Molares impactados en la rama ascendente de la mandíbula. Presentación de un caso clínico

Se presenta el caso de una mujer de 23 años de edad que presentaba los molares inferiores permanentes segundo y tercero impactados verticalmente en la rama ascendente de la mandíbula. Las superficies oclusales de ambos dientes se encontraban en contacto. Tras un diagnóstico preciso, que incluyó una tomografía computarizada, se decidió extraer ambos dientes. El conducto del nervio dentario inferior, que en las radiografías se consideró que se encontraba bajo riesgo, no sufrió ningún daño, gracias a una técnica quirúrgica cuidadosa.

Relación entre el apiñamiento y la erupción de los terceros molares

En el presente trabajo se ha realizado una revisión bibliográfica de la relación existente entre la erupción de los terceros molares y la posibilidad de que aparezca un apiñamiento anterior (normalmente inferior). El apiñamiento es una malposición dental muy frecuente en la población, por lo que si realmente se puede relacionar con la erupción del tercer molar, el tratamiento precoz en dichos casos evitaría la aparición de esta malposición dental. Conoceremos las posturas de los diferentes autores al respecto, los distintos tratamientos que se pueden realizar y otros aspectos relacionados con el tema.

Razonamiento terapéutico en un caso de protrusión de incisivos superiores. Caso clínico

El caso estudiado corresponde a una niña de 13 años y 1 mes, que acude a la consulta de ortodoncia por una ligera protrusión de incisivos superiores. Presenta una oclusión de clase I, molar y canina, y clase I esquelética. Con una discrepancia inferior de 4 mm, un patrón de crecimiento dólico, y un perfil recto con el surco supramentoniano borrado. Ante una paciente de estas características se nos plantean diversas posibilidades de tratamiento, con o sin extracciones, e incluso la posibilidad de no tratar.

Estudio del postoperatorio de 100 terceros molares mandibulares incluidos, en relación a la edad, el sexo, el tabaco y la higiene bucal

La extracción del tercer molar inferior incluido provoca efectos secundarios como dolor, inflamación y trismo. Presentamos un estudio cuyo objetivo fue relacionar la edad, el sexo, el tabaco y la higiene oral con el postoperatorio de 100 de terceros molares inferiores incluidos. La edad, el sexo y el consumo de tabaco no influyeron significativamente en el postoperatorio. Sólo hallamos una correlación estadísticamente significativa entre la higiene oral y el dolor a las 6 horas de la exodoncia.

Prediction of free imatinib concentrations based on total plasma concentrations in patients with gastrointestinal stromal tumours.

AIM: Total imatinib concentrations are currently measured for the therapeutic drug monitoring of imatinib, whereas only free drug equilibrates with cells for pharmacological action. Due to technical and cost limitations, routine measurement of free concentrations is generally not performed. In this study, free and total imatinib concentrations were measured to establish a model allowing the confident prediction of imatinib free concentrations based on total concentrations and plasma proteins measurements. METHODS: One hundred and fifty total and free plasma concentrations of imatinib were measured in 49 patients with gastrointestinal stromal tumours. A population pharmacokinetic model was built up to characterize mean total and free concentrations with inter-patient and intrapatient variability, while taking into account α1 -acid glycoprotein (AGP) and human serum albumin (HSA) concentrations, in addition to other demographic and environmental covariates. RESULTS: A one compartment model with first order absorption was used to characterize total and free imatinib concentrations. Only AGP influenced imatinib total clearance. Imatinib free concentrations were best predicted using a non-linear binding model to AGP, with a dissociation constant Kd of 319 ng ml(-1) , assuming a 1:1 molar binding ratio. The addition of HSA in the equation did not improve the prediction of imatinib unbound concentrations. CONCLUSION: Although free concentration monitoring is probably more appropriate than total concentrations, it requires an additional ultrafiltration step and sensitive analytical technology, not always available in clinical laboratories. The model proposed might represent a convenient approach to estimate imatinib free concentrations. However, therapeutic ranges for free imatinib concentrations remain to be established before it enters into routine practice.

Antibody-fluorescein conjugates for photoimmunodiagnosis of human colon carcinoma in nude mice.

To improve the detectability of tumors by light-induced fluorescence, the use of monoclonal antibodies (MoAb) as carriers of fluorescent molecules was studied. As a model for this approach, the biodistribution of an anticarcinoembryonic antigen (CEA) MoAb coupled to fluorescein was studied in mice bearing a human colon carcinoma xenograft. In vitro, such conjugates with fluorescein-MoAb molar ratios ranging from four to 19, doubly labeled with 125I, showed more than 82% binding to immobilized CEA. In vivo, conjugates with a fluorescein-MoAb molar ratio of ten or less resulted in a tumor uptake of more than 30% of the injected dose of radioactivity per gram tumor at 24 hours. Tumor to liver, kidney, and muscle ratios of 20, 30 and 72, respectively, were obtained 48 hours after injection of the 125I-MoAb-(fluorescein)10 conjugate. The highest fluorescence intensity was always obtained for the tumor with the anti-CEA MoAb conjugate; whereas in control mice injected with fluoresceinated control immunoglobulin G1, no detectable increase in tumor fluorescence was observed. To compare these results with a classically used dye, mice bearing the same xenografts received 60 micrograms of Photofrin II. The intensity of the fluorescence signal of the tumor with this amount of Photofrin II was eight times lower than that obtained after an injection of 442 ng of fluorescein coupled with 20 micrograms of MoAb, which gave an absolute amount of fluorescein localized in the tumor of up to 125 ng/g of tumor. These results illustrate the possibility of improving the specificity of in vivo tumor localization of dyes for laser-induced fluorescence photodetection and phototherapy by coupling them to MoAb directed against tumor markers.

Digestibilidade de nutrientes em dietas de bovinos contendo uréia ou amiréia em substituição ao farelo de soja

O objetivo deste trabalho foi avaliar efeitos da substituição do farelo de soja por uréia ou amiréia na digestibilidade de nutrientes e alguns parâmetros ruminais em bovinos. Seis novilhos da raça Nelore, com massa média inicial de 420 kg, foram utilizados em um delineamento de quadrado latino 3x3 duplicado. O farelo de soja foi utilizado em uma dieta deficiente em proteína degradável no rúmen, e a uréia e amiréia, em uma dieta adequada em proteína degradável no rúmen. O bagaço de cana-de-açúcar in natura foi a única fonte de volumoso (20% da matéria seca). O farelo de soja promoveu menor (P<0,05) consumo de matéria seca comparado aos tratamentos com uréia e amiréia. A digestibilidade da matéria seca, matéria orgânica, carboidratos não fibrosos, extrato etéreo e proteína bruta não diferiram (P>0,05) entre os tratamentos. A digestibilidade da fibra em detergente ácido e fibra em detergente neutro foi superior (P<0,05) nas dietas contendo uréia e amiréia. Não houve efeito de tratamento e da interação tratamento x horários (P>0,05) nos valores de pH, ácidos graxos voláteis total, acetato, propionato, butirato e relação acetato:propionato do fluido ruminal. Observou-se maior (P<0,05) concentração molar de valerato, isobutirato e isovalerato no tratamento com farelo de soja, não havendo diferença (P>0,05) entre os tratamentos com uréia e amiréia. A substituição total do farelo de soja por uréia ou amiréia, ajustando a proteína degradável no rúmen na dieta de bovinos de corte, é viável.

Wear of two denture teeth materials in vivo-2-year results.

OBJECTIVE: (1) To quantify wear of two different denture tooth materials in vivo with two study designs, (2) to relate tooth variables to vertical loss. METHODS: Two different denture tooth materials had been used (experimental material=test; DCL=control). In study 1 (split-mouth, 6 test centers) 60 subjects received complete dentures, in study 2 (two-arm, 1 test center) 29 subjects. In study 1 the mandibular dentures were supported by implants in 33% of the subjects, in study 2 only in 3% of the subjects. Impressions of the dentures were taken and poured with improved stone at baseline and after 6, 12, 18 and 24 months. Each operator evaluated the wear subjectively. Wear analysis was carried out with a laser scanning device. Maximal vertical loss of the attrition zones was calculated for each tooth cusp and tooth. A mixed linear model was used to statistically analyse the logarithmically transformed wear data. RESULTS: Due to drop-outs and unmatchable casts, only 47 subjects of study 1 and 14 of study 2 completed the 2-year recall. Overall, 75% of all teeth present could be analysed. There was no statistically difference in the overall wear between the test and control material for either study 1 or study 2. The relative increase in wear over time was similar in both study designs. However, a strong subject effect and center effect were observed. The fixed factors included in the model (time, tooth, center, etc.) accounted for 43% of the variability, whereas the random subject effect accounted for another 30% of the variability, leaving about 28% of unexplained variability. More wear was consistently recorded in the maxillary teeth compared to the mandibular teeth and in the first molar teeth compared to the premolar teeth and the second molars. Likewise, the supporting cusps showed more wear than the non-supporting cusps. The amount of wear did not depend on whether or not the lower dentures were supported by implants. The subjective wear was correct in about 67% of the cases if it is postulated that a wear difference of 100μm should be subjectively detectable. SIGNIFICANCE: The clinical wear of denture teeth is highly variable with a strong patient effect. More wear can be expected in maxillary denture teeth compared to mandibular teeth, first molars compared to premolars and supported cusps compared to non-supported cusps. Laboratory data on the wear of denture tooth materials may not be confirmed in well-structured clinical trials probably due to the large inter-individual variability.

Peptide-antibody conjugates for tumour therapy: a MHC-class-II-restricted tetanus toxin peptide coupled to an anti-Ig light chain antibody can induce cytotoxic lysis of a human B-cell lymphoma by specific CD4 T cells.

Anti-idiotype antibody therapy of B-cell lymphomas, despite numerous promising experimental and clinical studies, has so far met with limited success. Tailor-made monoclonal anti-idiotype antibodies have been injected into a large series of lymphoma patients, with a few impressive complete tumour remissions but a large majority of negative responses. The results presented here suggest that, by coupling to antilymphoma idiotype antibodies a few molecules of the tetanus toxin universal epitope peptide P2 (830-843), one could markedly increase the efficiency of this therapy. We show that after 2-hr incubation with conjugates consisting of the tetanus toxin peptide P2 coupled by an S-S bridge to monoclonal antibodies directed to the lambda light chain of human immunoglobulin, human B-lymphoma cells can be specifically lysed by a CD4 T-lymphocyte clone specific for the P2 peptide. Antibody without peptide did not induce B-cell killing by the CD4 T-lymphocyte clone. The free cysteine-peptide was also able to induce lysis of the B-lymphoma target by the T-lymphocyte clone, but at a molar concentration 500 to 1000 times higher than that of the coupled peptide. Proliferation assays confirmed that the antibody-peptide conjugate was antigenically active at a much lower concentration than the free peptide. They also showed that antibody-peptide conjugates required an intact processing function of the B cell for peptide presentation, which could be selectively inhibited by leupeptin and chloroquine.(ABSTRACT TRUNCATED AT 250 WORDS)

Movement evaluation of overerupted upper molars with absolute anchorage: An in-vitro study

Introduction: The overeruption of upper molars due to the premature loss of antagonist teeth can be treated with the help of miniscrews. The aim of this study was to evaluate the movement of a typodont molar according to the biomechanical approach used with miniscrews. Study design: The study was conducted with four plaster models filled with typodont wax. In each model we used one absolute anchorage on the palatal side and another on the buccal side in different positions, thus generating four different biomechanical systems. A force of 150 g was applied to each side of the resin tooth. Periapical radiographs were taken preintrusion and immediately after completion of the intrusion. Photographs were taken in both the sagittal and occlusal planes every 3 min. The radiographic films and photographs were measured and compared. Results: A vertical movement of the molar was observed in all the models, with system 4 showing the greatest movement. Rotation in the occlusal plane only occurred in system 2, while in system 1 there was a change in the axial axis of 37 degrees. Conclusions: The anchorage site and the combination of forces applied may determine the resulting tooth movement

Avaliação de variáveis que influenciam a hidrólise enzimática da caseína do leite de cabra Moxotó

O objetivo deste trabalho foi avaliar os efeitos da temperatura, pH, relação enzima:substrato (E:S) e tempo de reação sobre a hidrólise enzimática da caseína do leite de cabra Moxotó, com uso de diferentes enzimas proteolíticas. A hidrólise enzimática da caseína caprina foi realizada com uso de tripsina, pepsina e papaína. Para cada enzima, foram utilizados dois níveis de cada variável, na avaliação de seus efeitos sobre a hidrólise da caseína, em um fatorial completo 2(4). Os produtos da hidrólise foram visualizados em eletroforese SDS-PAGE. O melhor valor do grau de hidrólise com a enzima papaína foi obtido em pH 6,5, E:S de 1:150 e 5 horas de hidrólise a 50ºC (28,17%); com a tripsina, em pH 8,5, E:S de 1:150 e 5 horas a 40ºC (29,55%); e com a pepsina, em pH 3,0, E:S de 1:100 e 5 horas a 40ºC (38,27%). A hidrólise da caseína caprina é influenciada positivamente pelo pH e tempo de hidrólise, com o uso da pepsina. Foram observadas interações significativas antagônicas entre pH e relação E:S, com o uso da tripsina; e entre pH, temperatura e tempo de hidrólise, com o uso da papaína. A pepsina apresenta elevada eficiência na hidrólise de αs1, β e κ-caseína, evidenciada por hidrolisados com massa molar abaixo de 14,4 kDa.

The kinetic parameters and energy cost of the Hsp70 chaperone as a polypeptide unfoldase.

Hsp70-Hsp40-NEF and possibly Hsp100 are the only known molecular chaperones that can use the energy of ATP to convert stably pre-aggregated polypeptides into natively refolded proteins. However, the kinetic parameters and ATP costs have remained elusive because refolding reactions have only been successful with a molar excess of chaperones over their polypeptide substrates. Here we describe a stable, misfolded luciferase species that can be efficiently renatured by substoichiometric amounts of bacterial Hsp70-Hsp40-NEF. The reactivation rates increased with substrate concentration and followed saturation kinetics, thus allowing the determination of apparent V(max)' and K(m)' values for a chaperone-mediated renaturation reaction for the first time. Under the in vitro conditions used, one Hsp70 molecule consumed five ATPs to effectively unfold a single misfolded protein into an intermediate that, upon chaperone dissociation, spontaneously refolded to the native state, a process with an ATP cost a thousand times lower than expected for protein degradation and resynthesis.

Tracing of the Rhône River, wastewater, and mixing within Lake Geneva : stable isotope compositions of water and dissolved inorganic carbon

This study presents an evaluation of the stable isotopic composition of water (hydrogen and oxygen) and dissolved inorganic carbon (DIC) of Lake Geneva, a deep, peri-alpine lake situated at the border between Switzerland and France. The research goal is to apply vertical and seasonal variations of the isotope compositions to evaluate mixing processes of pollutants, nutrients and oxygen. Depth profiles were sampled at different locations throughout Lake Geneva on a monthly and seasonal basis over the course of three years (2009-2011). The results of the oxygen isotopic composition indicate a Rhône River interflow, which can be traced for about 55 km throughout the lake during summer. The Rhône River interflow is 7 to 15 m thick and the molar fraction of Rhône water is estimated to amount up to 37 %. Calculated density of the water and measured isotopic compositions demonstrate that the interflow depth changes in conjunction with the density gradient in the water column during fall. Partial pressure of CO2 indicates that the epilimnion is taking up CO2 from the atmosphere between spring and fall. The epilimnion is most enriched in 13CDIC in September and a progressive depletion of 13CDIC can be observed in the metalimnion from spring to late fall. This stratification is dependent on the local density stratification and the results demonstrate that parameters, which are indicating photosynthesis, are not necessarily linked to δ13CDIC values. In addition, the amount of primary production shows a strong discrepancy between summer 2009 and 2010, but δ13CDIC values of the epilimnion and metalimnion do not indicate variations. In the hypolimnion of the deep lake δ13CDIC values are constant and the progressive depletion allows tracing remineralization processes. The combination of stable carbon and oxygen isotopic compositions allows furthermore tracing Rhône River water fractions, as well as wastewater, stormwater and anthropogenic induced carbon in the water column of the shallow Bay of Vidy. In combination with the results of measured micropollutants, the study underlines that concentrations of certain substances may be related to the Rhône River interflow and/or remineralization of particulate organic carbon. Water quality monitoring and research should therefore be extended to the metalimnion as well as sediment water interface.

Retentiopolymeerin optimointi täyteaineiden yhtäaikaisannostelussa

Kirjallisuusosassa perehdyttiin retentioaineisiin ja täyteaineisiin sekä retentioaineiden ja rainanmuodostusolosuhteiden vaikutukseen retentioon, vedenpoistoon ja paperin ominaisuuksiin. Tarkemmin kirjallisuusosassa keskityttiin täyteaineiden esiflokkaukseen, retentiopolymeerin adsorptioon sekä retentiopolymeerien ja täyteaineiden annostelutapoihin. Kokeellisessa osassa tutkittiin sarjaa retentiopolymeerejä, joiden varaustiheys ja moolimassa muuttuivat. Yksi polymeereistä oli kahdesta polymeeristävalmistettu suoladispersio ja yksi modifioitu kationinen PAM. Näillä polymeereillä käytiin läpi koesarjoja, joissa muutettiin täyteaineen annosteluaikaa retentiopolymeerin annosteluajan pysyessä vakiona. Lähinnä vertailtiin keskenään perinteistä annostelua, jossa täyteaine annosteltiin paljon ennen retentiopolymeeriä,ja yhtäaikaista annostelua, jossa molemmat annosteltiin yhtä aikaa lähellä perälaatikkoa. Kokeet tehtiin MBF-laitteella, jolla pystytään paperikonetta vastaaviin pulsaatiotaajuuksiin ja sillä voidaan valmistaa tasoviirakoneella valmistetunpaperin kaltaisia laboratorioarkkeja. Valmistetuista arkeista tutkittiin retentioita ja paperiteknisiä ominaisuuksia. Laboratoriokokeiden perusteella yhtäaikainen annostelu antoi paremmat täyteaineretentiot verrattaessa perinteiseen annosteluun lähes kaikissa koesarjoissa. Varsinkin lyhytketjuiset polymeerit näyttivättoimivan hyvin yhtäaikaisannostelulla, mikä saattaisi johtua siitä, että lyhyt reagointiaika sulpun kanssa on lyhytketjuisille polymeereille edullinen, sillä silloin polymeeriketjun konformaatio ei ehdi asettua liian alhaiseksi ja ketjun toimintakyky säilyy parempana. Polymeerin varaustiheyden kasvaessa riittävästi laski täyteaineretentio seuraavissa tapauksissa: SC-massa + kaoliini ja SC-massa +GCC kummallakin annostelulla sekä SC-massa + PCC A perinteisellä annostelulla. Hienopaperimassalla samaa trendiä noudatti täyteaine GCC kummallakin annostelulla, kun taas PCC H:ta käytettäessä paranivat täyteaineretentiot molemmilla annosteluilla. Retentiopolymeerin moolimassan kasvaessa riittävästi kääntyi täyteaineretentio laskuun täyteaineilla GCC ja kaoliini, kun käytettiin SC-massaa. Hienopaperimassalla GCC noudatti tätä samaa taipumusta. Sen sijaan SC-massalla PCC A:takäytettäessä täyteaineretentio puolestaan nousi hieman moolimassan kasvaessa. Näin kävi myös hienopaperimassalla, kun täyteaineena käytettiin PCC H:ta. Käytettäessä SC-massaa, perinteisellä annostelulla saatiin parempi tai yhtä hyvä valonsironta kuin yhtäaikaisella annostelulla kaikilla täyteaineilla. Tämä saattaisi johtua siitä, että yhtäaikaisannostelulla on muodostunut suurempia täyteaineflokkeja, mikä on alentanut valoa sirottavia pintoja. Täyteaineista korkeimmat valonsirontakertoimet antoi PCC A ja alhaisimmat kaoliini. PCC A:lla oli kapein partikkelikokojakauma, mikä korottaa paperin valonsirontaa. Hienopaperimassalla valonsirontakerroin ja opasiteetti suurenivat GCC-pitoisuuden kasvaessa kummallakin annostelulla, mikä voisi johtua täyteainepartikkelien antamasta paremmasta sironnasta. Yhtäaikaisella annostelulla saavutettiin huomattavasti paremmat valonsironnan arvot perinteiseen annosteluun verrattuna. PCC H-pitoisuuden kasvaessa suurenivat myös valonsirontakerroin ja opasiteetti kummallakin annostelulla. PCC H antoi korkeammat valonsirontakertoimet kuin GCC. PCC omaa suuremman valonheijastusluvun kuin GCC, minkä vuoksi se antaa paremmat valonsirontakertoimen arvot. PCC H:n partikkelikokojakauma oli myös kapeampi kuin GCC:n, mikä mahdollisti paremman valonsironnan ja opasiteetin saavuttamisen.

Väkevän urealiuoksen puhdistaminen kalvotekniikalla

Kirjallisuusosassa käsiteltiin nanosuodatus-, käänteisosmoosi- ja elektrodialyysitekniikoita liuosten puhdistuksessa. Nanosuodatuksella ja käänteisosmoosilla voidaan liuottimesta erottaa pienen moolimassan omaavia liuenneita aineita ohuen kalvon avulla. Nanosuodatuksessa ja käänteisosmoosissa ajavana voimana on paine, jonka tulee ylittää liuoksen osmoottinen paine. Elektrodialyysissä ajavana voimana toimii sähköpotentiaaliero. Tekniikka käyttää hyväkseen ionien tai molekyylien kykyä johtaa sähköä. Elektrodialyysillä voidaan liuoksesta erottaa toisistaan varauksettomat ja varaukselliset komponentit sähköä johtavan membraanin avulla. Kokeellisessa osassa väkevää ureavesiliuosta suodatettiin nanosuodatus- ja käänteisosmoosikalvoilla tutkien paineen, lämpötilan ja konsentroitumisen vaikutusta vuohonja retentioon. Tarkoituksena oli saada urea tuotteena permeaattiin ja epäpuhtaudet erottumaan retentaattiin. Permeaattien epäpuhtauksien pitoisuuksia verrattiin tuotteen spesifikaation raja-arvoihin. Suodatukset tehtiin Lappeenrannan teknillisen yliopiston tiloissa DSS Labstak M20 suotimella. Työssä käytettiin NF1-, NF2-, NF270-, NF-, NF90-, Desal-5 DK-, OPMN-P 70- ja TFC ULP-kalvoja. Nanosuodatuskalvot NF2- ja NF270 antoivat parhaan vuon ja erotuskyvyn suhteen puhdistettaessa urealiuosta. Paineen noustessa kalvojen retentiot paranivat. Lämpötilan noustessa vuo parani, joskin täytyy huomioida urean kiihtyvä hajoaminen lähestyttäessä 40 °C astetta. Kalvojen kestävyyttä ureasuodatuksissa ei voitu näiden kokeiden avulla varmentaa.