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Biomedical subjects

D Laufer

Publications and source records attributed to D Laufer.

At least 73 records · Page 4Linked to original sources
PubMed1997

Preoperative prophylaxis for C1 esterase-inhibitor deficiency in patients undergoing oral surgery: a report of three cases.

C1-inhibitor deficiency, or hereditary angioedema, is a genetic disorder characterized by recurrent circumscribed, nonpruritic, nonpitting subepithelial edema. Minor trauma to the tissue, such as tooth extraction, can trigger life-threatening laryngeal edema. The use of fresh frozen plasma and/or danazol before treatment prevents angioedema attacks. A critical review of the treatment regimen and prophylaxis for C1-inhibitor deficiency is presented, and three new cases are described.

Adult↗
PubMed1997

The relationship between cervical enamel projection and class II furcation defects in humans.

The purposes of the present study were to examine the frequency of cervical enamel projection in mandibular molars with class II furcation defects and to examine the response of these teeth to guided tissue regeneration procedures. Probing depth and vertical and horizontal periodontal attachment levels were recorded with a constant-force electronic periodontal probe. Following surgical exposure of the bifurcation and prior to membrane placement, the cervical enamel projection was examined and then graded clinically; photographs were taken to allow further examination of the bifurcation. An overall improvement in clinical parameters was observed in most sites. Cervical enamel projection was present in 82.1% of all molars examined. Grade II was the most prevalent (34.8%). Patients with any degree of cervical enamel projection demonstrated significantly higher mean probing depths at baseline than did patients without cervical enamel projection. Likewise, pretreatment probing attachment levels were higher in patients with some degree of cervical enamel projection. However, greater posttreatment horizontal and vertical attachment gains were observed in sites with a baseline cervical enamel projection.

Analysis of Variance↗
PubMed1997

Use of tranexamic acid mouthwash to prevent postoperative bleeding in oral surgery patients on oral anticoagulant medication.

The clinical hemostatic effect of tranexamic acid mouthwash after oral surgery was evaluated in 47 patients receiving oral anticoagulant therapy. Surgery was performed after the anticoagulant medication was reduced in 15 patients (control group) and with no change in anticoagulant therapy in 32 patients (test group). The only statistical difference between the two treatment groups at baseline was the level of anticoagulation, which was significantly higher in the test group. There was no significant difference between the two treatment groups in the incidence of bleeding after oral surgery. The results indicated that a combination of local antifibrinolytic therapy and a local hemostatic agent is effective in preventing postoperative bleeding after oral surgery in patients treated with anticoagulants.

Administration, Oral↗
PubMed1996

Salivary flow-rate and composition in schizophrenic patients on clozapine: subjective reports and laboratory data.

The extent of hypersalivation was evaluated in a group of 25 schizophrenic patients on clozapine. A high prevalence of the complaint was detected by a questionnaire; up to 80% of the patients complained of hypersalivation at night. Salivary flow-rate and composition was examined in 17 patients who agreed to participate and in a matched group of healthy controls. No significant differences were detected in composition or flow-rates of resting and stimulated saliva. The salivary flow-rates in the schizophrenic patients on clozapine did not correlate with the subjective complaint of hypersalivation. Because the severity and prevalence of the complaint was higher at night, a possibility of an altered circadian rhythm of salivation might be suggested in these patients.

Adult↗
PubMed1996

Parotid gland dysfunction in an animal model of chronic graft-vs-host disease.

BACKGROUND: Xerostomia is observed in 85% of patients suffering from chronic graft-vs-host disease (cGVHD). The pathophysiological mechanism of the major salivary gland dysfunction is unclear. OBJECTIVE: To evaluate parotid gland function in a mouse model of cGVHD. DESIGN: The volume, flow rate, lag phase, and composition of secreted saliva were assessed in mice with cGVHD after pilocarpine stimulation (5 mg/kg) by cannulation of the main parotid excretory duct with polyethylene tubing. RESULTS: Significant reduction in the secreted saliva volume was observed in the mice with cGVHD compared with the syngeneic controls (39.1 +/- 2.9 microL/30 minutes and 71.2 +/- 5.7 microL/30 minutes, respectively) (P < .05). In addition, we observed a flattening of the normal salivary flow rate curve in the mice with cGVHD. The lag phase (time between pilocarpine stimulation and saliva secretion) was significantly longer in the cGVHD group than in the controls (2.5 +/- 0.3 vs 1.9 +/- 0.2 minutes) (P < .05). Sialochemical analysis showed a significant decrease in sodium level (42.1 +/- 1.9 vs 61.4 +/- 4.8 mmol/L) (P < .01) and a significant increase in potassium level (20.0 +/- 1.2 vs 15.1 +/- 1.2 mmol/L) (P < .05) in the saliva of the mice with cGVHD compared with syngeneic mice. Histopathological evaluation of the parotid glands demonstrated moderate lymphocyte infiltration and parenchymal destruction. CONCLUSION: The parotid gland dysfunctions leading to xerostomia observed in a mouse model of cGVHD may be of clinical importance.

Animals↗
PubMed1996

Oral complaints related to menopause.

OBJECTIVES: The purpose of the present study was to correlate oral and systemic symptoms of menopause and the oral health and salivary composition and flow rate in a group of women in menopause prior to hormone replacement therapy. METHODS: One-hundred fifty-four women attending a menopause clinic were divided into two groups. Group A, 58 women, without any systemic disease or treatments, and Group B,96 women with diseases and on various medications. They answered a questionnaire on their general health and oral and systemic complaints related to menopause. Fifty-four of the women agreed to have an oral examination and saliva analysis. Whole resting and submandibular (SM-SL) stimulated saliva were analyzed. RESULTS: The oral discomfort complaint was found in 45% in Group A and in 60% in Group B. 74% complained of climacteric symptoms in Group A and 63% in Group B. The odds ratio (OR) between oral discomfort and climacterics complaints of menopause was 8.03 in Group A and 4.08 in Group B. The salivary composition and flow rates did not differ significantly between the groups of menopausal women. However the salivary total protein and IgA concentrations were significantly higher in comparison to healthy young controls. CONCLUSIONS: The present study reports a high prevalence of oral discomfort in the women attending a menopause clinic. A highly significant odds ratio between systemic and oral complaints of menopause was found. The significantly altered salivary composition in these women might point to sympathetic activation due to psychological stress.

Adult↗
PubMed1996

CD45 engagement induces L-selectin down-regulation.

The CD45 glycoprotein isoforms exhibit a receptor-like composition and display intracellular protein tyrosine phosphatase (PTPase) activity. The present study links CD45 to the regulation of L-selectin (CD62L), a leucocyte glycoprotein important for extravasation and homotypic aggregation. Monoclonal antibodies (MoAbs) IOL1b and AICD45.2, but not GAP8.3, all of which are directed against common CD45 epitopes, were found to elicit lymphocyte L-selectin down-regulation. Lymphocyte L-selectin down-regulation in response to anti-CD45 MoAbs was enhanced by high cell density and partially antagonized by the protein tyrosine kinase (PTK) inhibitor, herbimycin A. The MoAbs IOL1b, AICD45.2 and GAP8.3 recognized granulocyte-expressed CD45 but did not induce loss of L-selectin expression of granulocytes. In contrast, the CD45 PTPase inhibitor, vanadate, induced L-selectin down-regulation both in lymphocytes and granulocytes. The PTPase activation by nitric oxide (NO) or the NO-generating compound, sodium nitroprusside, did not affect L-selectin surface expression. Increased concentrations of soluble L-selectin were detected after anti-CD45 or vanadate-induced down-regulation of L-selectin surface expression. While activation of protein kinase C (PKC) by phorbol 12-myristate 13-acetate (PMA) induces rapid L-selectin down-regulation of L-selectin surface expression in both lymphocytes and granulocytes, the PKC inhibitor, H 7, was also found to down-regulate lymphocyte and granulocyte L-selectin surface expression. The inhibitor H 7 synergized with vanadate in down-regulating lymphocyte L-selectin surface expression, but partially inhibited vanadate-induced granulocyte L-selectin down-regulation. The results suggest that in a cell type-specific fashion the PKC system and tyrosine phosphorylation and dephosphorylation cascades are involved in the regulation of L-selectin surface expression.

Adult↗
PubMed1996

Multiple segmental gradual distraction of facial skeleton: an experimental study.

The method of distraction osteogenesis was used to move several facial segments in different directions with formation of new bone. On 3 young adult sheep a Le Fort II osteotomy, combined with circumferential orbital osteotomies, was performed. The periosteum over the osteotomies was preserved. Titanium bone screws were placed as bone markers. The segments were fixed with pins and plates to a combined distraction apparatus in order to advance the segments in different directions. By a gradual distraction, the midface was advanced forward by 30 mm. The left orbit was moved laterally 20 mm and the right orbit was moved forward 20 mm. In both orbits there was a concomitant globe movement. New bone formation in the distracted area was obvious radiographically, clinically, and histologically. In conclusion, multiple segmental distraction is possible in the adult sheep face and may offer three-dimensional (3D), controlled correction of complex face deformities.

Animals↗
PubMed1995

Midface advancement in sheep by gradual distraction: a 1-year follow-up study.

PURPOSE: The purpose of this study was to find a solution to the unsatisfactory postoperative maxillary relapse after major maxillary advancement or inferior repositioning of the maxilla. MATERIALS AND METHODS: Major midface advancement by gradual distraction was performed on three young adult sheep over 21 days. Using an external device, the midface was advanced 36 mm in the nasofrontal area and 43 mm in the lateral aspect of the maxilla. The apparatus remained as an external fixation device for 6 weeks after the distraction to allow better ossification. After removal of the device, a 1-year clinical and radiographic follow-up was conducted. RESULTS: Direct measurements between the markers showed 2- to 3-mm relapse after 1 year. Radiologic measurements demonstrated that the relapse occurred during the first 3 months after removal of the distraction apparatus. CONCLUSION: It was concluded that midface advancement by gradual distraction may obviate the need for bone grafting and offer a greater movement of bone segments with good skeletal stability.

Animals↗
PubMed1995

Humoral and cell-mediated immune responses in healthy children after one or two doses of varicella vaccine.

This study compared the immune responses of healthy children to one or two doses of Oka/Merck varicella vaccine. Both cell-mediated and humoral immune responses were significantly stronger 1 year later among children given two doses 3 months apart than among those given a single dose. Long-term follow-up studies are needed to determine whether two doses of vaccine indeed provide more complete and more durable protection than a single dose against breakthrough varicella in healthy children.

Antibodies, Viral↗
PubMed1995

[Osteoradionecrosis of the jaws].

9 patients with osteoradionecrosis of the mandible were treated during 1975-1994. All primary tumor had received high dose external radiation or brachytherapy, using iridium-192 sources. In 6 patients the complication was triggered, shortly before or after irradiation, by surgical interventions such as tooth extraction, or by the presence of an infected focus in the mandible. The complications were treated conservatively, including 2 cases by hyperbaric oxygen. The value of prevention is emphasized.

Adult↗
PubMed1994

[Cervical necrotizing fasciitis].

Necrotizing fasciitis of the head and neck is a rare infection caused by a mixed bacterial flora with anaerobic predominance. Mortality is due to misdiagnosis which results in late and inadequate treatment. The natural course of this serious infection involves spreading necrosis of the soft tissues of the neck with erosion of major blood vessels. A 33-year-old man and a 66-year-old woman are presented to demonstrate the usual etiological factors of cervical necrotizing fasciitis, mainly dental and pharyngeal infections. Diagnosis is by bacteriological culture and CT-scan; a high degree of clinical suspicion is necessary. Treatment included aggressive surgery, appropriate antibiotic coverage and hyperbaric oxygen, and resulted in successful outcomes in our 2 cases.

Adult↗
PubMed1994

Traumatic self-inflicted bite with embedded tooth fragments in the lower lip.

An unusual case of traumatic self-inflicted bite of the lower lip in a 7-year-old girl is presented. As a result of the bite, due to a fall, four fragments of the right upper incisor tooth were embedded in the lower lip. The large tooth fragment appeared 18 days later, protruding through the skin of the lower lip. Radiographs confirmed the presence of these tooth pieces, which were removed under local anesthesia. Early diagnosis and surgical removal of the tooth fragments could prevent undesirable foreign-body reactions and scarring.

Accidental Falls↗