Search

Twenty cadaveric kidney allograft recipients were prerandomized into two groups. Ten patients (control group) were treated postoperatively with azathioprine (AZA) plus methylprednisolone (MP): the other ten received cyclosporin A (CyA) as the only immunosuppressive agent. Both groups received MP during rejection. One patient was excluded from the CyA group because of an early postoperative cardiac infarction and death. All transplants were monitored by alternate-day tine-needle aspiration biopsy and transplant aspiration cytology. Some patients treated with CyA had a significant initial decrease in urine output, reaching control values approximately 1 week postoperatively. The mechanism behind this deteriorated renal function is not clear, but it seemed to have been caused by injuries to the kidney tubular component, since a distinct monocytic-lymphocytic inflammation and severe cytological changes resembling pronounced acute tubular necrosis were observed concomitantly in transplant aspiration cytology. The CyA-treated patients had normal levels of blood leucocytes, thrombocyte and lymphocytes but displayed a strong early blood eosinophilia that was absent in the control subjects. During the first 30 days after transplantation 15 in situ episodes of inflammation were recorded in the nine transplants treated with CyA, whereas only 6 episodes were found in the 10 transplants receiving AZA + MP(P < 0.01). The first inflammatory episode in the CyA-treated transplants peaked between days 5 and 8 after transplantation and was followed by another distinct inflammatory episode between days 23 and 26. In the AZA- plus MP-treated transplants, only one inflammation episode was observed, with a peak on day 14 postoperatively. The inflammatory cell types most prominently present in the CyA-treated transplants were lymphocytes, B plasmablasts and monocytes. The early inflammatory episodes in the CyA-treated transplants may have been related to the fact that during the initial intramuscular administration, therapeutic CyA concentrations in patient serum were not achieved until the fourth postoperative day during peroral administration. The onset of transplant function had no impact on the in situ inflammatory response of rejection in the CyA-treated transplants or on the concentration of CyA in patient serum. This indicates that CyA may also be used in initially nonfunctioning transplants, Confirming our earlier results, we were unable to demonstrate the major histocompatibility complex (MHC) antigens on the healthy grafts treated with AZA plus MP. However, in healthy allografts treated with CyA, both classes of MHC antigens were nearly invariably demonstrable on the graft endothelial cell surface. Approximately 60% allograft survivals were recorded in both groups at 6 months, and all patients with functioning grafts were able to work [ABSTRACT FROM AUTHOR]

Aim: To evaluate outcomes and predictive factors for the long-term stability of root coverage using a sub-epithelial connective tissue graft., Materials and Methods: One-hundred and two healthy subjects (221 gingival recessions, GRs) were treated from 1987 to 1996. Keratinized tissue width (KTW), GR depth (RD), GR width (RW) and GR area (RA) were evaluated at baseline (M0) and at 1 month (M1), 1 year (M2), 11 years (M3), 21 years (M4) and 27 years (M5) after surgery. Primary outcomes consisted of complete root coverage (cRC) and relative dimensional changes in recession depth (measured in mm [c%-RD]), recession width (measured in mm [c%-RW]) and recession area (measured in mm 2 [c%-RA])., Results: cRC was 88.7% at 1 year (M2), 59.8% at M3, 44.4% at M4 and 51.9% at M5. Average c%-RD was 95.2% at 1 year, 81.9% at M3, 71.5% at M4 and 81.7% at M5. KTW increased after surgery and over time and was positively correlated with favourable outcomes. Increased baseline RA was associated with less favourable clinical outcomes., Conclusions: The sub-epithelial connective tissue graft is effective in the treatment of GRs and facilitates long-term stability of clinical outcomes. Wider baseline RA was a strong predictor of unfavourable short- and long-term RC outcomes., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To evaluate the impact of herpesvirus type-1 and -2 on the clinical outcomes of periodontal regenerative procedures in isolated deep intrabony pockets, in an experimental population with no detectable periodontal pathogens., Materials and Methods: Seventeen periodontal intraosseous defects in 17 moderate-to-advanced periodontitis patients were treated with regenerative therapy and amelogenins. Microbiological evaluation was performed at baseline (after the completion of initial therapy) and at 1 year to exclude the presence of periodontal pathogens. Herpesviruses-1 and -2 DNA were quantified in the pocket tissues associated to the intrabony defect using molecular assays. Clinical attachment level (CAL), probing pocket depth (PPD) and gingival recession (REC) were recorded at baseline and at 1 year., Results: After 1 year, the 17 defects resulted in significant CAL gain, PPD reduction and REC increase. HSV-1 was detected in five patients. Herpesvirus-2 was never found. The two subpopulations positive or negative to herpesvirus-1 were homogeneous at baseline. At 1 year, the five herpesvirus-1 positive patients resulted in lower amounts of CAL-gain and PPD reduction and greater amount of REC with respect to the 12 herpesvirus-1 negative patients., Conclusions: The presence of herpesvirus-1 at baseline is associated with poor clinical outcomes following regenerative therapy., (© 2012 John Wiley & Sons A/S.)

To study the effect of prolonged ethanol consumption on calcium metabolism and on the prevalence of osteoporosis we examined 38 Finnish noncirrhotic male alcoholics (30-55 years of age) with dietary interviews and biochemical measurements and by measuring the bone mineral content of the forearm using single photon absorptiometry (SPA) and the bone mineral density of the spine, humerus and proximal femur using nonquantified computer tomography (CT) and dual-energy x-ray absorptiometry (DEXA). In comparison two groups of healthy controls were studied. The mean daily dietary intake of calcium was 1.3 g in the patients and 1.2 g in the controls. The dietary intake of vitamin D was equal in the study groups, too. The serum levels of calcium, phosphate and parathyroid hormone did not show any difference between the patients and controls but in the alcoholics the urinary excretion of calcium was reduced by 42% (p less than 0.0001) as compared to the controls. The serum levels of 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and 24,25-dihydroxyvitamin D3 were reduced in the alcoholics by 40% (p less than 0.0001), 23% (p less than 0.01), and 48% (p less than 0.0001), respectively, as compared to the controls. The alcoholic men had normal levels of serum testosterone and they did not have hypercortisolism. The bone mineral content of the dominant forearm measured by SPA was similar in the study groups as were the bone mineral densities (BMD) of the lumbar and humeral areas measured by CT. The BMD at the lumbar, femoral neck, Ward's triangle and trochanter sites measured by DEXA did not differ, either.(ABSTRACT TRUNCATED AT 250 WORDS)