Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial

BACKGROUND A newly developed collagen matrix (CM) of porcine origin has been shown to represent a potential alternative to palatal connective tissue grafts (CTG) for the treatment of single Miller Class I and II gingival recessions when used in conjunction with a coronally advanced flap (CAF). However, at present it remains unknown to what extent CM may represent a valuable alternative to CTG in the treatment of Miller Class I and II multiple adjacent gingival recessions (MAGR). The aim of this study was to compare the clinical outcomes following treatment of Miller Class I and II MAGR using the modified coronally advanced tunnel technique (MCAT) in conjunction with either CM or CTG. METHODS Twenty-two patients with a total of 156 Miller Class I and II gingival recessions were included in this study. Recessions were randomly treated according to a split-mouth design by means of MCAT + CM (test) or MCAT + CTG (control). The following measurements were recorded at baseline (i.e. prior to surgery) and at 12 months: Gingival Recession Depth (GRD), Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Keratinized Tissue Width (KTW), Gingival Recession Width (GRW) and Gingival Thickness (GT). GT was measured 3-mm apical to the gingival margin. Patient acceptance was recorded using a Visual Analogue Scale (VAS). The primary outcome variable was Complete Root Coverage (CRC), secondary outcomes were Mean Root Coverage (MRC), change in KTW, GT, patient acceptance and duration of surgery. RESULTS Healing was uneventful in both groups. No adverse reactions at any of the sites were observed. At 12 months, both treatments resulted in statistically significant improvements of CRC, MRC, KTW and GT compared with baseline (p < 0.05). CRC was found at 42% of test sites and at 85% of control sites respectively (p < 0.05). MRC measured 71 ± 21% mm at test sites versus 90 ± 18% mm at control sites (p < 0.05). Mean KTW measured 2.4 ± 0.7 mm at test sites versus 2.7 ± 0.8 mm at control sites (p > 0.05). At test sites, GT values changed from 0.8 ± 0.2 to 1.0 ± 0.3 mm, and at control sites from 0.8 ± 0.3 to 1.3 ± 0.4 mm (p < 0.05). Duration of surgery and patient morbidity was statistically significantly lower in the test compared with the control group respectively (p < 0.05). CONCLUSIONS The present findings indicate that the use of CM may represent an alternative to CTG by reducing surgical time and patient morbidity, but yielded lower CRC than CTG in the treatment of Miller Class I and II MAGR when used in conjunction with MCAT.

Assessment of Gastrointestinal Motility in Renal Transplant Recipients by Alternate Current Biosusceptometry

Background. Gastrointestinal (GI) complications are common after renal transplantation, mainly owing to immunosuppressive therapy. Assessment of GI transit time can facilitate rational management of these disorders.Objective. We evaluate the GI transit parameters in renal transplant recipients taking tacrolimus, azathioprine, and prednisone with the use of the alternate current biosusceptometry (ACB) technique and compared them with healthy volunteers.Methods. Ten renal transplant recipients and 10 healthy volunteers were enrolled in this study. After an overnight fast, patients and volunteers ingested a standard meal containing magnetic markers. The biomagnetic monitoring was performed at 10-minute intervals for at least 8 hours to obtain gastric emptying as well as the colonic arrival time-intensity curves. Mean gastric emptying time (MGET), mean colon arrival time (MCAT), and mean small intestinal transit time (MSITT) were quantified and compared between control and patient groups with results expressed as mean +/- SD.Results. The MGET measured by the ACB technique was 48 +/- 31 minutes and 197 +/- 50 minutes for patients and healthy subjects, respectively. MSITT and MCAT values calculated for patients versus volunteers were 171 +/- 71 minutes versus 197 +/- 71 minutes and 219 +/- 83 minutes versus 373 +/- 52 minutes, respectively. Renal transplant recipients showed significantly faster; gastric emptying and colon arrival times (P < .001) compared with normal volunteers; however, small intestinal transit time was not significantly different (P = .44).Conclusions. In stable renal transplant recipients, the GI transit parameters were significantly faster than in normal healthy volunteers. ACB sensors are versatile technologies that can be used for clinical research, because they offer an excellent opportunity to evaluate GI transit in a noninvasive manner without the use of ionizing radiation.

Avaliação da atividade de contração e evaziamento gástrico em ratos gastretomizados por biosusceptometria AC

Pós-graduação em Biologia Geral e Aplicada - IBB

Alternate current biosusceptometry for the assessment of gastric motility after proximal gastrectomy in rats: a feasibility study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Medical Students' Attitudes Toward The Medical College Admission Test

The following study analyzed the attitudes held by pre-clinical medical students about the Medical College Admission Test or MCAT. One hundred and eighty first-year and second-year medical students at a public Midwestern medical university participated in this study. Participants completed the “Medical Students Attitudes toward the Medical College Admission Test” survey during their morning lectures near the end of their spring semester. A composite scale score of the Likert items of the survey was computed and the proportion of students with attitudes ranging from strongly agree to strongly disagree was calculated. For six of the twelve Likert items the largest proportion of participants disagreed with the statements about the MCAT and its use in the admission process and its applicability to their current medical education. Other questions included how participants prepared for the MCAT and if they completed each of the subsections were addressed as well. Future research could determine if attitudes between students accepted into medical school and those not accepted are drastically different. Advisor: Kurt F. Geisinger

Analyse der Transportfunktion und Proteinexpression des kationischen Aminosäure-Transporters hCAT-3 und des verwandten Proteins SLC7A4

Die vorliegende Arbeit befasst sich mit der Charakterisierung des humanen kationischen Aminosäure-Transporters 3 (hCAT-3) und mit der Generierung spezifischer Antikörper gegen hCAT-3, mCAT-3 und das verwandte Protein SLC7A4. Im ersten Teil dieser Arbeit wurde gezeigt, dass hCAT-3 glykosyliert und in der Plasmamembran lokalisiert ist. Transportstudien an hCAT-3-exprimierenden Xenopus laevis Oozyten demonstrierten einen selektiven Transport von kationischen L-Aminosäuren. Die Transporteigenschaften von hCAT-3 (KM, Vmax, Trans-Stimulation) ähnelten den der Isoform hCAT-2B am meisten. Diese Ergebnisse stehen im Gegensatz zu Untersuchungen an CAT-3 von Maus und Ratte, in denen nur eine geringe CAT-Aktivität gezeigt wurde, die zudem durch neutrale und anionische Aminosäuren und durch D-Arginin hemmbar war. Die höchste Expression von hCAT-3 wurde im Thymus gefunden, was bedeutet, dass er nicht auf neuronale Zellen beschränkt ist. Dieser Befund steht im Gegensatz zur ausschließlich neuronalen Expression von rCAT-3 bzw. mCAT-3. Ein Schwerpunkt der Arbeit lag in der Generierung spezifischer Antikörper gegen die C-Termini des humanen und murinen CAT-3 und des verwandten Proteins SLC7A4. Dafür wurden Antiseren gegen Fusionsproteine zwischen dem bakteriellen trpE-Protein und den C-Termini der jeweiligen Isoform gewonnen. Zur Aufreinigung der Antikörpern wurden Affinitätssäulen mit Fusionsprotein aus Glutathion S-Transferase und den jeweils gleichen carboxyterminalen Aminosäuren von hCAT-3, SLC7A4 und mCAT-3 hergestellt. Zur Überprüfung der Spezifität der Affinitäts-aufgereinigten Antikörper wurden Western-Blot-Analysen mit Lysaten von X. laevis-Oozyten durchgeführt, die mit cRNA der jeweiligen Isoform injiziert worden waren. Weiterhin wurden humane U373MG Glioblastom-Zellen, in denen die jeweilige Isoform überexprimiert worden war, zur Überprüfung der Antikörper verwendet. Es konnte nachgewiesen werden, dass die neu gewonnenen Antikörper das jeweilige glykosylierte und deglykosylierte CAT-Protein spezifisch erkannten. Die hCAT-3 Antikörper wurden dazu verwendet die endogene Expression in NT2-Teratokarzinom-Zellen nachzuweisen. Hierbei zeigte sich, dass die intrazelluläre Expression höher war als an der Zelloberfläche. Nur etwa 10-20% des hCAT-3-Gesamtproteins wurden an der Zelloberfläche exprimiert. Die gleiche subzelluläre Verteilung zeigte sich in mit hCAT-3.EGFP stabil transfizierten U373MG-Zellen. Um die Auswirkung einer PKC-Aktivierung auf die Aktivität und Expression von hCAT-3 untersuchen zu können, wurden Transportexperimente an Oozyten und Western-Blot Analysen mit biotinylierten Zelloberflächen-Proteinen durchgeführt. Der PKC-Aktivator PMA reduzierte die hCAT-3 Expression um ca. 35% reduziert. Sowohl in X. laevis Oozyten, als auch in U373MG-Zellen war die Verminderung der Transportaktivität von einer Reduktion der Zelloberflächen-Expression von hCAT-3 begleitet. Die Vorbehandlung mit dem PKC-Inhibitor Bisindolylmaleimid I (BIM I) reduzierte beide PMA-Effekt. Es ist daher davon auszugehen, dass die Reduktion der Zelloberflächen-Expression durch PKC vermittelt wurde. Ähnlich wie hCAT-1 scheint auch hCAT-3 durch eine klassische PKC, am wahrscheinlichsten PKC? und PKC?, herunterreguliert zu werden. Durch konfokale Mikroskopie von überexprimierten hCAT-3.GFP-Konstrukten in U373MG-Zellen konnten diese Ergebnisse bestätigt werden. Ähnliche Ergebnisse wurden auch unter Verwendung der selbst hergestellten Antikörper gegen den endogenen hCAT-3 in NT2 Teratokarzinom-Zellen erzielt.

The modified coronally advanced tunnel combined with an enamel matrix derivative and subepithelial connective tissue graft for the treatment of isolated mandibular Miller Class I and II gingival recessions: a report of 16 cases.

OBJECTIVES To clinically evaluate the healing of mandibular Miller Class I and II isolated gingival recessions treated with the modified coronally advanced tunnel (MCAT) in conjunction with an enamel matrix derivative (EMD) and subepithelial connective tissue graft (SCTG). METHOD AND MATERIALS Sixteen healthy patients (13 women and 3 men) exhibiting one isolated mandibular Miller Class I and II gingival recessions of a depth of ≥ 3 mm, were consecutively treated with the MCAT in conjunction with EMD and SCTG. Treatment outcomes were assessed at baseline and at 12 months postoperatively. The primary outcome variable was complete root coverage (CRC) (eg, 100% root coverage). RESULTS Postoperative pain and discomfort were low and no complications such as postoperative bleeding, allergic reactions, abscesses, or loss of SCTG were observed. At 12 months, statistically significant (P < .0001) root coverage was obtained in all 16 defects. CRC was measured in 12 out of the 16 cases (75%) while in the remaining 4 defects root coverage amounted to 90% (in two cases) and 80% (in two cases), respectively. Mean root coverage was 96.25%. Mean keratinized tissue width increased from 1.98 ± 0.8 mm at baseline to 2.5 ± 0.9 mm (P < .0001) at 12 months, while mean probing depth did not show any statistically significant changes (ie, 1.9 ± 0.3 mm at baseline vs 1.8 ± 0.2 mm at 12 months). CONCLUSION Within their limits, the present results indicate that the described treatment approach may lead to predictable root coverage of isolated mandibular Miller Class I and II gingival recessions.

A mammalian arginine/lysine transporter uses multiple promoters.

The mCAT-2 gene encodes a Na(+)-independent cationic amino acid (AA) transporter that is inducibly expressed in a tissue-specific manner in various physiological conditions. When mCAT-2 protein is expressed in Xenopus oocytes, the elicited AA transport properties are similar to the biochemically defined transport system y+. The mCAT-2 protein sequence is closely related to another cationic AA transporter (mCAT-1); these related proteins elicit virtually identical cationic AA transport in Xenopus oocytes. The two genes differ in their tissue expression and induction patterns. Here we report the presence of diverse 5' untranslated region (UTR) sequences in mCAT-2 transcripts. Sequence analysis of 22 independent mCAT-2 cDNA clones reveals that the cDNA sequences converge precisely 16 bp 5' of the initiator AUG codon. Moreover, analysis of genomic clones shows that the mCAT-2 gene 5'UTR exons are dispersed over 18 kb. Classical promoter and enhancer elements are present in appropriate positions 5' of the exons and their utilization results in regulated mCAT-2 mRNA accumulation in skeletal muscle and liver following partial hepatectomy. The isoform adjacent to the most distal promoter is found in all tissues and cell types previously shown to express mCAT-2, while the other 5' UTR isoforms are more tissue specific in their expression. Utilization of some or all of five putative promoters was documented in lymphoma cell clones, liver, and skeletal muscle. TATA-containing and (G+C)-rich TATA-less promoters appear to control mCAT-2 gene expression. The data indicate that the several distinct 5' mCAT-2 mRNA isoforms result from transcriptional initiation at distinct promoters and permit flexible transcriptional regulation of this cationic AA transporter gene.