Conservative management of tooth wear: A case series

Tooth wears in general term means loss of tooth structure. Tooth loss increases with age and thus causes difficulty in chewing and increased sensitivity. Wear facets on the occlusal surface are subjected to high occlusal stresses leading to repeated dislodgment of the restoration. This article presents the use of bonded amalgam as a restorative material for restoring localized occlusal wear facets.

Chronic ethanol induces a pro-inflammatory switch in interleukin-1β regulation of GABAergic signaling in the medial prefrontal cortex of male mice

Neuroimmune pathways regulate brain function to influence complex behavior and play a role in several neuropsychiatric diseases, including alcohol use disorder (AUD). In particular, the interleukin-1 (IL-1) system has emerged as a key regulator of the brain's response to ethanol (alcohol). Here we investigated the mechanisms underlying ethanol-induced neuroadaptation of IL-1β signaling at GABAergic synapses in the prelimbic region of the medial prefrontal cortex (mPFC), an area responsible for integrating contextual information to mediate conflicting motivational drives. We exposed C57BL/6J male mice to the chronic intermittent ethanol vapor-2 bottle choice paradigm (CIE-2BC) to induce ethanol dependence, and conducted ex vivo electrophysiology and molecular analyses. We found that the IL-1 system regulates basal mPFC function through its actions at inhibitory synapses on prelimbic layer 2/3 pyramidal neurons. IL-1β can selectively recruit either neuroprotective (PI3K/Akt) or pro-inflammatory (MyD88/p38 MAPK) mechanisms to produce opposing synaptic effects. In ethanol naïve conditions, there was a strong PI3K/Akt bias leading to a disinhibition of pyramidal neurons. Ethanol dependence produced opposite IL-1 effects - enhanced local inhibition via a switch in IL-1β signaling to the canonical pro-inflammatory MyD88 pathway. Ethanol dependence also increased cellular IL-1β in the mPFC, while decreasing expression of downstream effectors (Akt, p38 MAPK). Thus, IL-1β may represent a key neural substrate in ethanol-induced cortical dysfunction. As the IL-1 receptor antagonist (kineret) is already FDA-approved for other diseases, this work underscores the high therapeutic potential of IL-1 signaling/neuroimmune-based treatments for AUD.

Biological and Chemical Properties of 2-in-1 Calcium-chelating and Antibacterial Root Canal Irrigants

OBJECTIVES

To evaluate the capacity of canal wall smear layer removal, precipitation caused by irrigant interaction, antibacterial activity and cytotoxicity of three 2-in-1 root canal irrigating solutions METHODS: Forty single-rooted teeth were mechanically instrumented and irrigated with QMix, SmearOFF, Irritrol or 0.9% saline. Each tooth was evaluated for smear layer removal using scanning electron microscopy. Precipitation after interaction of the irrigating solutions with sodium hypochlorite (NaOCl) was evaluated with ¹H nuclear magnetic resonance and mass spectroscopy. Confocal laser scanning microscopy was used to evaluate the antimicrobial activity of the irrigants against Enterococcus faecalis biofilms. Neutral red and clonogenic assays were performed on Chinese hamster V79 cells to evaluate the short-term and long-term cytotoxicity of the irrigants RESULTS: There was no significant difference between QMix and SmearOFF in eliminating smear layers from the coronal-third and middle-third of the canal spaces. In the apical-third, SmearOFF removed smear layers effectively. Irritrol incompletely removed smear layers from all the canal-thirds. When mixed with NaOCl, precipitation was evident only with Irritrol. QMix demonstrated a higher E. faecalis cell death percentage and a smaller biovolume. SmearOFF exhibited a larger decrease in biovolume compared with Irritrol, although Irritrol had a higher death percentage. Irritrol was more cytotoxic than the other irrigants on a short-term interval. In terms of long-term cytotoxicity, both Irritrol and QMix were cytotoxic CONCLUSION: QMix and SmearOFF performed better in smear layer removal and antimicrobial activity. QMix and Irritrol were cytotoxic when compared to SmearOFF. Irritrol was associated with precipitation after interacting with NaOCl.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

A persistent ultraviolet outflow from an accreting neutron star binary transient

All disc-accreting astrophysical objects produce powerful disc winds. In compact binaries containing neutron stars or black holes, accretion often takes place during violent outbursts. The main disc wind signatures during these eruptions are blue-shifted X-ray absorption lines, which are preferentially seen in disc-dominated 'soft states'^1,2. By contrast, optical wind-formed lines have recently been detected in 'hard states', when a hot corona dominates the luminosity³. The relationship between these signatures is unknown, and no erupting system has as yet revealed wind-formed lines between the X-ray and optical bands, despite the many strong resonance transitions in this ultraviolet (UV) region⁴. Here we report that the transient neutron star binary Swift J1858.6-0814 exhibits wind-formed, blue-shifted absorption lines associated with C IV, N V and He II in time-resolved UV spectroscopy during a luminous hard state, which we interpret as a warm, moderately ionized outflow component in this state. Simultaneously observed optical lines also display transient blue-shifted absorption. Decomposing the UV data into constant and variable components, the blue-shifted absorption is associated with the former. This implies that the outflow is not associated with the luminous flares in the data. The joint presence of UV and optical wind features reveals a multi-phase and/or spatially stratified evaporative outflow from the outer disc⁵. This type of persistent mass loss across all accretion states has been predicted by radiation-hydrodynamic simulations⁶ and helps to explain the shorter-than-expected duration of outbursts⁷.

Circadian influence on post-exercise hypotension: a review

Circadian rhythm (CR) can influence the physiological and psychological parameters in every individual. There is a sinusoidal response to blood pressure brought about by the CR. A drop in blood pressure response immediately after an exercise is termed as post-exercise hypotension (PEH). The objective of the present paper is to review the influence of CR on PEH. Comparing the types of exercises, aerobic training showed a higher magnitude of the drop in PEH than resistance training. However, the majority of the studies have not considered the CR influence on PEH. With the evidence available, we can conclude that morning exercise shows the higher magnitude of the drop in PEH and could be sustained for a longer duration.

Influence of particulate alkaline biomaterial remnants in dentin on the adhesion of two resin-based bonding systems

To study aimed to evaluate the influence of infiltrated alkaline biomaterials on the bond strength of composite obtained with etch and rinse and universal adhesive systems. Coronal dentin of extracted human molars was exposed and infiltrated with calcium hydroxide, MTA, or bioactive glass 45S5 powder. Non-infiltrated dentin specimens served as controls. Subsequently, dentin was either acid-etched or not, and remaining alkali content was measured by pH induction in water. Shear bond strength of an etch-and rinse system (Adper Single Bond 2) on etched dentin was then compared to that of a universal counterpart (Single Bond [(Scotchbond) Universal] by the same manufacturer. Data was compared between groups using one-way ANOVA and Tukey's HSD. On sound dentin, the etch-and-rinse system adhered stronger than the universal system (p < .05). All particles rendered the dentin alkaline. Acid etching reduced the alkali content in the infiltrated dentin. However, bond strength values were stronger with the universal system without etching than with the etch-and rinse counterpart, which lost more than 60% of its adhesiveness. The universal adhesive system was less susceptible to alkaline contamination of the dentin than the etch-and-rinse counterpart. Based on the similar composition of the two systems under investigation, this is likely to the due to its 10-MDP component.

Genetic Consequences of the Transatlantic Slave Trade in the Americas

According to historical records of transatlantic slavery, traders forcibly deported an estimated 12.5 million people from ports along the Atlantic coastline of Africa between the 16th and 19th centuries, with global impacts reaching to the present day, more than a century and a half after slavery's abolition. Such records have fueled a broad understanding of the forced migration from Africa to the Americas yet remain underexplored in concert with genetic data. Here, we analyzed genotype array data from 50,281 research participants, which-combined with historical shipping documents-illustrate that the current genetic landscape of the Americas is largely concordant with expectations derived from documentation of slave voyages. For instance, genetic connections between people in slave trading regions of Africa and disembarkation regions of the Americas generally mirror the proportion of individuals forcibly moved between those regions. While some discordances can be explained by additional records of deportations within the Americas, other discordances yield insights into variable survival rates and timing of arrival of enslaved people from specific regions of Africa. Furthermore, the greater contribution of African women to the gene pool compared to African men varies across the Americas, consistent with literature documenting regional differences in slavery practices. This investigation of the transatlantic slave trade, which is broad in scope in terms of both datasets and analyses, establishes genetic links between individuals in the Americas and populations across Atlantic Africa, yielding a more comprehensive understanding of the African roots of peoples of the Americas.

Evaluation of various irrigation activation systems to eliminate bacteria from the root canal system: A randomized controlled single blinded trial

OBJECTIVE

To evaluate the effect of NaOCl irrigant activation using passive ultrasonic activation, F-files, XP-endo Finisher files and or needle irrigation alone on the reduction of intracanal bacteria from root canals in teeth undergoing root canal treatment.

METHODS

Eighty patients with asymptomatic apical periodontitis were randomly divided into four groups. Access cavities were prepared and pre-treatment samples were taken (S1). Canals were then prepared and post-instrumentation samples (S2) taken. NaOCl was then activated with the various irrigant activation systems and post-irrigation samples (S3) taken. The samples were processed and colony forming units (CFUs) of bacteria were determined. The reduction in CFUs among the experimental groups were analysed using the Kruskal Wallis test and pairwise comparisons with the Mann-Whitney test. The Friedman test was used to compare the differences in the reduction of CFUs within the groups.

RESULTS

Overall, for all groups there was a significant reduction in the CFUs from S1 to S2 (P < 0.05) and from S2 to S3 (P < 0.05). Both XP-endo Finisher and passive ultrasonic activation techniques were associated with the greatest reduction in CFUs with no significant difference between them (P = 0.24). However, both were associated with significantly lower CFUs when compared to F-file activation and needle irrigation (P < 0.05). F-file activation reduced the CFUs significantly more compared to needle irrigation (P = 0.04).

CONCLUSIONS

XP-endo Finisher file activation and passive ultrasonic activation were equivalent in terms of reduction in CFUs. F-file activation did not reduce the CFUs to the same extent as the XP-endo Finisher file and ultrasonic activation but reduced the CFUs more than needle irrigation.

CLINICAL SIGNIFICANCE

The present study highlights the effect of new XP-endo Finisher file and passive ultrasonic activation in reducing the bacterial load from the root canal system which is important for the success of root canal treatment.

The association of depression and painful physical symptoms–a review of the European literature

Objective:

The presence of painful physical symptoms may confound the diagnosis of major depressive disorder and may worsen patient prognosis. Epidemiological literature was reviewed to investigate the association between depression and painful physical symptoms.

Method:

MEDLINE and EMBASE database searches were conducted. Studies where a definable organic basis for pain was given were excluded. The search was unrestricted by language but limited to European studies and countries. After filters were applied, 70 eligible studies were reviewed.

Results:

The majority of studies reviewed showed an association between depression and painful physical symptoms. Over 40% of all studies examining the association between pain and depression were carried out in pain clinics in secondary care. Very few studies were conducted in psychiatric settings.

Conclusion:

The findings of this review suggest that painful physical symptoms may be an important part of the depressive syndrome. Although the relationship between depression and painful physical symptoms is not yet fully understood, findings suggest that diagnosis and treatment of depression should involve investigating and treating the full spectrum of symptoms (emotional and physical). Further research in psychiatric and generalist settings is needed to elucidate the relationship between depression and painful physical symptoms as experienced by patients and at the clinical level.

Nine-hour X-ray quasi-periodic eruptions from a low-mass black hole galactic nucleus

In the past two decades, high-amplitude electromagnetic outbursts have been detected from dormant galaxies and often attributed to the tidal disruption of a star by the central black hole^1,2. X-ray emission from the Seyfert 2 galaxy GSN 069 (2MASX J01190869-3411305) at a redshift of z = 0.018 was first detected in July 2010 and implies an X-ray brightening by a factor of more than 240 over ROSAT observations performed 16 years earlier^3,4. The emission has smoothly decayed over time since 2010, possibly indicating a long-lived tidal disruption event⁵. The X-ray spectrum is ultra-soft and can be described by accretion disk emission with luminosity proportional to the fourth power of the disk temperature during long-term evolution. Here we report observations of quasi-periodic X-ray eruptions from the nucleus of GSN 069 over the course of 54 days, from December 2018 onwards. During these eruptions, the X-ray count rate increases by up to two orders of magnitude with an event duration of just over an hour and a recurrence time of about nine hours. These eruptions are associated with fast spectral transitions between a cold and a warm phase in the accretion flow around a low-mass black hole (of approximately 4 × 10⁵ solar masses) with peak X-ray luminosity of about 5 × 10⁴² erg per second. The warm phase has kT (where T is the temperature and k is the Boltzmann constant) of about 120 electronvolts, reminiscent of the typical soft-X-ray excess, an almost universal thermal-like feature in the X-ray spectra of luminous active nuclei^6-8. If the observed properties are not unique to GSN 069, and assuming standard scaling of timescales with black hole mass and accretion properties, typical active galactic nuclei with higher-mass black holes can be expected to exhibit high-amplitude optical to X-ray variability on timescales as short as months or years⁹.

The efficacy of different irrigation protocols in removing tricalcium silicate-based sealers from simulated root canal irregularities

OBJECTIVE

The aim of this study was to evaluate the efficacy of different irrigation protocols in removing two tricalcium silicate-based sealers from simulated root canal irregularities and root canal walls.

MATERIAL AND METHODS

Root canals of 140 single-rooted teeth were instrumented. In one-half of each root, an apical groove was created. The samples were divided into two main groups (n = 70) based on the sealer used. In group 1, the grooves were filled with MTA Fillapex; in group 2, BioRoot RCS. The reassembled root halves were divided into six experimental and one control groups: 2.5% NaOCl-17% EDTA (Passive ultrasonic irrigation [PUI]), 5% NaOCl/9% DualRinse HEDP (PUI), 2.5% NaOCl-7% Maleic acid (PUI), 2.5% NaOCl-17% EDTA (Er:YAG laser activated irrigation [LAI]), 2.5% NaOCl/9% DualRinse HEDP (LAI), 2.5% NaOCl-7% Maleic acid (LAI), Distilled water (Control). Specimens were scored using SEM. The data were analysed using Kruskal-Wallis and Mann Whitney U tests.

RESULTS

Maleic acid and DualRinse HEDP removed higher amounts of MTA Fillapex from the grooves compared to EDTA, when used with both activation methods (p < .001).

CONCLUSIONS

Ultrasonically activated maleic acid or DualRinse HEDP can be an effective irrigation regimen in removing tricalcium silicate-based sealers.

A multicentre, multinational, randomized, placebo-controlled, double-blind, phase 3 trial to evaluate the efficacy and safety of gemigliptin (LC15-0444) in patients with type 2 diabetes

AIM

This study was designed to assess the efficacy and safety of the dipeptidyl peptidase IV inhibitor gemigliptin (LC15-0444) 50 mg versus placebo in patients with type 2 diabetes.

METHODS

We conducted a 24-week, randomized, double-blind, placebo-controlled phase III trial in 182 patients (74 from Korea and 108 from India) with type 2 diabetes. After an initial 2 weeks of a diet and exercise programme followed by 2 weeks of a single-blind placebo run-in period, eligible patients were randomized to gemigliptin 50 mg or placebo, receiving the assigned treatment for 24 weeks. HbA1c and fasting plasma glucose (FPG) were measured periodically, and oral glucose tolerance test was performed at baseline and weeks 12 and 24.

RESULTS

At week 24, gemigliptin treatment led to significant reductions in HbA1c measurements compared to placebo (adjust mean after subtracting the placebo effect size: -0.71%, 95% confidence interval: -1.04 to -0.37%). A significantly greater proportion of patients achieved an HbA1c <7% with gemigliptin than with placebo. The placebo-subtracted FPG change from baseline at week 24 was -19.80 mg/dl. The overall incidence rates for adverse events were similar in the gemigliptin and placebo groups.

CONCLUSIONS

This study showed the efficacy and safety of gemigliptin 50 mg administered once daily as a monotherapy for type 2 diabetes patients.

The volume and pH of residual pharyngeal fluid aspirated from the TaperGuard Evac™ Endotracheal Tube following elective surgery: a prospective pilot study

BACKGROUND

Oropharyngeal suctioning prior to extubation aims to minimize postextubation tracheal soiling from remaining fluid. We investigated the amount and nature of any fluid remaining after such suctioning and contributing factors.

METHODS

ASA I - III patients undergoing elective surgery under general anesthesia with endotracheal intubation participated in this prospective observational pilot study. Following oropharyngeal suctioning immediately prior to extubation, a dedicated port of the endotracheal tube (TaperGuard Evac™ Endotracheal Tube) was aspirated. The amount and pH of residual fluid was recorded. Data collection included age, sex, body mass index, comorbidities, ASA status, procedure type and duration. The Chi-Square, Wilcoxon Rank-Sum, t-tests, and univariate regression analysis were used as appropriate.

RESULTS

Ninety-eight patients completed the study. The mean aspirated volume in 38 (38.8%) patients was 0.9 ± 1.3 mL and sixty patients (61.2%) had no aspirate. A body mass index of ≥ 30 kg/m2 was associated with the presence of fluid (P=0.03), and a higher volume (P=0.03). The fluid pH was 7 ± 0.81 (mean ± SD). A duration of surgery ≥ 120 minutes predicted a lower pH.

CONCLUSION

The prevalence and amount of residual fluid after oropharyngeal suctioning was low and likely clinically insignificant. A higher body mass index was associated with a higher incidence and volume of residual fluid. Longer procedure duration determined a slightly lower pH, with a mildly acidic pH range. The possibility of a lower fluid pH after prolonged surgery contributing to postoperative sore throat via mucosal irritation warrants investigation.

Female with rash, acute kidney failure and rheumatoid arthritis

This case describes a 42-year-old female with longstanding history of rheumatoid arthritis (RA) and Felty syndrome (FS). She presented with acute renal kidney failure, skin rash and hemoptysis. A clinical suspicion of small vessel vasculitis (SVV) was thought, serology was also positive for various markers of SVV. However, these serology markers could be false-positive in a patient of rheumatoid arthritis. A renal biopsy was performed that led to the final diagnosis of cryoglobulinemic vasculitis. Patient was managed according to the standard guidelines for therapy (plasmafiltration and immunosuppression). It is challenging to manage a patient of RA, in the presence of Felty syndrome-related granulocytopenia and thrombocytopenia. Patient initially showed signs of improvement, but finally succumbed to complications of therapy. The case provides insight into the diagnosis and management of such cases.

Muir-Torre syndrome: a case report and screening recommendations

Muir-Torre syndrome is a rare genodermatosis (hereditary cancer syndrome associated with distinguishing cutaneous signs) characterised by occurrence of sebaceous neoplasia and visceral malignancy. Colorectal cancer is the commonest visceral malignancy associated with Muir-Torre syndrome. We discuss a case report along with recommendations for diagnosis and screening.

Venous thromboembolism. Prophylaxis on a Saturday morning in a district hospital

BACKGROUND

Implementation of guidelines to prevent venous thromboembolism (VTE) is essential to help guide junior medical staff but adherence to such protocols is insufficient. This study aims to audit the use of VTE prophylaxis (Tinzaparin 3500 units and/or thromboembolic deterrent stockings (TED) in general surgical inpatients in a district hospital on a random day at the beginning (Group A) and at the end of the junior house officer's 6 monthly term (Group B).

METHODS

Patients were analyzed within the subgroups elective and emergency admissions and assessed regarding the appropriate prescription of tinzaparin and TED-stockings. The presence of a significant time lag between patients arriving on the ward and VTE-prophylaxis being prescribed was documented.

RESULTS

Tinzaparin was appropriately prescribed or not prescribed if contraindicated in 86% of elective admissions in Group A (versus 91% in Group B) and in 58% of emergency admissions in Group A (versus 85% in Group B). The subcutaneous injection of tinzaparin was commenced on the day of admission in 67% in Group A and in 75% of patients in Group B. CONCLUSIONS. Despite the institution of local guidelines adherence to such recommendations appears to be sub-optimal even at the end of the junior house officer's 6 monthly term when one would expect a higher vigilance.

Effect of terminal group sterics and dendron packing on chirality transfer from the central core of a dendrimer

[structure: see text] The conformational properties of intramolecularly hydrogen-bonded dendrimers constructed from (S)-1,1'-bi-2-naphthol as a chiral central core are described. Circular dichroism studies revealed that chirality transfer to the periphery occurs only when sterically demanding terminal esters are employed and when packing interactions are present.

Crossed renal ectopia with pelvic lipomatosis: a new syndrome involving chromosome 1

An 18-year-old male patient is described who possesses both kidneys on one side (crossed renal ectopia), together with pelvic lipomatosis. In general, lipomatosis is benign, but here the tissue shows the rare feature of malignancy. Chromosomally, the patient is typically characterised by somatic translocations involving chromosome 1 (37% metaphases); these almost always exhibit a whole chromosome translocation with chromosome 6 (35%), although involvement of chromosome 1 with chromosome 8 is present in 2% of metaphases. Other chromosomal features encountered in Giemsa-stained and G-banded preparations from lymphocyte cultures include the prevalence of a small Y chromosome in 25% of metaphases, the presence of marker dots in 20%, and acrocentric associations in 8%-10% of metaphases. However, more than 50% of metaphases have a normal 46XY karyotype with a normal-sized Y-chromosome. Crossed renal ectopia with pelvic lipomatosis can therefore be assigned to a new syndrome characterised by a whole-chromosome translocation involving chromosomes 1 and 6.

Intrapulmonary shunting during deliberate hypotension with nifedipine, diltiazem and labetalol in dogs

Pulmonary shunt (Qs/Qt) was calculated in 49 mongrel dogs weighing 18-20 kg during mechanical ventilation, before and during deliberate hypotension with either nifedipine (group N), diltiazem (group D), labetalol (group L), or ethyl alcohol and polyethylene glycol (group E). A 30 per cent decrease in mean arterial blood pressure occurred after two minutes of nifedipine infusion, two minutes after diltiazem, and three minutes after labetalol; these effects lasted two hours after nifedipine administration, 90 minutes after diltiazem and three hours after labetalol. There was an accompanying significant decrease in systemic and pulmonary vascular resistance. Qs/Qt and cardiac output increased significantly after nifedipine infusion. Shunt increased (mean +/- S.E.) from 9.7 +/- 0.8 to 18.25 +/- 1.05 per cent at two minutes (p less than 0.0005); 19.05 +/- 1.2 per cent at 30 minutes (p less than 0.005); 17.5 +/- 1.6 per cent at two hours (p less than 0.01); and 12 +/- 1.1 per cent at three hours (p less than 0.025). No increase in shunt occurred after the administration of diltiazem, labetalol or polyethylene glycol and ethyl alcohol. Arterial oxygen tension (PaO2) decreased significantly after nifedipine infusion from 146 +/- 11.5 to 105 +/- 3.5 mmHg two minutes after infusion; to 89.5 +/- 3 mmHg 30 minutes after; 115 +/- 4.75 mmHg two hours after; and 130 +/- 10.75 mmHg three hours later. PaO2 was not significantly different after diltiazem, labetalol, or polyethylene glycol and ethyl alcohol administration. With nifedipine cardiac output increased from 2.25 +/- 0.3 to 3.95 +/- 0.25 after two minutes (p less than 0.005) to 3.85 +/- 0.35 after 30 minutes (p less than 0.005), 3.7 +/- 3 after two hours (p less than 0.01) to 2.9 +/- 1.1 after three hours. No significant increase in cardiac output occurred in groups D or L. These results suggest that only nifedipine infusion significantly alters oxygenation in dogs and therefore its use warrants caution in the presence of a preexisting abnormal Qs/Qt.

Microbiological transformation of biflavone

Incubation of 5,5'-7,7'-tetramethoxy-8,8'-biflavone with Aspergillus niger results in the formation of 4,4'-dihydroxy-5,5'-7,7'-tetramethoxy-8,8'-biflavan.