Abstract Introduction The study aimed to investigate the 5-year survival of root-filled posterior cracked teeth and its related factors. Methods Two hundred patients who had root canal–treated ...posterior cracked teeth at the National Dental Centre were recalled for a 5-year review. Eighty-four patients who met the inclusion criteria were included in this study. The cases were managed following the treatment protocol for cracked teeth at the center. The data for analyses were obtained from the patients' clinical records. Statistical analyses were performed using SPSS 21.0 (SPSS Inc, Chicago, IL). The outcome measure was the presence of tooth at the time of the review. Results At 5 years, 77 teeth “survived” (92%), and 7 teeth (8 %) were extracted. Patient demographics, tooth type and location, existing restoration, number and location of cracks, presence of pretreatment signs and symptoms, and initial pulpal and periapical diagnosis did not significantly affect the survival of the teeth. Univariate analysis showed that teeth with extension of the cracks onto the pulpal floor were more often extracted (odds ratio = 4.5, P = .07). Multivariable analyses found that extension of cracks onto the pulpal floor independently increased the odds of tooth loss by 11-fold (odds ratio = 11, P = .033), with other factors being held constant. The 5-year survival estimate in the absence and presence of crack extension onto the pulpal floor was 99% and 88%, respectively. Conclusions Coronal cracks may be predictably treated, whereas radicular cracks increased the odds of the tooth being extracted.
Healed rates of endodontic microsurgery (EMS) may decrease over time, but research on the long-term outcomes is scarce. The aims of this retrospective cohort study were to evaluate the 5- to 9-year ...healed and survival rates of EMS, to identify associations between prognostic factors and healing status, and to compare the short-term (1- to 2-year) with long-term (5- to 9-year) outcomes.
One hundred fifty-one eligible patients (166 teeth) who underwent EMS in 2007–2010 were invited for a follow-up examination. Eighty-three patients (94 teeth) participated in the study. Survival status and reasons for extraction of all teeth were determined, and survival rates were calculated by Kaplan-Meier analyses. Outcomes were determined on the basis of clinical and radiographic findings and associated with potential prognostic variables via multivariate Cox regression analyses.
Thirty-two teeth were extracted: 6 because of endodontic failure, 20 for unrelated reasons, and 6 for unknown reasons. Outcomes were categorized as healed and not healed. Multivariate analysis revealed that adjusted hazard ratio for failure was 5.95 times higher (95% confidence interval, 1.54–22.91) for teeth treated with intermediate restorative material than with mineral trioxide aggregate and 3.38 times higher (95% confidence interval, 1.05–10.9) for teeth with no known history of nonsurgical retreatment. Teeth classified as healed in the 1- to 2-year review mostly remained healed at 5- to 9-year review (45/48 teeth); those with uncertain healing had varied outcomes at long-term review.
EMS results in high long-term healed (78.3%, 72/92 teeth) and survival (95.2%) rates. Root-end filling material and nonsurgical retreatment before EMS may influence the long-term outcome.
In this report, we have prepared self-assembling nanospheres of hydrophobized pullulans. Pullulan acetate as a hydrophobized pullulan was synthesized by acetylation of pullulan and characterized by ...Fourier transform infrared (FTIR) measurement. From the results of photon correlation spectroscopy (PCS), hydrophobized pullulans could be self-assembled in water as nanospherical aggregates, and their number-average particle size was 74.3 ± 38.2 nm with a unimodal distribution. Also, morphological studies observed by transmission electron microscopy (TEM) showed that self-assembly of hydrophobized pullulans results in nice spherical shapes with a size range of about 50-100 nm, which was in accordance with PCS measurements. Their size and morphology have acceptable properties for intravenous injectable drug-targeting carriers. The fluorescence probe technique was used for self-association of hydrophobized pullulans in water using pyrene as a hydrophobic probe. From the fluorescence measurement, the fluorescence intensity of pyrene increased with increasing concentration of hydrophobized pullulans, which indicates self-assembly formation of hydrophobized pullulans in water. Also, in the fluorescence excitation spectrum, a red shift was observed with increasing concentration of hydrophobized pullulans. These results also revealed that hydrophobized pullulans could be self-assembled in water, and from the plot of I337 I334 versus log c of hydrophobized pullulans, the critical association concentration was 0.0022 g l, which was considerably lower than that of low molecular weight surfactants or poloxamer. A drug loading study was performed using clonazepam (CNZ) as a hydrophobic model drug. We observed that the higher the feeding amount of drug was, the more the drug loading contents were, the lower the drug loading efficiency was, and the larger the particle size was. CNZ was released from nanospheres via pseudo-zero-order kinetics, and the increased drug loading contents led to slower release of the drug.
Background and Purpose
Pain is common in post‐stroke patients and has been shown to be associated with depression, fatigue, and decreased quality of life (QOL). However, studies examining different ...types of post‐stroke pain are scarce. We investigated differences in the related factors and their QOL impacts between musculoskeletal pain (MSP) and central post‐stroke pain (CPSP).
Methods
We assessed 364 consecutive stroke patients who were admitted to Asan Medical Center and contacted 12 months after stroke onset. We categorized pain and paresthesia as MSP, CPSP, combined pain, or other pain. Post‐stroke depression (Beck Depression Inventory), fatigue (Fatigue Severity Scale), sleep disturbance (Verran Snyder‐Halpern scale), social support (ENRICHED Social Support Instrument), and QOL (Medical Outcome Study 36‐Item Short Form) were assessed.
Results
Of the 364 patients analyzed, 135 (37.1%) had pain, 78 (21.4%) had MSP, 22 (6.0%) had CPSP, 16 (4.4%) had combined pain, and 19 (5.2%) had other pain. In multivariate analyses, CPSP was related to modified Rankin scale (P=.004), sensory dysfunction (P<.001), thalamus lesion (P=.001), medulla lesion (P=.007), and fatigue (P=.026). MSP was related to motor dysfunction (P<.001) and fatigue (P=.003). QOL varied among groups with different types of pain (P<.001) and was the poorest in patients with combined pain.
Conclusions
Pain is common 12 months post‐stroke. The factors associated with CPSP and MSP differ, but are both closely associated with fatigue rather than depression. QOL is the poorest in patients with combined pain. Management of pain and fatigue may be important for improving the QOL in stroke patients.
RUNX3, runt-domain transcription factor, is a master regulator of gene expression in major developmental pathways. It acts as a tumor suppressor in many cancers but is oncogenic in certain tumors. We ...observed upregulation of RUNX3 mRNA and protein expression in nasal-type extranodal natural killer (NK)/T-cell lymphoma (NKTL) patient samples and NKTL cell lines compared to normal NK cells. RUNX3 silenced NKTL cells showed increased apoptosis and reduced cell proliferation. Potential binding sites for MYC were identified in the RUNX3 enhancer region. Chromatin immunoprecipitation-quantitative PCR revealed binding activity between MYC and RUNX3. Co-transfection of the MYC expression vector with RUNX3 enhancer reporter plasmid resulted in activation of RUNX3 enhancer indicating that MYC positively regulates RUNX3 transcription in NKTL cell lines. Treatment with a small-molecule MYC inhibitor (JQ1) caused significant downregulation of MYC and RUNX3, leading to apoptosis in NKTL cells. The growth inhibition resulting from depletion of MYC by JQ1 was rescued by ectopic MYC expression. In summary, our study identified RUNX3 overexpression in NKTL with functional oncogenic properties. We further delineate that MYC may be an important upstream driver of RUNX3 upregulation and since MYC is upregulated in NKTL, further study on the employment of MYC inhibition as a therapeutic strategy is warranted.
Abstract Introduction The aim of this retrospective study was to evaluate the outcome of endodontic microsurgery and to examine prognostic factors related to healing. Methods The clinical records of ...all patients who had undergone endodontic microsurgery from 1997–2003 at the National Dental Centre of Singapore were examined. Teeth with a recall period of 1–2 years were selected. All surgical procedures, except for flap raising and suturing, were performed under a surgical operating microscope. Root-end cavities prepared with ultrasonic tips were filled with Intermediate Restorative Material (Caulk, Milford, DE) or mineral trioxide aggregate. Teeth were evaluated for clinical signs and symptoms after surgery. Preoperative and postoperative radiographs were evaluated independently by 2 endodontists. Results Of 243 root-end surgeries performed, 93 were eligible for the study. Outcomes were categorized as healed, healing, or persistent disease; 78.5% of teeth were assessed to be healed or healing, and 21.5% had persistent disease. The percentages of healed and healing teeth for anterior and posterior root-end surgeries were 76.5% and 80.4%, respectively, with no significant difference in the procedures ( P = .8). Ordinal logistic regression showed a higher likelihood of healing in females compared with males ( P = .001) and maxillary anterior teeth compared with mandibular anterior teeth ( P = .03). Preoperative probing depths of ≤3 mm were significantly associated with healing ( P = .05). Conclusions The use of modern endodontic surgical techniques resulted in 78.5% healed and healing teeth with a recall period of 1–2 years. Prognostic factors affecting successful healing include sex, tooth type, and preoperative probing depths.
To investigate the characteristics and prevalence of poststroke depression (PSD) and poststroke emotional incontinence (PSEI) and the factors related to these conditions at admission and 3 months ...after stroke.
We evaluated 508 consecutive patients with acute ischemic stroke for PSD and PSEI at admission and 3 months later. PSD was evaluated using the Beck Depression Inventory, and PSEI was evaluated using Kim's criteria. Blood samples were collected and genotyped for the promoter region of the serotonin transporter protein (5-HTTLPR) and the number of tandem repeats within intron 2 (STin2 VNTR). Perceived social support (the ENRICHD Social Support Inventory) was also measured.
PSD and PSEI were present in 13.7% and 9.4% of patients, respectively, at admission and in 17.7% and 11.7%, respectively, at 3 months after stroke. Multivariate analyses showed that PSD at admission was associated with the NIH Stroke Scale score at admission (p < 0.001), whereas PSD at 3 months was associated with the presence of microbleeds (p < 0.01) and perceived low social support (p < 0.001). In contrast, only lesion location (p = 0.022) was associated with PSEI at admission, whereas modified Rankin Scale score (p = 0.019), STin2 VNTR (p = 0.040), and low social support (p = 0.042) were related to PSEI 3 months after stroke.
Diverse factors such as neurologic dysfunction, lesion location, microbleeds, genetic traits, and social support are differently related to acute and subacute emotional disturbances. Strategies to prevent or manage these problems should consider these differences.
Chitosan, a cationic polysaccharide, has been widely employed as dietary supplement and in pharmacological and biomedical applications. Although numerous studies have focused on its applications as ...pharmaceutical excipients or bioactive reagents, molecular weight (MW)-dependent pharmaceutical and bioactive properties remain unclear. As a preliminary study, we investigated the MW-dependent Caco-2 cell layer transport phenomena (in vitro) and intestinal absorption patterns after oral administration (in vivo) of water-soluble chitosans (WSCs). The absorption of chitosan was significantly influenced by its MW. As the MW increases, the absorption decreases. Compared to high-MW chitosan (WSC 230K, MW=230 kDa), absorption profiles were observed to increase more than 23 and 25 times with WSC 3.8K (MW=3.8 kDa) in both in vitro and in vivo transport experiments, respectively. Furthermore, the chitosans showed concentration- and MW-dependent cytotoxic effects, and the chitosan oligosaccharides (MW<10 kDa) showed negligible cytotoxic effect on the Caco-2 cells. In consideration with safety and absorption profiles, chitosan oligosaccharides may be considered as safe and potential candidates for pharmaceutical and biomedical applications.
Abstract Introduction The purpose of this study was to compare healing after root-end surgery by using grey mineral trioxide aggregate (MTA) and EndoSequence Root Repair Material (RRM) as root-end ...filling material in an animal model. Methods Apical periodontitis was induced in 55 mandibular premolars of 4 healthy beagle dogs. After 6 weeks, root-end surgeries were performed by using modern microsurgical techniques. Two different root-end filling materials were used, grey MTA and RRM. Six months after surgery, healing of the periapical area was assessed by periapical radiographs, cone-beam computed tomography (CBCT), micro computed tomography (CT), and histology. Results Minimal or no inflammatory response was observed in the majority of periapical areas regardless of the material. The degree of inflammatory infiltration and cortical plate healing were not significantly different between the 2 materials. However, a significantly greater root-end surface area was covered by cementum-like, periodontal ligament–like tissue, and bone in RRM group than in MTA group. When evaluating with periapical radiographs, complete healing rate in RRM and MTA groups was 92.6% and 75%, respectively, and the difference was not statistically significant ( P = .073). However, on CBCT and micro CT images, RRM group demonstrated significantly superior healing on the resected root-end surface and in the periapical area ( P = .000 to .027). Conclusions Like MTA, RRM is a biocompatible material with good sealing ability. However, in this animal model RRM achieved a better tissue healing response adjacent to the resected root-end surface histologically. The superior healing tendency associated with RRM could be detected by CBCT and micro CT but not periapical radiography.
PDF
