bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modest protection of early hydrocortisone treatment in a rat model of volume‐controlled haemorrhage
Authors: Gundersen Y. , Vaagenes P. , Reistad T. , Opstad P. K. 
Published: September 2003

Background:  Major insults may trigger generalized inflammatory responses that contribute to progressive multiple organ dysfunction. The present study was performed to test the potential of early hydrocortisone treatment to influence these responses as well as organ function following an episode of rapid and profound blood loss.Methods:  In isoflurane anaesthesia, 35 spontaneously breathing male Sprague‐Dawley rats were bled 2.5 ml 100 g−1 body weight over 10 min. Immediately following withdrawal of blood, one group (n = 17) was given 2 mg of hydrocortisone, and the other (n = 18) had the same amount of normal saline. Seventy‐five minutes after initiation of bleeding, two‐thirds of the blood was retransfused, together with a new injection of hydrocortisone or saline. Thereafter the rats were observed for 2 h. Key mediators of systemic inflammation and plasma markers of organ function and integrity were measured. Internal organs were weighed and scored for visible pathology. Leukocyte infiltration of the liver was counted in a light microscope.Results:  Hydrocortisone reduced the plasma levels of IL‐6 (P < 0.05); non‐significant reductions of TNF‐α (P = 0.12) and IL‐10 (P = 0.44) were noted. The synthesis of reactive oxygen species in peritoneal cells was unaffected. Relative organ weights and organ injury scores tended to be reduced, but only wet organ weight for the lungs reached statistical significance. Leukocyte infiltration of the liver was equal in both groups. Plasma levels of ALT, AST, α‐GST and creatinine did not differ significantly between groups. Two of the hydrocortisone treated rats died compared with four controls.Conclusion:  Early treatment with hydrocortisone had a limited organ protective effect in this model of controlled haemorrhagic shock. Although a general tendency for better outcome in the hydrocortisone group was noted, clear‐cut and significant advantages of the treatment were not obtained.
Effects of propofol on bronchoconstriction and bradycardia induced by vagal nerve stimulation
Authors: Hashiba E. , Hirota K. , Suzuki K. , Matsuki A. 
Published: September 2003

Background:  Vagolysis has been considered as a mechanism by which propofol produces bronchodilation. However, it has also been suggested that propofol‐induced bradycardia may result from increased vagal tone. In this study, we have determined whether propofol has vagolytic effects on both the airway and cardiovascular system.Methods:  Mongrel dogs were anesthetized with pentobarbital. Bronchoconstriction was assessed by measuring changes in a bronchial cross‐sectional area (BCA) using a bronchoscopic method. Heart rate (HR) and direct arterial blood pressure were also monitored. Vagal nerve stimulation (VNS) was performed for 60 s to produce both bronchoconstriction and bradycardia. To determine the effect of propofol on VNS‐induced bronchoconstriction and bradycardia (n = 7), 0 (saline), 2.0 and 20 mg/kg propofol were administered intravenously at 20‐min intervals with VNS commenced 5 min later. In addition, to determine if propofol‐induced bradycardia is due to a vagomimetic action, two groups of six dogs were given 20 mg/kg propofol with or without 0.2 mg/kg atropine pre‐treatment. HR was measured before and 5 min after propofol.Results:  Propofol 20 mg/kg significantly inhibited VNS‐induced bronchoconstriction. Although propofol per se significantly reduced HR (24%) and blood pressure (37%), the reduction in HR produced by VNS after 20 mg/kg propofol did not differ from that after saline or the lower dose of propofol (2 mg/kg). As atropine pre‐treatment did not attenuate propofol‐induced bradycardia, this response is unlikely to be simply due to vagomimetic actions.Conclusion:  Propofol has vagolytic effects on the airway but does not worsen bradycardia produced by parasympathetic stimulation.
Intensive care unit acquired infection: a prevalence and impact on morbidity and mortality
Authors: Vosylius S. , Sipylaite J. , Ivaskevicius J. 
Published: September 2003

Background:  Severe infection is a common reason for intensive care and contributes to increased morbidity and mortality. The aim of the study was to determine the prevalence of infection among intensive care unit (ICU) patients and to evaluate the consequences of ICU‐acquired infection on morbidity and mortality.Methods:  A total of 812 patients consecutively admitted for more than 48 h to the ICU at Vilnius University Emergency Hospital, Lithuania, were included in the prospective observational study. Organ dysfunction was assessed using the Sequential Organ Failure Assessment (SOFA) system.Results:  Thirty‐seven per cent of patients were identified who developed at least one ICU‐acquired infection. Respiratory, bloodstream and urinary tract infections were the most common. The main isolates were coagulase‐negative Staphylococcus, S. aureus, Acinetobacter and Pseudomonas species. More severe degree of organ dysfunction, prolonged stay in the ICU and higher hospital mortality rate were more common among patients who acquired infection in the ICU than that of non‐infected patients.Conclusion:  The prevalence of infection in the ICU was similar to other studies in European countries. The occurrence of ICU‐acquired infection was significantly related to the increase in morbidity and mortality. The findings are useful for the comparison of the prevalence rate of infection and implementation of strict infection control policy.
Which administration route of fentanyl better enhances the spread of spinal anaesthesia: intravenous, intrathecal or both?
Authors: Kararmaz A. , Kaya S. , Turhanoglu S. , Ozyilmaz M. A. 
Published: September 2003

Background:  To enhance the spread of spinal anaesthesia, fentanyl may be administered intrathecally (i.t.) or intravenously (i.v.). The purpose of this prospective study was to investigate the effects of fentanyl administered i.v., i.t. or concurrently by both i.v. and spinal routes on the spread of spinal anaesthesia.Methods:  Sixty patients were randomly assigned to one of three groups. In Groups I and II, spinal anaesthesia was performed with plain bupivacaine 10 mg plus 20 µg fentanyl and in Group III with 10 mg of plain bupivacaine. The level of first peak sensory block was marked. In addition, fentanyl 50 µg was administered i.v. in Groups II and III or by saline in Group I after the sensory blockade reached the highest dermatomal level. Ten minutes after i.v. administration, the level of the second peak sensory block was marked. The distance between the first‐ and second‐highest levels of sensory block was measured.Results:  The distance between the first‐ and second‐highest level of sensory block was significantly different for the three groups: Group II (5.8 ± 2.6 cm) > Group III (2.9 ± 2.1 cm)  > Group I (−0.15 ± 1.7 cm). The peak dermatomal level of spinal block was significantly higher in Group II [T4 (T3–T7)] than in Group I [T6 (T4–T9)] and Group III [T6 (T4‐T8)]. In Groups I and II the sensory block regressed to S2 for a longer period of time than it did in Group III.Conclusion:  Both the spinal and systemic administration of fentanyl enhanced the spread of spinal anaesthesia. The co‐administration of spinal and i.v. fentanyl produced a greater increase in the cephalad spread of spinal block.
Radiographic bone density around immediately loaded oral implants
Authors: Barone Antonio , Covani Ugo , Cornelini Roberto , Gherlone Enrico 
Published: September 2003

Abstract: Objectives: The aim of this study was to analyze the bone density around immediately loaded oral implants by a new volumetric CT scan (Maxiscan) and to compare it with that of unloaded implants.Material and methods: Four patients with an age range from 44 to 65 years old were selected for this study. All the patients needed a prosthetic rehabilitation in partially edentulous posterior maxillas or mandibles. A total of 12 oral implants were placed in the four patients. Six of these implants were immediately loaded while six were left unloaded. Six months after placement, immediately loaded and unloaded oral implants were analyzed by a volumetric CT scan.Results: The overall success rate in this study with immediately loaded oral implants was 100%. The radiological assessments showed that the mean densitometric profile, which is a measure of bone mineralization, was higher in the immediately loaded group than in the unloaded group. The differences observed between the two groups of oral implants (immediately loaded and unloaded) were statistically significant (P<0.05). The bone was significantly more dense around immediately loaded than unloaded oral implants on the basis of a radiological assessment.Conclusion: The innovative aspect of this clinical study is to propose a new method to analyze the bone density, reducing the need for histological analysis from human biopsy.
Representative marketing‐oriented study on implants in the Austrian population. II. Implant acceptance, patient‐perceived cost and patient satisfaction
Authors: Tepper Gabor , Haas Robert , Mailath Georg , Teller Christoph , Bernhart Thomas , Monov Gabriel , Watzek Georg 
Published: September 2003

Abstract: Oral implantology is an established subspecialty of restorative dental and oral surgery. While an extensive body of evidence on the fundamentals of osseointegration and associated factors has been published, marketing‐oriented analyses based on representative public opinion polls of implant acceptance, patient‐perceived cost and patient satisfaction are scarce. In this study, an attempt was made to address these points by questioning a representative sample of 1000 adults in the household setting.The interviewees were presented with 14 questions. Of those familiar with implants as one of the treatment alternatives, 61% reported they would accept implants if the need arose. Implant acceptance was highest among males and interviewees below the age of 30 years. The interest in implants increased with increasing family incomes. Four percent of those questioned already had implants. Twenty‐five percent knew someone who had undergone implant treatment. All those questioned found implant‐supported rehabilitation to be very expensive. Many of them blamed the dentists for the high cost. One detail was particularly evident: satisfaction among implanted patients was clearly higher than satisfaction rates perceived by them from what they were told about implants by others. First‐hand experiences with implants proved to be less biased than reported second‐hand information.
Correlation of insertion torques with bone mineral density from dental quantitative CT in the mandible
Authors: Beer Andreas , Gahleitner André , Holm Anders , Tschabitscher Manfred , Homolka Peter 
Published: September 2003

Abstract: Objective: The aim of this study was to establish a correlation between bone mineral density measured preoperatively with dental computed tomography (CT), and insertion torque of screw‐shaped dental implants.Material and methods: In eight human mandibles obtained postmortem, bone mineral density (BMD) was measured with dental quantitative CT (DQCT) and correlated with insertion torque values at 45 implant sites during insertion of screw‐shaped dental implants (Brånemark System MKIII, Nobel Biocare, AB, Göteborg, Sweden).Results: A significant correlation (r=0.86, P<0.001) between BMD and torque values was observed, indicating that local BMD at a specific implant position is related to the supportive capacity of the jawbone. BMD exhibited no correlation with bone height or position.Conclusion: The noninvasive assessment of BMD using a DQCT scan employing a low‐dose protocol may be used to estimate expected primary stability depending on BMD, implant type and preparation procedure. These data may therefore help the surgeon to select the optimum implant position, implant type and operation technique.
Critical review of immediate implant loading
Authors: Gapski Ricardo , Wang Hom‐Lay , Mascarenhas Paulo , Lang Niklaus P. 
Published: September 2003

Abstract:Background: Implant dentistry has become successful with the discovery of the biological properties of titanium. In the original protocol, studies have advocated a 2‐stage surgical protocol for load‐free and submerged healing to ensure predictable osseointegration. However, the discomfort, inconvenience, and anxiety associated with waiting period remains a challenge to both patients and clinicians. Hence, loading implant right after placement was attempted and has gained popularity among clinicians. Issues/questions related to this approach remain unanswered. Therefore, it is the purpose of this review article to (1) review and analyze critically the current available literature in the field of immediate implant loading and (2) discuss, based on scientific evidence, factors that may influence this treatment modality.Material and Methods: Literature published over the past 20 years was selected and reviewed. Findings from these studies were discussed and summarized in the tables. The advantages and disadvantages associated with immediate implant loading were analyzed. Factors that may influence the success of immediate implant loading, including patient selection, type of bone quality, required implant length, micro‐ and macrostructure of the implant, surgical skill, need for achieving primary stability/control of occlusal force, and prosthesis guidelines, were thoroughly reviewed and discussed.Results and Conclusion: Various studies have demonstrated the feasibility and predictability of this technique. However, most of these articles are based on retrospective data or uncontrolled cases. Randomized, prospective, parallel‐armed longitudinal human trials are primarily based on short‐term results and long‐term follow‐ups are still scarce in this field. Nonetheless, from available literature, it may be concluded that anatomic locations, implant designs, and restricted prosthetic guidelines are key to ensure successful outcomes. Future studies, preferably randomized, prospective longitudinal studies, are certainly needed before this approach can be widely used.
Ridge preservation following tooth extraction using a polylactide and polyglycolide sponge as space filler: a clinical and histological study in humans
Authors: Serino Giovanni , Biancu Salvatore , Iezzi Giovanna , Piattelli Adriano 
Published: September 2003

Abstract: Background: The placement of different graft materials and/or the use of occlusive membranes to cover the extraction socket entrance are techniques aimed at preserving/reducing alveolar ridge resorption. The use of grafting materials in fresh extraction sockets has, however, been questioned because particles of the grafted material have been found in alveolar sockets 6–9 months following their insertion.Aim: The aims of the study were to (i) evaluate whether alveolar ridge resorption following tooth extraction could be prevented or reduced by the application of a bioabsorbable polylactide–polyglycolide sponge used as a space filler, compared to natural healing by clot formation, and (ii) evaluate histologically the amount and quality of bone tissue formed in the sockets, 6 months after the use of the bioabsorbable material.Material and methods: Thirty‐six patients, undergoing periodontal therapy, participated in this study. All patients were scheduled for extraction of one or more compromised teeth. Following elevation of full‐thickness flaps and extraction of teeth, measurements were taken to evaluate the distance between three landmarks (mesio‐buccal, mid‐buccal, disto‐buccal) on individually prefabricated stents, and the alveolar crest. Twenty‐six alveolar sockets (test) were filled with a bioabsorbable polylactide–polyglycolide acid sponge (Fisiograft®), while 13 sockets (controls) were allowed to heal without any filling material. The flaps were sutured with no attempt to achieve primary closure of the surgical wound. Re‐entry for implant surgery was performed 6 months following the extractions. Thirteen biopsies (10 test and three control sites) were harvested from the sites scheduled for implant placement.Results: The clinical measurements at 6 months revealed, in the mesial‐buccal site, a loss of bone height of 0.2 mm (1.4 SD) in the test and 0.6 mm (1.1 SD) in the controls; in the mid‐buccal portion a gain of 1.3 mm (1.9 SD) in the test and a loss of 0.8 mm (1.6 SD) in the controls; and in the distal portion a loss of 0.1 mm (1.1 SD) in the test and of 0.8 (1.5 SD) mm in the controls. The biopsies harvested from the test sites revealed that the new bone formed at 6 months was mineralized, mature and well structured. Particles of the grafted material could not be identified in any of the 10 test biopsies. The bone formed in the control sites was also mature and well structured.Conclusion: The results of this study indicate that alveolar bone resorption following tooth extraction may be prevented or reduced by the use of a bioabsorbable synthetic sponge of polylactide–polyglycolide acid. The quality of bone formed seemed to be optimal for dental implant insertion.
Ratio of immature cornified envelopes does not correlate with parakeratosis in inflammatory skin disorders
Authors: Hirao Tetsuji , Terui Tadashi , Takeuchi Izuho , Kobayashi Hiromi , Okada Mikiko , Takahashi Motoji , Tagami Hachiro 
Published: September 2003

Abstract:  We have previously established a non‐invasive method to evaluate the maturity of cornified envelopes (CEs), and have reported the appearance of immature CEs in the stratum corneum (SC) with poor barrier function, such as the SC of the face. The purpose of the present study was to evaluate CEs in inflammatory skin disorders, and to clarify the relationship between the appearance of the immature CEs and parakeratosis, which is often used as a marker for defective keratinization in inflammatory skin disorders.Cornified envelopes in the outermost SC of involved areas of psoriasis vulgaris (PV) and atopic dermatitis (AD) were strikingly heterogeneous, and consisted of immature CEs stained with anti‐involucrin and mature CEs stained with Nile red, whereas CEs of the uninvolved areas were relatively homogeneous, exhibiting mature phenotype. The ratio of immature CEs was significantly higher in the involved areas of PV and AD than that in the corresponding uninvolved areas, suggesting that defective CE maturation may, at least in part, account for the inflammatory disorders.Simultaneous evaluation of CE maturity and parakeratosis was carried out by a combination of involucrin immunostaining and nuclear staining of detergent‐dissociated corneocytes. In the involved area of PV, four types of corneocytes in regard to the combination of involucrin staining and nuclear remnant were observed, while both immature CEs and parakeratosis were more often detected in the involved areas of PV than in the uninvolved areas or the upper arm of healthy subjects as a normal control. Thus, corneocytes with involucrin‐positive immature CEs were not always associated with parakeratosis at the cellular level. In the involved areas of PV, the ratio of immature CEs and that of parakeratosis were heterogeneous, depending on the cases, and no correlation between the ratios was observed. Inter‐individual and intraindividual variations in CE maturity were also suggested by the heterogeneous localization of involucrin in the psoriatic epidermis as examined by immunohistochemistry. In addition, in the face of healthy subjects, four types of corneocytes were similarly detected, and the ratio of immature CEs was significantly higher than that of parakeratosis. These results obviously suggest that the maturation of CEs and disappearance of nuclei are differentially regulated in the epidermis.
Infiltrating cells and related cytokines in lesional skin of patients with chronic idiopathic urticaria and positive autologous serum skin test
Authors: Caproni M. , Volpi W. , Macchia D. , Giomi B. , Manfredi M. , Campi P. , Cardinali C. , D'Agata A. , Fabbri P. 
Published: September 2003

Abstract:  In approximately one‐third of patients with chronic idiopathic urticaria (CIU), autoantibodies against the high‐affinity IgE receptor and/or against IgE can be detected and a wheal‐and‐flare response can be provoked by the intradermal injection of autologous serum (ASST). In this study we aimed to further characterize the inflammatory response observed in the subgroup of CIU patients with positive ASST and serum‐evoked histamine‐release in vitro from basophils in comparison with unaffected skin and healthy donors. An immunohistochemical analysis of infiltrating cells (CD4, MPO, EG1, EG2, tryptase), cytokines (IL‐4, IL‐5, IFN‐γ), chemokines and chemokine receptors (IL‐8, CCR3, CXCR3), and adhesion molecules (ICAM‐1, VCAM‐1, ELAM‐1) was performed on seven selected patients (four males and three females; median age: 45 years; range: 22–57) and five healthy donors. Cytokine evaluation was also performed in five psoriatic patients to obtain an additional control.In spontaneous wheals we observed an increased number of CD4+ T lymphocytes when compared with the controls, and an increased number of neutrophils and eosinophils, whereas mast cells did not show a significant variation. A significant expression for IL‐4 and IL‐5 could only be observed in lesional skin, while IFN‐γ showed a slight expression in the same site. Chemokine receptors CCR3 and CXCR3 did not show a defined polarized response in either lesional or unaffected skin. An increased expression of all cellular adhesion molecules (CAMs) studied was detected in spontaneous wheals. The lack of a significant difference in the expression of tryptase + mast cells, T lymphocytes, IL‐8, CXCR3 and CCR3, a few CAMs between the lesional and unaffected skin of CIU patients suggests a wide immunological activation that involves not only lesional tissues, but possibly extends to the whole of the skin's immune system.
Regulation of PDGF and PDGF receptor in cultured dermal papilla cells and follicular keratinocytes of the human hair follicle
Authors: Kamp H. , Geilen C. C. , Sommer C. , Blume‐Peytavi U. 
Published: September 2003

Abstract:  Platelet‐derived growth factor (PDGF) is a potent mitogenic factor for many cell types and has been shown to be important in follicular development and vasculogenesis. In this study, we examined the expression pattern of both PDGF factors and their corresponding receptors in mesenchyme‐derived dermal papilla cells (DPCs) and epithelial follicular keratinocytes (FKs). Both types of PDGF receptors are expressed in FKs, whereas DPCs only express PDGF receptor β on the protein level, a finding also seen in whole organ cultures. By examining the expression of PDGF ligands, we were able to show that cultured FKs synthesize both PDGF‐A and PDGF‐B, whereas, DPCs only express PDGF‐A.As immunomodulatory cytokines were shown to affect hair growth, we investigated the effects of IL‐1β, IL‐4, TNF‐α, TGF‐β and IFN‐γ on the expression levels of PDGF factors in cultured DPCs and FKs. Interestingly, we could show a significant down‐regulatory effect by catagen‐inducing cytokines like IL‐1β or IFN‐γ, suggesting a possible involvement of PDGF signaling in the induction of catagen. The question concerning the latter hypothesis remains to be elucidated in further studies on whole organ cultures.