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Epiploic appendagitis of the rectosigmoid junction: demonstration with transrectal sonography.

A 24-year-old man presented with lower abdominal pain that had been present for 18 hours. Physical examination revealed mild tenderness in the lower abdomen. Digital rectal examination revealed a tender point approximately 9 cm above the anal verge. Transrectal sonographic examination demonstrated an ovoid echogenic noncompressible mass surrounded by a hypoechoic halo attached to the wall of the rectosigmoid junction. A diagnosis of epiploic appendagitis was made on the basis of sonographic findings and was subsequently confirmed with contrast-enhanced CT.

Abdominal Pain↗

Digital vision theory: Boolean logic model.

Guild (1932) stated the general requirements for processing signals in color vision system and a digital format of his paradigm is developed in this paper. The disk structure generates the digital receptor pulse. The input modalities form sets, linked by intersections, joins, and complement junctions. The synapses are elements in these junctions. Complex synapses form complex junctions to create Boolean logic processing. A computer program using these Boolean logic functions calculates: Light and dark adaptation responses; Color matching and spectral coordinate functions; Chromatic adaptation and color shift responses; and dynamic neural responses. These calculations compare favorably with the experimental data.

Adaptation, Physiological↗

A small asymptomatic intracranial aneurysm in an elderly woman that ruptured soon after discovery.

A 78-year-old woman underwent magnetic resonance (MR) imaging to assess the deterioration of her right hemiparesis initially caused by putaminal hemorrhage that occurred 5 years prior to referral. MR imaging detected an anterior communicating artery aneurysm but no new lesion was seen that might have caused the deterioration was observed. Hemiparesis improved within several days and she was referred for endovascular treatment of the aneurysm. Digital subtraction angiography demonstrated a 4.4 mm long aneurysm at the A1-A2 junction of her left anterior cerebral artery. Information on the risk associated with treatment caused her to hesitate. Three days after discharge and 40 days after the discovery of the aneurysm it ruptured, causing severe subarachnoid hemorrhage. The patient died on the following day.

Aged↗

Comparison of observer reliability in assessing alveolar bone height on direct digital and conventional radiographs.

OBJECTIVES: Radiographs are an important adjunct in the assessment of periodontal disease in clinical practice and research. The purpose of this study is to compare intraexaminer and interexaminer reproducibility in assessing alveolar bone height on direct digital and conventional radiographs. MATERIALS AND METHODS: Matched sets of conventional radiographs and digital radiographs were taken on 23 subjects. Bone levels were measured on radiographs as the distance from the cementoenamel junction to the alveolar crest in millimetres at the mesial and distal surfaces of all available teeth excluding third molars. Two examiners measured bone levels twice on each type of imaging system independent of one another. Correlations and paired t-test values were computed. RESULTS: Intraexaminer relative agreement (r-value) on both digital and conventional radiographs ranged from 0.73 to 0.98, P<0.05; however, differences between measurements (absolute agreement) for each examiner were non-significant, P>0.05. Interexaminer relative agreement on both digital and conventional radiographs ranged from 0.70 to 0.95, P<0.05, and measurement differences between the two examiners were also significant, P<0.05. One examiner tended to score higher measurements than the other, P<0.05. CONCLUSIONS: Alveolar bone measurements are reproducible on both digital and conventional radiographs. Intraexaminer reproducibility is superior to interexaminer reproducibility. Direct digital radiographs did not enhance examiner agreement over conventional radiographs.

Adolescent↗

Vascular anatomy of the digital extensors.

Fifty upper extremities from fresh human cadavers age range 20 to 80 years were used in the study of the vascularization of the tendons of the digital extensor muscles. The blood supply to the tendon originates from different sources at different levels. At the level of the musculotendineal junction the tendon receives the blood supply through the arteries of the fleshy part of the muscle. In the synovial sheath the arteries reach the tendon through the mesotendon. In the metacarpal region and on the back of the digits the arteries reach the tendon through the paratenonium and through the branches of the digitopalmar arches. In all cases and at all levels the arterial branches to the extensors divide in a "T" shape manner into an ascending and a descending branch. Some areas of the tendon which are exposed to the less favourable mechanical conditions receive less blood supply.

Adult↗

Modulation of pancreatic acinar cell to cell coupling during ACh-evoked changes in cytosolic Ca2+.

The temporal changes in cytosolic free Ca2+ ([Ca2+]i), Ca2+-dependent membrane currents (Im), and gap junctional current (Ij) elicited by acetylcholine (ACh) were measured in rat pancreatic acinar cells using digital imaging and dual perforated patch-clamp recording. ACh (50 nM-5 microM) increased [Ca2+]i and evoked Im currents without altering Ij in 19 of 37 acinar cell pairs. Although [Ca2+]i rose asynchronously in cells comprising a cluster, the delay of the [Ca2+]i responses decreased with increasing ACh concentrations. Perfusion of inositol 1,4,5-trisphosphate (IP3) into one cell of a cluster resulted in [Ca2+]i responses in neighboring cells that were not necessarily in direct contact with the stimulated one. This suggests that extensive coupling between acinar cells provides a pathway for cell-to-cell diffusion of Ca2+-releasing signals. Strikingly, maximal (1-5 microM) ACh concentrations reduced Ij by 69 +/- 15% (n = 9) in 25% of the cell pairs subjected to dual patch-clamping. This decrease occurred shortly after the Im peak and was prevented by incubating acinar cells in a Ca2+-free medium, suggesting that uncoupling was subsequent to the initiation of the Ca2+-mobilizing responses. Depletion of Ca2+-sequestering stores by thapsigargin resulted in a reduction of intercellular communication similar to that observed with ACh. In addition, ACh-induced uncoupling was prevented by blocking nitric oxide production with L-nitro-arginine and restored by exposing acinar cells to dibutyryl cGMP. The results suggest that ACh-induced uncoupling and capacitative Ca2+ entry are regulated concurrently. Closure of gap junction channels may occur to functionally isolate nearby cells differing in their intrinsic sensitivity to ACh and thereby to allow for sustained activity of groups of secreting cells.

Acetylcholine↗

Minimum lateral wall heights for conservative class I cavity preparations.

PURPOSE: To quantify the minimum necessary Class I cavity preparation lateral wall heights (LWH) for a cavity preparation 0.8 mm in width and extending to the dentin-enamel junction in a set of extracted human permanent posterior teeth. MATERIALS AND METHODS: 183 bucco-lingual or mesio-distal undecalcified sections were cut from a set of 73 posterior teeth. Macroscopic digital images were made of fissures within the sections and a computer-generated digital measuring device was superimposed to obtain LWH measurements corresponding to a cavity preparation 0.8 mm in width and extending to the dentin-enamel junction. Preparation LWH data was analyzed by tooth type and groups for mean, minimum, maximum, standard deviation, count, and frequency distribution. RESULTS: LWH varied between 1.2 mm and 2.5 mm for the 183 fissures tested. Mean LWH was 1.925 mm with a standard deviation of 0.262 mm. The most common LWH was 2.0 mm, found in 18% of the samples. Seventy percent of LWHs were 2.0 mm or less. Only two sections had LWHs of 1.2 mm, both in maxillary first premolars. Only two sections had LWHs of 2.5 mm, one in a mandibular second molar and the other in a maxillary first molar. Maximum LWH correlated positively (r = .469) with bucco-lingual crown width.

Bicuspid↗

Patient absorbed doses in digital grey-scale fluorography.

This article describes a preliminary comparison between the levels of patient dose used in digital grey-scale fluorography (DGF) and screen-film radiography. Patient doses were measured in three common radiographic examinations, postero-anterior chest, antero-posterior lumbar spine and lateral lumbo-sacral junction, using thermoluminescent dose-meters and an anthropomorphic phantom. Within the limitations of the image quality currently available in DGF, the findings indicate that digital radiography with the large-field X-ray image intensifier promises significant savings in patient dose compared with conventional radiography.

Film Dosimetry↗

Topographically induced bone formation in vitro: implications for bone implants and bone grafts.

We have investigated the influence of substrate topography on the timing and location of bone formation by rat osteoblasts. 250 mu m thick slabs of dental tissues were used intact or had a rectangular grid of grooves (350 mu m wide and of variable depth) cut with a diamond wheel. They were then seeded with rat calvarial osteoblasts and cultured in MEM with 10% FCS at 37 degrees C in 5% CO(2). Ascorbic acid 50 mu g/mL and beta-glycero-phosphate 2 mmol/L were added at confluence. Cultures were observed daily from 2 to 4 weeks, until fixation (and storage) in 70% ethanol. Most were stained with alizarin red S to visualize the newly formed bone. The presence of gap junctions in the bone nodules was determined using connexin-43 immunolabeling and confocal microscopy. Two specimens were embedded in polymethylmethacrylate (PMMA): micromilled blockfaces were coated with carbon and examined by digital backscattered electron (BSE) microscopy. Bone formation began in the second week, preferentially wherever cellular condensation was favored: these locations were (a) within the grooves; (b) at the junction between the slab and the bottom of the culture dish; (c) at the periphery of the dish; and (d) in cracks where dissimilar tissues had separated. In the grooves, a grid of aligned bone developed, the deeper trenches showing bone formation earlier than shallower ones, with bone formation tapering off as a groove became shallower. BSE images showed that the bone formed was well mineralized and contained a high volume proportion of osteocytes. Mean and median values for the mean BSE coefficients were: in vitro bone in grooves 0.138528, 0.141484; in vivo aged bone (2 year old rat mandible) 0.143431, 0.144206; and in vivo young bone (neonate rat cranium) 0.129011, 0.132696. Connexin-43 gap junctions were immunolocalized on osteocytes fully enclosed within bone and on osteoblasts overlying it. We conclude first that local topography is an important factor in the location and timing of bone formation in vitro, and that it is likely to be equally important in vivo in normal bone turnover, fracture repair and the incorporation of bone grafts. Second, the mineral density of the bone formed in vitro is consistent with its being true bone.

Animals↗

Accuracy of assessing infrabony defects using a special digital filter for periodontal bone loss.

PURPOSE: To assess the accuracy of linear measurements of bone loss within infrabony defects on digitized radiographs after digital filtering particularly designed to image periodontal bone loss. METHODS: Before surgery, 50 standardized radiographs of 50 infrabony defects were obtained. Intrasurgically the distances from the cementoenamel-junction (CEJ) to the alveolar crest (AC), from the CEJ to the bottom of the bony defect (BD), and the depth of the infrabony component (INFRA) were assessed. All radiographs were digitized and the distances CEJ-AC, CEJ-BD, and INFRA were measured on digitized but unchanged radiographs and after use of the filter. RESULTS: There was a small overestimation of CEJ-AC (0.35-0.68 mm) and underestimation of CEJ-BD (0.84-1.12 mm) and INFRA (0.66-0.76 mm). Accuracy of measurement of the distance CEJ-AC was influenced by vertical angulation difference (P= 0.047) and the intrasurgical CEJ-AC (P= 0.003). Accuracy of CEJ-BD was influenced by intrasurgically assessed bone loss (P= 0.012). Accuracy of INFRA was influenced by individual patient, intrasurgically assessed INFRA (P< 0.001), and filter (P= 0.018).

Adult↗

Comparison of direct digital and conventional intraoral radiographs in detecting alveolar bone loss.

BACKGROUND: Intraoral radiographs are important diagnostic aids in periodontics. The authors conducted a study to compare estimates of bone levels from direct digital and conventional radiographic under normal clinical use. METHODS: A full-mouth series of conventional radiographs was taken for each of 25 subjects who had periodontitis. A long cone paralleling technique was used for periapical, or PA, images, and a paper sleeve with biting tab was employed for bitewing, or BW, images. A set of direct digital radiographs matching the conventional radiographs was taken for each subject under the same conditions. The distance from the cementoenamel junction to the interproximal alveolar crest on all readable surfaces was measured. RESULTS: Examiners measured 857 PA image sites and 315 BW image sites matched on both radiographic systems. Paired t test showed significant differences in bone levels between the two systems. Measurements from conventional PA images were higher in all maxillary sextants (P < or = .02), and measurements from digital PA images were higher in mandibular anterior sextants (P = .007). Measurements in digital BW images were higher in mandibular posterior sextants (P = .002). A chi2 analysis of categorical bone levels (normal, early-to-moderate loss or advanced loss) showed significant differences between the imaging systems in revealing bone levels in both PA (P < .04) and BW (P < .001) images. Digital radiographs showed a higher number of sites with bone loss than did conventional radiographs. CONCLUSIONS: Under normal clinical use, alveolar bone levels revealed on intraoral direct digital radiographs differ from those revealed on conventional radiographs. CLINICAL IMPLICATIONS: Intraoral direct digital radiographs are not an equivalent substitute for conventional radiographs in evaluating alveolar bone levels.

Adolescent↗

Shielding of augmented tendon--tendon repair.

Strength and function of autogenic and xenogenic reconstruction of digital extensor tendons was examined in an ovine model. In this study, tendon-graft junctions were formed by either suture augmented with a woven polyester tube (A), or augmented and shielded from surrounding tissues by chemically-treated bovine pericardium (S). By 12 wk, both A and S sheep had returned to full range of motion. Mechanical strength of both the autograft-host and xenograft-host repair sites was similar, with a pooled strength of 131 +/- 25 N (n = 15). Similarly, the mid-portion xenograft strengths were constant at approximately 366 +/- 97 N (n = 7). In contrast, mid-portion autograft strengths decreased from 380 +/- 110 N (N = 4) to 120 +/- 66 N (n = 4) if shielding was omitted. The loss in autograft strength was attributed to loss of function associated with adhesions. The use of the augmentation device coupled with an adhesion barrier gives higher initial reconstruction strength and improved function during the host repair period up to 12 wk.

Animals↗

A gross anatomic and histologic study of the innervation of the proximal interphalangeal joint.

The innervation of the proximal interphalangeal joint was studied by gross dissection with magnification and histologic analysis. The joint is innervated by a constant articular branch arising from the palmar proper digital nerve at the level of the midproximal phalanx. This articular nerve bifurcates adjacent to the joint, and its terminal branches enter the joint in the midlateral plane at the junction of the palmar plate and lateral capsule. No contribution to the articular innervation was found to arise from the sensory radial, dorsoulnar cutaneous, and collateral branches of the proper digital nerve that cross the joint. The innervation of the proximal interphalangeal joint is congruent with the palmar sensory innervation and has no relation to the dorsal sensory innervation.

Finger Joint↗

Cyclic changes in the organization of cell adhesions and the associated cytoskeleton, induced by stimulation of tyrosine phosphorylation in bovine aortic endothelial cells.

In this study we have investigated the relationships between the stimulation of tyrosine-specific protein phosphorylation and the state of assembly of cell-cell and cell-matrix adherens-type junctions. Bovine aortic endothelial (BAE) cells were treated with either the phosphotyrosine phosphatase inhibitor pervanadate or with epidermal growth factor (EGF), and the effect of the treatment on the organization of cell contacts and the actin cytoskeleton was evaluated by digital immunomicroscopy. We show here that pervanadate induced a dramatic (about 40-fold) increase in the level of phosphotyrosine labeling of cell-cell junctions, which reached maximal values following 20 minutes of incubation. Concomitantly, the junctional levels of vinculin, actin and plakoglobin increased, followed by a slower recruitment of cadherins to these sites. Upon longer incubation cell-cell junctions deteriorated and stress fibers and focal adhesions were formed. EGF stimulation of serum-starved BAE cells induced a rapid 'wave' of junctional tyrosine phosphorylation, followed by cyclic changes in the local levels of phosphotyrosine labeling. Periodic changes were also found in the intensity of labeling of junctional actin, vinculin and cadherins. These results suggest that tyrosine phosphorylation and the assembly of cell-cell adherens junctions are interdependent processes, and raise the possibility that the cross-talk between the two is responsible both for the regulation of junction formation and for adhesion-mediated signaling.

Animals↗

The influence of loss of bone mass on induced periodontal disease: a radiographic and densitometric study of female rats.

BACKGROUND: Changes in mineral density in the mandibular and femoral bones (BMD) after estrogen deficiency caused by ovariectomy (OVX) and the influence of these changes on induced periodontal disease were evaluated in female rats. METHODS: Forty-eight female Holtzman rats (90 days old) were randomly divided into five groups: 0: control (N = 9); 1: SHAM without induced periodontal disease (N = 11); 2: SHAM with induced disease (N = 10); 3: OVX without induced disease (N = 9); and 4: OVX with induced disease (N = 9). In groups 2 and 4, the first lower molars were tied with ligatures for 30 days 120 days after surgery. After 5 months the animals were sacrificed to measure global mineral density (BMD) and that of the sub-regions of the mandible and femur by dual energy x-ray absorptiometry (DXA). The extent of vertical bone loss was evaluated with digital radiography by measuring the distance from the bone crest to the cemento-enamel junction at the mesial of the first lower molar. RESULTS: Results of the femur (Kruskal-Wallis test) showed a significant difference (P <0.001) between the groups SHAM and OVX in bone density values for all regions. Comparison between the groups in relation to the BMD of the mandible, both in the sub-regions and global revealed no differences (P >0.05). The vertical bone loss measured for the groups with induced disease was similar (P = 0.713). CONCLUSIONS: Differences between the groups were found in the bone mineral density BMD of the femur but not of the mandible. OVX had no influence on induced periodontal disease.

Alveolar Bone Loss↗

Intercellular calcium waves in HeLa cells expressing GFP-labeled connexin 43, 32, or 26.

This study was undertaken to obtain direct evidence for the involvement of gap junctions in the propagation of intercellular Ca(2+) waves. Gap junction-deficient HeLa cells were transfected with plasmids encoding for green fluorescent protein (GFP) fused to the cytoplasmic carboxyl termini of connexin 43 (Cx43), 32 (Cx32), or 26 (Cx26). The subsequently expressed GFP-labeled gap junctions rendered the cells dye- and electrically coupled and were detected at the plasma membranes at points of contact between adjacent cells. To correlate the distribution of gap junctions with the changes in [Ca(2+)](i) associated with Ca(2+) waves and the distribution of the endoplasmic reticulum (ER), cells were loaded with fluorescent Ca(2+)-sensitive (fluo-3 and fura-2) and ER membrane (ER-Tracker) dyes. Digital high-speed microscopy was used to collect a series of image slices from which the three-dimensional distribution of the gap junctions and ER were reconstructed. Subsequently, intercellular Ca(2+) waves were induced in these cells by mechanical stimulation with or without extracellular apyrase, an ATP-degrading enzyme. In untransfected HeLa cells and in the absence of apyrase, cell-to-cell propagating [Ca(2+)](i) changes were characterized by initiating Ca(2+) puffs associated with the perinuclear ER. By contrast, in Cx-GFP-transfected cells and in the presence of apyrase, [Ca(2+)](i) changes were propagated without initiating perinuclear Ca(2+) puffs and were communicated between cells at the sites of the Cx-GFP gap junctions. The efficiency of Cx expression determined the extent of Ca(2+) wave propagation. These results demonstrate that intercellular Ca(2+) waves may be propagated simultaneously via an extracellular pathway and an intracellular pathway through gap junctions and that one form of communication may mask the other.

Adenosine Triphosphate↗

A comparison of two registration techniques for digital subtraction radiography.

The dental radiograph is a diagnostic tool that is used to view internal structures without any invasive procedures. A difference radiograph, i.e. one showing the changes that occurred over time, is the best tool for diagnosing slow or small changes. The difficulty in creating a meaningful difference radiograph, or its digital image, is that the imaging geometry of the image pair must be identical. This paper addresses the problem of reproducing imaging geometry. A new technique for registering digital images of radiographs based on the correspondence of 3D anatomical structures (such as root apices and the cemento-enamel junction) was compared with a registration method using occlusal stents. In a pilot study of 30 volunteers, difference images were created by three different registration techniques (no registration, mathematical methods and occlusal stents). The standard deviations of the difference images were used to compare the registration techniques. The results show that this new mathematical technique applied to digital images of radiographs can be used to establish correspondence between pairs of clinical images taken at different projection angles and to produce reconstructed images comparable with images taken with occlusal stents.

Adult↗

Gap junctions mediate intercellular calcium signalling in cultured articular chondrocytes.

Gap junction-mediated intercellular communication has been implicated in a variety of cellular functions. Among these, signal transduction can be coordinated among several cells due to gap junctional permeability to intracellular second messengers. Chondrocytes from articular cartilage in primary culture respond to extracellular ATP by rhythmically increasing their cytosolic Ca2+ concentration. Digital imaging fluorescence microscopy of Fura-2 loaded cells was used to monitor Ca2+ in confluent and semi-confluent cell layers. Under these conditions, Ca2+ spikes propagate from cell to cell giving rise to intercellular Ca2+ waves. The functional expression of gap junctions was assessed, in confluent chondrocyte cultures, by the intercellular transfer of Lucifer yellow dye in scrape-loading experiments. Intercellular dye transfer was blocked by the gap junction inhibitor 18 alpha-glycyrrhetinic acid. In imaging experiments, the inhibitor caused the loss of synchrony of ATP-induced Ca2+ oscillations, and blocked the intercellular Ca2+ propagation induced by mechanical stimulation of a single cell in a monolayer. It is concluded that gap junctions mediate intercellular signal transduction in cartilage cells and may provide a mechanism for co-ordinating their metabolic activity.

Adenosine Triphosphate↗