The human genome project: what's in it for the pediatric gastroenterologist?
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Biomedical subjects
Publications and source records attributed to W A Walker.
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In this introduction to the supplement on the use of pre- and probiotics in the health and disease of pediatric patients, I have summarized factors affecting the initial colonization of the neonatal intestine. The term bacterial-epithelial cross-talk was defined, and examples of the enterocyte response to both pathologic and indigenous flora stimulation illustrated. Immaturities in the human neonatal intestinal response to bacteria and their toxins were reviewed in the context of the pathogenesis of age-specific, bacterial gastrointestinal infectious diseases. Finally, the importance of pre- and probiotics as measures to strengthen the neonate's intestinal host defenses in the prevention and treatment of specific age-related disease were considered.
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This study evaluated the sectional gutta-percha obturation technique advocated by Lightspeed Technology, Inc. Single relatively straight-canaled teeth were prepared with rotary instruments and divided into three groups. Groups A and B served as controls and were obturated using laterally condensed gutta-percha and either Roth's 801 or Ketac-Endo sealer. Group C was obturated using the Lightspeed technique that included placement of a 5-mm apical section of gutta-percha, followed by backfill with Ketac-Endo sealer and a single gutta-percha cone. All teeth were suspended in India ink for 14 days then cleared. Four additional teeth, which were obturated as in group C then sectioned, revealed a tightly adapted apical section of gutta-percha with a very thin layer of sealer. However, voids were noted in the middle and coronal areas. There was no significant difference in apical microleakage among the three groups. The sectional method was significantly faster than lateral condensation and seems to offer promise as an effective obturation method.
This study evaluated the sealing ability of fast and regular set Super-EBA with different powder-to-liquid ratios as a root-end filling material. Fifty extracted maxillary central incisors were uniformly cleaned and shaped using a crown-down technique with Gates-Glidden drills and Profile series 29.04 taper rotary instruments. After root-end resection and ultrasonic preparation, 48 root sections were randomly assigned to 4 groups of 12 teeth each and filled with a thick or thin mix of fast or regular set Super-EBA. Fast and regular set Super-EBA were mixed to a thick (1 scoop powder:1 drop liquid) or a thin (1 scoop powder:2 drops liquid) consistency. Positive and negative controls were used. Microleakage was assessed at 24 h, 72 h, 1 wk, 2 wk, 4 wk, 6 wk, and 8 wk using a fluid filtration system. There were no significant differences in the microleakage measured for any group at any of the time points evaluated. These results suggest that either fast or regular set Super-EBA mixed to various consistencies may be acceptable for root-end filling.
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Not only does breast milk provides an ideal nutrient composition for the newborn, but it also contains a variety of substances that may actively influence growth and development of the infant and stimulate neonatal protection against gastrointestinal diseases. Hormones, growth factors, cytokines and even whole cells are present in breast milk and act to establish biochemical and immunological communication between mother and child. In addition, milk nutrients such as nucleotides, glutamine and lactoferrin have been shown to influence gastrointestinal development and host defense. The unique properties of milk as a mediator of biochemical messages will be presented and the clinical significance of breastfeeding in the prevention of neonatal gastrointestinal diseases will be discussed.
VEGF (vascular endothelial growth factor) is a multifunctional cytokine active on blood vessel cells. The present study measured VEGF in the aqueous phase of human milk and examined how the concentration varied with gestational age and the duration of lactation after birth. We hypothesized that VEGF-specific receptors were present on the apical surface of intestinal epithelial cells. The concentration of monomeric VEGF (containing 165 residues) measured by ELISA in the breast milk was 2 orders of magnitude greater than that measured in the serum of normal adults. The VEGF165 concentration in the first week of lactation was greater in the breast milk of mothers of full-term than in preterm babies (p < 0.05). The concentration in the breast milk of mothers of full-term infants decreased (p < 0.01) after the first week of lactation. Scatchard analysis of radioligand-receptor binding showed the presence of specific receptors for 125I-VEGF165 on the surface of Caco-2, an intestinal epithelial cell line, with a kd of 2.85 to 4 nM. Reverse transcriptase PCR of Caco-2 cell RNA showed mRNA for the VEGF receptor flt-1. In conclusion, VEGF is present in high concentrations in breast milk and binds to specific receptors on cells derived from intestinal epithelium.
BACKGROUND: Mineral trioxide aggregate, or MTA, is a new material developed for endodontics that appears to be a significant improvement over other materials for procedures in bone. It is the first restorative material that consistently allows for the overgrowth of cementum, and it may facilitate the regeneration of the periodontal ligament. CASE DESCRIPTION: The authors present five cases in which MTA was used to manage clinical problems. These included vertical root fracture, apexification, perforation repair and repair of a resorptive defect. In each case, MTA allowed bone healing and elimination of clinical symptoms. CLINICAL IMPLICATIONS: Materials such as zinc oxide-eugenol cement and resin composite have been used in the past to repair root defects, but their use resulted in the formation of fibrous connective tissue adjacent to the bone. Because it allows the overgrowth of cementum and periodontal ligament, MTA may be an ideal material for certain endodontic procedures.
The normal human microflora is a complex ecosystem that is in part dependent on enteric nutrients for establishing colonization. The gut microbiota are important to the host with regard to metabolic functions and resistance to bacterial infections. At birth, bacterial colonization of a previously germ-free human gut begins. Diet and environmental conditions can influence this ecosystem. A breast-fed, full-term infant has a preferred intestine microbiota in which bifidobacteria predominate over potentially harmful bacteria, whereas in formula-fed infants, coliforms, enterococci, and bacteroides predominate. The pattern of bacterial colonization in the premature neonatal gut is different from that in the healthy, full-term infant gut. Those infants requiring intensive care acquire intestinal organisms slowly, and the establishment of bifidobacterial flora is retarded. A delayed bacterial colonization of the gut with a limited number of bacterial species tends to be virulent. Bacterial overgrowth is one of the major factors that promote bacterial translocation. The aberrant colonization of the premature infant may contribute to the development of necrotizing enterocolitis. Breast-feeding protects infants against infection. Oligo-saccharides and glycoconjugates, natural components in human milk, may prevent intestinal attachment of enteropathogens by acting as receptor homologues. Probiotics and prebiotics modulate the composition of the human intestinal microflora to the benefit of the host. These beneficial effects may result in the suppression of harmful microorganisms, the stimulation of bifidobacterial growth, or both. In the future, control and manipulation of the bacterial colonization in the neonatal gut may be a new approach to the prevention and treatment of intestinal infectious diseases of various etiologies.
Resin cements are sometimes recommended to enhance the retention of posts in endodontically treated teeth. Many sealer cements used in endodontics contain eugenol, however, which has been shown to inhibit the polymerization of resins. The purpose of this study was to evaluate the effects of a eugenol and a noneugenol sealer cement on the retention of posts. Sixty extracted canines were divided equally into four groups. Each tooth received conventional endodontic therapy and was prepared to receive a post. Two sealer cements were used in obturation: one contained eugenol and one was eugenol-free. The posts were cemented with either zinc phosphate cement or resin cement. Each combination of sealer and post cement was tested for retention on an Instron testing machine. The type of sealer used had no effect on post retention with either cement. Post retention was significantly greater with the zinc phosphate cement than the resin cement.
One hundred single-rooted teeth were instrumented with Lightspeed, Profile .04 Taper Series 29, and NT McXIM instruments according to the recommendations of the manufacturers, and Flex-R files using the balanced force technique. Groups were comparable with respect to average curvature, canal length, and major and minor foramen size. A standard amount of irrigant was used for each tooth. Apically extruded debris and irrigant were collected and weighed. Debris was desiccated before being weighed. There were no statistically significant differences among the four groups with respect to total extruded debris. The amount of extruded debris was positively correlated with the amount of irrigant extruded. Factors such as canal length, curvature, and foramen size did not affect the amount of debris extruded.
One hundred randomly selected mandibular incisors were examined to assess the prevalence and location of two canals and to describe the canal anatomy that may be encountered during apical surgery. Sections of the root were cut at 1, 2, and 3 mm from the apex, simulating a 20-degree beveled surgical resection. The sections were digitally imaged at x 50 magnification, and canal dimensions were measured using imaging software. The prevalence of two canals was 2% at 1 mm, 0% at 2 mm, and 1% at 3 mm. At these levels in the roots, the canal was rarely divided by hard tooth structure. An isthmus of tissue was present 20% of the time at 1 mm, 30% at 2 mm, and 55% at 3 mm. Four distinct canal types were noted: (i) round, (ii) oval, (iii) long oval, and (iv) ribbon. In 75% of the teeth, the canal shapes varied from one level to the next. The more coronally the root-end resection was made, the more elongated the canal tended to become.
This study compared the sealing ability of TERM as an interim restoration for the "walking bleach" technique when using either sodium perborate/water or sodium perborate/superoxol. Thirty-three extracted maxillary premolars were restored with TERM after placing either a cotton pellet (control), a paste of sodium perborate and water, or a paste of sodium perborate and superoxol in the chamber. Microleakage was assessed at 24 h, 8 days, and 15 days using a fluid filtration method. Statistical analysis revealed both "walking bleach" groups had significantly higher numbers of teeth demonstrating microleakage than the control group. There was no statistically significant difference in microleakage between the two "walking bleach" groups. The results of this study indicated that the temporary restorative material, TERM, provided an unsatisfactory seal when used with either walking bleach technique. When used over a cotton pellet, TERM provided an excellent seal.
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Not only is the gastrointestinal tract the largest immune organ in the body, but it also contains one of the most important and interesting immunologic compartments. Host protection against pathogens and injurious agents by the gastrointestinal tract is essential for an individual's survival. The intestinal mucosal immune system, which is linked with other mucosal surfaces and together represents the common mucosal immune system, prevents the passage of potentially harmful antigens and pathogens into the systemic circulation of the host. In a healthy host, antigens crossing the mucosal barrier in physiologic quantities evoke the appropriate immune response, which includes polymeric IgA antibody production to the antigen and systemic tolerance.