Alveolar bone grafting: a review of 115 patients.

The results of alveolar bone grafting carried out at The Hospital for Sick Children, Great Ormond Street, London, UK, between January 1982 and January 1989 were assessed. Cancellous bone from the iliac crest was grafted to alveolar cleft defects in 115 patients (63 male and 52 female). Eighty-seven unilateral (58 left and 29 right) and 28 bilateral clefts were operated on.

The functional balance of metalloproteinases and inhibitors in tissue degradation: relevance to oral pathologies.

Members of the family of matrix metalloproteinases (MMPs) are key enzymes in normal and pathological tissue remodelling. They function at neutral pH and can digest synergistically all the macromolecules of the extracellular matrix. Biochemical and cloning studies indicate that there are three major groups: the specific collagenases cleave interstitial collagens; the gelatinases degrade other types of collagen and act synergistically with collagenases by degrading denatured collagens (gelatins); and the stromelysins which have broader specificity and can degrade basement membrane collagens as well as proteoglycans and matrix glycoproteins.

Catch-up growth induced by growth hormone in the craniofacial skeleton of the Snell strain of the hypopituitary dwarf mouse.

Immature Snell strain dwarf mice were treated with human growth hormone for 20 and 40 days, between the ages of 22 and 41 days and 22 and 61 days, respectively. Mature dwarfs were similarly treated for 20 and 40 days between the ages of 62 and 81 days and 62 and 101 days, respectively. These groups of treated mice were compared with untreated dwarfs and normal mice reared under the same conditions.

Identification of matrix metalloproteinases and their inhibitor in the articular disc of the craniomandibular joint of the rabbit.

Connective tissue cells synthesize and secrete matrix metalloproteinases (MMPs), a family of matrix-degrading enzymes (comprising collagenases, gelatinases and stromelysins), which are capable of degrading all the constituent molecules of connective tissues at physiological pH. This investigation documents the synthesis and distribution of MMPs and their inhibitor TIMP-1 (tissue inhibitor of metalloproteinases-1) in the developing articular disc of the craniomandibular joint of the rabbit using indirect immunofluorescence microscopy. Cells of the disc synthesised all three classes of MMPs as well as TIMP-1 in all regions of the disc at all stages examined.

Informed consent for upper gastrointestinal endoscopy.

Informed consent for upper gastrointestinal endoscopy requires that the patient understands the nature of, and reason for, the proposed procedure, and that he or she is given adequate time to deliberate and ask questions. In a prospective study, 200 outpatients completed questionnaires immediately before, and one day after, endoscopy, which assessed satisfaction with information provided by: (a) the referring doctor, (b) a standard information sheet sent out two to four weeks before endoscopy, and (c) the endoscopist. The first 100 patients were asked to read and sign a standard consent form immediately before the endoscopy.

Physical fitness of 9 year olds in England: related factors.

Study Objective: To examine the influence of social factors, passive smoking, and other parental health related factors, as well as anthropometric and other measurements on children's cardiorespiratory fitness.

Design: This was a cross sectional study.

Setting: The analysis was based on 22 health areas in England.

Identification of Btk mutations in 20 unrelated patients with X-linked agammaglobulinaemia (XLA).

X-linked agammaglobulinaemia (XLA) is an inherited immunodeficiency resulting from mutations in the gene for a cytoplasmic protein tyrosine kinase (Btk). We have utilised reverse-transcription-based PCR in combination with the chemical cleavage and mismatch technique (CCM) to screen for Btk mutations in 42 unrelated patients having classical XLA or 'leaky' XLA-like phenotypes. A variety of mutations, including point mutations, large deletions and splicing defects were detected using this strategy.

Effect of acute bile acid pool depletion on total and ionized calcium concentrations in human bile.

Although calcium salts are important components of gallstones, there are few data on the total and ionized calcium content of human bile. Therefore, in 14 fasting T-tube patients studied 7-11 days after cholecystectomy, we measured bile flow, bile acid [BA], total [CaTOT] and free ionized [Ca++] calcium concentrations, in 20-30 min bile collections during acute BA pool depletion induced by 6-8 h of continuous bile drainage. During washout of the BA pool there were parallel falls in bile flow, BA output and total calcium output (correlation coefficients ranging from 0.

Genital-associated lymphoid tissue in female non-human primates.

We investigated genital-associated lymphoid tissue (GENALT) in non-human primates (macaques), by augmenting vaginal with oral immunization. The vaccine was a recombinant particulate SIV antigen (p27:Ty-VLP), linked to CT-B, and administered into the vagina by a paediatric naso-gastric tube and into the stomach by a gastric tube. Oro-vaginal or vagino-oral sequence of immunization elicited specific CD4+ T cell proliferative responses to p27 antigen in the genital lymph nodes and the spleen but not in unrelated lymph nodes.

FISH detection of trisomy 21 in interphase by the simultaneous use of two differentially labelled cosmid contigs.

Techniques have been reported in which fluorescence in situ hybridisation (FISH) and cosmid probes are used to detect trisomy 21 (and other abnormalities involving chromosomes X, Y, 13, and 18) on uncultured amniocytes. However the detection rate of trisomy 21 is lower than for the other anomalies owing to a larger number of uninformative results and false negatives. We report the simultaneous use of two differentially labelled cosmid contigs to improve the detection rate of trisomy 21 on uncultured amniocyte samples thus allowing the prenatal diagnosis of Down's syndrome even if only few labelled nuclei are available.

Endoscopy: throat spray or sedation?

Anxious patients tolerate endoscopy poorly. It was proposed that such patients might derive most benefit from sedation, while most non-anxious patients would prefer endoscopy with lignocaine throat spray alone. In a prospective study, 200 outpatients underwent diagnostic endoscopy after receiving one of two detailed information sheets which offered them either the choice between spray or sedation (n = 100) or the same choice but encouraged those who were anxious about endoscopy to choose sedation (n = 100).

Radiographic detection of occlusal caries: effect of X-ray beam factors on diagnosis.

The aim of this laboratory study was to determine whether the diagnostic potential of bite-wing radiographs in the diagnosis of occlusal caries could be improved by alteration of X-ray beam properties. Bite-wing radiographs of molar teeth with 16 sound and 32 carious occlusal surfaces were taken at conventional settings of 65 kVp, 15 mA and 0.3 s (4.

Effect of poly DL-lactide--co-glycolide implants and xenogeneic bone matrix-derived growth factors on calvarial bone repair in the rabbit.

Polymer implant discs composed of 50:50 poly DL-lactide-co-glycolide (molecular weight about 9000) were used to repair 5 mm calvarial defects in 2 kg rabbits and osseous repair compared to spontaneous healing (control). After 4 weeks the implants had undergone substantial degradation with little evidence of residual polymer. The extent to which the defects had been replaced by bone showed individual variation.

Alterations in the glomerular charge barrier in human lupus nephritis.

Renal tissue taken from ten patients with proteinuria and diagnosed as suffering from human lupus nephritis was examined by a post-embedding charge labelling method using cationic gold (CG). The method allows localization of the anionic charge in the glomerular epithelial cell coat and/or glomerular basement membrane (GBM). Our results demonstrate that in human lupus nephritis there are gaps in the charge barrier associated with immune deposits found in the lamina rara externa of the GBM.

Gastric mucosal toxicity of duodenal juice constituents in the rat. Acute studies using ex vivo rat gastric chamber model.

To determine the acute gastrotoxicity of refluxed duodenal contents, an ex vivo rat gastric chamber was used to study mucosal damage produced by conjugated and unconjugated human bile acids and lysolecithin at neutral and acidic pH; the effects of trypsin, human duodenal aspirate, and combinations of chenodeoxycholic acid, lecithin, and lysolecithin were also studied. At neutral pH, all bile acids except tauroursodeoxycholic acid, caused dose-dependent falls in mucosal potential difference and losses of mucosal nucleic acid into the chamber fluid, indicating mucosal damage. The di-alpha-hydroxy bile acids, deoxycholic and chenodeoxycholic acids, were more gastrotoxic than cholic and ursodeoxycholic acids, and all unconjugated bile acids were more toxic than their conjugated species, none of which produced damage at concentrations below 2.

Blood flow changes in permanent maxillary canines during retraction.

The influence of external load on the blood flow of permanent maxillary canine teeth was assessed by laser Doppler flowmetry (LDF). Blood flow readings were obtained from 10 maxillary canines and compared with the contralateral teeth simultaneously. Readings were obtained from the teeth before, during, and after the application of a 50 g force (gf) which was applied using a removable appliance.

Gall stone recurrence and its prevention: the British/Belgian Gall Stone Study Group's post-dissolution trial.

The British/Belgian Gall Stone Study Group (BBGSG) post-dissolution trial was a prospective, multicentre, randomised, double blind trial of: (i) low dose ursodeoxycholic acid, (ii) placebo, and (iii) a high fibre, low refined carbohydrate diet in the prevention of gall stone recurrence in patients with complete gall stone dissolution. Further aims included establishing the timing and frequency of recurrence and its association with biliary symptoms, a comparison of the sensitivity of ultrasonography v oral cholecystectography in detecting recurrent stones, and a search for risk factors predicting recurrence. Ninety three patients entered the study, and 82 were followed up for up to five years (mean (SEM) 28 (1.

Electrical effects at the bone surface.

While many factors have been isolated in enhancing and modifying bone remodelling there has been renewed interest in electrical based theories. As an adjunct to these theories magnetic based forces have been used to modify tooth movement. It would, therefore, seem prudent to re-examine the theories of electrical signalling within bone to determine if there is a basis for modification of bone modelling and remodelling as a consequence of these phenomena.

Enumeration of interleukin-1 alpha and beta producing cells by flow cytometry.

A technique for intracytoplasmic immunofluorescence staining to detect and quantify human interleukin-1 alpha (IL-1 alpha) and beta (IL-1 beta) in CD4, CD8, and CD14 positive lymphoid cells is described. Mononuclear cells stimulated in vitro with PHA to produce IL-1, were fixed and made permeable to antibodies by sequential exposure to paraformaldehyde and the detergent n-octyl-glucoside. Cytoplasmic and surface staining of both forms of IL-1 were demonstrated by indirect fluorescence using IL-1 beta and IL-1 alpha specific mouse monoclonal antibodies and quantified with flow cytometry.

Gallstones during octreotide therapy.

Gallbladder stones (GBS) are found in up to 50% of patients receiving octreotide, but the reported prevalence of cholecystolithiasis in patients treated with octreotide is variable and little is known about gallstone incidence, composition, pathogenetic mechanisms, dissolvability, and primary prevention. Octreotide treatment apart, in industrialised societies most GBS are mixed in composition, cholesterol-rich (arbitrarily greater than 70% cholesterol by weight), radiolucent (70%), and, given a patent cystic duct (70%), dissolvable in bile rendered unsaturated in cholesterol by oral ursodeoxycholic (UDCA) +/- chenodeoxycholic (CDCA) acid treatment. They form when (1) GB bile becomes supersaturated with cholesterol (as the molar ratio of cholesterol to phospholipids in biliary vesicles approaches 1:1, the vesicles become unstable); (2) there is an imbalance between pro- and anti-nucleating factors, which favors cholesterol crystal precipitation; and (3) there is stasis within the GB as a result of altered motor function and/or excess mucus that traps the crystals.

Calcium and carbonate ion concentrations in gallbladder and hepatic bile.

Calcium carbonate is a major component of gallstones, but there are few data on calcium and carbonate (CO3(2-)) concentrations in human bile. Therefore, in patients undergoing cholecystectomy for gallstones, total [CaTOT] and free ionized [Ca2+] calcium concentrations, pH, PCO2, and total [CO2] were measured and [CO3(2-)] was derived in gallbladder and hepatic bile (aspirated anaerobically at surgery or from T tubes). Gallbladder bile had lower pH (6.