Retention kestoon ja hoitotuloksen pysyvyyteen vaikuttavat tekijät:kirjallisuuskatsaus

Tiivistelmä. Tämän kirjallisuuskatsauksen tavoitteena oli selvittää oikomishoidon pysyvyyttä ennustavat osatekijät sekä löytää vastaus siihen, mitä on huomioitava retention kestoa suunniteltaessa. Lähdeaineisto etsittiin PubMed- ja Medline-tietokantojen sekä oikomishoidon oppikirjojen avulla. Varsinaisessa tutkimusosiossa tarkasteltiin 25 artikkelia. Lähestyminen aiheeseen tehtiin ensisijaisesti kasvavan lapsen sekä nuoren aikuisen ja edelleen kehittyvän hampaiston kannalta. Katsauksen ulkopuolelle jätettiin julkaisut, joissa oikomishoitoa on suoritettu kirurgisin keinoin. Purennan palautumista on todettu esiintyvän eniten kahden ensimmäisen oikomishoitoa seuraavan vuoden aikana. Tällöin hammasta ympäröivien kudosten uudelleenjärjestäytyminen sekä kiinnittyminen vaikuttavat hoitotuloksen pysyvyyteen. Yleisesti suositaankin vähintään kahden vuoden pituista retentiojaksoa. Huomion arvoista on myös se, että retention olisi hyvä kestää yksilön aktiivisen kasvun päättymiseen saakka. Lisäksi tutkimuksissa tuli hyvin vahvasti esille, ettei palautumisen etiologiaa vielä täysin tunneta. Siihen vaikuttavia tekijöitä on kuitenkin tutkittu laajasti. Hoitotuloksen palautumiseen liittyviä muutoksia on usein vaikeaa erottaa normaaliin ikääntymiseen liittyvästä purennan kehittymisestä. Muutoksiin vaikuttavien mekanismien yhteisvaikutusten parempi tunteminen voisi edesauttaa oikomishoitojen kautta saavutettavien tulosten pysyvyyttä. Toisaalta pitkäkestoista pysyvyyttä ei voida saavuttaa ilman yksilöllisesti suunniteltua retentiovaihetta. Lisäksi on todettu, että palautumista tapahtuu jossain määrin retentiosta huolimatta

Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial

Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p <0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p <0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p <0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p <0.05) but increased in the 5-FU group (p <0.05). TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Carboxylesterase Activities and Protein Expression in Rabbit and Pig Ocular Tissues

Hydrolytic reactions constitute an important pathway of drug metabolism and a significant route of prodrug activation. Many ophthalmic drugs and prodrugs contain ester groups that greatly enhance their permeation across several hydrophobic barriers in the eye before the drugs are either metabolized or released, respectively, via hydrolysis. Thus, the development of ophthalmic drug therapy requires the thorough profiling of substrate specificities, activities, and expression levels of ocular esterases. However, such information is scant in the literature, especially for preclinical species often used in ophthalmology such as rabbits and pigs. Therefore, our aim was to generate systematic information on the activity and expression of carboxylesterases (CESs) and arylacetamide deacetylase (AADAC) in seven ocular tissue homogenates from these two species. The hydrolytic activities were measured using a generic esterase substrate (4-nitrophenyl acetate) and, in the absence of validated substrates for rabbit and pig enzymes, with selective substrates established for human CES1, CES2, and AADAC (D-luciferin methyl ester, fluorescein diacetate, procaine, and phenacetin). Kinetics and inhibition studies were conducted using these substrates and, again due to a lack of validated rabbit and pig CES inhibitors, with known inhibitors for the human enzymes. Protein expression levels were measured using quantitative targeted proteomics. Rabbit ocular tissues showed significant variability in the expression of CES1 (higher in cornea, lower in conjunctiva) and CES2 (higher in conjunctiva, lower in cornea) and a poor correlation of CES expression with hydrolytic activities. In contrast, pig tissues appear to express only CES1, and CES3 and AADAC seem to be either low or absent, respectively, in both species. The current study revealed remarkable species and tissue differences in ocular hydrolytic enzymes that can be taken into account in the design of esterase-dependent prodrugs and drug conjugates, the evaluation of ocular effects of systemic drugs, and in translational and toxicity studies.Peer reviewe

Size distributions, sources and source areas of water-soluble organic carbon in urban background air

International audienceThis paper represents the results of one year long measurement period of the size distributions of water-soluble organic carbon (WSOC), inorganic ions and gravimetric mass of particulate matter. Measurements were done at an urban background station (SMEAR III) by using a micro-orifice uniform deposit impactor (MOUDI). The site is located in northern European boreal region in Helsinki, Finland. The WSOC size distribution measurements were completed with the chemical analysis of inorganic ions, organic carbon (OC) and monosaccharide anhydrides from the filter samples. During the measurements gravimetric mass in the MOUDI collections varied between 3.4 and 55.0 ?g m?3 and the WSOC concentration was between 0.3 and 7.4 ?g m?3. On average, water-soluble particulate organic matter (WSPOM, WSOC multiplied by 1.6) comprised 25±7.7% and 7.5±3.4% of aerosol PM1 mass and the PM1?10 mass, respectively. Inorganic ions contributed 33±12% and 28±19% of the analyzed PM1 and PM1?10 aerosol mass. Five different aerosol categories corresponding to different sources or source areas were identified (long-range transport aerosols, biomass burning aerosols from wild land fires and from small-scale wood combustion, aerosols originating from marine areas and from the clean arctic areas). Clear differences in WSOC concentrations and size distributions originating from different sources or source areas were observed, although there are also many other factors which might affect the results. E.g. the local conditions and sources of volatile organic compounds (VOCs) and aerosols as well as various transformation processes are likely to have an impact on the measured aerosol composition. Using the source categories, it was identified that especially the oxidation products of biogenic VOCs in summer had a clear effect on WSOC concentrations

Potential implications of differential preservation of testate amoeba shells for paleoenvironmental reconstruction in peatlands

Testate amoebae are now commonly used in paleoenvironmental studies but little is known of their taphonomy. There is some experimental evidence for differential preservation of some testate amoeba shell types over others, but it is unclear what, if any impact this has on palaeoenvironmental reconstruction. To investigate this issue we looked at palaeoecological evidence for the preservation of different shell types. We then investigated the possible impact of selective preservation on quantitative palaeoenvironmental inference. We first used existing palaeoecological data sets to assess the vertical patterns of relative abundance in four testate amoeba shell types: (1) shells made of secreted biosilica plates (idiosomes, e.g. Euglypha), (2) idiosomes with thick organic coating (Assulina), (3) proteinaceous shells (e.g. Hyalosphenia), (4) shells built from recycled organic or mineral particles (xenosomes) (e.g. Difflugia, Centropyxis). In three diagrams a clear pattern of decay was only observed for the idiosome type. In order to assess the implications of differential preservation of testate amoeba taxa for paleoenvironmental reconstruction we then carried out simulations using three existing transfer functions and a wide range of scenarios, downweighting different test categories to represent the impact of selective test decomposition. Simulation results showed that downweighting generally reduced overall model performance. However downweighting a shell type only produced a consistent directional bias in inferred water table depth where that shell type is both dominant and shows a clear preference along the ecological gradient. Applying a scenario derived from previous experimental work did not lead to significant difference in inferred water table. Our results show that differential shell preservation has little impact on paleohydrological reconstruction from Sphagnum-dominated peatlands. By contrast, for the minerotrophic peatlands data-set loss of idiosome tests leads to consistent underestimation of water table depth. However there are few studies from fens and it is possible that idiosome tests are not always dominant, and/or that differential decomposition is less marked than in Sphagnum peatlands. Further work is clearly needed to assess the potential of testate amoebae for paleoecological studies of minerotrophic peatlands

Do different facets of littoral macroinvertebrate diversity show congruent patterns in a large lake system?

Modern biodiversity research focuses on multiple diversity facets because different indices may describe different ecological and environmental processes, as well as the effects of varied disturbances of natural and anthropogenic origins. We investigated littoral macroinvertebrate diversity in a large boreal lake system and specifically explored congruence of indices within and between the three diversity facets: species diversity, functional diversity and taxonomic distinctness. First, we found that the indices of taxonomic distinctness were the most sensitive indicators of eutrophication. Second, we observed that most correlations between the indices within the same diversity facet, and between the indices of functional and species diversity, were relatively strong. However, the indices of taxonomic distinctness (Δ+ and Λ+) were weakly associated with other metrics of diversity, emphasising the importance of taxonomic distinctness as a complementary dimension of biodiversity. Therefore, our observations support the importance to examine multiple facets for mapping biodiversity or for assessing the effects of anthropogenic disturbances on biological communities

Microseminoprotein-Beta Expression in Different Stages of Prostate Cancer

Microseminoprotein-beta (MSMB, MSMB) is an abundant secretory protein contributed by the prostate, and is implicated as a prostate cancer (PC) biomarker based on observations of its lower expression in cancerous cells compared with benign prostate epithelium. However, as the current literature on MSMB is inconsistent, we assessed the expression of MSMB at the protein and mRNA levels in a comprehensive set of different clinical stages of PC. Immunohistochemistry using monoclonal and polyclonal antibodies against MSMB was used to study protein expression in tissue specimens representing prostatectomies (n = 261) and in diagnostic needle biopsies from patients treated with androgen deprivation therapy (ADT) (n = 100), and in locally recurrent castration-resistant PC (CRPC) (n = 105) and CRPC metastases (n = 113). The transcript levels of MSMB, nuclear receptor co-activator 4 (NCOA4) and MSMB-NCOA4 fusion were examined by qRT-PCR in prostatectomy samples and by RNA-sequencing in benign prostatic hyperplasia, PC, and CRPC samples. We also measured serum MSMB levels and genotyped the single nucleotide polymorphism rs10993994 using DNA from the blood of 369 PC patients and 903 controls. MSMB expression in PC (29% of prostatectomies and 21% of needle biopsies) was more frequent than in CRPC (9% of locally recurrent CRPCs and 9% of CRPC metastases) (p<0.0001). Detection of MSMB protein was inversely correlated with the Gleason score in prostatectomy specimens (p = 0.024). The read-through MSMB-NCOA4 transcript was detected at very low levels in PC. MSMB levels in serum were similar in cases of PC and controls but were significantly associated with PC risk when adjusted for age at diagnosis and levels of free or total PSA (p<0.001). Serum levels of MSMB in both PC patients and controls were significantly associated with the rs10993994 genotype (p<0.0001). In conclusion, decreased expression of MSMB parallels the clinical progression of PC and adjusted serum MSMB levels are associated with PC risk