A papaína no tratamento da periodontite crônica

A raspagem subgengival e o alisamento radicular constituem o "padrão ouro" e o tratamento de eleição para a periodontite; porém, é um procedimento difícil de ser executado, que requer um intenso treinamento e que pode expor a dentina, causando hipersensibilidade dentinária pela remoção excessiva de cemento, ou produzir defeitos, como sulcos e ranhuras, além de deixar cálculo residual e não conseguir atingir toda as superfície radicular. Recentemente, um gel a base de papaína e cloramina foi introduzido no mercado (Papacárie), utilizado no tratamento da remoção de dentina cariada. Este gel poderia auxiliar na remoção do cálculo subgengival com menor desgaste do cemento. O objetivo deste trabalho foi comparar a eficácia e analisar a superfície radicular na utilização de um gel à base de papaína e cloramina, associado ao alisamento radicular, na região subgengival. Após receberem instruções de higiene oral, raspagem supragengival e polimento coronário, 18 pacientes com periodontite crônica, 6 mulheres e 12 homens, com idade média de 51 anos (8) foram tratados num modelo de boca dividida. O tratamento-teste foi constituído pela aplicação do gel na área subgengival por 1 min., seguida pelo alisamento radicular; o tratamento-controle foi constituído pela raspagem subgengival e alisamento radiculares. A terapia foi executada por 3 operadoras e os exames inicial, de 28 dias e 3 meses, foram realizados por um único examinador. Quatro dentes nunca tratados de dois outros pacientes (2 incisivos centrais inferiores e 2 premolares), com indicação para extração, foram submetidos ao tratamento teste e controle e, após a exodontia, analisados em microscopia eletrônica de varredura (MEV). Ao longo dos 3 meses, os resultados demonstraram significativa melhora nos parâmetros clínicos: sangramento à sondagem, profundidade de bolsa e ganho de inserção, tanto no lado-teste, como no lado-controle, principalmente aos 28 dias; mas não foi observada significância estatística quando ambas as formas de terapia foram comparadas. O índice de placa médio permaneceu alto ao longo do estudo. A análise do MEV demonstrou que o tratamento-teste deixou uma maior quantidade de cálculo residual sobre a superfície radicular; porém, áreas livres de cálculo também foram observadas. No tratamento-controle, verificaram-se regiões mais profundas não atingidas pelas curetas, áreas livres de cálculo e um sulco produzido pela cureta. Concluiu-se que tanto o tratamento-teste, como o controle, foram eficazes no tratamento da periodontite crônica nos 3 meses observados.

Relação da doença periodontal com a anticoagulação oral e os benefícios do tratamento periodontal em pacientes anticoagulados

Anticoagulantes orais são amplamente indicados para prevenção de eventos tromboembólicos. No entanto, nem sempre os pacientes atingem a faixa terapêutica recomendada. Os objetivos desse estudo foram avaliar a associação entre periodontite e níveis de anticoagulação (fase 1) e o efeito do tratamento periodontal nos níveis de anticoagulação (fase 2) em pacientes que faziam uso do anticoagulante oral varfarina. O exame clínico incluiu índice CPO-D, índice de placa, sangramento à sondagem, profundidade de bolsa e nível de inserção clínica. Coeficiente normalizado internacional (INR), níveis de albumina, proteína C-reativa (PCR) e fibrinogênio foram avaliados no dia zero e até 180 dias após tratamento periodontal. Na fase 1 do estudo foram examinados 62 pacientes (42 mulheres e 20 homens, com idade média de 50,8 9,2 anos). Observamos uma correlação negativa entre extensão e severidade da doença periodontal e índice de placa com valores de INR. Não houve associação entre diagnóstico periodontal e níveis de anticoagulação. Dentre os pacientes fora do alvo terapêutico, 87% apresentavam diagnóstico de periodontite, enquanto no grupo na faixa terapêutica apenas 56%. Participaram da fase 2 do estudo 26 pacientes com periodontite severa (15 mulheres e 11 homens, com idade média de 51,3 9,2 anos). O tratamento periodontal resultou em melhora significativa de todos os parâmetros periodontais e dos níveis de anticoagulação 30, 60 90 e 180 dias após conclusão da terapia periodontal. Não houve alteração significativa na dose semanal da varfarina. Foi observada redução significativa entre níveis séricos de albumina dos dia 90 e 180 após a terapia periodontal, quando comparado aos valores do dia 0 (p < 0,05). De acordo com o alvo terapêutico estabelecido, observamos que no dia 0 doze pacientes (46,15%) estavam fora dessa faixa. Esse percentual foi reduzido significativamente após tratamento periodontal, sendo 26,1% e 29,2% nos dias 60 e 90, respectivamente. Embora tenha ocorrido melhora nos níveis de anticoagulação, não houve alteração significativa nos níveis de PCR e fibrinogênio. Sendo assim, pacientes com periodontite severa podem apresentar dificuldade para atingir a faixa terapêutica e o tratamento periodontal pode resultar em benefícios na busca da anticoagulação plena. Novos estudos são necessários para avaliar se formas menos severas de doença periodontal também podem interferir com a varfarina.

Information-theoretic Studies and Capacity Bounds: Group Network Codes and Energy Harvesting Communication Systems

Network information theory and channels with memory are two important but difficult frontiers of information theory. In this two-parted dissertation, we study these two areas, each comprising one part. For the first area we study the so-called entropy vectors via finite group theory, and the network codes constructed from finite groups. In particular, we identify the smallest finite group that violates the Ingleton inequality, an inequality respected by all linear network codes, but not satisfied by all entropy vectors. Based on the analysis of this group we generalize it to several families of Ingleton-violating groups, which may be used to design good network codes. Regarding that aspect, we study the network codes constructed with finite groups, and especially show that linear network codes are embedded in the group network codes constructed with these Ingleton-violating families. Furthermore, such codes are strictly more powerful than linear network codes, as they are able to violate the Ingleton inequality while linear network codes cannot. For the second area, we study the impact of memory to the channel capacity through a novel communication system: the energy harvesting channel. Different from traditional communication systems, the transmitter of an energy harvesting channel is powered by an exogenous energy harvesting device and a finite-sized battery. As a consequence, each time the system can only transmit a symbol whose energy consumption is no more than the energy currently available. This new type of power supply introduces an unprecedented input constraint for the channel, which is random, instantaneous, and has memory. Furthermore, naturally, the energy harvesting process is observed causally at the transmitter, but no such information is provided to the receiver. Both of these features pose great challenges for the analysis of the channel capacity. In this work we use techniques from channels with side information, and finite state channels, to obtain lower and upper bounds of the energy harvesting channel. In particular, we study the stationarity and ergodicity conditions of a surrogate channel to compute and optimize the achievable rates for the original channel. In addition, for practical code design of the system we study the pairwise error probabilities of the input sequences.

Sensing and Actuation from Biology to Electronics

We introduce an in vitro diagnostic magnetic biosensing platform for immunoassay and nucleic acid detection. The platform has key characteristics for a point-of-use (POU) diagnostic: portability, low-power consumption, low cost, and multiplexing capability. As a demonstration of capabilities, we use this platform for the room temperature, amplification-free detection of a 31 bp DNA oligomer and interferon-gamma (a protein relevant for tuberculosis diagnosis). Reliable assay measurements down to 100 pM for the DNA and 1 pM for the protein are demonstrated. We introduce a novel "magnetic freezing" technique for baseline measurement elimination and to enable spatial multiplexing. We have created a general protocol for adapting integrated circuit (IC) sensors to any of hundreds of commercially available immunoassay kits and custom designed DNA sequences.

We also introduce a method for immunotherapy treatment of malignant gliomas. We utilize leukocytes internalized with immunostimulatory nanoparticle-oligonucleotide conjugates to localize and retain immune cells near the tumor site. As a proof-of-principle, we develop a novel cell imaging and incubation chamber for in vitro magnetic motility experiments. We use the apparatus to demonstrate the controlled movement of magnetically loaded THP-1 leukocytes.

Finally, we introduce an IC transmitter and power ampli er (PA) that utilizes electronic digital infrastructure, sensors, and actuators to self-heal and adapt to process, dynamic, and environmental variation. Traditional IC design has achieved incredible degrees of reliability by ensuring that billions of transistors on a single IC die are all simultaneously functional. Reliability becomes increasingly difficult as the size of a transistor shrinks. Self-healing can mitigate these variations.

Kinetics and mechanisms of adsorption of Escherichia coli bacteriophage T_4 to activated carbon

A study was conducted on the adsorption of Escherichia coli bacteriophage T₄ to activated carbon. Preliminary adsorption experiments were also made with poliovirus Type III. The effectiveness of such adsorbents as diatomaceous earth, Ottawa sand, and coconut charcoal was also tested for virus adsorption.

The kinetics of adsorption were studied in an agitated solution containing virus and carbon. The mechanism of attachment and site characteristics were investigated by varying pH and ionic strength and using site-blocking reagents.

Plaque assay procedures were developed for bacteriophage T₄ on Escherichia coli cells and poliovirus Type III on monkey kidney cells. Factors influencing the efficiency of plaque formation were investigated.

The kinetics of bacteriophage T₄ adsorption to activated carbon can be described by a reversible second-order equation. The reaction order was first order with respect to both virus and carbon concentration. This kinetic representation, however, is probably incorrect at optimum adsorption conditions, which occurred at a pH of 7.0 and ionic strength of 0.08. At optimum conditions the adsorption rate was satisfactorily described by a diffusion-limited process. Interpretation of adsorption data by a development of the diffusion equation for Langmuir adsorption yielded a diffusion coefficient of 12 X 10^-8 cm²/sec for bacteriophage T₄. This diffusion coefficient is in excellent agreement with the accepted value of 8 X 10^-8 cm²/sec. A diffusion-limited theory may also represent adsorption at conditions other than the maximal. A clear conclusion on the limiting process cannot be made.

Adsorption of bacteriophage T₄ to activated carbon obeys the Langmuir isotherm and is thermodynamically reversible. Thus virus is not inactivated by adsorption. Adsorption is unimolecular with very inefficient use of the available carbon surface area. The virus is probably completely excluded from pores due to its size.

Adsorption is of a physical nature and independent of temperature. Attraction is due to electrostatic forces between the virus and carbon. Effects of pH and ionic strength indicated that carboxyl groups, amino groups, and the virus's tail fibers are involved in the attachment of virus to carbon. The active sites on activated carbon for adsorption of bacteriophage T₄ are carboxyl groups. Adsorption can be completely blocked by esterifying these groups.

Part I: The abortive infection of bacteriophage øx174 at low temperatures. Part II: The early stages in the process of infection by bacteriophage øx174

Part I

The infection of E. coli by ΦX174 at 15°C is abortive; the cells are killed by the infection but neither mature phage nor SS (single-stranded) DNA are synthesized. Parental RF (replicative form) is formed and subsequently replicated at 15°C. The RF made at 15°C shows normal infectivity and full competence to act as precursor to progeny SS DNA after an increase in temperature to 37°C. The investigations suggest that all of the proteins required for SS DNA synthesis and phage maturation are present in the abortive infection at 15°C.

Three possible causes are suggested for the abortive infection at 15°C: (a) A virus-coded protein whose role is essential to the infection is made at 15°C and assumes its native conformation, but its rate of activity is too low at this temperature to sustain the infection process. (b) Virus maturation may involve the formation of a DNA-protein complex and conformational changes which have an energy threshold infrequently reached at 15°C. (c) A host-coded protein present in uninfected cells, and whose activity is essential to the infection at all temperatures, but not to the host at 15°C, is inactive at 15°C. An hypothesis of this type is offered which proposes that the temperature-limiting factor in SS DNA synthesis in vivo may reflect a temperature-dependent property of the host DNA polymerase.

Part II

Three distinct stages are demonstrated in the process whereby ΦX174 invades its host: (1) Attachment: The phage attach to the cell in a manner that does not irreversibly alter the phage particle and which exhibits "single-hit" kinetics. The total charge on the phage particle is demonstrated to be important in determining the rate at which stable attachment is effected. The proteins specified by ΦX cistrons II, III and VII play roles, which may be indirect, in the attachment reaction. (2) Eclipse: 'The attached phage undergo a conformational change. Some of the altered phage particles spontaneously detach from the cell (in a non-infective form) while the remainder are more tightly bound to the cell. The altered phage particles detached (spontaneously or chemically) from such complexes have at least 40% of their DNA extruded from the phage coat. It is proposed that this particle is, or derives from, a direct intermediate in the penetration of the viral DNA.

The kinetics for the eclipse of attached phage particles are first-order with respect to phage concentration and biphasic; about 85% of the phage eclipse at one rate (k = 0.86 min^-1) and the remainder do so at a distinctly lesser rate (k = 0.21 min^-1).

The eclipse event is very temperature-dependent and has the relatively high Arrhenius activation energy of 36.6 kcal/mole, indicating the cooperative nature of the process. The temperature threshold for eclipse is 17 to 18°C.

At present no specific ΦX cistron is identified as affecting the eclipse process. (3) DNA penetration: A fraction of the attached, eclipsed phage particles corresponding in number to the plaque-forming units complete DNA penetration. The penetrated DNA is found in the cell as RF, and the empty phage protein coat remains firmly attached to the exterior of the cell. This step is inhibited by prior irradiation of the phage with relatively high doses of UV light and is insensitive to the presence of KCN and NaN₃. Temporally excluded superinfecting phages do not achieve DNA penetration.

Both eclipsed phage particles and empty phage protein coats may be dissociated from infected cells; some of their properties are described.