Semilunar vestibular incision technique for treatment of multiple gingival recession in maxillary teeth - An evaluative study

Background

Recession is a mucogingival condition affecting teeth causing hypersensitivity. Although many techniques are there for recession coverage, semilunar vestibular incision technique (SVIT) is a novel procedure for management of multiple gingival recession in maxillary teeth.

Aim

To evaluate the efficacy of root coverage in maxillary teeth with multiple gingival recession using SVIT.

Methodology

Twenty systemically healthy patients were recruited with Miller's class I and II gingival recessions in maxillary teeth. Parameters such as recession height (RH), recession weight (RW), avascular surface area (ASA), width of keratinized gingiva (WKG), width of attached gingiva (WAG), and clinical attachment level (CAL) were measured at baseline three and six months post-surgery.

Results

The outcome measures were statistically significant at baseline, three and six months. A reduction of 86% was achieved in terms of RH and RW. Gain in WKG and WAG as achieved at six-month follow-up was 31.5% and 55%, respectively. An 87% decrease in ASA was obtained and reduction in CAL was 82.4%. Between three and six months there was a significant increase in WAG.

Conclusion

SVIT results in improved measures of attached gingiva on six-month follow-up.

Anti-plaque efficacy of Hi-Ora mouthrinse and 0.12% chlorhexidine gluconate in patients with chronic gingivitis: A case-control study

Background

Chlorhexidine (CHX) gluconate has remained the gold standard chemical plaque control agent till date, though, being associated with several disadvantages including its tendency to stain teeth and leading to irritation of soft tissues. To overcome these inherent disadvantages, there has been a surge of studies in the recent past to evaluate the efficacy of herbal mouthrinses as against CHX.

Objective

The present study was planned to compare the anti-plaque efficacy of Hi-Ora mouthrinse as against 0.12% CHX in patients with chronic gingivitis.

Materials and Methods

The present study was designed as a case-control study including 90 patients with chronic gingivitis who were divided into 3 groups including Group A in which 0.12% CHX was prescribed, Group B in which patients were prescribed Hi-Ora and Group C in which normal saline was prescribed after oral prophylaxis while the mean Gingival Index (GI) and Plaque Index (PI) scores were recorded on the 5^th postprocedural day.

Results

The mean GI score in CHX group was found to be 0.70 ± 0.25 as against 0.66 ± 0.16 in Hi-Ora and 1.59 ± 0.55 in normal saline groups. Similarly, the mean PI score in CHX group was found to be 0.80 ± 0.31 as against 0.77 ± 0.30 in Hi-Ora and 1.86 ± 0.61 in normal saline groups.

Conclusions

The results of the present study suggested Hi-Ora to be more effective than 0.12% CHX in reducing the mean GI and PI scores among all the 3 groups.

Acoustic interrogation and optical visualization of ultrasound contrast agents within microcapsules

The effectiveness of localized drug delivery as a treatment for breast cancer requires sufficiently high therapeutic dose, as well as an ability to image the drug for proper spatial targeting. To balance treatment potential and imaging capabilities, we have begun to design a novel drug reservoir using microcapsules that are large in size (> 30 µm) but functionalized with microbubbles or ultrasound contrast agents (UCAs). We term these carriers as 'Acoustically Sensitive Microcapsules' (ASMs). In previous work, we have demonstrated preparation of ASM carriers and their structural changes under therapeutic ultrasound by imaging static changes. In this paper, we describe a combined optical-acoustic setup coupled with a microfluidic device to trap these carriers for imaging and sonication. Using the setup, continuous wave ultrasound (180 kPa, 2.25 MHz, 3 s) produced an average displacement of 3.5 µm in UCAs near the ASM boundary, and exhibited displacement as high as 90 µm near the center of the microcapsule. Longer exposure time and higher acoustic pressure increased UCA displacement within an ASM. These two parameters can be carefully optimized in the future to cause these UCAs to travel to the membrane boundary to help in the drug elution process.

A threonine to isoleucine missense mutation in the pericentriolar material 1 gene is strongly associated with schizophrenia

Markers at the pericentriolar material 1 gene (PCM1) have shown genetic association with schizophrenia in both a University College London (UCL) and a USA-based case-control sample. In this paper we report a statistically significant replication of the PCM1 association in a large Scottish case-control sample from Aberdeen. Resequencing of the genomic DNA from research volunteers who had inherited haplotypes associated with schizophrenia showed a threonine to isoleucine missense mutation in exon 24 which was likely to change the structure and function of PCM1 (rs370429). This mutation was found only as a heterozygote in 98 schizophrenic research subjects and controls out of 2246 case and control research subjects. Among the 98 carriers of rs370429, 67 were affected with schizophrenia. The same alleles and haplotypes were associated with schizophrenia in both the London and Aberdeen samples. Another potential aetiological base pair change in PCM1 was rs445422, which altered a splice site signal. A further mutation, rs208747, was shown by electrophoretic mobility shift assays to create or destroy a promoter transcription factor site. Five further non-synonymous changes in exons were also found. Genotyping of the new variants discovered in the UCL case-control sample strengthened the evidence for allelic and haplotypic association (P=0.02-0.0002). Given the number and identity of the haplotypes associated with schizophrenia, further aetiological base pair changes must exist within and around the PCM1 gene. PCM1 protein has been shown to interact directly with the disrupted-in-schizophrenia 1 (DISC1) protein, Bardet-Biedl syndrome 4, and Huntingtin-associated protein 1, and is important in neuronal cell growth. In a separate study we found that clozapine but not haloperidol downregulated PCM1 expression in the mouse brain. We hypothesize that mutant PCM1 may be responsible for causing a subtype of schizophrenia through abnormal cell division and abnormal regeneration in dividing cells in the central nervous system. This is supported by our previous finding of orbitofrontal volumetric deficits in PCM1-associated schizophrenia patients as opposed to temporal pole deficits in non-PCM1-associated schizophrenia patients. Caution needs to be exercised in interpreting the actual biological effects of the mutations we have found without further cell biology. However, the DNA changes we have found deserve widespread genotyping in multiple case-control populations.

DISC1 association, heterogeneity and interplay in schizophrenia and bipolar disorder

Disrupted in schizophrenia 1 (DISC1) has been associated with risk of schizophrenia, schizoaffective disorder, bipolar disorder, major depression, autism and Asperger syndrome, but apart from in the original translocation family, true causal variants have yet to be confirmed. Here we report a harmonized association study for DISC1 in European cohorts of schizophrenia and bipolar disorder. We identify regions of significant association, demonstrate allele frequency heterogeneity and provide preliminary evidence for modifying interplay between variants. Whereas no associations survived permutation analysis in the combined data set, significant corrected associations were observed for bipolar disorder at rs1538979 in the Finnish cohorts (uncorrected P=0.00020; corrected P=0.016; odds ratio=2.73+/-95% confidence interval (CI) 1.42-5.27) and at rs821577 in the London cohort (uncorrected P=0.00070; corrected P=0.040; odds ratio=1.64+/-95% CI 1.23-2.19). The rs821577 single nucleotide polymorphism (SNP) showed evidence for increased risk within the combined European cohorts (odds ratio=1.27+/-95% CI 1.07-1.51), even though significant corrected association was not detected (uncorrected P=0.0058; corrected P=0.28). After conditioning the European data set on the two risk alleles, reanalysis revealed a third significant SNP association (uncorrected P=0.00050; corrected P=0.025). This SNP showed evidence for interplay, either increasing or decreasing risk, dependent upon the presence or absence of rs1538979 or rs821577. These findings provide further support for the role of DISC1 in psychiatric illness and demonstrate the presence of locus heterogeneity, with the effect that clinically relevant genetic variants may go undetected by standard analysis of combined cohorts.

Video-EEG in the diagnosis of paroxysmal events in children with mental retardation and in children with normal intelligence

Video-EEG monitoring was performed to evaluate 193 children (91 females, 102 males; mean age 9.6 years, SD 5.7) who presented with paroxysmal events of uncertain etiology. Diagnosis of the type of event, i.e. epileptic or non-epileptic, was successfully established in 130 of 193 patients (67.3%). Seventy children (36%) had mental retardation* (MR). Children with MR were more likely (p<0.05) than children without MR to have events during the studies. Children with and without MR had strikingly similar frequencies of epileptic and non-epileptic events. In participants who had events recorded and characterized, epileptic seizures were identified in 67 children (51.5%), non-epileptic events in 54 children (41.5%), and both epileptic and non-epileptic events in nine children (7%). Improved diagnosis prompted appropriate management. This should encourage more frequent use of video-EEG in children, especially in those with MR, to differentiate epilepsy from behavioral disturbances so that specific treatment can be provided.

Parallel distributed detection of feature trajectories in multiple discontinuous motion image sequences

Concerns the 3D interpretation of image sequences showing multiple objects in motion. Each object exhibits smooth motion except at certain time instants when a motion discontinuity may occur. The objects are assumed to contain point features which are detected as the images are acquired. Estimating feature trajectories in the first two frames amounts to feature matching. As more images are acquired, existing trajectories are extended. Both initial detection and extension of trajectories are done by enforcing pertinent constraints from among the following: similarity of the image plane arrangement of neighboring features, smoothness of the 3D motion and smoothness of the image plane motion. The constraints are incorporated into energy functions which are minimized using 2D Hopfield networks. Wrong matches that result from convergence to local minima are eliminated using a 1D Hopfield-like network. Experimental results on several image sequences are shown.

Thymectomy for the myasthenia gravis patient: factors influencing outcome

Thymectomy is a therapeutic option for patients with myasthenia gravis with moderate to severe disability. To document the efficacy of thymectomy coupled with medical therapy to treat this disease and to identify clinical factors that influence outcome, the clinical courses of all 46 patients (12 male and 34 female; mean age, 30 +/- 16 years) with myasthenia gravis who underwent thymectomy through a median sternotomy at a single institution over a 21-year period were reviewed. Clinical staging was determined preoperatively, at 1 month, 6 months, and 12 months postoperatively, and at last follow-up (mean time, 75 months postoperatively) using the Oosterhuis classification. Changes in severity of illness were graded as "deteriorated," "unchanged," "improved," or "much improved." Preoperative Oosterhuis classification was 3.3 +/- 1.1 and at last follow-up, 1.4 +/- 1.2 (p = 0.022). At last follow-up, 40 patients (87%) were in the improved or much improved category, and 6 patients were in the deteriorated or unchanged category. Status at 1 month, 6 months, and 12 months after operation predicted outcome at last follow-up visit (p = 0.007, p = 0.005, and p = 0.001, respectively). Clinical factors that positively influenced outcome were age less than 45 years (p = 0.004), female sex (p = 0.0309), and preoperative stage (p = 0.021).