

AIM: To determine the kinetics of platelet activating factor (PAF) and prostaglandin E2 (PGE2) receptor desensitisation during intestinal inflammation induced by trinitrobenzenesulphonic acid (TNB) instillation and to study the relation between receptor regulation, inflammatory lesions, and PAF content of the gut wall. METHODS: Receptor desensitisation was assessed on isolated smooth muscle cells from the circular layer. PAF content of the intestinal wall was determined by thin layer chromatography and radioimmunoassay. RESULTS: After an acute inflammatory phase on day 1, subacute changes appeared in TNB instilled ileum, with a maximal intensity on day 6. In control animals, PAF 10 nM and PGE2 10 nM provoked a maximal contraction in the range of 24% of cell shortening. On days 1 and 3 after intestinal instillation of TNB, PAF induced contraction was not altered whereas the effect of PGE2 was progressively desensitised (2 logM rightward shift of its concentration-response curve: Cmax = 1 microM; p < 0.01). Between days 4 and 6, the concentration-response curve of PGE2 shifted by only 1 logM (p < 0.05) whereas the curve of PAF induced contraction shifted by 2 logM (Cmax = 1 microM; p < 0.01). The PAF content of the ileal wall was maximal between days 3 and 5 (300 ng/mg tissue). On days 10 and 15, PAF and PGE2 induced contractions were similar to those observed on day 1, and PAF content returned to basal. CONCLUSION: Inflammation induced by TNB instillation triggers PAF and PGE2 receptor desensitisation; this is dependent on the duration of inflammation and correlates with PAF content in the ileum. This receptor desensitisation may play a protective role by preventing overstimulation of intestinal smooth muscle cells.

A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group.

CONTEXT: EGb 761 is a particular extract of Ginkgo biloba used in Europe to alleviate symptoms associated with numerous cognitive disorders. Its use in dementias is based on positive results from only a few controlled clinical trials, most of which did not include standard assessments of cognition and behavior. OBJECTIVE: To assess the efficacy and safety of EGb in Alzheimer disease and multi-infarct dementia. DESIGN: A 52-week, randomized double-blind, placebo-controlled, parallel-group, multicenter study. PATIENTS: Mildly to severely demented outpatients with Alzheimer disease or multi-infarct dementia, without other significant medical conditions. INTERVENTION: Patients assigned randomly to treatment with EGb (120 mg/d) or placebo. Safety, compliance, and drug dispensation were monitored every 3 months with complete outcome evaluation at 12, 26, and 52 weeks. PRIMARY OUTCOME MEASURES: Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog), Geriatric Evaluation by Relative's Rating Instrument (GERRI), and Clinical Global Impression of Change (CGIC). RESULTS: From 309 patients included in an intent-to-treat analysis, 202 provided evaluable data for the 52-week end point analysis. In the intent-to-treat analysis, the EGbgroup had an ADAS-Cog score 1.4 points better than the placebo group (P=.04) and a GERRI score 0.14 points better than the placebo group (P=.004). The same patterns were observed with the evaluable data set in which 27% of patients treated with EGb achieved at least a 4-point improvement on the ADAS-Cog, compared with 14% taking placebo (P=.005); on the GERRI, 37% were considered improved with EGb, compared with 23% taking placebo (P=.003). No difference was seen in the CGIC. Regarding the safety profile of EGb, no significant differences compared with placebo were observed in the number of patients reporting adverse events or in the incidence and severity of these events. CONCLUSIONS: EGb was safe and appears capable of stabilizing and, in a substantial number of cases, improving the cognitive performance and the social functioning of demented patients for 6 months to 1 year. Although modest, the changes induced by EGb were objectively measured by the ADAS-Cog and were of sufficient magnitude to be recognized by the caregivers in the GERRI.

Evaluation of an HPTLC method for the determination of strychnine and crimidine in biological samples.

In an attempt to improve the sensitivity and selectivity of thin-layer chromatographic analysis for the detection of strychnine and crimidine in biological samples, a rapid high-performance thin-layer chromatographic (HPTLC) method with densitometry is described. Fortified dog serum and stomach content samples were analyzed after extraction with chloroform. Quantitation was achieved by densitometry in the ultraviolet (UV) range (260 nm) of HPTLC silica gel 60 plates. Detection of trace levels as low as 5 ng proved feasible. Linearity was obtained over a range of 10-250-ng deposits for crimidine and 12.5-250-ng deposits for strychnine with simple or F254 plates. No interferences were observed in the UV spectra (220-380 nm) when peaks obtained with HPTLC of the standard substances and positive biological contents were scanned.

Recent acute and subacute mycotoxicoses recognized in France.

Successful investigation and prevention of mycotoxic problems requires close collaboration between scientists from several disciplines ranging from agronomists and technologists required during production of food and feeds, to toxicologists and pathologists examining the effects of mycotoxins on animals and man. Zootoxic metabolites following fungal infection result from four general mechanisms: (i) secondary fungal metabolism (mycotoxins, eg, aflatoxins); (ii) bioconversion of vegetal compounds (eg, dicoumarol); (iii) plant reactions (phytoalexins, eg, coumestrol); and (iv) plant-fungus associations (endophytes, eg, Acremonium/Festuca). In reported pathologic field cases, close cooperation through a selected veterinary network has allowed diagnosis of acute and subacute mycotoxicoses in France. Natural stachybotryotoxicosis may not be limited only to cold climates, but may also occur in mild and warm ones (eg, south west of France, Morocco). A considerable variation was observed in symptoms and lesions depending on toxin levels, ranging from a poor performance in a horse race to a general haemorrhagic syndrome. Several cases of acute equine leucoencephalomalacia, characterized by pathognomonic lesions and recently supported by fumonisin analysis, have been diagnosed in the southern part of France and other countries (eg, New Caledonia and the Ivory Coast). Facial eczema in sheep is endemic in the Basque country, as a result of specific bioclimatic and zootechnic conditions. Reproductive disorders in sheep, cattle, goats and rabbits have been associated with high levels of coumestrol in alfalfa, clover and their derivatives. A few cases of fescue foot disease, associated with the endophyte Acremonium, have been diagnosed recently. In addition, several nervous disorders may be due to unknown mycotoxins. These acute or subacute mycotoxicoses suggest a potentially widespread occurrence of low level toxins and insidious asymptomatic mycotoxicoses, and justify interdisciplinary research in order to improve diagnosis and preventative measures.

Characterization of monascidin A from Monascus as citrinin.

Following our investigations on red pigments and monascidin co-production by Monascus species, the antibiotic called monascidin A was characterized as citrinin. Evidence was given by qualitative methods, mass spectra and NMR. Citrinin, a nephrotoxic agent was produced both by Monascus purpureus and Monascus ruber, either in submerged culture of concentrations of 270 and 340 mg/l, respectively, or in solid state culture of concentration of 100 and 300 mg/kg dried matter, respectively. Since citrinin is a toxic product, it is essential that the production of red pigments as food additives from Monascus spp. avoid the occurrence of citrinin.