Randomized study of phentolamine mesylate for reversal of local anesthesia.

Local anesthetic solutions frequently contain vasoconstrictors to increase the depth and/or duration of anesthesia. Generally, the duration of soft-tissue anesthesia exceeds that of pulpal anesthesia. Negative consequences of soft-tissue anesthesia include accidental lip and tongue biting as well as difficulty in eating, drinking, speaking, and smiling. A double-blind, randomized, multicenter, Phase 2 study tested the hypothesis that local injection of the vasodilator phentolamine mesylate would shorten the duration of soft-tissue anesthesia following routine dental procedures. Participants (122) received one or two cartridges of local anesthetic/vasoconstrictor prior to dental treatment. Immediately after treatment, 1.8 mL of study drug (containing 0.4 mg phentolamine mesylate or placebo) was injected per cartridge of local anesthetic used. The phentolamine was well-tolerated and reduced the median duration of soft-tissue anesthesia in the lip from 155 to 70 min (p < 0.0001).

Social roles as process: caregiving careers and women's health.

Is involvement in multiple roles beneficial for women's health or do the often noted health benefits of multiple roles reflect an ongoing process of role management? We address this question by looking at two roles, caregiving and employment, and by investigating changes in women's health as they move into and out of both roles. We examine changes in physical health limitations and psychological distress over a two-year period with data from a nationally representative sample of 2,929 late-midlife women. Looking first at health changes associated with caregiving, we find that psychological distress increases as women move into and continue caring for an ill or disabled person in their household. Caregiving has a weaker effect on physical health, but increases in physical limitations prompt exists from caregiving. Increases in physical limitations also appear to be greater for non-employed women, but some or all of this difference reflects selection out of the labor force for women having difficulty combining both roles. Our findings provide further evidence that care work has implications for women's health, while also suggesting a need for further attention to the ways that women actively manage problematic role combinations.

delta 13C analyses of vegetable oil fatty acid components, determined by gas chromatography--combustion--isotope ratio mass spectrometry, after saponification or regiospecific hydrolysis.

The delta 13C values of the major fatty acids of several different commercially important vegetable oils were measured by gas chromatography--combustion--isotope ratio mass spectrometry. The delta 13C values obtained were found to fall into two distinct groups, representing the C3 and C4 plants classes from which the oils were derived. The delta 13C values of the oils were measured by continuous flow elemental isotope ratio mass spectrometry and were found to be similar to their fatty acids, with slight differences between individual fatty acids. Investigations were then made into the influence on the delta 13C values of fatty acids of the position occupied on the glycerol backbone. Pancreatic lipase was employed to selectively hydrolyse fatty acids from the 1- and 3-positions with the progress of the reaction being followed by high-temperature gas chromatography in order to determine the optimum incubation time. The 2-monoacylglycerols were then isolated by thin-layer chromatography and fatty acid methyl esters prepared. The delta 13C values obtained indicate that fatty acids from any position on the glycerol backbone are isotopically identical. Thus, whilst quantification of fatty acid composition at the 2-position and measurement of delta 13C values of oils and their major fatty acids are useful criteria in edible oil purity assessment, measurement of delta 13C values of fatty acids from the 2-position does not assist with oil purity assignments.

Options for immediate reconstruction of the traumatized temporomandibular joint.

The management of condylar fractures is one of the most controversial topics in the repair of the maxillofacial skeleton. An extensive volume of literature exists describing the various indications for a specific treatment of this injury. This article outlines the absolute and relative indications for an open procedure and describes three different modalities for the immediate reconstruction of the temporomandibular joint system. Three different case reports are used to illustrate the respective procedures--replacement of the temporomandibular joint with autologous rib graft, replacement of the temporomandibular joint with an alloplast, and vertical ramus osteotomy for repositioning of the condylar stump. The discussion section reviews the findings and preferences of various treatment modalities described in the literature, along with the advantages and disadvantages.

Short-latency somatosensory evoked potentials in multiple sclerosis. Comparison with auditory and visual evoked potentials.

Short-latency somatosensory potentials after median nerve stimulation were recorded in 17 patients with clinically definite cases of multiple sclerosis and in 15 patients with probable, possible, or suspected cases. Abnormalities, usually prolongation of component wave latencies, were found in 20 patients, often with normal clinicaly sensory testing. Abnormalities in brief auditory evoked potentials were found less often but were significantly more frequent in the group with clinically definite cases. Pattern evoked visual potentials may have been more useful in identifying early cases. The recording of all three evoked potentials showed an abnormality of at least one in most patients.

Clinical evaluation of eterobarb, a new anticonvulsant drug.

Two clinical investigations of a new anticonvulsant, eterobarb, N,N' dimethoxymethyl phenobarbital (DMMP), were conducted in separate geographic regions. The drug has considerable efficacy in reducing the frequency of partial seizures, with and without secondary generalization, as well as generalized tonic-clonic seizures. Sedation did not appear to be as prominent with this barbiturate as it was with phenobarbital or primidone.