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Tas E, Landes RD, Diaz EC, Bai S, Ou X, Buchmann R, Na X, Muzumdar R, Børsheim E, Dranoff JA. Effects of short-term supervised exercise training on liver fat in adolescents with obesity: a randomized controlled trial. Obesity (Silver Spring) 2023; 31:2740-2749. [PMID: 37731271 DOI: 10.1002/oby.23887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The objective of this study was to quantify the effects of a 4-week, supervised, high-intensity interval training (HIIT) on intrahepatic triglyceride content (IHTG, percentage), cardiorespiratory fitness (CRF), and cardiometabolic markers in adolescents with obesity. METHODS A total of 40 adolescents (age 13-18 y, BMI 36.7 ± 5.8 kg/m2 ) at risk for metabolic dysfunction-associated steatotic liver disease (MASLD) based on obesity and elevated Fibroscan measured controlled attenuation parameter (CAP) scores were randomized to HIIT three times a week for 4 weeks (n = 34) or observation (control; n = 6). Liver magnetic resonance imaging proton-density fat-fraction (MRI-PDFF), CAP, oral glucose tolerance test, serum alanine aminotransferase, dual-energy x-ray absorptiometry, and CRF tests were performed before and after intervention. Within- and between-group differences were compared. RESULTS A total of 13 (38%) and 4 (66%) children had MASLD by MRI-PDFF (IHTG ≥ 5%) in the HIIT and control groups, respectively. The implemented HIIT protocol had no impact on CRF or IHTG (baseline 5.26%, Δ = -0.31 percentage points, 95% CI: -0.77 to 0.15; p = 0.179), but it decreased the 2-h glucose concentration (baseline 116 mg/dL, Δ = -11 mg/dL; 95% CI: -17.6 to -5.5; p < 0.001). When limiting the analysis to participants with MASLD (n = 17), HIIT decreased IHTG (baseline 8.81%, Δ = -1.05 percentage points, 95% CI: -2.08 to -0.01; p = 0.048). Between-group comparisons were not different. CONCLUSIONS The implemented exercise protocol did not reduce IHTG, but it led to modest improvement in markers of cardiometabolic health.
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Affiliation(s)
- Emir Tas
- Department of Pediatrics, University of Pittsburgh College of Medicine, Pittsburgh, Pennsylvania, USA
- Division of Endocrinology and Diabetes, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Reid D Landes
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Eva C Diaz
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
| | - Shasha Bai
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Xiawei Ou
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Robert Buchmann
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Xiaoxu Na
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Radhika Muzumdar
- Department of Pediatrics, University of Pittsburgh College of Medicine, Pittsburgh, Pennsylvania, USA
- Division of Endocrinology and Diabetes, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elisabet Børsheim
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
| | - Jonathan A Dranoff
- Center for Childhood Obesity Prevention, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- VA Connecticut Health Center, West Haven, Connecticut, USA
- Section of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA
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Doan D, Buchmann R, Murphy J, Joshi S. Autoimmune evaluation of joint pain reveals a surprising diagnosis of Scurvy. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00530-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Lin H, Mercer KE, Ou X, Mansfield K, Buchmann R, Børsheim E, Tas E. Circulating microRNAs Are Associated With Metabolic Markers in Adolescents With Hepatosteatosis. Front Endocrinol (Lausanne) 2022; 13:856973. [PMID: 35498403 PMCID: PMC9047938 DOI: 10.3389/fendo.2022.856973] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/14/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Altered hepatic microRNA (miRNA) expression may play a role in the development of insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD). Circulating miRNAs could mirror the liver metabolism. OBJECTIVE This study aimed to assess the relationship between serum miRNA profile in children with obesity, IR, and NAFLD. METHODS Adolescents with obesity (n = 31) were stratified based on insulin resistance and NAFLD status. One-hundred seventy-nine miRNAs were determined in the serum by quantitative RT-PCR. Differentially expressed miRNAs were compared between groups, and log-transformed levels correlated with metabolic markers and intrahepatic triglyceride. RESULTS Serum miR-21-5p, -22-3p, -150-5p, and -155-5p levels were higher in children with IR and NAFLD, and their expression levels correlated with hepatic fat and serum triglyceride. In patients with NAFLD, miR-155-5p correlated with ALT (r = 0.68, p<0.01) and AST (r = 0.64, p<0.01) and miR-21-5p and -22-3p levels correlated with plasma adiponectin (r = -0.71 and r = -0.75, respectively, p<0.05) and fibroblast growth factor-21 (r = -0.73 and r = -0.89, respectively, p<0.01). miR-27-3a level was higher in children without IR and NAFLD. CONCLUSIONS Several miRNAs are differentially expressed in children with IR and NAFLD. Determining their mechanistic roles may provide newer diagnostic tools and therapeutic targets for pediatric NAFLD.
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Affiliation(s)
- Haixia Lin
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kelly E. Mercer
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Childhood Obesity and Prevention, Arkansas Children’s Research Institute, Little Rock, AR, United States
| | - Xiawei Ou
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Childhood Obesity and Prevention, Arkansas Children’s Research Institute, Little Rock, AR, United States
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kori Mansfield
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Robert Buchmann
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Elisabet Børsheim
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Childhood Obesity and Prevention, Arkansas Children’s Research Institute, Little Rock, AR, United States
| | - Emir Tas
- Arkansas Children’s Nutrition Center, Little Rock, AR, United States
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Childhood Obesity and Prevention, Arkansas Children’s Research Institute, Little Rock, AR, United States
- Endocrinology and Diabetes, Arkansas Children’s Hospital, Little Rock, AR, United States
- *Correspondence: Emir Tas,
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Wong K, Van Tassel D, Lee J, Buchmann R, Riemann M, Egan C, Youssfi M. Making the diagnosis of midgut volvulus: Limited abdominal ultrasound has changed our clinical practice. J Pediatr Surg 2020; 55:2614-2617. [PMID: 32471760 DOI: 10.1016/j.jpedsurg.2020.04.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess the diagnostic accuracy of limited abdominal ultrasound (US) examination for midgut volvulus (MGV) and to evaluate how clinical practice has changed in a free-standing children's hospital leading to the near obsolescence of upper GI (UGI) studies for the diagnosis of MGV. MATERIALS AND METHODS All patients with suspected MGV who underwent abdominal US during 2016-2017 were identified using keyword search tools in the radiology information system. Retrospective, blinded image review was performed by a certificate of added qualification (CAQ), board certified pediatric radiologist. US images were evaluated for the presence of the superior mesenteric artery (SMA) cutoff sign and twisting of the bowel and mesentery around the SMA (whirlpool sign). The results were compared with the operative reports. RESULTS 195 US studies were performed from 2016 to 2017. The most common presentations were vomiting (44%), abdominal pain (7%), and suspected malrotation (10%) 195 US studies were reviewed, of which 16 were nondiagnostic. The remaining 179 diagnostic studies showed MGV in 14 patients. Those 14 patients were surgically explored and confirmed to have midgut volvulus. 7 of the 16 nondiagnostic US studies were further evaluated with UGI examination with 1 patient demonstrating malrotation without volvulus, which was confirmed at surgery. 2 had CT exams which were normal. 4 were followed clinically. The remaining 3 patients went to surgery, all of which did not show MGV. There were 164 negative US, none of whom went to surgery. US was diagnostic in 92% of patients and when diagnostic the positive and negative predictive values of US were 100%. CONCLUSION Limited abdominal US is a highly accurate examination for the diagnosis of midgut volvulus. UGI exposes patients to ionizing radiation and should be reserved for patients in whom US is nondiagnostic or inconclusive. TYPE OF STUDY Retrospective review. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Kevin Wong
- University of Arkansas for Medical Sciences, Little Rock, AR; Arkansas Children's Hospital, Little Rock, AR.
| | | | - Justin Lee
- Phoenix Children's Hospital, Phoenix, AZ
| | - Robert Buchmann
- University of Arkansas for Medical Sciences, Little Rock, AR; Arkansas Children's Hospital, Little Rock, AR
| | | | - Craig Egan
- Phoenix Children's Hospital, Phoenix, AZ
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Tas E, Bai S, Ou X, Mercer K, Lin H, Mansfield K, Buchmann R, Diaz EC, Oden J, Børsheim E, Adams SH, Dranoff J. Fibroblast Growth Factor-21 to Adiponectin Ratio: A Potential Biomarker to Monitor Liver Fat in Children With Obesity. Front Endocrinol (Lausanne) 2020; 11:654. [PMID: 33071964 PMCID: PMC7533567 DOI: 10.3389/fendo.2020.00654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/11/2020] [Indexed: 01/12/2023] Open
Abstract
Background: There is a pressing need for effective and non-invasive biomarkers to track intrahepatic triglyceride (IHTG) in children at-risk for non-alcoholic fatty liver disease (NAFLD), as standard-of-care reference tools, liver biopsy and magnetic resonance imaging (MRI), are impractical to monitor the course disease. Objective: We aimed to examine the association between serum fibroblast growth factor (FGF)-21 to adiponectin ratio (FAR) and IHTG as assessed by MRI in children with obesity. Methods: Serum FGF21 and adiponectin levels and IHTG were measured at two time points (baseline, 6 months) in obese children enrolled in a clinical weight loss program. The association between percent change in FAR and IHTG at final visit was examined using a multiple linear regression model. Results: At baseline, FAR was higher in the subjects with NAFLD (n = 23, 35.8 ± 41.9 pg/ng) than without NAFLD (n = 35, 19.8 ± 13.7 pg/ng; p = 0.042). Forty-eight subjects completed both visits and were divided into IHTG loss (≥1% reduction than baseline), no change (within ±1% change), and gain (≥1% increase than baseline) groups. At 6 months, the percent change in FAR was different among the three groups (p = 0.005). Multiple linear regression showed a positive relationship between percent change in FAR and the final liver fat percent in sex and pubertal stage-similar subjects with NAFLD at baseline (slope coefficient 6.18, 95% CI 1.90-10.47, P = 0.007), but not in those without NAFLD. Conclusions: Higher value in percent increase in FAR is positively associated with higher level of IHTG percent value at 6 months in children with baseline NAFLD. FAR could be a potential biomarker to monitor the changes in IHTG in children with NAFLD.
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Affiliation(s)
- Emir Tas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Endocrinology and Diabetes, Arkansas Children's Hospital, Little Rock, AR, United States
- Arkansas Children's Research Institute, Little Rock, AR, United States
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
- *Correspondence: Emir Tas
| | - Shasha Bai
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Xiawei Ou
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kelly Mercer
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Arkansas Children's Research Institute, Little Rock, AR, United States
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Haixia Lin
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Kori Mansfield
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Robert Buchmann
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Eva C. Diaz
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Arkansas Children's Research Institute, Little Rock, AR, United States
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Jon Oden
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Endocrinology and Diabetes, Arkansas Children's Hospital, Little Rock, AR, United States
- Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Elisabet Børsheim
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Arkansas Children's Research Institute, Little Rock, AR, United States
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Sean H. Adams
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Arkansas Children's Research Institute, Little Rock, AR, United States
- Arkansas Children's Nutrition Center, Little Rock, AR, United States
| | - Jonathan Dranoff
- Arkansas Children's Research Institute, Little Rock, AR, United States
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
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Abstract
Exaggerated neutrophil responses are a critical component in the pathogenesis of periodontal disease. We investigated whether leukocyte activity in aggressive periodontitis (AP) is increased compared with that in chronic periodontitis (CP) by gingival crevicular fluid (GCF) analysis of myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH), cathepsin D (CD), and elastase-alpha-1-proteinase inhibitor complex (alpha-1-EPI) before and 6 months after therapy. Initial AP neutrophil responses were significantly amplified compared with those in CP (MPO, 3.2-fold; beta-NAH, 37.5-fold; CD, 2.2-fold; alpha-1-EPI, 1.4-fold; p < 0.05). Surgical therapy resulted in a significant reduction of GCF markers compared with non-surgical treatment. However, the changes in clinical parameters were not different between AP and CP (P > 0.05). Analysis of the results suggests that the local inflammatory response in AP is characterized by increased release of inflammatory mediators of neutrophil origin into the GCF. Analysis of the data further suggests that surgical therapy is a more predictable method for removal of the pro-inflammatory etiology.
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Affiliation(s)
- R Buchmann
- Department of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, Boston, MA, USA.
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Khoury F, Buchmann R. Surgical therapy of peri-implant disease: a 3-year follow-up study of cases treated with 3 different techniques of bone regeneration. J Periodontol 2001; 72:1498-508. [PMID: 11759861 DOI: 10.1902/jop.2001.72.11.1498] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Advanced peri-implant intrabony defects require comprehensive surgical treatment regimens different from periodontal therapy strategies. The purpose of this longitudinal trial was to evaluate the peri-implant outcomes following guided bone regeneration with 3 treatment protocols. METHODS In 25 patients, 41 peri-implant defects with supporting bone loss >50% of the implant length were treated with flap surgery plus autogenous bone grafts alone (FG) (controls, n = 12) plus non-resorbable (FGM) (test 1, n = 20) or bioabsorbable barriers (FGRM) (test 2, n = 9) and supportive antimicrobial therapy. Following submerged healing, the membranes were removed (FGM), and the peri-implant probing depths (PD), probing bone levels (BL), mobility scores (PT), and intrabony defect height (DH) were radiographically evaluated at baseline, 6 months, and 1 and 3 years post-therapy. RESULTS Non-surgical/anti-infective therapy resulted in a limited improvement of PD scores after 6 months. At the 3-year visit, surgical treatment revealed significant changes from baseline for the controls and both of the test groups for PD: 5.1 +/- 2.7 mm (FG), 5.4 +/- 3.0 mm (FGM), and 2.6 +/- 1.6 mm (FGRM), and for BL: 3.2 +/- 2.4 mm (FG), 3.4 +/- 2.4 mm (FGM), and 2.3 +/- 1.6 mm (FGRM), Mann-Whitney test, P < or = 0.05. The changes for DH and PT were significant only for FG- and FGM-treated subjects. The overall improvement for FGRM-treated patients during the 3-year observation was less marked. However, the differences between the 3 surgical treatment protocols did not affect the treatment outcomes after 3 years. CONCLUSIONS Autogenous bone grafting is an appropriate treatment regimen to augment open crater-formed peri-implant defects. Although certain clinical situations require an additional fixation of barrier membranes, their routine application should be approached with caution.
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Affiliation(s)
- F Khoury
- Department of Oral and Maxillofacial Surgery, Westfalian Wilhelm-University, Münster, Germany.
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Abstract
OBJECTIVES In the present prospective trial, the PMN response following resorbable GTR barrier placement was evaluated in mandibular class II furcation lesions. MATERIALS AND METHODS In 10 patients with treated chronic periodontitis, we randomly selected the 1st molars in the mandible with buccal degree II furcation involvement for either polylactic-citric-acid-ester (PLA) or glycolide-lactic-copolymer (PGL) GTR membrane therapy. We examined contralateral healthy molar sites as untreated controls. We then evaluated the PMN-derived inflammatory tissue response at baseline, weekly up to 6 weeks post-therapy and at 12 and 24 weeks using GCF myeloperoxidase (MPO), beta-glucuronidase (betaG) and beta-N-acetyl-hexosaminidase (betaNAH). RESULTS The enzyme levels increased from baseline to the 6-week examination. After the 6-week reappointment, enzyme levels dropped reaching the baseline scores at both the 12- and 24-week visit. At PGL sites, the enzyme levels decreased earlier. Compared with healthy control sites, the MPO, betaNAH and betaG tests revealed different maximum levels at week 2 and 3 (PGL) and week 4, 5 and 6 (PLA). For both of the barriers the clinical parameters revealed a sustained improvement following therapy. CONCLUSION The release of PMN enzymes following placement of bioabsorbable membranes reflects the early soft tissue healing process. Our results suggest that the PMN response is barrier-dependent with the maximum response occuring at different times. However, the host response did not measureably affect the course of clinical healing.
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Affiliation(s)
- R Buchmann
- Department of Periodontology and Oral Biology, Goldman School of Dental Medicine, Boston University, MA 02118, USA.
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Abstract
BACKGROUND Convincing data exist that A. actinomycetemcomitans is an etiologic agent of periodontal disease. The purpose of this longitudinal study was to evaluate A. actinomycetemcomitans as a diagnostic indicator for periodontal disease in treated and periodontally maintained patients. METHODS Following comprehensive mechanical/surgical and supportive amoxicillin plus metronidazole therapy in 13 subjects with A. actinomycetemcomitans-associated destructive periodontal disease, we monitored subgingival A. actinomycetemcomitans at 4 individual sites in each patient up to 3 years post-therapy. The periodontal status was determined, and A. actinomycetemcomitans levels were quantitatively enumerated on TSBV agar in CFU/ml. Six patients with a persistence of subgingival A. actinomycetemcomitans at each reexamination within 3 years post-therapy were selected to be at risk for minor periodontal treatment outcomes and further recurrence of periodontal disease (test group). Seven subjects with a complete suppression of A. actinomycetemcomitans at each post-therapy visit served as controls. RESULTS The periodontal parameters decreased from overall values of 6.39 mm (probing depth, PD) and 7.64 mm (clinical attachment level, CAL) at the outset to 3.81 mm (PD) and 5.62 mm (CAL) 2 years post-therapy (Friedman, P< or =0.05). At the 3-year reexamination, the PD/CAL scores increased to 4.03/5.78 mm. Among the 6 individuals (46%) with persistence of subgingival A. actinomycetemcomitans at the final 3-year visit (test group), periodontal status yielded increased levels of 4.45 mm (PD) and 6.60 mm (CAL). The control subjects (n = 7) revealed lower values of 3.67 mm (PD) and 5.09 mm (CAL). However, on a patient level, during the 3-year observational trial, the periodontal status of the 13 individuals was not statistically affected by subgingival infection with A. actinomycetemcomitans. CONCLUSIONS Although in advanced periodontal disease, comprehensive mechanical and antimicrobial treatment is an appropriate regimen for sustained improvement of periodontal health, long-term control of subgingival infection with A. actinomycetemcomitans could not be achieved. In the maintenance care of destructive periodontitis, the persistence of A. actinomycetemcomitans is not a diagnostic parameter for periodontal disease.
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Affiliation(s)
- R Buchmann
- Department of Periodontology, School of Dental Medicine, University of Münster, Germany.
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Buchmann R, Khoury F, Faust C, Lange DE. Peri-implant conditions in periodontally compromised patients following maxillary sinus augmentation. A long-term post-therapy trial. Clin Oral Implants Res 1999; 10:103-10. [PMID: 10219129 DOI: 10.1034/j.1600-0501.1999.100204.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Augmentation of the maxillary sinus in the atrophied edentulous posterior maxilla is an integral part of implant prosthodontics. This study examined the clinical outcome in 50 periodontally compromised successfully treated subjects with severe maxillary atrophy following oral implantation with Brånemark, IMZ or Frialit-2 endosseous implants between 1991 and 1994. Simultaneous sinus augmentation was achieved using autogenous bone grafts harvested from the anterior mandible. Oral implants in 37 periodontally healthy patients directly placed in the stable local maxillary bone served as controls. The oral rehabilitation included implant supported restorations or removable superstructures over a period between 3 and 5 years. The peri-implant status of implant abutments inserted in the periodontal compromised augmented maxilla resulted in values comparable to the local maxillary bone except for the GCF rates with enhanced levels of 63.9 +/- 49.9 (controls 37.9 +/- 40.7). The average peri-implant Periotest values in the augmented maxillary sinus (test group) were -3.1 PT and +0.2 PT in the controls. The Periotest scores in the sinus area ranked between -7.0 and +5.0 with mean PT values of -1.5 for IMZ, -3.2 for Brånemark and -4.0 for Frialit-2 abutments. The functional integration of oral implants following sinus augmentation with autologous bone grafts and conventionally placed endosseous implants in the local bone was similar. The additional implant stabilization within the mandibular cortical bone grafts resulted in very low Periotest scores. In periodontally compromised subjects treated for chronic adult periodontitis with minimal maxillary bone height less than 5 mm the endosseous implantation with simultaneous sinus augmentation is recommended as an appropriate technique for long-term oral implant rehabilitation.
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Affiliation(s)
- R Buchmann
- Department of Periodontology, School of Dental Medicine, University of Münster, Germany.
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Abstract
A 53-year-old patient developed an impairing muscle hernia when a fascia lata graft was harvested as a substitute for a cruciate ligament of the knee and closure of the defect was not possible. The fascial defect enlarged with time, extending along the whole upper leg. The large muscle protrusion and incarceration in the distal fascial slit was extremely painful during walking and getting up from a chair. Since autologous grafts were disregarded because of the high tissue pressure and alloplastic substitutes seemed problematic, the large hernia was successfully reduced by local muscle denervation with injections of botulinum-A toxin into the protruding vastus lateralis muscle. This procedure achieved relief of pain and enabled the patient to walk without complaints. Side effects were not observed.
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Affiliation(s)
- D Burg
- Klinik für Wiederherstellungschirurgie, Universitätsspitals Zürich
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Buchmann R, Ham AJ, Lange DE. [Application of Periotest procedures in periodontal diagnosis--clinical studies in critical view]. Quintessenz 1991; 42:785-91. [PMID: 1961898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- R Buchmann
- Zentrum für Zahn-, Mund- und Kieferkrankheiten der Westfälischen, Wilhelms-Universität Münster
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Buchmann R, Lange DE. [Effect of fluoride iontophoresis in dentin hypersensitivity of periodontally treated patients]. Dtsch Zahnarztl Z 1989; 44:297-300. [PMID: 2702169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Independent of chosen stimulus, age or differences in selected groups of teeth, a reduction in pain intensity of about 50% can be attained following initial treatment with fluoride iontophoresis. The second treatment after 4 weeks leads to a nearly complete reduction in dentin-hypersensitivity. Subsequent to a third application of fluoride iontophoresis only minimal hypersensitivity is detectable. Precipitation of calcium-fluoride and blockage of dentinal tubules should be discussed. A decrease in hypersensitivity is likewise observed in the control group. The results of the final clinical examination show that slightly greater sensitivity remains. Electroanalgetic effects are probably responsible for the reduction of dentinal pain. Treatment of hypersensitivity is dependent upon such factors as age and oral hygiene. Supervised therapy for refractive dentinal pain appears to have greater success when fluoride iontophoresis is used.
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Buchmann R, Lange DE. [Postoperative evaluation of the functional state of single-rooted maxillary teeth following flap procedures using the Periotest method]. Dtsch Zahnarztl Z 1988; 43:701-4. [PMID: 3165856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Buchmann R. [Indications and use of electric toothbrushes in individual oral hygiene--a comparison]. Quintessenz 1987; 38:531-5. [PMID: 3474685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Munzinger U, Dubs L, Buchmann R. [Femoropatellar pain syndrome. Conservative treatment and results 7-10 years following Maquet operation]. Orthopade 1985; 14:247-60. [PMID: 4069702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Owing to the largely unsatisfactory results achieved to date following surgery for chondromalacia patellae, and owing to our greater knowledge of the functional relationships within the knee joint, the range of aetiological factors in femoropatellar pain needs to be expanded. Functional variants in the muscular and ligamentous system must be considered as well as anatomical variants. On the basis of symptomatology and the results of clinical examination, two extreme forms can be distinguished, depending on ligamentous laxity and muscular stabilisation capacity. Physiotherapy must be determined by these. There remain few cases in which surgery is indicated.
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