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  • 1
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In the treatment of psoriasis with topical vitamin D3 analogues, lesional and perilesional irritation is the main side-effect. The aim of this study was to investigate whether local side-effects generated by tacalcitol, a vitamin D3 analogue, show concentration dependence. 3 different concentrations of tacalcitol (0.4; 4; 40 μg/g ointment) and the vehicle were applied on normal skin of the back of 25 healthy volunteers under occlusive conditions for 5 days. Assessment of erythema, infiltration and scaling as well as measurement of transepidermal water loss (TEWL) was performed on days 1 to 5. On day 5, additional skin barrier tests (DMSO test, alkali resistance test) were performed. Erythema and slight infiltration, but no scaling, were observed in a number of subjects without significant differences. TEWL also did not show significant differences for the test formulations, though there was a tendency towards lower values in the untreated areas. In the skin barrier tests, a tendency towards higher alkali resistance in the test areas treated with 40 μg tacalcitol/g ointment was detected. Thus, under occlusive conditions, the irritant potential of tacalcitol is very low. There is no convincing evidence of concentration dependence in irritation generated by tacalcitol when applied under occlusive conditions.
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  • 2
    Electronic Resource
    Electronic Resource
    Copenhagen : Munksgaard International Publishers
    Experimental dermatology 9 (2000), S. 0 
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: These results demonstrate for the first time that human keratinocytes under in vivo-like conditions have the capacity of the enzymatic hydroxylation of vitamin D3 to hormonally active calcitriol (1α,25(OH)2D3). Supplementation of the culture medium with bovine serum albumin (BSA) up to 1.5% (w/v) amplifies the conversion of vitamin D3 to 1α,25(OH)2D3. The maximum turnover rate of this reaction at 780 nM vitamin D3 in presence of 1.0% (w/v) BSA amounts to approximately 3 pmol 1α,25(OH)2D3 per 106 cells after 6 h of incubation. The hydroxylation of vitamin D3 to 1α,25(OH)2D3 is inhibited by the P-450 oxidase inhibitor ketoconazole. The generation of 1α,25(OH)2D3 from vitamin D3 has an apparent Michaelis constant (Km) of 2.3×10−6 M. The intrinsic conversion of vitamin D3 to biologically active 1α,25(OH)2D3 may be of importance for the regulation of proliferation and differentiation of keratinocytes.
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  • 3
    ISSN: 1399-3038
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: It has been hypothesized that cesarean delivery might have an impact on the development of atopic diseases because of its gut flora modulating properties. In the present study, we analysed the association between cesarean delivery and atopic diseases using data of 2500 infants enrolled in the LISA-Study, a German prospective multicenter birth cohort study. Data on symptoms and physician-diagnosed atopic diseases were gathered by questionnaires shortly after birth and at infant's age 6, 12, 18, and 24 months. In addition, sensitization to common food and inhalant allergens was assessed by measuring specific immunoglobulin E (IgE) using the CAP-RAST FEIA method at the age of 2 yr. Confounder-adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by multiple logistic regression. We found a positive association between cesarean delivery and occurrence of at least one episode of wheezing [aOR 1.31 (95% CI 1.02–1.68)] and of recurrent wheezing [1.41 (1.02–1.96)] during the first 2 yr of life. Furthermore, effect estimates for allergic sensitization defined as at least one specific IgE ≥0.70 kU/l against any allergen [1.48 (0.98–2.24)], against food allergens [1.64 (1.03–2.63)], and against inhalant allergens [1.75 (0.98–3.12)] were increased. Symptoms of atopic dermatitis [1.21 (0.92–1.59)], physician-diagnosed atopic dermatitis [1.04 (0.79–1.39)], and symptoms of allergic rhinoconjunctivitis [1.40 (0.80–2.44)] were only marginally increased in children delivered by cesarean section. In conclusion, our results suggest that cesarean delivery may be an additional risk factor for wheezing and allergic sensitization at least to food allergens up to the age of 2 yr. This should be considered when cesarean section is done for other than medical reasons.
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  • 4
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The principle of guided tissue regeneration has been successfully applied for the regeneration of bone in various jaw defects in human. The purpose of this study was to assess the bone volume regenerated using nonresorbable membrane barriers. Nineteen patients with jaw bone defects of various sizes and configurations were included in the study. Combined split-thickness/full-thickness mucosal flaps were elevated in the area of missing bone. The size of the defects was assessed by measuring the distance from a reference line between 2 adjacent teeth (cementoenamel junctions) to the alveolar crest (a) every 2 or 3 mm. In addition, the crestal width was measured. Consequently, the surface of the triangle formed by a and the width of the crest as well as the volume between all triangles were calculated geometrically. Following the placement of Gore-Tex® augmentation material as a barrier, the distance (b) to the top of the membrane from the reference line was assessed, and the maximum possible volume for bone regeneration based on (a-b) and the width of the crest was calculated. At the time of membrane removal (3–8 months later). the same measurements were performed and the percentages of regenerated bone in relation to the possible volume for regeneration determined. In 6 patients in whom the membranes had to be removed early due to an increased risk for infection between 3 and 5 months, bone regeneration varied between 0 and 60%. In 13 patients in whom membranes were left for 6–8 months, regenerated bone filled 90–100% of the possible volume. It was concluded that successful bone regeneration consistently occurred with an undisturbed healing period of at least 6 months.
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  • 5
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The effects of magnetostrictive ultrasonic instruments and piezoelectric ultrasonic instruments on tooth surfaces seem to differ with regards to root debridement.Aim: The purpose of this study was to compare a magnetostrictive ultrasonic scaling instrument with a piezoelectric ultrasonic scaling instrument and a hand curette regarding time taken, calculus removal, tooth surface roughness (Ra), and SEM examination before and after instrumentation.Methods: 30 extracted human teeth with subgingival calculus were assigned to one of three treatment groups (n=10). The working force was standardised for both ultrasonic instruments at 200 g and for the curette at 500 g.Results: The results revealed that the time needed for instrumentation was 126.1±38.2 s for the curette, significantly more than for the piezoelectric ultrasonic instrument (74.1±27.6 s; p〈0.05) and 104.9±25.4 s for the magnetostrictive ultrasonic instrument. Remaining calculus was similar for all three groups. The end Ra values were significantly worse for the piezoelectric instrument (2.02±0.41; p〈0.05) compared to 1.42±0.48 for the curette and 1.36±0.41 for the magnetostrictive instrument. The SEM examination revealed the smoothest surfaces but, subjectively, the most tooth substance loss after the curette, followed by the magnetostrictive instrument, with the least substance loss, and then the piezoelectric instrument, with medium substance loss.Conclusion: The piezoelectric ultrasonic scaler was more efficient than the magnetostrictive ultrasonic scaler in removing calculus but left the instrumented tooth surface rougher.
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  • 6
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aims: This study investigated the loss of tooth substance (μg) by means of liquid scintillation in combination with profilometric and SEM analyses in order to evaluate the roughness and morphological changes of the root surface before and after instrumentation.Method: 40 polished and irradiated bovine root surfaces were scaled in vitro while covered with 50 ml destilled water using a sonic prototype (Periosonic® 1/2), a magnetostrictive ultrasonic (Cavitron® with Slimline® inserts) scaler and a hand curette. Pressures were applied for the Periosonic, Cavitron and hand curette at 500, 500 and 30 g respectively, for 30-s intervals, up to 120 s. Loss of apatite (μg) was determined from the decays/min (32P) of the water samples using the radiochemical method of liquid scintilation. Replicas were made of the specimens for SEM and profilometric analyses.Results: The least substance loss was noted significantly (p〈0.01) at all time intervals after Slimline, followed by the fine sonic prototype Periosonic 2, then the Periosonic 1 and finally the hand curette. In contrast, profilometric and SEM analyses revealed the smoothest root surfaces after the hand curette, whereas Cavitron produced a less smooth surface.Conclusion: It can be concluded that this method can reveal very precisely small quantities of substance lost and, in combination with SEM analysis and microroughness measurements, be of considerable value in evaluating the aggressiveness and efficacy of periodontal instruments.
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  • 7
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: UVB irradiation of cultured human keratinocytes induces both the conversion of 7-dehydrocholesterol (7-DHC) to calcitriol (1α,25(OH)2D3) and the release of tumor necrosis factor-a (TNF-α) in these cells. Calcitriol synthesis in human keratinocytes was reduced in the presence of a neutralizing polyclonal antibody directed against human TNF-α. On the other hand, we found a 1.7-fold higher stimulatory effect of UVB on liberation of TNF-α in cultured keratinocytes enriched with 7-DHC compared with irradiated cell cultures in absence of 7-DHC. These observations argue in favor of a synergetic relationship between generation of TNF-α and calcitriol in UVB irradiated keratinocytes. In addition, we found that TNF-α potently increases the conversion rate of vitamin D3(cholecalciferol) to calcitriol this cell system. The UVB-triggered formation of both TNF-α and calcitriol in cultured keratinocytes as wavelength-, time- and dose-dependent. Maximum formation of TNF-α and calcitriol was found at 300 nm and UVB doses of 30 mJ/cm2. The enhancement of both, the formation of TNF-α and calcitriol in keratinocytes by UVB may be of relevance for regulation of growth and apoptosis in light-exposed epidermal cells and, in addition, may play a role in the UVB treatment of deseased skin, including psoriasis.
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  • 8
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The skin is the only tissue yet known in which the complete UVB-induced pathway from 7-dehydrocholesterol (7-DHC) to hormonally active calcitriol (1α,25-dihydroxyvitamin D3) occurs under physiological conditions. It is well known that both calcitriol and UVB radiation exert potent antipsoriatic effects. We speculate that the therapeutic effect of UVB radiation can be attributed to UVB-triggered cutaneous synthesis of calcitriol for which the optimum wavelength was a range of 300 ± 3 nm in vitro and in vivo. On the other hand, the narrowband Philips TL-01 lamp which is commonly used as UVB source for therapeutical treatment of psoriasis, has a maximum spectral irradiance at around 311 nm. The aim of this study was to investigate the calcitriol-inducing potential of the TL-01 lamp in organotypic cultures of keratinocytes supplemented with 25 μM 7-DHC at different radiant exposures (125–1000 mJ/cm2). We found that the maximum calcitriol-generating capacity of the TL-01 lamp at 500 mJ/cm2(corresponding to 2.1 SED [Standard Erythema Dose]) and 16 h after irradiation still amounts to approximately 45 percent of that of monochromatic radiation at 300 nm and 30 mJ/cm2. We conclude from our findings that irradiation with the narrowband TL-01 lamp in therapeutic dose range can affect calcitriol synthesis in epidermal keratinocytes. Thus, the antipsoriatic effect observed after TL-01 lamp exposures may be, at least partially, explained by the known action of newly-synthesized calcitriol on the epidermal cell proliferation and differentiation.
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  • 9
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The present case report demonstrates the application of guided tissue regeneration (GTR) in combination with antimicrobial therapy for the treatment of an early implant failure. This treatment approach both prevented further loss of bone as well as led to the regeneration of lost bone. By means of color-converted digital subtraction images, remodelling of the tissues adjacent to the defect was documented as early as one month postsurgically. The images demonstrated “bone-fill” in the apical portion of the defect and resorptive changes at the bone crest. This case report demonstrates that combined regenerative and antimicrobial therapy may be a successful treatment approach restoring osseointegration of dental implants following loss of bone due to infection. Continuously increasing bone-fill inside the defect was documented when comparing the radiograph obtained immediately before the GTR procedure and at months 1, 2, 4, 5 and 6 of the healing period, respectively. Clinical measurement obtained at the time of the surgery and at the time of the membrane removal confirmed the radiographic evidence of bone-fill by demonstrating new tissue resistant to probing in close contact to the implant surface at the site of the previous defect. Antimicrobial therapy included an antibiotic regimen during the 1st month of healing as well as topical rinses with an antiseptic (chlorhexidine) over the entire healing period of 6 months. As a result of this treatment approach, the implant was saved and could be used as an abutment for a bridge reconstruction.
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  • 10
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The aim of this study was to evaluate in vivo the effectiveness of scaling and root planing of new oscillating instruments (Periosonic®) using a sonic handpiece compared to hand curettes with a split mouth design after 2 months.Methods: 11 patients with adult periodontitis participated in this study. Plaque index (PII) (O’Leary), bleeding on probing (BOP), probing pocket depth (PPD), recession (REC) and clinical attachment level (CAL) were recorded at baseline and 2 months after treatment. After oral hygiene instruction, 2 randomly assigned quadrants per patient were scaled and root planed with curettes (control side) and the remaining 2 quadrants with the Periosonic® instruments 1 and 2 (test side). The student t-test for paired data was used to test the significance of difference between test and control sides.Results: There was no statistical difference (p〉0.05) between the 2 sides for the improvement of the clinical parameters excepted for the group with initial PPD of 4–6 mm (test: 1.3±0.4 mm PPD reduction, control: 1.6±0.4 mm). For PPD 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE281209:ges" location="ges.gif"/〉7 mm, the test side had better clinical improvement in attachment levels (2.2±0.9 mm), less recession (−0.4±0.5 mm) with lower PPD reduction (2.4±0.6 mm) than the control side (AL: 1.6±1.8 mm; REC: −1.3±0.7 mm, PPD reduction: 3.0±1.4 mm).Conclusion: This clinical study demonstrated that Periosonic® instruments are clinically at least as effective as curettes in PPD reduction when initial PPD is 〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE281209:les" location="les.gif"/〉6 mm and show better clinical attachment level improvement with less recession for initial PPD of 〈inlineGraphic alt="geqslant R: gt-or-equal, slanted" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE281209:ges" location="ges.gif"/〉7 mm.
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