Antibiotic prophylaxis in alloplastic temporomandibular joint replacement surgery: A multi-national survey of temporomandibular joint surgeons

Temporomandibular disorders include a wide spectrum of extra-articular and intra-articular conditions affecting the temporomandibular joint (TMJ). In salvage cases involving intra-articular end-stage disease, alloplastic temporomandibular joint replacement (TMJR) is a management option which can be utilised to rehabilitate a disabled joint's function and form. Whilst post-TMJR infection is rare, it is one of the most serious complications. The principles governing TMJR surgery antibiotic prophylaxis have been based on those established in orthopaedic surgery literature. Antibiotic resistance due to antibiotic over-use is a significant concern, therefore antibiotic stewardship has been developed to deal with this world-wide public health concern. The TMJ's anatomical proximity to the external auditory canal and oral cavity creates the potential for bacterial contamination. The aim of this study was to explore the views of 39 sub-specialist TMJ surgeons across nine nations usual approach to antibiotic prophylaxis and their management of TMJR infection. To accomplish this, an international survey was developed and conducted using Google Forms. The results demonstrated that 97.4% of the respondents employ prophylactic antibiotics at TMJR surgery, 83.8% on discharge. Variability in antibiotic choice with additional antimicrobial perioperative practices were also reported. Opinions on the management of a TMJR infection also varied. This survey establishes there is an agreement on the use of antibiotic prophylaxis, However the variability in choice, timing, course, duration of antibiotic use as well as the management of a postoperative TMJR infection demonstrates the need for further study leading to development of standardised antibiotic prophylaxis and infection management protocols for TMJR surgery.

NMT1 and NMT3 N-Methyltransferase Activity Is Critical to Lipid Homeostasis, Morphogenesis, and Reproduction

Phosphatidylcholine (PC) is a major membrane phospholipid and a precursor for major signaling molecules. Understanding its synthesis is important for improving plant growth, nutritional value, and resistance to stress. PC synthesis is complex, involving several interconnected pathways, one of which proceeds from serine-derived phosphoethanolamine to form phosphocholine through three sequential phospho-base methylations catalyzed by phosphoethanolamine N-methyltransferases (PEAMTs). The contribution of this pathway to the production of PC and plant growth has been a matter of some debate. Although a handful of individual PEAMTs have been described, there has not been any in planta investigation of a PEAMT family. Here, we provide a comparative functional analysis of two Arabidopsis (Arabidopsis thaliana) PEAMTs, NMT1 and the little known NMT3. Analysis of loss-of-function mutants demonstrates that NMT1 and NMT3 synergistically regulate PC homeostasis, phase transition at the shoot apex, coordinated organ development, and fertility through overlapping but also specific functions. The nmt1 nmt3 double mutant shows extensive sterility, drastically reduced PC concentrations, and altered lipid profiles. These findings demonstrate that the phospho-base methylation pathway makes a major contribution to PC synthesis in Arabidopsis and that NMT1 and NMT3 play major roles in its catalysis and the regulation of PC homeostasis as well as in plant growth and reproduction.

Allelopathy, DIMBOA production and genetic variability in accessions of Triticum speltoides

A screening was conducted to study the allelopathic potential of Australian-held accessions of Triticum speltoides. Of 26 accessions, four were found to inhibit root growth in the indicator species, lettuce (Lactuca sativa). The methanol leaf extracts of these accessions significantly reduced the root length of wild oat (Avena spp.). In all but one case, alellopathic accessions contained higher amounts of DIMBOA than did nonallelopathic accessions. Since some variation in allelopathic response was detected within lines, random amplified polymorphic DNA (RAPD) markers were used to estimate genetic diversity between and within the allelopathic accessions of Triticum speltoides L. The average genetic similarity between all possible pairs of selected accessions was found to be 55% and ranged from 44% to 88%. Comparison of DNA extracted from different single seedlings within the same accession revealed significant intraaccession genetic diversity (4-24%), although this was much less than that observed between accessions tested. This intraaccession diversity has significant implications for the selection of T. speltoides accessions in breeding or screening programs.

Changes in haemodynamic parameters following Tai Chi Chuan and aerobic exercise in patients recovering from acute myocardial infarction

In this study, 126 patients (90 males, average age 56 years, range 39-80) were randomised to Wu Chian-Ch'uan style Tai Chi (38), aerobic exercise (41) or a non-exercise support group (47) following acute myocardial infarction. Patients attended twice weekly for three weeks then weekly for a further five weeks. Heart rate and blood pressure were recorded before and after each session. Over the 11 sessions of exercise there was a negative trend in diastolic blood pressure only in the Tai Chi group (Rs = 0.79, p < 0.01). Significant trends in systolic blood pressure occurred in both exercise groups (Rs = 0.64 and 0.63, both p < 0.05). Only four (8%) patients completed the support group eight-week programme which was less than the number completing Tai Chi (82%; p < 0.001) and aerobic exercise groups (73%; p < 0.001).

Field trial of an electrically passive optical-fiber magnetometer

A field trial of an electrically passive optical-fiber magnetometer incorporated into the transient electromagnetic method of geomagnetic surveying is described. The transducer of the magnetometer consisted of metallic glass wire cocoated with a length of optical fiber. The magnetometer was capable of measuring the decay rate of the surface magnetic field produced by the surveying technique. The sensor's minimum detectable field was 2.5 × 10(-8) G/√Hz at 2 kHz.

Cadmium-induced sexual dysfunction does not involve increased hepatic metabolism of testosterone nor increased circulating levels of corticosterone

Sexually experienced male rats were injected IP with 0, 0.3, 1.5, 3.0, or 6.0 mg/kg cadmium chloride. The highest dose was fatal within 48 h of injection. A dose-related deficit in erectile function was observed in ex copula tests 48 h after injection. Copulatory dysfunction was evident in mating tests 72 h after injection. Hepatic mixed function oxidase activity after 0.3 mg/kg injections was not different from controls, but was diminished by 50% in rats treated with 3.0 mg/kg. The higher cadmium doses (1.5 and 3.0 mg/kg) were associated with equivalent and marked reductions in circulating testosterone levels, and lesser decrements in circulating corticosterone levels. The rats treated with 1.5 or 3.0 mg/kg cadmium chloride lost weight (32 +/- 12 and 39 +/- 9 g, respectively). Relative decapsulated adrenal gland weights were markedly increased in rats treated with 3.0 mg/kg. These data indicate that exposure to cadmium is associated with alterations in sexual, hepatic, and adrenal function, with erectile dysfunction occurring at the lowest dose. The effects on copulatory behavior are especially striking because it requires some weeks for copulatory behavior to wane following castration.

Estradiol stimulates cortisol production by adrenal cells in estrogen-dependent primary adrenocortical nodular dysplasia

Adrenal glands from a patient with ACTH-independent Cushing's syndrome, whose symptoms worsened during pregnancy and oral contraceptive use, were cultured in different concentrations of estradiol. Estradiol stimulated cortisol secretion in a dose-response manner in the absence of ACTH. Since immunoglobulins G from this patient did not stimulate corticosterone production in a mouse adrenal bioassay, an adrenal-stimulating immunoglobulin is unlikely to be the cause of adrenal hyperfunction in this case. This is the first description of estradiol stimulation of cortisol production by cultured adrenal cells in ACTH-independent Cushing's syndrome.

Cold Stress Response in Patients with Severe Burns After ?? -Blockade

Adrenergic receptor blockade has been shown to be of benefit in the treatment of adverse cardiovascular changes in patients with burns during the hypermetabolic phase. This article examines the stress response to cold exposure in adults and children with 33% to 95% total body surface area burns with and without beta-blockade. Resting energy expenditures were measured by indirect calorimetry; the test subjects were exposed to mean temperatures of 27.5 degrees C (room temperature) or 24.6 degrees C (cold). The mean resting energy expenditure at ambient room temperature in patients with burns without beta-blockade was 1411 +/- 70 kcal/m2/day (mean +/- SEM). This value was 142% of that predicted for normal control subjects without burns. When placed in a cold temperature, patients with burns significantly increased their resting energy expenditures by 160% of predicted values, whereas patients with similar burns and beta-blockade increased their resting energy expenditures by 156%. Adults with septic burns had a mean resting energy expenditure 198% of the predicted value. These patients did not significantly increase their resting energy expenditures when they were exposed to cold either with or without beta-blockade. Data suggest that patients with septic burns already have a maximal metabolic response and that cold stress does not further increase this response. Males, ages 17 to 54 years, were found to increase their resting energy expenditures by 11.4 kcal/m2/day for each percent total body surface area burn. We conclude that beta-blockade with propranolol in therapeutic doses may be used in patients with burns without adversely affecting the cold stress response.

Segmental infarction of the omentum: diagnosis by ultrasound

Pre-operative diagnosis of segmental infarction of the omentum is difficult because of its rarity and non-specific clinical features. We present a case of omental infarction and suggest that ultrasound scan may be helpful in the diagnosis of this entity.