Endoscopic suturing.

Suturing at flexible endoscopy might extend the range of less invasive surgical procedures that can be performed without incision. The development of sewing machines that can place single and multiple stitches in the gastrointestinal tract is outlined. Methods of tying knots and cutting thread at flexible endoscopy have also been developed.

An ambulant porcine model of acid reflux used to evaluate endoscopic gastroplasty.

Background: There is a lack of suitable models for testing of therapeutic procedures for gastro-oesophageal reflux disease. Endoscopic sewing methods might allow the development of a new less invasive surgical approach to treatment of gastrointestinal disorders.

Aims: To develop an animal model of gastro-oesophageal reflux for testing the efficacy of a new antireflux procedure, endoscopic gastroplasty, performed at flexible endoscopy without laparotomy or laparoscopy.

The natural history of tibial radiolucent lines in a proximally cemented stemmed total knee arthroplasty.

A total of 207 tibial components in total knee arthroplasty (TKA) have been reviewed at a maximum of 10 years after replacement. Twelve knees developed aseptic femoral loosening and were reviewed separately from the remaining 195. All tibial components were fixed with cement confined to the proximal surface of the implant combined with an uncemented stem.

Clinical trials and clinical practice: do doctors use the same criteria to judge outcome?

Aims: The results of clinical trials often seem to have little influence on the practice of individual doctors. This could be because trial information is presented in the style of a scientific experiment which cannot often be clearly related to the context of everyday patient care. We tested the hypothesis that such framing effects would cause doctors to assess the clinical significance of treatment outcomes differently when presented as clinical trial results rather than as individual patient data.

HIV type 1 envelope glycoprotein 120 carboxy-terminal peptide-induced human T cell lines selectively suppress heterogeneous proliferative T cell responses to soluble antigens.

It has been proposed that the highly conserved human immunodeficiency virus type 1 (HIV-1) envelope gp120 carboxy-terminal sequence, TKAKRRVVEREKR (CT120), may represent a functional mimic of the human leukocyte antigen (HLA) class II DR beta-chain third hypervariable region (HVR3) sequence motif located at position 69-81. Presentation of this potentially pathogenic fragment by HLA class I and/or II molecules, in a manner analogous to the indirect pathway of allorecognition, may induce both widespread cellular activation and also break self-tolerance, resulting in the selective and progressive anti-self HLA class II-directed immune suppression, which is a central feature of HIV-1 infection and the associated acquired immune deficiency syndrome (AIDS). To investigate the functional role of the HIV-1 gp120 C-terminal fragment T cell lines (TCLs) were raised from three healthy HIV-1-seronegative subjects at low risk of HIV-1 exposure, by repeated stimulation with a short synthetic 13-mer CT120 peptide in vitro.

beta-Lactamase inhibition and in vitro activity of sulbactam and sulbactam/cefoperazone.

beta-Lactamase inhibitors such as sulbactam are beta-lactam compounds that have low antimicrobial activity but are able to inhibit enzymes (beta-lactamases) that destroy beta-lactam antibiotics like penicillins and cephalosporins. The main activity of beta-lactamase inhibitors is directed against plasmid-mediated transferable enzymes and various extended-spectrum enzymes. Sulbactam is also active against some of the fixed chromosomally mediated enzymes produced by gram-negative bacteria and is active against Bacteroides and Acinetobacter species.

A review of the use of the neodymium YAG laser in oral and maxillofacial surgery.

A review of the use of neodymium:YAG laser in oral and maxillofacial surgery is presented. The Nd:YAG laser wavelength exhibits minimal tissue absorption and maximal penetration by comparison with the CO2 laser's maximal absorption and minimal penetration. These properties allow a variety of uses in maxillofacial surgery particularly coagulation of angiomatous lesions, haemostasis in bleeding diatheses, arthroscopic surgery of the temporomandibular joint, combination with CO2 wavelength for resections in vascular tissues (e.

The Role of Reactive Oxygen Species in Inflammatory Disease: Evaluation of Methodology.

The production of reactive oxidants has been implicated in the pathology of a number of inflammatory conditions, including inflamed arthritic joints. Many assays for the detection of these oxidants in diseased states have been described, but there are a number of potential pitfalls in both experimental design and the interpretation of results obtained with these techniques. Here, we describe a number of commonly used assays to detect the production of reactive oxidants and critically discuss their usefulness and limitations.

Metabolism of glycoprotein-derived sialic acid and N-acetylglucosamine by Streptococcus oralis.

Nine strains of Streptococcus oralis, isolated from blood cultures of patients with infective endocarditis or from the oral cavity as part of the normal flora, were examined for their ability to elaborate sialidase (neuraminidase) and N-acetylglucosaminidase, enzymes which are involved in the degradation of glycoproteins. Both glycosidases were induced when bacteria were grown in a minimal medium supplemented with porcine gastric mucin, a model glycoprotein, and repressed when growth occurred in the presence of glucose. Cell-free extracts mucin-grown cultures expressed elevated levels of N-acetylneuraminate pyruvate-lyase (the first intracellular enzyme in the pathway of N-acetylneuraminate catabolism), N-acetylglucosamine (glcNAc)-6-phosphate deacetylase and glucosamine-6-phosphate deaminase (enzymes involved in the intracellular catabolism of GlcNAc 6-phosphate); activity of each of these intracellular enzymes was markedly repressed when bacteria were grown in media supplemented with alpha 1-acid glycoprotein, a major component of human plasma.

A synthetic 10-kD heat shock protein (hsp10) from Mycobacterium tuberculosis modulates adjuvant arthritis.

The heat shock protein, hsp10, is an abundant protein in Mycobacterium tuberculosis (Mtb), its nucleotide sequence encoding a protein of 99 amino acids with a molecular mass of 10.7 kD. This sequence is phylogenetically conserved, being represented by the GroES homologue of Escherichia coli.

Protein Turnover, Energy Expenditure and Body Composition in Patients with Acute Leukaemia Undergoing Chemotherapy.

1. Measurements of whole body protein turnover using the (13)C-leucine tracer technique, of body composition using anthropometric measurements and DEXA scanning, and of resting energy expenditure (REE) assessed by indirect calorimetry were made in 8 patients with acute leukaemia undergoing a single course of chemotherapy. Measurements were made in the post absorptive state immediately before chemotherapy and were repeated close to the time of discharge from hospital (mean days in hospital 31 ± 4.

GM-CSF Priming of U937 Monocytic Cells Accelerates, But Does Not Increase, Tissue Factor (TF) Expression or Procoagulant Activity (PCA) After Stimulation with Endotoxin (LPS).

The monocytic U937 cell line, though immature, has many properties in common with mature monocytes. We have studied the antigenic expression and activity of tissue factor (TF) in the cytosol and on the surface of U937 cells after exposure to GM-CSF and endotoxin (LPS). Following exposure to LPS, both TF phenotype and procoagulant activity (PCA) increased linearly, with peak expression and activity after 18 hours of stimulation.

Modulation of surface TNF expression by human leukaemic cells alters their sensitivity to exogenous TNF.

In this study, U937 leukaemic cells underwent apoptotic cell death following exposure to TNF. Pre-incubation of cells for 48 h with VitD(3) (10(-8)M) induced resistance to TNF, whereas incubation with tau-IFN or GM-CSF increased susceptibility to TNF. Resistance to exogenous TNF (exTNF) following culture with VitD(3) was associated with increased expression of endogenous TNF (enTNF).

Laparoscopic Treatment of Rectal Prolapse.

Rectal prolapse is a distressing condition often affecting elderly patients. Open rectopexy has a proven track record in the treatment of this condition but may be complicated by significant morbidity. The benign nature of the disease and reduced pain and pulmonary complications of the laparoscopic approach makes this an attractive operation in this patient group.

Cytokine networks in destructive periodontal disease.

Background: Cytokines are important regulatory proteins, produced by activated cells, which act by binding high affinity cell surface receptors. They are involved in almost all aspects of cell biology and form interacting networks, with cascades of sequential cell activation. They often show overlapping activities (redundancy) or the same cytokine may have a variety of different effects (pleiotropy).

Ketone bodies promote a rapid rise in glutamate efflux from the isolated perfused rat liver without altering the rate of glutamine production.

Livers of starved (48 hr) male Wistar rats were perfused in a non recirculating manner with a near physiological mix of ammonium, lactate, ornithine and pyruvate in Krebs buffer. The addition of ketone bodies (3-DL-hydroxybutyrate [B OHB] 2-30 mM or lithium-acetoacetate (15 mM) to the perfusate resulted in a rapid rise in the efflux of glutamate from the liver (five times above basal). This was not seen with control solutions (sodium chloride or lithium chloride).

Soft lining materials--a review.

Soft linings are compliant, viscoelastic materials used to form all or part of the fit surface of a denture. Their complete function is debatable, but they serve to distribute the forces of mastication more evenly and to absorb energy. Other uses include obturators and maxillo-facial prostheses.

Heterogeneity among 16S-23S rRNA intergenic spacers of species within the 'Streptococcus milleri group'.

The 16S-23S rRNA intergenic spacer has been suggested as a suitable region of the bacterial genome from which to derive useful taxonomic information, particularly with regard to identification at the species level. To investigate this approach as an aid to the identification of the three species comprising the 'Streptococcus milleri group' (SMG), the spacers of isolates of Streptococcus intermedius, Streptococcus anginosus and Streptococcus constellatus were amplified by PCR and length polymorphisms determined by agarose gel electrophoresis. Phenotypically atypical isolates which had been identified presumptively as belonging to these three species were also included.

The role of antibiotics in the treatment of periodontitis. (Part I--Systemic delivery.

Controlled release devices containing tetracyclines or metronidazole are now commercially available for use in periodontal pockets. This review, in two parts, evaluates the evidence for and against using antibiotics in the treatment of periodontitis and considers the role for systemic and local delivery. Guidelines for antibiotic usage and recommended regimes are proposed.

The effect of age on the recognition thresholds of three sweeteners: sucrose, saccharin and aspartame.

It is believed that people's sensitivity to taste declines with age but the evidence is inconclusive. This study was designed to test the hypothesis that taste recognition thresholds (TRTs) for sweetness are higher in older than in younger individuals, using groups of 16 younger subjects (18-30) and 16 older subjects (60-85). Three test substances were used: sucrose, aspartame and saccharin.

An unusual vascular hamartoma on the gingiva of an 11-year-old boy.

A case is reported of an unusual vascular lesion on the gingiva of an 11-year-old boy which clinically and histopathologically did not fit well into any current classification of vascular lesions. The lesion presented as a firm nodular swelling of the buccal and lingual gingiva which had been present for 9 years. The term endovascular papillary haemangioma is suggested.

The effect of linear interpolation of the filtered projections on image noise in x-ray computed tomography.

Measured values for image noise variance in x-ray computed tomography were found to be less than half of the values predicted by published formulas. This phenomenon had previously been attributed qualitatively to the use of linear interpolation of the filtered projections in the back projection process. An analysis of the reconstruction process has allowed the derivation of a formula for image noise variance which incorporates the effect of this interpolation, giving results which are less than 50% of the previously predicted values.

Application of scanning microradiography and x-ray microtomography to studies of bones and teeth.

In scanning microradiography (SMR), a thin section is stepped across a 15-μm diameter X-ray beam and the transmitted intensity measured at each point. This technique has permitted more accurate measurements of the spatial variation of the mineral concentration in sections of dentin and enamel than conventional photographic microradiography. Moreover, because the section is not in close contact with an emulsion, SMR allows continuous study while the specimen is bathed in a reaction solution.