TINH QUA SHELLAC F

TCNCYH Phu trwong 74 (3) - 2011

DOC TINH QUA SHELLAC F VQ! NGUYEN BAQ SQI CUA NLPQU NGLPQI

Hoing Dao Bao Tram^-^, Hoang Tu? Hung\ Imad About^

^Dai hoc Y Dwoc Thanh phd Hd Chi Minh, Viet Nam.

^Labo IMEB - ERT30 - Khoa Nha - Dai hoc Mediterranee, Marseille, Phdp.

Dinh gii dde tinh ciia Shellac F ddi vdi nguyen bao sal ciia nwdu ngwdi. Phwang phap: Phwang phip thir dpc tinh vai ti bap qua chit tiit tw vit lieu theo chuin chau Au ISO 10993 - 5. Te bao dwvc nuoi eiy trong cie mdi trwdng da tiep xiic vdi vpt lipu thir, a cie ndng dp khic nhau (pha loing theo ty le 1:1, 1:2, 1:10, 1:100, 1:1000, 1:10000). Mit dp te bao dwac dinh gia bang thir nghiem MTT, sir dung may quang phd ki E 960 (Bioblock, Strasbourg, France) a budc song 550nm. Kit qui: Ddi vdi nguyen bao sal cua nwdu ngwdi. Shellac F khdng cdn dpc tinh a mwc dp pha loang mdi trudng la 1:10 (ty Ip ti bao sdng tmng binh li 96,13%,), twang dwang vdi Duraphaf (98,86%), trong khi dd Isodan khdng dpc a dp pha loang 1:100 (ty Ip te bao sdng trung binh la 100%). Kit luan: Ddi vdi nguyen bao sai cua nwdu ngudi, mire dp dde tinh vdi ti bao cua Shellac F twang dwang vdi Duraphaf va thip han Isodan.

Tu- khoa: Shellac F, dpc tinh vo-i t§ bao, nguyen bao sgi cua nu-o-u ngu-o-i

I. DAT

V A N

Dfe

Nhudm ring l i mdt phong tyc cd truyin d Viet Nam va mpt sd nude thupc khu vyc Ddng Nam A.

Tif nhan xet thiy cac rang nhudm dugc bao ve tdt khong bi siu, trong nhirng nam cuoi thap nien 60 va thip nien 70, nginh Rang Him Mat Viet Nam da CO nhu-ng d i t i i su- dyng nhua canh kien tren lam sing d i diiu tri e budt eo rang va phdng chong sau rang (Hoing Thj Thuc et al., 1968; Nguyin Duang Hdng, 1970). Nhiiu thu- nghiem lim sing sau dd dugc tiip tue thye hien cho thiy hieu qua cua viec su- dyng nhya einh kiin trong c h i ngy nhay cam ngi v i du phdng s i u rang (Vd T h i Quang et al., 1985; Dao Thj Hdng Quan, 1996).

V6c - ni Shellac F l i mdt v i t lidu duge c h i tao tir nhya einh kiin do cd NaF D i y la san pham qui mo phdng thi nghidm, kit qua eua Cdng trinh nghien cu-u eua khoa Ring Ham Mat - Dai Hpc Y Dugc TP HCM, phoi hgp vdi Khoa Hda - Dai Hpc Bich Khoa TP. HCM (Hoing Tu- Hung et al., 2000). Theo Hiep hdi Nha khoa Quoe te (Stanford JW et al., 1980), de dinh g i i cac die tinh sinh hpc cua mdt vit lieu sinh hpc (Stanley RS et al., 1985), cin thye hidn mdt chudi gdm ba loat thu- nghiem nii tiep: thu- nghiem c i p 1 in vitro, thu- nghiem cip 2 - in vivo, v i thu- nghiem su- dyng. Trong cie logi thLP nghiem cip 1, thCr nghidm dde tinh vdi t i bio l i thu- nghidm bit budc doi vdi v i t lieu nha khoa. Thu- nghiem v i dde tinh eua Shellac F ddi vdi ddng t i bio L929 v i so sinh vdi cie v i t lieu ChCrng d i duge thye hidn cho phep danh g i i mu-c

dp dpc vdi t i bao cua vat lieu vdi ddng t i bao bat tu-, dugc su- dung pho biin trong cie thu- nghiem in vitro tai nhieu phdng thi nghiem tren t h i gidi. Loai t i bao nay ed nhung dac diim thuan Igi ddi vdi cie thu- nghiem in vitro. Ddng thdi, viec su- dung cung mdt loai t i bao cho phep so sinh kit qua eua cac thu- nghiem giira cie ca sd nghien eCru vdi nhau.

Tuy nhien, L929 khdng phai la t i bio dich m i vit lieu thye su tiip xue v i tac ddng tren lim sang vdi muc tieu: Dinh gia dpc tinh cua Shellac F ddi vdi nguyen bao sgi eua nudu ngudi, so sinh vdi eic vat lieu ehCrng la Duraphat® (Colgate), Isodan (Septodont).

II. 0 6 l TU'QNG VA PHU'QNG

P H A P 1. Ddi tu'ang

Shellac F: sodium fluoride (5%), ethanol, aceton, gum lac biin tinh epoxy, silica.

Duraphat® (Colgate): sodium fluoride (5%), ethanol (96%), sip ong tring (E901), gum lac (E904), eolophan, mastic, saccharin (E954), huang diu.

Isodan (Septodont): potassium nitrate, HEMA, sodium fluoride, cac chit phy gia.

Nguyen bio sgi eua nudu duge liy tCr cie md nudu linh manh cua ring khdn eua ngudi, theo phuang phip eua Uehara (Uehara A et al., 2005).

T i bio duge nhan tCr nhirng ngudi khde manh, duge thdng tin v i xie nhin tinh nguyen tham gia, theo Institutional Review Board approval.

Vit lieu - dyng cy nudi eiy t i bao eua Gibeo BRL (Life Technologies Inc., Grand Island, NY, USA).

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TCNCYH Phu trwong 74 (3) - 2011

Mdi trudng nudi eiy t i bio MEM, bo sung huyit thanh thai bd 5%, penicillin 100 Ul/ml, streptomycin 100 |jg/ml (Biowhittaker, Grany, France).

2. Phu'ang phap

Phuang phip thu- dde tinh vdi te bao i p dyng trong thu- nghidm niy l i phuang phip thu- qua chit tiit tir v i t lieu. Theo phuang phap nay, mdi trudng se duge su dyng d i nudi eiy t i bio thu- duge tiip xCic trye tiip vdi v i t lieu theo ty le, diiu kidn md phdng lim sing, v i trong mdt khoang thdi gian x i c djnh. ThLP nghiem thye hien theo chuan chau Au ISO 10993 - 5 (AFNOR, 1999).

Cie budc tiin hinh thu nghiem

Chuin bj t i bao: Nguyen bio sgi cua nudu ngudi dugc nudi eiy vdi mat dp 1 x 10^ t i bio/cm^

trong trong dieu kien 5% CO2, 95% khdng khi, nhiet dp 37°C, dp am tuang ddi 100%. Td bio dugc dua vio cie khay thCr (Beeton Dickinson Labware, Lincoln Park, NJ, USA) vdi mat dp l i 40000 te bio/cm^

Chuin bj mdi tru'd'ng:

Mdi trudng thu-: Cie v i t lieu thu- duge ngim ridng re trong mdi trudng nudi cay, vdi ty le 0,1 g/ml, d nhiet dd 37°C trong 24 gid. Sau dd, mdi trudng thu- dugc liy ra v i pha loang d cac ndng dp khac nhau (1:1, 1:2, 1:10, 1:100, 1:1000, 1:10000) d i chuin bj nudi eiy t i bio.

- Mdi trudng chu-ng duang tinh.

- Mdi trudng chu-ng i m tinh.

T i i n hanh thii' nghiem: C i e khay t i b i o da Bang 1. Ty le t i bao c h i t trung binh 6- c i e khay

trong mdi tru'd'ng thii' d' c i e

chuan bj duge nudi eiy bing eic mdi trudng thO- (vdi s i u mCrc nong dp pha loang) v i mdi trudng ehCrng trong 24 gid.

D i n h g i i k i t qua: Sau khi trai qua thu- nghiem MTT, k i t qua duge dpc bing miy quang pho ke E 960 (Bioblock, Strasbourg, France) d budc song 550 nm. Vdi ty Id t i bao chit dudi 20%, vit ligu duge coi l i khdng dpc vdi t i bio.

III. KI^T QUA

Thu- nghiem dugc thye hien nhim dinh gii dpc tinh eua vat lieu thu- nghiem Shellac F, so sinh vdi cie vat lieu ehu-ng l i Duraphat® v i Isodan ddi vdi nguyen bio sgi eua nudu ngudi.

Cy ndng dp mdi trudng thu- 1:1, dde tinh eua ca Shellac F, l i Duraphat® v i Isodan ddi vdi nguyen bio sgi cua nudu ngudi d i u d mCre cao, vdi ty lg t i bio chit trung binh tuang Crng l i 88,47%;

87,96% v i 90,04%. Shellac F bit diu khdng the hien dpc tinh d nong dp pha Ipang mdi trudng nuoi eiy 1:10, vdi ty Id t i bio chit trung binh la 3,87%.

Duraphat® giam dde tinh vdi t i bao rd ret d nong dp pha loing 1:2 va trd nen khdng dpc d ndng do pha loing 1:10, vdi ty Id t i bio chit trung binh la 1,14%. Mdi trudng nudi eiy tuang Crng eua Isodan bit d i u hit dpc hoin toin vdi nguyen bio sgi cua nudu ngudi d ndng dp pha loang 1:100, vdi mit dp te bao tuang duang vdi mat dd t i bio d eic 6 chCrng duang tinh. Bang kit qua trinh biy ty 1$

phin tram t i bao chit d eae khay nudi eiy nguydn bio sgi eua nudu ngudi, thu- vdi ba vit lieu, d sau ndng dp pha loing mdi trudng thu-.

thiP khi nudi e i y nguyen b i o sgi cua nu'd'u ngudi ndng dp pha loang khac nhau

Vat lieu

Shellac F

Duraphat®

Isodan

Ndng dd 1:1 86.246 90.700 88.473 88.140 87.784 87.962 88.250 91.836 90.043

Tyle Ndng dd

1:2 86.246 90.000 88.123 31.536 10.227 20.882 88.250 91.836 90.043

p h i n tram t i b i o c h i t so vd'i chii'ng d Ndng dd

1:10 ' 7.736 0.000 3.868 0.000 2.272 1.136 88.250 89.540 88.895

Ndng dd 1:100 "

6.876 0.000 3.438 0.000 2.804 1.402 0.000 0.000 0.000

Ndng do 1:1000'

6.590 0.000 3.295 0.000 0.000 0.000 0.000 0.000 0.000

Lpang tinh Ndng dp

1:10000 6.300 0.000 3.150 0.000 0.000 0.000 0.000 0.000 0.000

Chii'ng am tinh 6.300 0.000 3.150 0.000 0.000 0.000 0.000 0.000 0.000

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TCNCYH Phu truxyng 74 (3) - 2011 Qua ty Id t i bio song khi nudi eiy trong cie mdi trudng thu- d i tiip xue trye tiip vdi eae vit lidu thu-, cd the thay mCre dp dde tinh eua vat lidu giam din thep mCre dd pha Icing mdi trudng thCr. Ddi vdi nguyen bio sgi eua nudu ngudi. Shellac F khdng edn dde tinh d mCre dp pha loang mdi trudng l i 1:10 (ty Id t i bio song trung binh l i 96,13%), tuang duang vdi. Duraphat® (98,86%), trong khi dd Isodan khdng dde d dd pha loing 1:100 (ty Id t i b i o sing trung binh l i 100%).

IV. BAN LUAN

V§ phu'ang phap va ky thuat ciia thii' nghiem: Thu- nghiem niy dugc thye hien theo phuang phip thu- dde tinh vdi t i bio qua chit tiit tir vit lieu, theo chuin chiu Au ISO 10993 5 (AFNOR, 1999). Diiu kien thu- nghiem thda min ti^u chuin quy djnh v i dam bao md phdng d mu-c do manh han so vdi diiu kien thye te lam sing.

Thir nghidm su- dyng t i bao thu- l i nguyen bio sgi cua nudu ngudi l i loai t i bao m i vit lieu thCr se tiep xue trye tiip v i ed t h i tie ddng trdn thye t i lim sing. Vide su- dyng loai t i bio niy trong thu- nghiem cho phep danh gia tinh tuang hgp cua vat li$u vdi ehinh eic loai t i bio dich phu hgp, ning cao gii trj v i mdi lien he giu-a thu- nghiem in vitro vi cie dang thu- nghidm khac cung nhu vdi tic dung cua vit lieu tren lim sing.

v i kit qua ciia thii' nghiem: Thu- nghiem nhim danh gii dde tinh eua vit lieu thu- nghiem Shellac F, so sinh vdi dde tinh eua hai vit lieu ehCrng l i Duraphat® v i Isodan, su- dyng t i bio thu- l i nguydn bio sgi cua nudu ngudi, theo phuang phip thu- (J6c tinh vdi t i bio qua chit tiit tCr vit lieu. Kit qua thu- nghidm cho thiy doi vdi ea nguydn bio sgi cua nu-du ngudi. Shellac F biiu hien mCre dp dpc tinh tu-ang duang Duraphat® v i thip han isodan.

V. K^T LUAN

Thu- nghiem cho thiy ddi vdi nguyen bio sgi cua nudu ngudi. Shellac F ed mu-e dp dpc vdi t i

bio tuang duang Duraphat® v i thip han Isodan.

TAI

LIEU THAM

KHAQ

1. Association Frangaise de Normalisation (AFNOR). (1999). Norme eurpeenne Norme frangaise.

2. Dao Thj Hdng Quan. Sii' dung canh kiin phdng ngira sau rang. (1996). Ky yiu cdng trinh nghien eu-u khoa hpc Khoa Rang Him Mat, 17-20,

3. Hoang Thj Thuc et al. Su- dyng nhya einh kiin dd de ehu-a mdn men rang "M.R - 68".

4. Hoang Tii' Himg et al. (2000). Nghien eCru chi tao san phim phdng ngCra benh siu ring tCr nhya einh kiin dd (shellac).Vin ban nghiem thu o i t i i cip Bd Y t i .

5. Nguyin Du'ang Hdng (1970). Cinh kiin v i ehu-a sau ring. Tap ehi Y hpc Viet Nam 3, 43 - 47.

6. Stanford J.W. (1980). Recommended standard practices for biological evaluation of dental materials. Int. Dent. J. 30, 140 -188.

7. Stanley R.S. (1985). Toxicity testing of dental materials. CRC Press. Boca Raton 10,

8. Uehara A et al. (2005). Arginine specific gingipains from Porphyromonas gingivalis stimulate production of hepatocyte growth factor (scatter factor) through protease activated receptors in human gingival fibroblasts in culture. J Immunol 175,6076-6084,

Summary

CYTOTOXICITY OF SHELLAC F ON HUMAN GINGIVAL FIBROBLAST

Evaluate the cytotoxicity of Shellac F on human gingival fibroblast. Methods: The cytotoxicity test was performed on human gingival fibroblast according to the Europe Standard ISO 10993 5. Cells were incubated in material - contacted medium with different dilutions (1;1, 1:2, 1:10, 1:100, 1:1000, 1:10000). A succinyl dehydrogenase (MTT) assay was pert^ormed and the absorbance of each 96 well dish was determined using an automatic microplate spectrophotometer (E 960, Bioblock, Strasbourg, France) at 550nm. Results: On human gingival fibroblast. Shellac F was non - toxic at the dilution of 1:10 (average cell viability: 96.13%), comparable to Duraphat® (98.86%), while Isodan showed non - toxic at 1:100 (average

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cell viability: 100%). Conclusions: On human gingival fibroblast. Shellac F showed a toxicity which was similar than that of Duraphat® and lower than that of isodan.

Keywords: shellac F, cytotoxicity, human gingival fibroblast

RUT NGAN THQI GIAN CLPA - BONG TREN BENH NHAN NHOI MAU CQ TIM CAP ST CHENH LEN CO CAN THIEP MACH VANH TIEN PHAT

Hoang Qudc Hoa Bdnh vidn Nhdn dan Gia Dinh, Thdnh phd Hd Chi Minh

Nghien ciru dwac tiin hanh nhim '^'Xac dmh thdi gian cira - bdng trwdc va sau khi thay ddi quy trinh vi cac phan doan thai gian trong thdi gian cira - bdng. '^'Khao sat die aim lim sang, cin lam sang, die aim tdn thwang DMV thii pham ddi vdi cac trwdng hap NMCT ST'ldwac chup va can thiep DMV tien phat. Kit qua: Tw thing 04/2009 - 3/2010, da can thiep mach vanh tien phit tren 293 trwdng hap NMCT ST. Ba yiu td nguy ca benh mach vanh chiim ty le hang dau la:

hut thude la: 61,85, tang HA 60,1%,, rdi loan lipid mau 38,2%,. Ty le benh nhan Killip IV chiim 10,6%,. Phan bd vj tri: Than Chung (LM) 0,7%, DM vanh xudng tmdc trii (LAD) 48,5. DM vanh phai (RCA) 43% va DM mu (LCx) 7,8%,. Cai tiin quy trinh giup tang dang ke ty le sd tnrdng hap CTMV TP dat thdi gian cira - bdng nhd han 90 phut: 52,6%, tmng nim 2010 - 2011 so vdi chi 10,7% frong nam 2009. Thdi gian cira - bdng tmng binh va tmng vj giam diu tW 146/130 phut xudng cdn 94/81 phut Kit luan: Rut ngan thdi gian cira - bdng tren benh nhin duac can thiep mach vanh tien phat dat dwac thanh cdng budc dau, cin phai hoan thien them ky nang can thiep de tdi wu hda rut ngan thdi gian cira - bdng, nang cao ty le thinh cdng, cim sdng BN NMCT cip hieu qua.

TCr khoa: nhdi mau co- tim ST chenh len (NMCT STj), Can thiep mach vanh tien phat (CTWIV TP), tho-i gian cCra - bong

I. OAT VAN DE

Hang n i m , benh vien N h i n d i n Gia Djnh t i i p nhan va d i i u trj khoang 1000 trudng hgp hdi chCrng vanh c i p , trong dd lugng benh nhan nhdi mau ca tim ST chenh len (NMCT STj) chiem ty le khdng nhd. Chup v i can thiep MV tien p h i t la phuang p h i p d i i u trj tai thdng mach v i n h huu hieu: Nhanh chdng, hieu qua, an t o i n [2]. Hieu qua nay dat dugc neu thdi gian eu-a bdng (thdi gian tinh tir khi benh n h i n v i o cCra Khoa cap cCru cho d i n khi nong bdng hoac dat stent, phuc hdi ddng chay mach vanh) dugc rut n g i n tdi da. Theo hudng dan eua Hpi Tim mach hpc va trudng mdn Tim mach hpc Hoa Ky AHA/ACC 2004 [1] cung nhu Hpi Tim chau Au ESC 2007, thdi gian eu-a bdng dugc xem la dat chuan n i u d u d i 90 phut.

Thanh lap tCr t h i n g 04/2009, D a n vj can thiep Tim mach benh vien N h i n dan Gia Dinh rat quan t i m d i n thdi gian thdi gian cira - bdng v i da ed luu dd hdi c h i n xu- tri cung nhu danh gia thdi gian nay ngay tir nhirng ea can thiep mach vanh tien phit d i u tien. Tuy nhien, k i t qua t h i n g ke nam 2009

cho thay chi 10,7% sd ea can thiep mach vanh tien p h i t tai benh vien dat thdi gian eu-a bong d u d i 90 phut. T r u d e tinh hinh thye t i tren,viec thay doi quy trinh n h i m rut n g i n thdi gian cCra bdng tai benh vien Nhan d i n Gia Djnh la h i t sCrc c i n thiet. Hang loat bien phap duge dua ra: tif giao due y thCrc, huan luyen n h i n vien y te hieu ro tam quan trpng cua thdi gian eCra bdng, phii hgp ddng bd giua c i e khoa cd lien quan cung nhu s i p x i p hgp ly cdng viec, soan quy trinh XLP tri mdi n h i m rut n g i n thdi gian eu-a bdng. Cac hay doi tCr d i u nam 2010 d i n nay d i cho k i t qua kha quan ban dau. Do dd, ehung tdi thye hien nghien cCru n i y n h i m muc tieu: Danh g i i hieu qua quy trinh mdi n h i m rut n g i n thdi gian cira - bdng tren benh nhan NMCT STT ed CTMVTP.

II. 0 6 l TU'QNG VA PHU'QNG

^{P H A P}

1. Ddi tipgng

Tat ca e i c trudng hgp NMCT STT trong vdng 24 gid dau (thda tidu c h u i n c h i n d o i n eua Hpi Tim mach hpc v i t r u d n g mdn Tim mach hpc Hoa

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