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Biomedical subjects

J L Gray

Publications and source records attributed to J L Gray.

At least 37 records · Page 2Linked to original sources
PubMed1993

Treatment-related fatigue and serum interleukin-1 levels in patients during external beam irradiation for prostate cancer.

To define changes in sleep and subjective fatigue associated with localized radiation treatment, and to determine their relationship to interleukin-1B (IL-1), we prospectively followed 15 men, none of whom were depressed during 8 wk of radiation treatment for localized prostate cancer. Each patient rated fatigue daily on a visual analogue scale, recorded hours slept, and completed the Beck Depression Inventory weekly. Serum IL-1, taken at baseline and Fridays, was measured by quantitative enzyme immunoassay. Ranked weekly mean fatigue scores for each subject increased at week 4 (mean, 17 fractions, 1.8 Gy) then plateaued and rose in weeks 6 and 7. In week 6, the last week of full volume radiation, subjects slept most compared to all other weeks including week 7 when treatment was coned down. Ranked serum IL-1 tended to rise between weeks 1 and 4, as fatigue scores rose. These data suggest that localized radiation treatment is associated with increased fatigue and sleep requirement independent of depressive symptoms. Relative serum IL-1 changes may be one signal for the systemic reaction and subjective fatigue associated with the acute effects of radiation.

Aged↗
PubMed1993

Thick free gingival and connective tissue autografts for root coverage.

Studies have shown partial to complete root coverage of denuded root surfaces with the use of thick free gingival autografts (FGGs) or subepithelial connective tissue autografts (CTGs). The purpose of this study was to determine which technique would result in more predictable root coverage of Miller Class I and II marginal tissue recession defects. Paired defects in 10 patients were randomly selected for treatment with either the FGG or the CTG. With stents as reference points, soft tissue recession was measured with a calibrated probe presurgically and 3 and 6 months postsurgically. No significant differences between paired sites in presurgical defect dimensions were found. One patient was dropped from the study for noncompliance with postoperative instructions. The mean percentage of root coverage for the CTG 3 and 6 months postsurgery for the remaining 9 patients was 78% and 80%, respectively. The mean percentage of root coverage for the FGG was 43% at both periods. The difference in root coverage between the 2 techniques was significant (P < 0.03). Complete root coverage was gained in 5 of 9 CTGs but only in one of 9 FGGs. Both techniques resulted in a significant improvement in keratinized tissue and probing attachment level, with most of the changes having occurred during the first three months postoperatively. Results suggest that the CTG may provide a greater percentage of root coverage than the FGG and that both techniques will effectively increase the width of keratinized tissue.

Adolescent↗
PubMed1993

Comparative SEM study on the effect of acid etching with tetracycline HCl or citric acid on instrumented periodontally-involved human root surfaces.

This study compared the surface characteristics of periodontally diseased single-rooted human teeth extracted after treatment with either tetracycline HCl or citric acid solutions. The study group was comprised of 30 teeth from 22 patients with advanced periodontal disease extracted before the start of periodontal therapy. Diseased surfaces were identified, outlined, and root planed by hand curet or finishing bur. The teeth were sectioned and solutions of tetracycline HCl or citric acid (pH 1) were applied to the surfaces with cotton pellets for 5 minutes. Extracted teeth were processed and root surface samples then examined by scanning electron microscope. The surfaces of both acid-treated sets of specimens differed considerably from specimens treated with root planing alone, regardless of root planing method. Acid-treated specimens exhibited dentinal tubules exposed by the removal of the smear layer, surfaces devoid of the debris normally present in root planed-only specimens, and the dense network of collagen fibers that make up the dentin structure. Although differences were seen in surface depressions and fiber-like structures among some specimens, the tetracycline HCl and citric acid solutions produced comparable morphologic characteristics.

Acid Etching, Dental↗
PubMed1992

Use of a synthetic skin substitute as a physical barrier to enhance healing in human periodontal furcation defects.

A study was conducted to evaluate the potential of guided tissue regeneration in the treatment of human molar Class II furcation defects using BioBrane temporary wound dressing as a barrier membrane and to compare the results to those with open debridement. Eight patients, with a total of nine pairs of Class II buccal furcation molar defects, were studied. Prior to surgery, soft tissue measurements, attachment levels, and hard tissue measurements were recorded. These measurements were repeated 4 to 6 weeks after membrane removal. The study revealed no significant difference between results of treatment using the BioBrane membrane and those obtained using open debridement alone, except in the measurement of horizontal open probing attachment, in which BioBrane-treated sites had a significant gain of soft tissue.

Adult↗
PubMed1992

Use of a collagen barrier to enhance healing in human periodontal furcation defects.

Guided tissue regeneration procedures are intended to selectively favor healing by the periodontal ligament tissues. However, in most studies of the efficacy of guided tissue regeneration, nonresorbable barriers and membranes have been used, necessitating their surgical removal after a time. The present study employed a resorbable collagen barrier to treat Class II function invasions. The results of this treatment were compared with the results of conventional therapy. For most clinical parameters, there was no statistically significant difference in the results of treatment with or without collagen membranes. Sites treated with a collagen barrier did exhibit statistically significant improvement in probing depth and horizontal osseous support; however, these findings cannot be attributed entirely to the placement of the collagen membrane.

Aged↗
PubMed1991

Control of dumping symptoms by somatostatin analogue in patients after gastric surgery.

Octreotide acetate is a long-acting analogue of the naturally occurring inhibitory gastrointestinal peptide, somatostatin. We tested the efficacy of octreotide in controlling the symptoms of dumping syndrome in response to a provocative meal in a randomized, double-blinded, crossover trial in nine severely affected patients. Pretreatment with octreotide acetate (100 micrograms injected subcutaneously) reduced postprandial dumping symptoms from a mean +/- SEM score of 15.7 +/- 1.6 (placebo treatment day) to 4.6 +/- 1.7. With placebo treatment, all nine patients became symptomatic in response to the meal, whereas with octreotide treatment, symptoms occurred in only two of nine patients. Similarly, all placebo-treated patients showed a postprandial increase in pulse rate to a mean +/- SEM of 105 +/- 6 beats per minute, whereas only one of nine octreotide-treated patients showed an increase in pulse rate (mean +/- SEM, 80 +/- 3 beats per minute). These differences were also statistically significant. While no significant changes were observed in postprandial hematocrit values or osmolality between placebo and octreotide treatments, octreotide prevented hypoglycemia in four affected patients and significantly inhibited insulin release. We conclude that octreotide is a useful tool in the treatment of patients with severe, refractory dumping syndrome.

Blood Glucose↗
PubMed1991

The use of a synthetic skin substitute as a physical barrier to enhance healing in human periodontal furcation defects: a follow-up report.

The purpose of this investigation is to compare the clinical response of guided tissue regeneration using a synthetic wound dressing with open flap debridement versus open flap debridement alone in the treatment of human furcation defects. The study group was composed of 19 patients with moderate to advanced adult periodontitis and at least one bilateral pair of Class II molar furcation defects. After the hygiene phase of therapy was completed, measurements were made with calibrated periodontal probes of the clinical attachment levels, probing depths, and soft tissue recession. Paired sites were randomly selected for treatment with either open flap debridement alone (control) or open flap debridement and placement of the synthetic wound dressing over the furcation (experimental). At the time of surgery, measurements of vertical and horizontal open probing attachment were recorded. The dressing was removed 5 to 6 weeks post-surgery. The sites were reentered at 6 months to evaluate healing and to repeat all measurements. Statistical comparisons using the Wilcoxon Sign Rank Test were made between the control and experimental sites. The results of 19 pairs of Class II molar furcation defects reveal statistically significant differences between the experimental and control sites in attachment levels, probing depths, and horizontal open probing attachment. These differences were of such small magnitude that they may not be clinically relevant. There were no other significant differences for any other clinical parameter, and none of the furcations in either group was completely closed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Clinical evaluation of the use of decalcified freeze-dried bone allograft with guided tissue regeneration in the treatment of molar furcation invasions.

The purpose of this study is to evaluate the potential of decalcified freeze-dried bone allograft (DFDBA) combined with a barrier material in the treatment of human molar furcation defects (experimental) as compared to the barrier technique alone (control). Fifteen pairs of Class II or III furcation invasion defects comprised the study group. Measurements with calibrated periodontal probes were made to determine soft tissue recession, probing depth, and attachment levels. Defects from each pair were randomly selected to be treated with an expanded polytetrafluoroethylene membrane (e-PTFE) and DFDBA or the membrane alone. Additional measurements were made during surgery to determine crestal resorption, and vertical and horizontal open probing attachment. The membrane was removed 4 to 6 weeks post-insertion. Six months post-treatment, each site was surgically reentered and measurements repeated. Following either treatment, recession was minimal with statistically significant improvement in probing depth reduction and clinical attachment level gain favoring the combined technique. Hard tissue changes were comparable for alveolar crestal resorption, however, there was a distinct difference, statistically, for both horizontal and vertical bone repair favoring the use of the demineralized bone graft in combination with the e-PTFE membrane.

Bone Transplantation↗
PubMed1991

The prevalence and sex ratio of juvenile periodontitis in a young racially mixed population.

The need to accurately determine the prevalence of a disease is important especially in establishing treatment needs for particular population groups. Reported prevalences for juvenile periodontitis (JP) have varied from less than 0.1% to 17%. The use of overall prevalence values to determine treatment needs in populations which include various ethnic groups is not reliable since there is evidence that the prevalence in different groups is unequal. The purpose of this study was to determine the prevalence and sex ratio of JP in a large group of military recruits and to compare these values between the different racial populations. Thirty-eight cases of JP were diagnosed from a group of 5,013 young male and female recruits of varying ethnic origin. The overall prevalence was 0.76% and the female:male ratio 1.1:1.0. These findings raise questions as to the continued quotation of a female:male ratio of 3:1, and provide additional evidence for an overall ratio closer to 1:1. In addition, prevalences of JP varied considerably between racial groups. Blacks had a much higher JP prevalence (2.1%) than caucasians (0.09%). Black males had a higher prevalence (3.81%) than black females (1.99%). For black recruits the F:M ratio was 0.52:1. For caucasian recruits the F:M trend is opposite (4.3:1), although the number of cases diagnosed in the caucasian group was too low to compute a true ratio. The data support studies which show that in the blacks, the disease is less prevalent in females than in males. Caution must be exercised in interpreting results in any study in which the sample population is not categorized.

Adolescent↗
PubMed1991

Clinical evaluation of guided tissue regeneration in the treatment of maxillary class II molar furcation invasions.

This investigation assessed and compared the clinical efficacy of combined open flap debridement/occlusive membrane therapy versus open flap debridement therapy alone, in the treatment of maxillary periodontal furcation defects. Seventeen patients presenting with advanced adult periodontitis, including at least one pair of Class II maxillary furcal defects, comprised the study group. Following completion of a hygienic phase of treatment, measurements were made with calibrated periodontal probes to determine soft tissue recession, probing pocket depths, and attachment levels. Each pair of furcation defects was surgically exposed and hard tissue measurements obtained. Defects were treated with either open flap debridement and a polytetrafluoroethylene periodontal membrane or open flap debridement alone. Membranes were removed at 4 to 6 weeks. Six months postsurgery, soft tissue measurements were repeated and all sites were surgically re-entered to obtain hard tissue measurements. No statistically significant differences were found in recession, probing depth reductions, clinical attachment gains, or resorption of alveolar crest height between test and control groups. Results for these parameters were inconsistent and unpredictable. Statistically significant improvements were found, however, in horizontal open probing attachment (HOPA) and vertical open probing attachment (VOPA) between experimental and control sites. The GTR procedure as used in this study likely has limited application as a therapeutic modality for Class II furcations of maxillary molars. Modifications or improvements in the procedure may result in more predictable healing of these lesions.

Adult↗
PubMed1991

Effect of oral melatonin treatment on the seasonal physiology of pony stallions.

This study tested the role of melatonin in the regulation of seasonal physiological change in the pony stallion. Four 3-year-old, Welsh Mountain pony stallions were housed initially under the prevailing short-day photoperiod in December (8 of light [L]:16 h of darkness [D]) before being transferred to long days (16L:8D) on 13 January for the remaining 22 weeks of the study. On Day 76 (11 weeks later) the stallions began an 11-week period of daily melatonin treatment (20 mg orally, 8 h after lights on). Marked changes in mean plasma testosterone, beta-endorphin and cortisol concentrations occurred in response to long days and to subsequent melatonin treatment. Photostimulation produced a sharp rise in overall mean daily testosterone to a peak of 6.74 nmol/litre by Day 30. Values then fell to a nadir (3.17 nmol/litre) by Day 85, suggesting a role for melatonin in the termination of breeding activity in the horse. Cortisol and beta-endorphin values remained low throughout the first 11 weeks, but by Day 105 (Day 30 of melatonin treatment) concentrations had risen sharply, attaining a peak on Day 125 (510 pg beta-endorphin/ml, 50 ng cortisol/ml). Concentrations of both hormones had fallen by Day 77 of melatonin treatment (Day 152), perhaps as a result of refractoriness. Parallelism between beta-endorphin and cortisol suggests a pituitary origin for peripheral beta-endorphin. Diurnal variation in cortisol was observed under long days but no change in beta-endorphin was detected. Long days and melatonin treatment stimulated shedding of the winter and summer coats respectively, whereas growth rate was increased (2.03 kg/week) during the period of melatonin treatment relative to that of long days only (0.37 kg/week). The study provides evidence that the diurnal pattern of melatonin secretion mediates the reproductive and non-sexual responses to photoperiodic change in pony stallions.

Administration, Oral↗
PubMed1989

Antimicrobial misuse in patients with positive blood cultures.

PURPOSE: Inappropriate antimicrobial use was examined among a randomly and prospectively selected cohort of patients with at least one positive result of blood cultures. This misuse was then analyzed with respect to hospital charges and length of stay (LOS). PATIENTS AND METHODS: The study consisted of 70 patients (average age, 58.5 years) who had not undergone bone marrow transplantation. Patient charts were reviewed daily for the following information: clinical signs and symptoms of infection, pertinent laboratory data, culture results, detailed data on each antimicrobial in every antimicrobial regimen and their appropriateness, hospital charges, LOS, diagnostic and procedure codes, and discharge status. Three severity of illness variables were generated. Inappropriate antimicrobial use was described according to one of 12 categories. RESULTS: The percent of antimicrobial misuse, defined as the proportion of days of administration of antimicrobials on which one or more antimicrobials were judged inappropriate, was found to be 22.3%. After adjustment for severity of illness and diagnosis, this average inappropriateness correlated with 4.2 additional hospitalization days and $5,368 additional hospital charges. CONCLUSION: Our results cannot distinguish among several possible reasons for these associations, including direct causality (e.g., toxicity and prolonged hospitalization for antimicrobial use) and indirect links such as inappropriate utilization of other resources and influences of severity of illness on antimicrobial use not accounted for in our equations. Nevertheless, the magnitude of the association gives import to the desirability of further studies.

Anti-Infective Agents↗
PubMed1989

Comparison of decalcified freeze-dried bone allograft and porous particulate hydroxyapatite in human periodontal osseous defects.

The purpose of this study was to clinically compare the healing potential of the osteoinductive decalcified freeze-dried bone allograft (DFDBA) with an osteoconductive synthetic graft, particulate porous hydroxyapatite (HA). Six patients ranging in age from 28 to 52 (mean age 42.6) participated in this investigation. They were without significant systemic disorders and had advanced periodontitis with at least two comparable periodontal defects. Each patient received initial therapy consisting of oral hygiene instruction, scaling, root planing, and occlusal adjustment as indicated. Probing pocket depth, gingival recession, attachment levels, and bleeding on probing were recorded in the posthygiene phase of therapy. Alveolar crest height and depth of osseous defect were obtained at the time of surgery. The cemento-enamel junction was used as the fixed reference point. All measurements were repeated at the time of a 6-month reentry. There was no significant difference in any of the soft tissue measurements when DFDBA and HA were compared. However, both treatment modalities reduced pocket depth and demonstrated a gain in clinical attachment levels. There was 2.2 mm of bone repair with DFDBA and 2.1 mm with HA. These values corresponded to a percent defect fill of 61% for DFDBA and 53% for HA. These values were likewise not statistically different.

Adult↗
PubMed1989

A comparison of freeze-dried bone allograft and demineralized freeze-dried bone allograft in human periodontal osseous defects.

This study was conducted to clinically compare freeze-dried bone allograft (FDBA) and demineralized freeze-dried bone allograft (DFDBA). Twenty-two defects (11 intrapatient pairs) in 9 patients were grafted with either DFDBA or FDBA. Evaluations were based on standardized radiographs, presurgical and postsurgical soft tissue measurements using the cemento-enamel junction as a fixed reference point, and osseous measurements at the time of surgery. Grafted sites were re-entered at a minimum of 6 months following placement. A mean osseous repair of 1.7 mm (59%) occurred with DFDBA and 2.4 mm (66%) with FDBA. A mean clinical attachment gain of 1.7 mm was obtained with DFDBA and 2.0 mm with FDBA. Probing depths decreased a mean of 2.00 mm with both DFDBA and FDBA. These findings reveal no significant differences between the two materials in primarily intraosseous defects when evaluated at a minimum 6 months postsurgery.

Adult↗
PubMed1989

Comparison of freeze-dried bone allograft and porous hydroxylapatite in human periodontal defects.

This study was conducted to clinically compare the efficacy of freeze-dried bone allograft (FDBA) and porous hydroxylapatite granules. Nineteen pairs of intraosseous defects were grafted in seven patients. One defect of each pair was implanted with FDBA, the other with granular porous hydroxylapatite. Matching defects were treated similarly in all other aspects. Evaluations were based on both preoperative and postoperative measurements from a fixed reference point, standardized radiographs, surgical osseous measurements, and histology of degranulated tissues. Grafted sites were reentered 6 to 11 months postsurgery. Results showed a mean osseous fill of 2.1 mm for FDBA versus 1.3 mm for granular porous hydroxylapatite (P = .07). A mean clinical attachment gain of 2.2 mm for FDBA versus 1.3 mm for granular porous hydroxylapatite (P less than .05), and a mean decrease in probing depths of 3.0 mm for FDBA versus 1.4 mm for granular porous hydroxylapatite (P less than 0.5) was found. FDBA was clinically indistinguishable from host bone, whereas porous hydroxylapatite appeared to be separated from host bone by soft tissue. The data and clinical findings suggested that FDBA may have some enhanced reparative potential when compared to granular porous hydroxylapatite in the treatment of periodontal defects in humans.

Adult↗
PubMed1989

Scaling and root planing efficacy in multirooted teeth.

The effect of operator experience level and root surface access on instrumentation of multirooted teeth was investigated. Fifty molars designated for extraction were randomly distributed among four operators of two different experience levels for scaling and root planing with or without surgical access. Following treatment the teeth were extracted and scored in a blind manner for residual calculus. Teeth were sectioned to allow assessment of the furcal aspects. Results show that operators of both experience levels obtained calculus-free root surfaces significantly more often with flap access than with a non-surgical approach. Additionally, operators with more experience achieved calculus-free root surfaces significantly more often than operators of lesser experience with both an open and closed procedure. However, when furcation aspects alone were assessed, it was found that the more experienced operators obtained a calculus-free surface only 68% of the time with an open approach. Results suggest that, although both surgical access and a more experienced operator significantly enhance calculus removal in molars with furcation invasion, total calculus removal in furcations utilizing conventional instrumentation may be limited.

Adult↗
PubMed1989

Pharmacy participation in pharmaceutical representative displays in a large teaching hospital.

The Department of Pharmacy in a 1200-bed private teaching hospital was seeking additional ways to inform the medical staff of pharmaceutical services and decided to participate as an exhibitor in an established pharmaceutical representative display. The format for the display consisted of three different exhibitors twice weekly in a centrally located area with catering provided. Topics presented by the Pharmacy Department, bi-monthly, included patient medication teaching sheets, drug information services, drug use evaluation results, Additive Room services, formulary content and use, as well as kinetics.

Drug Industry↗