Biomedical subjects

A Wenzel

Publications and source records attributed to A Wenzel.

At least 91 records · Page 5Linked to original sources

PubMed1998

Apoptotic cell death in retinal degenerations.

Apoptosis is a regulated mode of single cell death that involves gene expression in many instances and occurs under physiological and pathological conditions in a large variety of systems. We briefly summarize major features of apoptosis in general and describe the occurrence of apoptosis in the retina in different situations that comprise animal models of retinitis pigmentosa, light-induced lesions, histogenesis during development, and others. Apoptosis can be separated into several phases: the induction by a multitude of stimuli, the effector phase in which the apoptotic signal is transmitted to the cellular death machinery, the excecution period when proteolytic cascades are activated, and the phagocytic removal of cellular remnants. Control mechanisms for retinal apoptosis are only beginning to be clarified. Potential apoptotic signal transducers were investigated in our laboratory, including metabolites of arachidonic acid and downstream mediators of signaling molecules such as transcription factors. Work in our laboratory revealed an essential role of the immediate-early gene product c-Fos in light-induced apoptosis. c-Fos is a member of the AP-1 family of transcription factors and, together with other members of this family, it may regulate apoptosis in the central nervous system. Expression of the c-fos gene in the retina can be evoked by light exposure and follows a diurnal rhythm. Future studies will have to clarify how light can control the expression of specific genes, and specifically, the role of c-fos and other genes of retinal apoptosis including potential target genes and signaling pathways.

Animals↗

PubMed1998

Volumetry of bone grafts by three-dimensional computed tomographic reconstruction: an animal study in the minipig.

OBJECTIVES: To evaluate the accuracy of 3D-CT reconstruction for determination of bone graft volume in an animal model. MATERIALS AND METHODS: Eight minipigs had bone graft reconstruction of an alveolar ridge defect. The true volume of the graft (VOL I) was determined by Archimedes principle before reconstruction. Following fixation, axial CT-scans (1 mm slice thickness with 50% overlap) were performed and segmented into grafted and residual bone for 3D-reconstruction. Using the volume tool of the 3D program the volume (VOL II) was calculated. RESULTS: There was a strong correlation between VOL I and VOL II (r = 0.93, P = 0.001). There was a tendency, which was not statistically significant, to overestimate the volume measured by 3D-CT. CONCLUSION: The volume of a bone graft can be determined by 3D-CT. However, further refinements of the technique are needed to improve the accuracy.

Alveolar Process↗

PubMed1998

Digital radiography and caries diagnosis.

Direct digital acquisition of intra-oral radiographs has been possible only in the last decade. Several studies have shown that, theoretically, there are a number of advantages of direct digital radiography compared with conventional film. Laboratory as well as controlled clinical studies are needed to determine whether new digital imaging systems alter diagnosis, treatment and prognosis compared with conventional methods. Most studies so far have evaluated their diagnostic performance only in laboratory settings. This review concentrates on what evidence we have for the diagnostic efficacy of digital systems for caries detection. Digital systems are compared with film and those studies which have evaluated the effects on diagnostic accuracy of contrast and edge enhancement, image size, variations in radiation dose and image compression are reviewed together with the use of automated image analysis for caries diagnosis. Digital intra-oral radiographic systems seem to be as accurate as the currently available dental films for the detection of caries. Sensitivities are relatively high (0.6-0.8) for detection of occlusal lesions into dentine with false positive fractions of 5-10%. A radiolucency in dentine is recognised as a good predictor for demineralisation. Radiography is of no value for the detection of initial (enamel) occlusal lesions. For detection of approximal dentinal lesions, sensitivities, specificities as well as the predictive values are fair, but are very poor for lesions known to be confined to enamel. Very little documented information exists, however, on the utilization of digital systems in the clinic. It is not known whether dose is actually reduced with the storage phosphor system, or whether collimator size is adjusted to fit sensor size in the CCD-based systems. There is no evidence that the number of retakes have been reduced. It is not known how many images are needed with the various CCD systems when compared with a conventional bitewing, nor how stable these systems are in the daily clinical use or whether proper cross-infection control can be maintained in relation to scanning the storage phosphor plates and the sensors and the cable. There is only sparse evidence that the enhancement facilities are used when interpreting images, and none that this has changed working practices or treatment decisions. The economic consequences for the patient, dentist and society require examination.

Contrast Media↗

PubMed1998

Evaluation of a new radiographic technique: outcome following removal of mandibular third molars.

OBJECTIVE: To compare the effect on outcome of third molar removal of pre-operative radiographic assessment by two different techniques. METHODS: Two hundred and sixty three patients were allocated prior to surgery to one of two diagnostic groups. One hundred and thirty-seven were examined by the Scanora and 126 by a panoramic plus three intra-oral radiographs. Ten oral surgeons recorded their operating time in minutes. Postoperative pain was recorded 4 h after the operation by the patients on a Visual Analog Scale (VAS). The following clinical parameters were recorded at the 1-week postoperative examination: alveolitis, bleeding, and swelling related to the operation area, and any other complications such as paresthesia, nausea and trismus. RESULTS: There was no significant difference in operation time between the two groups of patients (t-test; P > 0.82) nor in the frequency of immediate postoperative pain (chi 2-test; P > 0.5). There were no statistically significant differences in pain score between patients who experienced pain in the two groups (P = 0.10). Sixty-four patients experienced one or more postoperative complications, but the differences between the two groups were not statistically significant (chi 2-test; P > 0.05). There were no significant differences between the surgeons in the number of patients they operated on who experienced pain (chi 2-test; P = 0.18) or who developed complications (chi 2-test; P = 0.27). CONCLUSION: There are no adverse effects on the rate of postoperative complications when surgeons with little experience with it base their diagnosis and treatment plan on Scanora compared with conventional radiography.

Adult↗

PubMed1998

Evaluation of a new radiographic technique: diagnostic accuracy for mandibular third molars.

OBJECTIVE: To compare the accuracy of Scanora with that of traditional panoramic and intra-oral radiography for the assessment of impacted mandibular third molars. METHODS: Two hundred and fifty-four patients referred for removal of impacted or partly erupted third molars were randomly allocated to one of two groups; 133 were examined by the Scanora system and 121 by a panoramic plus a series of three intra-oral radiographs. The radiographs were read by a trained oral radiologist and her diagnoses validated against the surgeons' findings at operation. RESULTS: There was agreement about the state of tooth eruption in 71.4% of Scanora and 74.4% of conventional examinations and about tooth position in 77.2 and 69.7% respectively (P < 0.05). The number of roots was assessed more accurately by Scanora (82.7% agreement) than by conventional (71% agreement) examination (P < 0.05). There was agreement about the root morphology in 70.4% of Scanora and 62.4% of conventional examinations. In 12% of the patients, the roots were in very close contact with the canal determined by the surgeon. In approximately 50% of these cases, the close contact to the canal was found by radiography with no significant differences between the methods. CONCLUSION: The Scanora method was more accurate when validated against the surgeons' findings for the position and number of roots of ectopic mandibular third molars while both methods were equally accurate in demonstrating the relation between the roots and the inferior alveolar nerve.

Adolescent↗

PubMed1998

[HPETE, an arachidonic acid metabolite, induces apoptosis in rat retina in vitro].

BACKGROUND: Apoptosis is a gene-regulated mode of cell death which gains increasing importance in retinal pathologies such as retinitis pigmentosa, retinal detachment and proliferative vitreoretinopathy. A better understanding of the regulation of apoptosis could imply the means to reduce photoreceptor cell death and thereby provide therapeutic strategies to influence the time course of retinal diseases. Previous studies in our laboratory demonstrated that light induces apoptosis in the rat retina in vivo as a function of light dose. In several cell systems, oxidative stress including oxygenated metabolites of arachidonic acid (AA) was found to evoke apoptosis. We have observed a light-elicited release of AA and the subsequent formation of its metabolites in the rat retina. Therefore, AA and its metabolites appeared to be suitable candidates for the induction of apoptosis during light exposure. MATERIALS AND METHODS: Isolated rat retinas were incubated for 60, 120 and 180 min, respectively, with and without the addition of 30 mumol 5S-hydroperoxyeicosatetraenoic acid (5-HPETE). Retinas were then processed for light- and electron microscopy and examined for the morphological signs of apoptosis. The rate of apoptosis in the outer nuclear layer was assessed quantitatively. RESULTS: 5S-HPETE induces apoptosis of photoreceptors in the rat retina in vitro. Quantitative analysis revealed a significant increase in the rate of apoptosis of 5S-HPETE-treated retinas when compared to untreated controls. CONCLUSION: Arachidonic acid metabolites released upon light exposure may represent messenger candidates for apoptosis in the retina.

Animals↗

PubMed1998

Influence of transducer frequency on Doppler microemboli signals in an in vivo model.

The purpose of this study was the comparison between 1 MHz and 2 MHz transducers in the detection of Doppler microembolic signals (MES). Intraoperative monitoring was performed over the arterial tubing of the extracorporal circulation circuit in 10 patients undergoing coronary artery bypass surgery, using a pulsed ultrasound machine (DWL X-4). 1 MHz and 2 MHz probes were mounted to insonate sequential tubing segments and all monitoring sessions saved on digital audio tapes (DAT). MES counts and intensity as detected by each probe were subsequently evaluated. Specific interobserver agreement was assessed using Cohen's kappa-statistic. Time delay in the appearance of MES between the transducers was minimal (0-0.1 msec). A total of 5293 (64%) MES were detected by both probes, 2796 (33.8%) only with the 1 MHz and 181 (2.2%) only with the 2 MHz probe. Significant differences in MES intensity were evident when comparing the 1 MHz to the 2 MHz transducer (16.4 +/- 0.1 and 11 +/- 0.1 dB with the 1 MHz and 2 MHz transducers respectively, p < 0.0001). Specific interobserver agreement was satisfactory (k = 0.78). Use of 1 MHz instead of 2 MHz transducers increases the yield of embolus detection in vitro. Evaluation of the applicability and performance of this transducer in clinical settings is warranted.

Catheters, Indwelling↗

PubMed1998

Reproducibility of cephalometric landmarks on conventional film, hardcopy, and monitor-displayed images obtained by the storage phosphor technique.

The aim of the present study was to evaluate and compare the reproducibility of cephalometric landmarks on (1) conventional films, and images acquired by storage phosphor digital radiography both on (2) hardcopy and (3) monitor-displayed versions. The material consisted of 19 cephalograms for each image modality. The phosphor plates were scanned in an image reader and the 10-bit normalized, raw data digital images were converted to 8-bit TIFF images for PC monitor-display. The digital hardcopies were produced in a laser printer. Six observers were asked to record 21 cephalometric landmarks on each conventional film, hardcopy, and monitor-displayed image. For the films and hardcopies, the landmark co-ordinates were recorded via a digitizing tablet. For the monitor-displayed images, the co-ordinates were recorded directly from the monitor using a dedicated Windows-based cephalometric program. Reproducibility was defined as an observer's deviation (in mm) from the mean between all observers. Differences between the image modalities and between the observers were tested by two-way analysis of variance for each landmark. There was a statistically significant difference between the reproducibility of film, hardcopy and monitor-displayed images in 11 of the 21 landmarks. There was no unequivocal trend that one modality was always the best. For a full cephalometric recording (the sum of all 21 landmarks), the monitor-displayed images (mean = 25.3 mm) had a lower precision than film (P < 0.005) and hard-copy (P < 0.02). There was no significant difference between film (mean = 21.8 mm) and hardcopy (mean = 22.8 mm). The lower reproducibility seen for the monitor-displayed images is most probably of little clinical significance.

Adolescent↗

PubMed1998

GTR therapy of intrabony defects using 2 different bioresorbable membranes: 12-month results.

This prospective split-mouth study was designed to compare the clinical and radiographic healing results in intrabony periodontal defects 12 months after GTR therapy with 2 different bioresorbable barriers. The study comprised 25 healthy patients with one pair of contralaterally located intrabony defects with a probing pocket depth of > or = 6 mm and radiographic evidence of angular bone loss of > or = 4 mm. The 2 defects of each patient were randomized for treatment either with polylactic acid (PLA) membranes or with polyglactin-910 (PG-910) membranes. The patients received systemic doxycycline (100 mg/d) for 11 days postoperatively. One blinded examiner recorded the following clinical parameters using a pressure calibrated probe at baseline and after 12 months: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), and probing attachment level (PAL). The vertical relative attachment gain (V-rAG) was calculated as a % of the PAL gain related to the maximum possible attachment gain (expressed by the intraoperatively measured depth of the osseous defect). Geometrically standardized intraoral radiographs were quantitatively evaluated for bone changes (density, area) in the defect region using digital subtraction radiography (DSR). Clinical and radiographic data were statistically analyzed using the Wilcoxon-signed-rank test (alpha=0.05). Postoperative membrane exposures occurred in 9 PLA and 13 PG-910 treated sites. After 12 months of healing, both barrier types provided significant PPD reductions and PAL gain [median (25/75 percentile)]: deltaPPD [PLA: 3.0 (2.0/4.0) mm; PG-910: 3.0 (2.0/4.5) mm]; deltaPAL [PLA: 3.0 (2.5/4.0) mm; PG-910: 2.0 (1.0/4.0) mm]. V-rAG amounted to 60% in PLA sites and 54% in PG-910 sites. DSR revealed significant bone density gain after 12 months. 58.3% of the initial defect area in PLA sites and 54.0% of the initial defect area in PG-910 sites showed bone density gain. Neither clinical nor radiographic data revealed any significant difference between the 2 barrier types after 12 months. In conclusion, this 12-month study demonstrated that PLA and PG-910 membranes provided similar favorable regeneration results in deep intrabony periodontal defects.

Adult↗

PubMed1998

Accuracy of quantitative digital subtraction radiography for determining changes in calcium mass in mandibular bone: an in vitro study.

The aim of this in vitro study was to determine the accuracy of digital subtraction radiography (DSR) to detect small changes in calcium mass in alveolar bone adjacent to tooth roots. In each of 4 dried porcine mandible segments, one interproximal and one buccal "defect" region was defined adjacent to a premolar root. A series of cortical and cancellous bone slices with a 50 microns--stepwise increasing thickness (0-5000 microns) were attached to the mandible segments covering the respective "defect" region. Standardized radiographs were quantitatively assessed for density changes using DSR. After dissolving each bone slice in hydrochloric acid, its calcium concentration was photometrically determined. For each bone slice, the mean calcium mass covering a single pixel of the subtraction image was calculated. The Wilcoxon signed-rank test and the Mann-Whitney U-test were used for statistical analysis (alpha = 0.05). A strong linear correlation (r2 = 0.86-1.00; p < or = 0.001) was found between the thickness of the bone slices and their calcium mass. Cortical bone showed a 3.5 times higher mean calcium mass/pixel than cancellous bone. Furthermore, a strong linear correlation (r2 = 0.63-1.00; p < or = 0.001) was found between the mean calcium mass per image pixel and the radiographic density changes. Neither the bone type nor the "defect" localization had a significant influence on radiographic density changes caused by changes in calcium mass. A change in mean calcium mass per image pixel of 0.1-0.15 mg was necessary to be detected by DSR. In conclusion, this study revealed a high accuracy of DSR to detect small changes in calcium mass in alveolar cortical and cancellous bone.

Alveolar Bone Loss↗

PubMed1998

Accuracy of radiographic detection of residual caries in connection with tunnel restorations.

The aim of this study was to evaluate the diagnostic accuracy of radiographic examination for the detection of residual caries after tunnel preparation and filling with glass ionomer cement. Further, two different radiographic modalities were compared. Forty-five extracted human premolars and molars with clinical signs of approximal caries were selected for the study. The teeth were radiographed in order to identify surfaces with dentinal lesions suitable for tunnel preparation. Seventeen of the teeth had lesions that were as a minimum through the enamel and as a maximum into the outer half of the dentin (14 teeth = 1 lesion, 3 teeth = 2 lesions). Seventeen surgically removed third molars were thereafter included. These teeth were sound with respect to caries. The teeth were arranged in blocks with approximal contacts and radiographed using two image receptors: Ektaspeed Plus film (E) and the Digora (D) digital storage phosphor plate system. The 20 carious surfaces and 20 surfaces of the impacted teeth were prepared following the guidelines for the class II tunnel technique and filled with glass ionomer cement. The radiographic examination was repeated with both modalities after filling, and the approximal surfaces scored on the radiographs by 5 observers using the criteria: 0 = no filling, 1 = filling with residual caries, 2 = filling with no adjacent caries. All teeth except the unerupted third molars were sectioned, and the sections examined under the microscope. Residual caries was observed in 8 surfaces. On average, sensitivity was 0.25 for E and 0.32 for D, specificity 0.83 for E and 0.76 for D, positive predictive value 0.38 for E and 0.32 for D, and negative predictive value 0.75 for E and 0.77 for D. The differences between the two modalities were not statistically significant (p > 0.3). Based on the relatively small number of lesions in this study, it is suggested that radiography immediately after tunnel restoration cannot be recommended, as the diagnostic benefit from this examination seems to be minuscule.

Bicuspid↗

PubMed1998

Reliability of visual examination, fibre-optic transillumination, and bite-wing radiography, and reproducibility of direct visual examination following tooth separation for the identification of cavitated carious lesions in contacting approximal surfaces.

The aim of this study was to evaluate the diagnostic accuracy of visual, fibreoptic transillumination (FOTI), and bite-wing radiographic examination performed by 4 observers for the identification of cavitated carious lesions in contacting approximal surfaces, and to assess the inter-observer agreement with these methods and with direct visual examination conducted after tooth separation, the method used as validation for definitive determination of cavitation. A total of 338 unrestored approximal surfaces in 53 students were examined independently by 4 dentists using the diagnostic methods under study. The results from the diagnostic methods were compared with the results from the validation method for each observer. The sensitivities for identification of cavitated lesions using visual examination ranged from 0.12 to 0.50. For FOTI and radiography, the sensitivities ranged from 0.00 to 0.08 and from 0.56 to 0.69, respectively. The specificities exceeded 0.90 for all observers with all methods. Kappa values expressing inter-observer reproducibility were lowest for FOTI, followed by visual and radiographic examination. On the basis of these results, it was concluded that FOTI was the least reliable of the diagnostic methods tested. For the validation method, the inter-observer agreement was only 'substantial'. This implies that the method cannot be used as a validation for other diagnostic methods applied for the identification of cavitated carious lesions in contacting approximal surfaces. However, visual inspection after tooth separation may serve as a supplementary diagnostic tool to conventional visual and radiographic examination for clinical management of aproximal carious lesions.

Adult↗

PubMed1998

Automated intraoperative detection of Doppler microembolic signals using the bigate approach.

BACKGROUND AND PURPOSE: We undertook this study to evaluate the performance of an automated detection software in the detection of Doppler microembolic signals (MES) during cardiac surgery. METHODS: Intraoperative monitoring was performed over two spatially separated vessel segments of each middle cerebral artery in 18 patients undergoing coronary artery bypass surgery (n= 16) or cardiac valve replacement (n=2). All monitoring sessions were saved on digital audiotape and subsequently played back to the same ultrasound machine, set up to automatically detect MES by evaluating the temporary delay in their appearance between the two segments, in the presence of an experienced examiner. Software sensitivity and specificity in MES detection were then evaluated, with the results of the human observer considered the gold standard. RESULTS: A total of 44,933 high-intensity signals (artifacts and MES) were evaluated. Overall sensitivity and specificity of the software, with the human observer considered the gold standard, were 64% and 78.5%, respectively, ranging from 54% to 96% and from 74% to 90% in individual patients. When the overall results of the software were compared with those of the human observer, kappa was 0.72. CONCLUSIONS: The tested software displayed a satisfactory specificity. Provided that the sensitivity is further improved, it could provide a valuable tool in intraoperative monitoring.

Artifacts↗

PubMed1998

Light-induced cell death of retinal photoreceptors in the absence of p53.

PURPOSE: Cell death by apoptosis is essential for normal development and tissue homeostasis, and it is involved also in a variety of pathologic processes. Apoptosis is the final common pathway of photoreceptor cell death in retinal dystrophies and degeneration. So far, little is known about genes regulating apoptosis in the retina. The tumor-suppressor gene product p53 is a potent regulator of apoptosis in numerous systems. However, p53-independent apoptotic pathways also have been described. In this study the authors investigated the role of p53 in the light-induced apoptosis of retinal photoreceptors using mice lacking p53. METHODS: Free-moving p53-/- and p53+/+ mice were dark adapted and were exposed to 8,500 or 15,000 lux of diffuse, cool, white fluorescent light for 2 hours. Animals were killed before and immediately after light exposure or at 12 hours in darkness after light exposure. Eyes were enucleated and processed for light and electron microscopy and histochemistry (TdT-dUTP terminal nick-end labeling method). Isolated retinas were subjected to the extraction of total retinal DNA. Electroretinogram (ERG) recordings were performed at all time points. RESULTS: Morphologic, biochemical, histochemical, and ERG analysis showed that the retinas of untreated p53-/- mice and wild-type control mice were structurally and functionally indistinguishable. After exposure to diffuse white fluorescent light, light-induced photoreceptor cell death was analyzed and was found to be the same in both groups of mice. CONCLUSIONS: These data suggest that light-induced apoptosis of photoreceptors is independent of functional p53.

Animals↗

PubMed1998

Retinal degeneration in the rd mouse in the absence of c-fos.

PURPOSE: Apoptosis is the final common death pathway of photoreceptors in light-induced retinal degeneration and in several animal models for retinal dystrophy. To date, little is known about gene regulation of apoptosis in the retina. The expression of the immediate early gene c-fos is upregulated concomitant with apoptosis in light-induced photoreceptor degeneration and in the rd mouse, an animal model for inherited retinal degeneration. In a recent study it was shown that c-Fos is essential for light-induced apoptosis of photoreceptors in vivo. To determine whether c-Fos is also involved in the apoptotic pathway of inherited retinal degeneration, rd/rd, c-fos -/- double-mutant mice have been generated. METHODS: Double-mutant mice (rd/rd, c-fos -/-) were crossbred from c-fos+/- mice and rd/rd mice. Their genotype was determined by polymerase chain reaction analysis of genomic DNA. Wild-type control mice and homozygous rd mice were killed at 2-day intervals from postnatal day (P)9 through P21. Double-mutant mice were killed at postnatal days P9, P11, P13, P15, and P21. To determine levels of apoptosis in the retina, eyes were enucleated and processed for light microscopy and in situ nick-end labeling. Total retinal DNA was extracted from isolated retinas for DNA fragmentation analysis. RESULTS: Morphologic, histochemical, and biochemical analyses showed that the time course of apoptosis and the outcome of photoreceptor degeneration in rd/rd, c-fos-/- double-mutant mice was indistinguishable from that in rd mice carrying functional c-fos. CONCLUSIONS: These data suggest that in contrast to its role in light-induced photoreceptor degeneration, c-Fos is not essential for apoptosis in the rd mouse.

Animals↗

PubMed1998

Discrimination between restorative dental materials by their radiopacity measured in film radiographs and digital images.

The aim of this study was to investigate the possibility of differentiating between various dental restorative materials by means of their radiopacity. Ten extracted molars and ten canines/anterior teeth were selected for the study. In the molar group a class II cavity and in the canines/anterior teeth group a class III cavity were cut by airrotor. The cavities were coated with vaseline before filling with five molar- and three anterior tooth restorative materials in the following sequence: for molars: amalgam, light-cured composite, glass ionomer cement, reinforced glass ionomer cement and light-cured composite. After each filling sequence radiographs were taken of the teeth on conventional film (Ektaspeed Plus) and by two digital systems: a storage phosphor plate (Digora) and a ccd-based sensor (Sidexis). Density was measured in the films with a densitometer in three areas of "air", in three areas of the class II fillings and one area of the class III fillings. The same areas were measured in the digital images where the program calculated automatically the mean grey shade values. The density values obtained from the filling areas were taken as a proportion of the values obtained from the areas of "air". Statistically significant differences in material density when related to "air" density (Wilcoxon's test) were observed between all materials in film (p < 0.01 for molars and p < 0.02 for canines/anterior teeth). For Digora only half of the materials differed significantly which was also the case for the Sidexis system (none of the CF materials were significantly different). In conclusion, the molar filling materials could be distinguished with a high probability in film while the two digital systems were less reliable. The results may be useful in forensic dentistry.

Absorptiometry, Photon↗

PubMed1997

Environmental hazard assessment of pharmaceuticals.

The pharmaceuticals and pharmaceutical metabolites salicylic acid, paracetamol, clofibrinic acid, and methotrexate were examined with regard to their biological degradability and toxicity toward algae, Daphnia, fish embryos, luminescent bacteria, ciliates, and the fish cell line BF-2. The EC50 values calculated for the most sensitive organismic test (all except cell cultures) in each case were for salicylic acid, 37 mg/L (fish embryos); for paracetamol, 50 mg/L (Daphnia); for clofibrinic acid, 86 mg/L (fish embryos); and for methotrexate, 45 mg/L (ciliates). However, in the case of paracetamol, clofibrinic acid, and methotrexate, the fish cell line BF-2 reacted even more sensitively with EC50 values of 19 mg/L (paracetamol), 14 mg/L (clofibrinic acid), and 3 mg/L (methotrexate). Salicylic acid and paracetamol proved to be easily degradable. The predicted exposure concentration calculated according to the procedure of the EU Draft Phase I for new pharmaceuticals (CEC III/5504/94, draft 4) was based on the total estimated quantity of these substances consumed and indicated that their entry into the environment is theoretically possible. These results show that (1) the four tested pharmaceuticals may be present in the environment, (2) the substances led to effects in at least one ecotoxicological test, and (3) the most sensitive reactions were observed for a nonstandard test which incorporates relevant end points for the respective pharmaceuticals. This demonstrates that a limitation to the standard tests (algae, Daphnia, and fish) would have underestimated the toxicity of paracetamol, clofibrinic acid, and methotrexate. In addition to improved exposure estimates, the EU guideline should therefore contain a test strategy adapted to their modes of action, which permits the definite identification of pharmaceuticals with high ecotoxic potential, and consequently the appropriate provisions.

Acetaminophen↗

PubMed1997

Postoperative exposure of bioresorbable GTR membranes: effect on healing results.

The goal of this investigation was to evaluate the effect of postoperative exposure of two different bioresorbable membranes on the guided tissue regeneration (GTR) healing results compared to nonexposed sites. In each of 25 patients one pair of contralateral intrabony lesions was treated either with polylactic acid (PLA) or polyglactin 910 (PG-910) membranes. Postoperative exposure occurred in 9 PLA and 13 PG-910 sites. Standardized clinical [papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), probing attachment level (PAL)] and radiographic examinations (digital subtraction radiography) were performed immediately before (baseline) and 6 and 12 months postoperatively (p.o.). Subgingival bacterial samples from surgical sites were evaluated by culture at baseline, 6 weeks, and 6 and 12 months p.o. Six months after surgery the changes (delta) of REC were significantly (P < or = 0.05) greater in exposed than in nonexposed sites, independently of the membrane material (median): exposed sites, delta REC = -1 mm; nonexposed sites, delta REC = 0.0 mm. However, 12 months p.o. no significant differences were found due to a decrease in the initial recessions in exposed sites. Although a higher percentage of exposed than nonexposed sites harbored periodontal pathogens 6 weeks p.o. at the gingiva-faced membrane surface, membrane exposure did not have a significant negative effect on delta PPD, delta PAL, or radiographic bone density changes 6 and 12 months p.o. Both membranes showed significant gains in PAL and bone density in both exposed and nonexposed sites. In conclusion, this study demonstrates that with consistent infection control the postoperative exposure of PLA and PG-910 membranes has no significant negative effect on the regeneration outcome, although higher initial gingival recessions must be expected than in the nonexposed sites. However, in exposed sites plaque and infection control were clearly impeded by the rough, exposed membrane surfaces and by the initially negative gingival morphology.

Adult↗