A study of shingles and the development of postherpetic neuralgia in East London.

The incidence of post-herpetic neuralgia following shingles and the factors that are known to predict it were examined in a prospective observational community study of patients with acute shingles presenting to their family doctors. The detection of viral DNA in the blood at presentation as a prognostic indicator for pain was also evaluated. Patients were followed for one year and the persistence of pain following rash assessed.

Lung volume measurements in childhood.

Although less commonly used in clinical practice than spirometry, lung volume measurements are helpful in assessing progress and response to therapy in situations where lung volume is likely to be increased, as in asthma or cystic fibrosis, or reduced secondary to pulmonary hypoplasia, pulmonary fibrosis, or musculoskeletal abnormalities. Their contribution to research has been considerable. The techniques most commonly used are those of inert gas dilution on rebreathing, applicable to children of all ages but tending to under-record in the presence of gas trapping.

Novel approaches to the diagnosis of basal cell nevous syndrome.

In 1960, Robert James Gorlin and William Goltz, both American physicians, defined a new syndrome. Little did they realize that 40 years later, the pathways involved in its development would be provoking serious and sustained interest amongst a plethora of specialists. Fruit-fly biologists, oncologists, geneticists, dermatologists, indeed, hardly a medical or dental specialist gets excluded.

A small earthquake?

In recent years, concerns about health and healthcare have been expressed by the public, the profession, patients and politicians. These are neither new nor confined to the UK. Doctors were not always held in high public esteem; that had been earned over the last 150 years through scientific discoveries such as anaesthesia which revolutionised patient care.

Could a herpesvirus be the cause of Kawasaki disease?

Kawasaki disease (KD) is an acute vasculitis of early childhood, the cause of which remains unknown. Many lines of evidence suggest an infectious aetiology, which may-in association with host genetic factors-lead to the characteristic clinical presentation of this disease. Accumulating data including animal models and epidemiological and immunological studies, suggest that viruses have an important role in human vasculitic disease.

Does GH replacement therapy in adult GH-deficient patients result in recurrence or increase in size of pituitary tumours?

Objective: Hypopituitary GH-deficient patients have an increased cardiovascular mortality and GH replacement in this population has resulted in considerable therapeutic benefit. GH replacement involves administration of a potentially mitogenic substance to patients with a previous or residual pituitary tumour. Our objective was to evaluate whether GH replacement results in an increase in the size of pituitary tumours.

Ovarian cancer screening.

Ovarian cancer is the fourth commonest cause of cancer deaths in women. Multimodal screening with serum CA125 and transvaginal ultrasonography have been shown to improve survival. However, the results so far do not justify routine screening until the impact of screening on mortality has been assessed in larger randomized trials.

The oral health consequences of chewing areca nut.

Deleterious effects of areca nut on oral soft tissues are published extensively in the dental literature. Its effects on dental caries and periodontal tissues, two major oral diseases, are less well researched. Areca-induced lichenoid lesions mainly on buccal mucosa or tongue are reported at quid retained sites.

Metabolic effects of the consumption of Areca catechu.

Betel nut (Areca catechu) is chewed regularly by at least 10% of the world population, imported by immigrant users wherever they settle, and is the fourth most widely used addictive substance. It is thought, by users, to soothe the digestion and to be a stimulant and its use has a major role in social situations. Specific arecal alkaloids act as competitive inhibitors of GABA receptors and have widespread effects in the body, including actions on the brain, cardiovascular system, lungs, gut and pancreas.

Differential expression of beta1 and beta2 integrins and L-selectin on CD4+ and CD8+ T lymphocytes in human blood: comparative analysis between isolated cells, whole blood samples and cryopreserved preparations.

Flow cytometric analysis was used to compare the expression of adhesion molecules on human CD4+ and CD8+ T lymphocytes in isolated blood mononuclear cells (MNCs) in whole blood samples and in cryopreserved MNC preparations. Examination of MNCs revealed that the CD11b and CD11c components of the beta2 integrins were preferentially expressed on CD8+ T cells, whereas CD62L was present on more CD4+ T cells. All CD4+ and CD8+ T lymphocytes were positive for CD11a but the CD8+ population had a higher intensity of expression of CD11a and also CD11b.

Expression of metalloproteinases from human retinal pigment epithelial cells and their effects on the hydraulic conductivity of Bruch's membrane.

Purpose: To evaluate the expression pattern of matrix metalloproteinases (MMPs) from retinal pigment epithelial (RPE) cells in culture, and to determine their ability to alter the transport properties of human Bruch's membrane.

Methods: Human RPE cells from either primary cultures or a cell line were maintained under culture conditions. At different time intervals after subculturing of cells the presence of MMPs in the bathing medium was determined by zymography.

Age-related alterations in the diffusional transport of amino acids across the human Bruch's-choroid complex.

Photoreceptor maintenance is dependent on effective delivery of nutrients from the choroidal circulation by way of the acellular Bruch's membrane and the retinal pigment epithelium. Aging of Bruch's membrane is associated with thickening, increased cross linking of fibers, and deposition of debris culminating in reduced porosity. The present study has investigated the effects of aging on the diffusional transport of eight amino acids across Bruch's membrane in 19 human donors.

Presence of protein deposits on 'cleaned' re-usable anaesthetic equipment.

Twenty previously used and supposedly clean, sterilised laryngeal mask airways, five bougies and five Magill forceps from the operating theatre, and 61 laryngoscope blades from different sites within a single hospital were randomly collected and stained with erythrosin B dye, which stains proteins if present on surfaces. All 20 laryngeal mask airways had been used before and were stained: four (20%) showed heavy staining, five (25%) moderate staining and 11 (55%) mild staining. Two unused laryngeal mask airways used as controls were without staining.

Oral hygiene and postoperative pain after mandibular third molar surgery.

Objective: The purpose of this study was to evaluate the association between oral hygiene before surgery and pain, inflammation, and trismus after the surgical removal of 190 impacted lower third molars.

Study Design: Patient hygiene was assessed by the simplified oral hygiene index. The maximum active interincisal oral opening was determined before surgery by using a millimeter scale, from the upper incisive edge to the lower incisive edge.

Increased distribution and expression of CD64 on blood polymorphonuclear cells from patients with the systemic inflammatory response syndrome (SIRS).

Evidence is growing to suggest that the multiple organ damage of the systemic inflammatory response syndrome (SIRS) arises from the untoward activity of blood polymorphonuclear cells (PMNs), which upon activation acquire the IgG high affinity receptor, CD64. In the current study, flow cytometry was used to assess the prevalence of CD64-bearing PMNs and the intensity of expression of CD64 in whole blood samples from 32 SIRS patients, 11 healthy normal subjects and from eight non-SIRS patients in the intensive care unit (ICU). The percentage of PMNs expressing CD64 was higher in SIRS patients (mean 65%) than in non-SIRS patients (mean 42%; P < 0.

Response of three types of cast posts and cores to static loading.

Objective: An analysis is made of the influence of continuous compression loading on different types of cast posts and cores and its effects on the crowns and teeth.

Method And Materials: Thirty extracted maxillary canines were prepared and divided into three groups (n = 10) according to the type of cast posts and cores used for restoration: chrome-nickel alloy, acetalic resin, and IPS-Empress porcelain. Metallic cast crowns were luted onto the cores.

Methodological considerations in the determination of working length.

Aim: The aim of this study was to evaluate the diagnostic efficacy of an electronic system for the determination of working length, in comparison with two radiological methods (conventional film and digital radiography).

Methodology: The study sample consisted of 28 root canals belonging to 20 human mandibular teeth. A comparison was made between the working length measurements obtained by two radiological methods (conventional film and digital radiography) and an apex locator, using as gold standard the observation of the file position within the root following selective grinding of the root tissue.

Orofacial pain as the sole manifestation of syringobulbia-syringomyelia associated with Arnold-Chiari malformation.

This is a case report of a male patient who presented with orofacial pain for a year as the only manifestation of syringobulbia-syringomyelia associated with Arnold-Chiari malformation. This article places emphasis on the clinical presentation and possible differential diagnoses. The pain was continuous and affected the left side of the face.

Mr angiography in cerebrovascular disease.

MR angiography has become a realistic diagnostic option for patients with neurovascular disease. MR angiography is not a single imaging sequence, but a collection of related methods for obtaining angiographic data. As a guide for practice, we review the literature on MR angiography in a spectrum of neurovascular indications with particular attention paid to choice of technique.

Dimethylarginines in chronic renal failure.

Background: Nitric oxide (NO) is a potent chemical mediator involved in many functions. In vivo production of NO is thought to be regulated by endogenous analogues of L-arginine: asymmetric dimethylarginine (ADMA).

Aim: To examine the effect of renal function and dialysis on the serum concentrations of ADMA and symmetric dimethylarginine (SDMA).