SDR Groups Research Articles

In vitro analysis of flowable and high viscosity bulk fill composite versus conventional composite in core build up of endodontically treated teeth.

This study aimed to test the load to fracture of flowable and high viscosity bulk-fill composites compared to a convetional (packable) composite used to build up pulpless teeth. 45 endodontically treated premolars were restored with fiber posts then divided into three groups (N = 15) according to the core build-up material. SDR group: (Smart Dentine Replacement), (BF): Filtek One Bulk Fill and (CC) Filtek Z350 packable composite. After core build up the teeth received full coverage crowns. Load to fracture (Newton) was recorded for each specimen. One-way ANOVA and Tukey multiple comparisons test were used. The highest load at fracture was shown by (CC) group (1067N), followed by (BF) group (879N), and the SDR group (838N). One way ANOVA and Tukey's multiple comparisons test demonstrated no significant differences between CC, SDR, and BF groups (p > 0.05). The three materials showed comparable load to fracture. Further studies with simulation to occlusal forces and oral temperature are required.

Influence of a budget single-peak light-curing unit on the microhardness and bond strength of bulk-fill resin composites to the gingival floor of proximal class II cavity preparations

ObjectiveTo evaluate the Vickers microhardness (VH) and long-term microtensile bond strength (μTBS) of bulk-fill resin-based composites (RBCs) at the bottom of the proximal boxes of Class II restorations when photo-cured using two different light-curing units (LCUs). MethodsMesio-occlusal-distal (MOD) cavities were prepared in 99 third molars (n = 7 per group) and restored with Tetric N-Ceram Bulk-Fill (TNC, Ivoclar), Filtek Bulk-Fill Flow (FBF, 3 M ESPE), or SDR flow+ (SDR, Dentsply Sirona). The RBCs were photo-cured with a dual-peak (Bluephase 20i, Ivoclar) or a single-peak budget LCU (Rainbow Curing Light, SML). The energy delivered by the lights were similar. The amount of light transmitted (% of maximum transmission) through the RBCs and the light beam profile through the restored teeth were recorded (n = 5). VH values were measured at the periphery of the RBC in the proximal box. After 24-h storage in water or after additional thermocycling, the teeth were sectioned to make 1 mm2 sticks. The μTBS of bulk-fill RBCs to the dentin on the gingival floor of the proximal boxes was then measured. Two-way repeated-measures ANOVA and 2-way ANOVA were used to analyze the VH and μTBS data, respectively, and Bonferroni's post-hoc test (α = 5%). No comparisons were made among RBCs. ResultsWhen the bonding agent was photo-cured with the budget light, all the specimens failed. Therefore, the Bluephase 20i photo-cured all the bonding resins and the budget light was only used to photo-cure the RBCs. The Bluephase 20i delivered a more homogeneous and wider light distribution through the restored teeth, higher VH values for TNC and SDR groups (p < 0.05), and higher μTBS in the TNC group (p < 0.05) than those produced by the single-peak budget LCU. The μTBS values to the dentin at the gingival floor of the proximal boxes decreased after thermocycling in the SDR group (p < 0.05). ConclusionWhen the bonding agent was photo-cured with the budget light, all the specimens failed. Photo-curing the RBC with a single-peak, budget LCU compared to the Bluephase 20i reduced the VH and μTBS values of bulk-fill RBCs to the gingival floor.

COMPARISON OF THE MICROHARDNESS OF BULK FILL COMPOSITES

The aim of this study is to compare the microhardness of five different bulk fill composites (SDR, TEC, XTF, SF, FBF). A total of 25 cylindrical molds were prepared. Composite resin was placed in each mold in sequence, at one time, by condensing it thoroughly. Then, the polymerization of the composites was achieved with the LED light device which was applied for 20 seconds. Microhardness measurements of the samples were made with the classical Vicker's test. The data of our study were evaluated by using the Kruskal Wallis H test with the SPSS 20.0 package program. When the measured surface microhardness values were compared between the groups; microhardness values SDR and FBF groups were found to be significantly lower than TEC, XTF and KSF groups (p&amp;lt;0.05). When the sub-surface microhardness values were compared between the groups; the microhardness value of the SDR group was found to be significantly higher than the FBF group, and significantly lower than the TEC, XTF and KSF groups (p&amp;lt;0.05). When both the lower and upper surface microhardness values were compared between the groups, XTF was found to be the bulk fill composite group with the best microhardness.

An In-Vitro Evaluation of Microleakage in Resin-Based Restorative Materials at Different Time Intervals.

A vital feature of conservative dentistry is the adhesion of the restorative material to the tooth structure for restoration of the tooth substance lost due to dental decay, trauma, or dental imperfections. In a perfect world, a restorative material should generate a lasting adhesion by bonding the restoration with tooth tissues. The ingress of micro-organisms, oral fluids, molecules, and ions through microscopic spaces due to faulty adhesion between restoration and tooth structure is known as microleakage. This study is focuses on the evaluation of adhesive failures between the restorative materials. In the past, studies have focused more on the bonding potential of a restorative material with the tooth surface. Therefore, there is need to carry out a study that compares the microleakage between resin-based restorative materials in a sandwich manner with and without the intermediate bonding layer after immersion in 2% methylene blue dye at different time intervals. The restorative materials used were composite Ceram X Mono plus (DENTSPLY) and Z350 (3M ESPE), Vitremer resin modified glass ionomer cement (RMGIC) (3M ESPE), smart dentine replacement SDR (3M ESPE), Bond NT (DENTSPLY), and Universal Bond (3M ESPE). A light emitting diode (LED) was used to cure the specimens. Artificial saliva was used as a storage medium for the specimens. Thermocycling of specimens was carried out at 500 cycles/30 s and 1000 cycles/30 s. The world health organization (WHO) grading tool for microleakage was used to analyze fluid ingress in the specimens through disclosing by 2% methylene blue dye. The statistical analysis was carried out with one-way analysis of variance (ANOVA) and Tukey post hoc test, keeping the level of significance at p ≤ 0.05. In Grade 0 = 85 samples, Grade 1 = 10 samples, Grade 2 = 7 samples, Grade 3 = 16 samples, and in Grade 4 = 2 samples were identified. This study describes that no microleakage was observed in SDR and resin composite groups as compared to Vitremer and resin composite groups.

Characteristics of behavioral symptoms in right-sided predominant semantic dementia and their impact on caregiver burden: a cross-sectional study

BackgroundThis study aimed to clarify the neuropsychiatric symptoms of right-sided predominant semantic dementia (SD-R) by comparing them with those of behavioral variant frontotemporal dementia (bvFTD), left-sided predominant SD (SD-L), and Alzheimer’s disease (AD). This study also aimed to identify clinical factors related to caregiver burden for bvFTD, SD-R, and SD-L.MethodsThe neuropsychiatric symptoms of 28 patients with bvFTD, 14 patients with SD-R, 24 patients with SD-L, and 43 patients with AD were evaluated using the Neuropsychiatric Inventory (NPI) and the Stereotypy Rating Inventory (SRI). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Dementia severity was assessed using the Clinical Dementia Rating. Activities of daily living were assessed using the Lawton Instrument Activities of Daily Living (IADL) scale and the Physical Self-Maintenance Scale. We compared the NPI and SRI scores among the four groups using the Kruskal-Wallis test. In addition, clinical factors related to caregiver burden, represented by the Japanese version of the Zarit Burden Interview (J-ZBI), were analyzed using multiple regression analysis in the bvFTD, SD-R, and SD-L groups.ResultsThe NPI total score and the NPI subscale scores of apathy and disinhibition were significantly higher in the bvFTD group than in the SD-L and AD groups. The SD-R group scores were closer to those of the bvFTD group than the SD-L group. The SRI total score and SRI subscale scores for eating and cooking and speaking were significantly higher in the bvFTD, SD-R, and SD-L groups than in the AD group. The NPI total score was significantly associated with the J-ZBI score in the bvFTD group. The NPI total score and Lawton IADL scale score were independently associated with the J-ZBI score in the SD-R group. Furthermore, the NPI total score and MMSE score were independently associated with the J-ZBI score in the SD-L group.ConclusionsSD-R seemed to be a similar condition to bvFTD rather than SD-L regarding behavioral symptoms. Our results suggest that each frontotemporal dementia subgroup requires different approaches to reduce the caregiver burden.

Early postoperative dressing removal in hand surgery: Novel concepts for individualized surgical dressing management

Postoperative dressing protocols after clean surgery without implant vary widely. The purpose of this study was to elucidate whether early postoperative dressing removal is a valid option, as compared to untouched dressing or twice-weekly dressing change approach. A prospective randomized study was conducted on patients who underwent carpal tunnel release (CTR) or trigger finger release (TFR) between January and November 2020. Patients were randomly distributed into 3 groups: surgical dressing untouched until first follow up (SDU); surgical dressing changed twice a week in a health maintenance organization (HMO); and surgical dressing removed at first postoperative day (SDR). Data collected included patient characteristics, pre-and post-operative functional (QuickDASH) and autonomy (Instrumental Activities of Daily Living performance (IADL)) scores, Vancouver scar scale (VSS) and potential complications. Eighty-four patients were included: 28 (33.3%), 29 (34.5%) and 27 (32.1%) in the SDU, HMO and SDR groups, respectively. Deterioration in mean IADL score at 2-week follow-up was statistically significant in the HMO group (mean delta 3.35, p = 0.008). Quick DASH score improved significantly between preoperative and 2-week follow-up values only in the SDU group (mean delta 9.12, p = 0.012). Other parameters, including wound complications, did not differ significantly between groups. Early removal of postoperative dressing and immediate wound exposure was a safe option after CTR and TFR. An untouched bulky dressing correlated with early functional improvement. Finally, iterative dressing change in HMO showed no benefit and led to significant deterioration in early postoperative autonomy. IRB approval0548-18-TLV. Level of evidenceI.

SLEEP DEPRIVATION INDUCES DIFFERENTIAL BIOLOGICAL RESPONSE IN RAT MASTICATORY MUSCLES: INFLAMMATION AND MYOGENESIS

Sleep plays an important role in promoting human health since it is closely involved in the maintenance of homeostasis of the human body. The aim of this study was to evaluate if sleep deprivation induces inflammation, autophagy, and myogenesis in rat masticatory muscles: the masseter and temporal muscle. A total of 18 animals were distributed into 3 groups: the control group (CTL, n = 6), subjected to sleep deprivation for 96 hours (SD96, n = 6) and subjected to sleep deprivation for 96 hours and 96 hours of sleep recovery (SD96R, n = 6). In the group SD96R, no inflammatory process was noted in the mas- seter only. Up-regulation of tumor necrosis factor-alpha (TNFa) production was detected in the SD96 group, while SD96R decreased TNF immunoexpression for both skeletal muscles evaluated. MyoD and myogenin increased in rats subjected to SD96. Nevertheless, the levels of MyoD decreased immunoexpression. Myogenin had high immunoexpression in SDR groups. Akt decreased in animals submitted to SD whereas, LC3 protein increased in the temporal muscle only. In summary, our results show that SD is able to induce inflammation, atrophy, and myogenesis in rat masticatory muscles and is dependent on skeletal muscle type and the recovery process. Sleep plays an important role in promoting human health since it is closely involved in the maintenance of homeostasis of the human body. The aim of this study was to evaluate if sleep deprivation induces inflammation, autophagy, and myogenesis in rat masticatory muscles: the masseter and temporal muscle. A total of 18 animals were distributed into 3 groups: the control group (CTL, n = 6), subjected to sleep deprivation for 96 hours (SD96, n = 6) and subjected to sleep deprivation for 96 hours and 96 hours of sleep recovery (SD96R, n = 6). In the group SD96R, no inflammatory process was noted in the mas- seter only. Up-regulation of tumor necrosis factor-alpha (TNFa) production was detected in the SD96 group, while SD96R decreased TNF immunoexpression for both skeletal muscles evaluated. MyoD and myogenin increased in rats subjected to SD96. Nevertheless, the levels of MyoD decreased immunoexpression. Myogenin had high immunoexpression in SDR groups. Akt decreased in animals submitted to SD whereas, LC3 protein increased in the temporal muscle only. In summary, our results show that SD is able to induce inflammation, atrophy, and myogenesis in rat masticatory muscles and is dependent on skeletal muscle type and the recovery process.

SLEEP DEPRIVATION INDUCES PATHOLOGIC CHANGES IN RAT MASTICATORY MUSCLES: ROLE OF TOLL-LIKE PATHWAY AND ATROPHY

We evaluated the toll-like signaling pathway and atrophy after sleep deprivation (SD) in masseter and temporal muscles. Twenty-four animals were distributed into 3 groups (n = 8/each): control (CTL), subjected to SD for 96 hours (SD96), and subjected to SD for 96 hours plus 96 hours of sleep recovery (SDR). Histopathologic analysis revealed acute inflammatory cells, congested vessels, fibrosis, and high cellularity in both muscles submitted to SD. These morphologic alterations were not observed in the control group. In rats of SDR, the absence of inflammation was noticed in the masseter. In this group, cyclooxygenase 2 and tumor necrosis factor-α downregulation were detected when comparing with controls. MyD88 and pIKK decreased in SD96 and SDR groups being pNFKBp50 downregulated in SDR. MyD88 expression increased in temporal of rats submitted to SD96 and SDR. On the other hand, pIKK decreased the protein expression in groups SD96 and SDR, while pNFKBp50 showed a decreased protein expression in the SD96 group only. The activation of atrophy by MAFbx upregulation was detected in temporal muscle in SD96 and SDR. Our results show that SD is able to induce morphologic alterations in rat masticatory muscles. Toll-like signaling pathway and atrophy play important roles in etiopathogenesis induced by SD, being dependent on muscle type. We evaluated the toll-like signaling pathway and atrophy after sleep deprivation (SD) in masseter and temporal muscles. Twenty-four animals were distributed into 3 groups (n = 8/each): control (CTL), subjected to SD for 96 hours (SD96), and subjected to SD for 96 hours plus 96 hours of sleep recovery (SDR). Histopathologic analysis revealed acute inflammatory cells, congested vessels, fibrosis, and high cellularity in both muscles submitted to SD. These morphologic alterations were not observed in the control group. In rats of SDR, the absence of inflammation was noticed in the masseter. In this group, cyclooxygenase 2 and tumor necrosis factor-α downregulation were detected when comparing with controls. MyD88 and pIKK decreased in SD96 and SDR groups being pNFKBp50 downregulated in SDR. MyD88 expression increased in temporal of rats submitted to SD96 and SDR. On the other hand, pIKK decreased the protein expression in groups SD96 and SDR, while pNFKBp50 showed a decreased protein expression in the SD96 group only. The activation of atrophy by MAFbx upregulation was detected in temporal muscle in SD96 and SDR. Our results show that SD is able to induce morphologic alterations in rat masticatory muscles. Toll-like signaling pathway and atrophy play important roles in etiopathogenesis induced by SD, being dependent on muscle type.

Comparison of different base materials on fracture strength of mesio-occlusal-distal composite restorations

Abstract Objective: The aim of this study was to evaluate the influence of different base materials on fracture strength of mesio-occlusal-distal (MOD) composite restorations. Materials and Methods: Forty-eight extracted, intact maxillary molar teeth with standardized, deep MOD cavities were randomly assigned into four groups according to the base material placed: Control group (CO); no base material, SDR group; bulk-fill flowable composite, CGIC group; chemically curing glass ionomer cement (GIC), and RGIC group; light curing resin reinforced GIC. All the specimens were then restored with a nanocomposite (CeramX Duo/Dentsply) in combination with etch and rinse adhesive following the manufacturer’s instructions. After aging fracture, strength of the specimens was tested by the application of a ramped oblique load to the buccal cusp in a universal testing machine. Mean fracture strength values for each group were calculated and compared using one-way ANOVA (P = 0.05). Fracture patterns of the specimens were also evaluated. Results: The mean loads necessary to fracture the samples were as follows: control: 819.22 ± 253.65; SDR: 694.46 ± 266. 55; CGIC: 559.15 ± 277.34; RGIC 861.87 ± 277.28: N. The control and RGIC groups showed significantly higher fracture strength than CGIC and SDR groups (P &lt; 0.05). Although the mean fracture strength value of SDR group was higher than that of CGIC group, the difference between these groups was not statistically significant (P &gt; 0.05). Most frequently observed fracture patterns were adhesive (58.3%) in CO, cohesive (50%) in SDR group, cohesive (83.3%) in CGIC group, and mixed (41.7%) in RGIC group. Conclusions: Resin-modified glass-ionomer cement as a base material or restoration of the tooth only with composite resin resulted in higher fracture strength than composite resin restoration with a conventional glass ionomer base or a flowable bulk-fill material. Fracture pattern distributions diversed according to the base material placed under composite restoration.

A comparison of dentin bond strength and degree of polymerization of bulk-fill and methacrylate-based flowable composites.

Objective:This study aimed to evaluate the dentin bond strength and degree of polymerization of bulk-fill and methacrylate-based flowable composites.Materials and Methods:Dentin bond strength of composites was evaluated using the microtensile bond strength (μTBS) test. Five different composites were applied on flat dentin surfaces with self-etch and etch-and-rinse adhesives. Twenty microspecimens with a 1 mm2 cross-sectional area were prepared for each group (n = 20). The μTBS test was then applied. To measure the degree of polymerization of composites, eight cylindrical blocks were prepared (n = 8) from each composite. The surface microhardness of each composite was measured on the bottom and top surfaces, and a hardness ratio (HR) was calculated. Data were analyzed using one-way ANOVA and the Tukey's honestly significant difference test (α = 0.05).Results:According to the μTBS test results, the SDR Etch-and-Rinse group exhibited the highest dentin bonding strength and the Aelita self-etch group exhibited the lowest (P < 0.05). HR measurement showed that all composite groups had a sufficient degree of polymerization at a 2-mm thickness, while only the SDR and Xtra-Base groups had sufficient polymerization at a 4-mm thickness.Conclusions:Bulk-fill composite demonstrates an even higher degree of polymerization of methacrylate-based flowable composite when applied in a 4-mm thickness.

'Effects of novel root repair materials on attachment and morphological behaviour of periodontal ligament fibroblasts: Scanning electron microscopy observation'.

The aim of this study was to evaluate the adhesion of periodontal ligament fibroblasts (PDLs) on newly proposed root repair materials [Biodentine, MM-MTA, polymethylmethacrylate (PMMA) bone cement, and SDR], in comparison with contemporary root repair materials [IRM, Dyract compomer, ProRoot MTA (PMTA), and Vitrebond]. Five discs from each material were fabricated in sterile Teflon molds, and the specimens were aged and prewetted in cell culture media for 96 hours. Three material discs were used for scanning electron microscopy (SEM) for the assessment of the attachment, density, and morphological changes in the PDLs, while two samples were used for energy dispersive x-ray spectroscopy (SEM-EDX) to determine the elemental composition of the materials. Human PDLs were plated onto the materials at a density of 10,000/well, and incubated for 3 days. The SEM micrographs were taken at different magnifications (500× and 5000×). In the SEM, the cells were attached and well spread-out on the surfaces of the Biodentine, PMTA, and Dyract compomer, while varied cell densities and morphological alterations were observed in the Vitrebond, IRM, MM-MTA, SDR, and PMMA bone cement groups. The SEM-EDX analysis revealed a maximum calcium percentage in the PMTA specimens, as well a maximum silicon percentage in the Dyract compomer specimens. This in vitro study demonstrated that the Biodentine and Dyract compomer supported PDL cell adhesion and spreading. The PMTA presented a favorable scaffold for better attachment of the PDL cell aggregates. Therefore, the calcium and silicon content of a material may enhance the PDL cell attachment.

Abstract 4113: Restricted ketogenic diet reduces growth and distant organ metastasis in the murine VM-M3 metastatic tumor model

Abstract Metastasis involves the spread of tumor cells throughout the body and is one of the leading causes of cancer death. Most current drug therapies for metastatic cancer are toxic and only marginally effective in providing long-term management. Respiratory insufficiency with compensatory aerobic fermentation (Warburg effect) is the hallmark biochemical phenotype of nearly all neoplastic cells within tumors. Most tumor cells are incapable of utilizing ketone bodies for energy due to their respiratory insufficiency. Calorie restriction, which lowers blood glucose and elevates ketone bodies, is known to reduce tumor growth. We previously showed that ketogenic diets with high fat/protein + carbohydrate ratios of 3-4:1 are better able to lower blood glucose and elevate ketone levels than is calorie restriction alone. We evaluated the influence of a new ketogenic diet formula from Solace Nutrition (KetoGen) on the growth and metastatic spread of the VM-M3 tumor. VM-M3 is a highly metastatic macrophage-like tumor that arose spontaneously in the brain of the syngeneic inbred VM/Dk mouse strain. The VM-M3 cells spread rapidly (within days) to lungs, liver, spleen, kidney, and brain with 100% fidelity following subcutaneous implantation. Tumor bearing VM mice were fed either a standard lab chow diet in unrestricted amounts (SD-UR), a standard lab chow restricted to obtain an 18% reduction in body weight (SD-R), or the KetoGen diet restricted (KG-R) to match the body weights of the SD-R control group. Tumor size was significantly smaller and organ metastasis was significantly less in the KG-R group than in the SD-UR or SD-R groups. Although blood glucose was reduced similarly in both the SD-R and KG-R groups, blood ketones were 3-fold higher in the KG-R group than in the SD-R group. These results show that VM-M3 tumor growth and systemic metastasis was managed better with the restricted KetoGen KD than with calorie restriction of a high carbohydrate standard diet. As all human and mouse tumors cells suffer from respiratory insufficiency, our findings suggest that the KetoGen diet should be an effective non-toxic therapy against systemic metastatic cancer. Citation Format: Zeynep Akgoc, Laura M. Shelton, David Ryan, Xijun Zhu, Thomas N. Seyfried. Restricted ketogenic diet reduces growth and distant organ metastasis in the murine VM-M3 metastatic tumor model. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4113. doi:10.1158/1538-7445.AM2014-4113

Influence of the bulk fill restorative technique on microleakage and microtensile of class II restorations

Abstract Background & Aim The aim of this study is to evaluate microleakage and bond strength test of the bulk fill restorative technique. Materials and methods AELITE LS Posterior and SureFil SDR flow were used as composite restoration, and Clearfil S 3 (Self Etch system) Bond and Prime&Bond NT (Total Etch system) were used as bonding agents. Standardized Class II cavities were made on sixty extracted premolar teeth and they were randomly divided into four groups. Thermo-cycling and mechanical loading was applied to all samples. The samples were stored in the %2 basic fuchsine solutions and the microleakage was evaluated. Results When total etching system groups were evaluated, the cervical microleakage values were higher than occlusal microleakage values on both composites ( P P Conclusions The results support the conclusion that the SureFil SDR flow exhibited the best performance in occlusal margins of Prime&Bond NT-SureFil SDR groups.

Resveratrol Delays Age-Related Deterioration and Mimics Transcriptional Aspects of Dietary Restriction without Extending Life Span

A small molecule that safely mimics the ability of dietary restriction (DR) to delay age-related diseases in laboratory animals is greatly sought after. We and others have shown that resveratrol mimics effects of DR in lower organisms. In mice, we find that resveratrol induces gene expression patterns in multiple tissues that parallel those induced by DR and every-other-day feeding. Moreover, resveratrol-fed elderly mice show a marked reduction in signs of aging, including reduced albuminuria, decreased inflammation, and apoptosis in the vascular endothelium, increased aortic elasticity, greater motor coordination, reduced cataract formation, and preserved bone mineral density. However, mice fed a standard diet did not live longer when treated with resveratrol beginning at 12 months of age. Our findings indicate that resveratrol treatment has a range of beneficial effects in mice but does not increase the longevity of ad libitum-fed animals when started midlife.

Can episodic memory tasks differentiate semantic dementia from Alzheimer's Disease?

The performance of two groups of patients with semantic dementia (SD), with predominant right (SDR) and left temporal lobe atrophy (SDL), was contrasted with that of cases with probable Alzheimer's disease (AD) on a range of standard episodic memory tasks. While the SDL group achieved a good score on a composite visual, but not a verbal, episodic memory measure, the AD and SDR groups were equivalently impaired at visual and verbal memory. The SD, but not the AD, groups were, by definition, impaired on simple tests of semantic memory. Standard verbal episodic memory tests, therefore, failed to discriminate patients with SD from those with probable AD and even visual memory tests may result in misclassification of SDR cases.

Role of glucose and ketone bodies in the metabolic control of experimental brain cancer.

Brain tumours lack metabolic versatility and are dependent largely on glucose for energy. This contrasts with normal brain tissue that can derive energy from both glucose and ketone bodies. We examined for the first time the potential efficacy of dietary therapies that reduce plasma glucose and elevate ketone bodies in the CT-2A syngeneic malignant mouse astrocytoma. C57BL/6J mice were fed either a standard diet unrestricted (SD-UR), a ketogenic diet unrestricted (KD-UR), the SD restricted to 40% (SD-R), or the KD restricted to 40% of the control standard diet (KD-R). Body weights, tumour weights, plasma glucose, β-hydroxybutyrate (β-OHB), and insulin-like growth factor 1 (IGF-1) were measured 13 days after tumour implantation. CT-2A growth was rapid in both the SD-UR and KD-UR groups, but was significantly reduced in both the SD-R and KD-R groups by about 80%. The results indicate that plasma glucose predicts CT-2A growth and that growth is dependent more on the amount than on the origin of dietary calories. Also, restriction of either diet significantly reduced the plasma levels of IGF-1, a biomarker for angiogenesis and tumour progression. Owing to a dependence on plasma glucose, IGF-1 was also predictive of CT-2A growth. Ketone bodies are proposed to reduce stromal inflammatory activities, while providing normal brain cells with a nonglycolytic high-energy substrate. Our results in a mouse astrocytoma suggest that malignant brain tumours are potentially manageable with dietary therapies that reduce glucose and elevate ketone bodies.

Comparison of Five Antimicrobial Regimens for the Treatment of Brucellar Spondylitis: A Prospective, Randomized Study

Brucellosis, a zoonosis with worldwide distribution, is a systemic infection and still an important public health problem in Turkey. The best antimicrobial combination and schedule for the treatment of brucellosis with spondylitis has not yet been clearly determined. In a prospective and randomized study, we compared the efficacy of five antimicrobial regimens for treatment of 102 patients with lumbar brucellar spondylitis. Patients were randomly assigned to receive antimicrobial combination therapy. Twenty patients received streptomycin 1 g/day intramuscularly for 15 days and tetracycline-HCl, 500 mg every 6 h orally for 45 days (ST), 21 patients received streptomycin 1 g/day i.m. for 15 days and doxycycline 100 mg every 12 h orally for 45 days (SD), 20 patients received doxycycline 100 mg every 12 h orally for 45 days and rifampicin 15 mg/kg per day in a single morning dose orally for 45 days (DR), 19 patients received ofloxacin, 200 mg every 12 h orally for 45 days and rifampicin 15 mg/kg per day in a single morning dose orally for 45 days (OR), and 22 patients received streptomycin 1 g/day i.m. for 15 days and doxycycline 100 mg every 12 h orally for 45 days plus rifampicin 15 mg/kg per day in a single morning dose orally for 45 days (SDR). Initial therapeutic failure occurred in 2 patients (10%) in the ST regimen group, 4 patients (19%) in the SD group, 3 patients (15%) in the DR group and 5 patients (26%) in the OR regimen. In addition, 2 patients (10%) in the DR group and 5 patients (26%) in the OR regimen relapsed during the follow-up period. There was no relapse in any patients in the ST, SD, and SDR groups. The response rates were 90% in the ST and 81% in the SD groups. In contrast, there was a maximum good response (100%) and no relapse in the SDR group. In conclusion, a combination of doxycycline, streptomycin, and rifampicin can be recommended as therapy for brucellar spondylitis and to reduce relapse rates.