bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicenter evaluation of two flow cytometric methods for counting low levels of white blood cells
Authors: Dijkstra‐Tiekstra Margriet J. , Van Der Meer Pieter F. , Pietersz Ruby N.I. , De Wildt‐Eggen Janny
Published: August 2004

BACKGROUND: Flow cytometric methods can be used to count residual white blood cells (WBCs) in WBC‐reduced blood products, which should contain fewer than 1 × 106WBCs per unit (∼3.3 WBCs/µL). In this study two flow cytometric methods for counting WBCs under routine conditions in nine laboratories were evaluated.

STUDY DESIGN AND METHODS: Panels of red blood cells (RBCs), platelets (PLTs), and plasma were prepared containing 33.3, 10.0, 3.3, 1.0, and 0.3 WBCs per µL and counted with flow cytometric methods (either LeucoCOUNT, BD Biosciences, four laboratories; or LeukoSure, Beckman Coulter, five laboratories). Requirements were that at the level of 3.3 WBCs per µL, coefficient of variation was ≤20 percent and accuracy was ≥80 percent. Routine flow cytometric quality control (QC) data of WBC‐reduced blood products from two laboratories were analyzed.

RESULTS: At the level of 3.3 WBCs per µL, none of the laboratories met the requirements for all three blood products. The LeucoCOUNT method met requirements at more laboratories than the LeukoSure method for RBCs and PLTs, but the opposite was true for plasma. Routine QC data showed that >99 percent of the flow cytometric measurements for WBC‐reduced products was below the 95 percent prediction interval at 3.3 WBCs per µL.

CONCLUSION: None of the laboratories met the requirements for accuracy and precision for all three blood products. Nevertheless, routine results showed that in >99 percent of the products, WBC counts were below guideline limits. Therefore, both flow cytometric methods are suitable for QC with pass‐fail criterion.
Hypotensive transfusion reactions can occur with blood products that are leukoreduced before storage
Authors: Arnold Donald M. , Molinaro Giuseppe , Warkentin Theodore E. , DiTomasso Julie , Webert Kathryn E. , Davis Ian , Lesiuk Lawrence , Dunn Geoffrey , Heddle Nancy M. , Adam Albert , Blajchman Morris A.
Published: August 2004

BACKGROUND:  Leukoreduction before storage, rather than bedside white blood cell filtration, is recommended to prevent hypotensive transfusion reactions.

STUDY DESIGN AND METHODS:  Investigation of hypotensive transfusion reactions during radical prostatectomy in two patients on angiotensin‐converting enzyme inhibitors. In Patient A, hypotension occurred during the transfusion of each of the following blood products: 2 units of autologous blood deposited and leukoreduced (LR) before storage; 3 units of allogeneic red cells LR before storage; and 2 units of non‐LR acute normovolemic hemodilution (ANH) whole blood. When each of the transfusions was stopped, the blood pressure recovered. In Patient B, hypotension occurred during the transfusion of non‐LR ANH whole blood. All implicated units were administered rapidly using a blood infuser at 37°C. Bradykinin (BK) and des‐Arg9‐BK formation and degradation and the activity of kinin‐degrading metallopeptidases were measured in plasma samples from both patients.

RESULTS:  Degradation of des‐Arg9‐BK was severely impaired and the activity of aminopeptidase P severely reduced in Patient A, but not in Patient B. BK degradation was mildly impaired in both patients.

CONCLUSION:  Hypotensive reactions can occur with blood products that are LR before storage and non‐LR ANH. An inherent defect in the metabolism of kinins may be a risk factor for the development of hypotensive transfusion reactions.
Increasing hemoglobin oxygen saturation levels in sickle trait donor whole blood prevents hemoglobin S polymerization and allows effective white blood cell reduction by filtration
Authors: Stroncek David F. , Byrne Karen M. , Noguchi Constance T. , Schechter Alan N. , Leitman Susan F.
Published: August 2004

BACKGROUND Red blood cell (RBC) components from donors with sickle cell trait (Hb AS) often occlude white blood cell (WBC) reduction filters. Techniques were investigated to successfully filter Hb AS donor blood by increasing the Hb oxygen saturation with storage bags and conditions suitable for transfusion products.

STUDY DESIGN AND METHODS:  Oxygenation kinetics were measured over 3 days in whole‐blood units stored in standard‐sized 600‐mL polyvinylchloride (PVC) bags and whole‐blood units divided into three equal parts and stored in standard‐sized blood bags made from PVC, tri‐2‐(ethylhexyl)trimellitate (CLX) plastic, or Teflon. The filterability of Hb AS blood stored for 3 days was tested with whole‐blood filters.

RESULTS:  Oxygen saturation levels did not increase in full whole‐blood units from donors without sickle cell trait during 3 days of storage in 600‐mL PVC bags. In divided Hb AS whole‐blood units stored for 3 days, oxygen saturation levels increased from baseline levels of 45 to 56, 66, and 94 percent after storage in 600‐mL PVC, CLX, and Teflon bags, respectively (n = 5, p < 0.02), and all components filtered completely. When full Hb AS whole‐blood units from eight donors were stored for 3 days in 1.5‐L CLX bags, all units filtered completely, but one had a high residual WBC count.

CONCLUSION:  Storage of Hb AS whole blood in large‐capacity oxygen‐permeable bags increases oxygen tension and allows more effective WBC reduction by filtration.
A red blood cell autoantibody with mimicking anti‐E specificity
Authors: Dwyre Denis M. , Clapper Adam , Heintz Mary , Elbert Char , Strauss Ronald G.
Published: August 2004

BACKGROUND:  Uncommonly, antibodies that appear to exhibit antigenic specificity on red blood cell (RBC) panels fail to maintain specificity following alloadsorption (i.e., they mimic antigenic specificity). Understanding both the pitfalls and the proper pathways to establish the diagnosis and to interpret the clinical significance of these mimicking antibodies is important for patient management.

CASE REPORT:  A 68‐year‐old woman was admitted with dyspnea, anemia, bilateral pulmonary emboli, and metastatic ovarian cancer. Blood bank evaluation identified anti‐E reactivity in the patient's plasma sample and a positive direct antiglobulin test (DAT).

RESULTS:  The DAT was positive for immunoglobulin G and negative for C3b. An eluate of the RBCs showed E‐antigen specificity on a RBC antibody panel. Repeat serologic testing with RBC antibody panels with adsorbed patient plasma showed removal of apparent anti‐E reactivity with either E‐antigen‐positive or E‐antigen‐negative RBC stroma.

CONCLUSION:  A mimicking autoantibody with apparent E‐antigen specificity was identified in the plasma sample of a woman with newly diagnosed ovarian cancer. Despite their relative low frequency, mimicking antibodies, whether auto‐ or alloantibodies, may interfere with the timely issuance of compatible blood products and may confuse laboratory and clinical staff. Determining the clinical significance of the antibody, by taking into account the RBC phenotype of the patient and the antigen prevalence in the general population, guides the extent of workup required to best utilize resources while assuring patient safety.
Real‐time amplification of HLA‐DQA1 for counting residual white blood cells in filtered platelet concentrates
Authors: Mohammadi Tamimount , Reesink Henk W. , Vandenbroucke‐Grauls Christina M.J.E. , Savelkoul Paul H.M.
Published: August 2004

BACKGROUNDA real‐time polymerase chain reaction (PCR) assay based on amplification of a conserved region of the HLA‐DQA1 locus was developed and validated to assess its suitability in quantitating low levels of white blood cells (WBCs) in filtered platelet (PLT) concentrates (PCs).

STUDY DESIGN AND METHODS: To determine the detection limit, serial dilutions of nonfiltered PCs with known quantities of WBCs were prepared. The analytical sensitivity and accuracy of the assay was tested with WBC concentrations ranging from 300 to 0.03 per µL with real‐time PCR and flow cytometry. In addition, 126 random PCs were investigated to assess the capacity of the PCR method to quantify residual WBCs in clinical specimens.

RESULTS: A sensitivity of 0.2 WBC equivalent per µL (1.5 × 104WBC equivalents/unit) was achieved. The assay was shown to be accurate and the HLA‐DQA1 gene was reproducibly and consistently amplified in all tested samples (coefficient of variance of < 5%). Overall, the results of the PCR assay correlated well with those of the flow cytometry. The PCR assay detected a concentration of 3 WBCs per µL (approximately 1 × 106WBCs/unit) with 100 percent accuracy.

CONCLUSION: Real‐time PCR is rapid, sensitive, accurate, and reproducible. Hence this approach may prove suitable in routine monitoring of residual WBCs in PCs.
An assay for parvovirus B19 neutralizing antibodies based on human hepatocarcinoma cell lines
Authors: Caillet‐Fauquet Perrine , Di Giambattista Mario , Draps Marie‐Louise , Hougardy Vincent , De Launoit Yvan , Laub Ruth
Published: August 2004

BACKGROUND:  Although intravenous immune globulin (IVIG) is used widely for managing parvovirus B19 infections, IVIG products are not monitored routinely for the presence of parvovirus B19 neutralizing antibody.

STUDY DESIGN AND METHODS:  An assay has been developed to measure parvovirus B19 infectivity and neutralization activity based on two hepatocarcinoma cell lines (HepG2 and HuH7). The sources of parvovirus B19 were B19‐DNA‐containing plasma samples. Neosynthesized progeny in supernatants of infected cells were quantified by nested polymerase chain reaction. To validate the model, purified rabbit antibodies to different capsid protein sequences and IVIG preparations were tested.

RESULTS:  The number of parvovirus B19 infectious neovirions in supernatants of infected cells increased with infection time. Both rabbit antibodies and IVIG products inhibited parvovirus B19 infectivity when incubated overnight with virus. The efficacy of IVIG to neutralized parvovirus B19 was product‐related.

CONCLUSION:  This assay for parvovirus B19 neutralization activity provides an improved and more specific method for selecting donors to produce IVIG with a high titer of parvovirus B19 neutralizing activity.
Marking time: using music to create inclusive religious education and inclusive schools
Authors: Stern Julian
Published: August 2004

Religious education (RE) is a vital subject in the inclusion of pupils and staff alike, as it brings together ways of life and communities, the personal and the social. Based on the philosophy of community of John Macmurray, and the philosophy of dialogue of Martin Buber, Julian Stern investigates ways of ‘marking time’, understanding and celebrating times and events in schools. Music, embedded in religious and other ways of life, adds a communicative dimension that strengthens inclusive RE and intercultural communication. RE with music can be used as a form of community‐making of the most comprehensive (i.e. inclusive) kind, engaging the imagination to such an extent that pupils, teachers and all members of school communities can, in Buber's words, ‘imagine the real’.
Ecological research for development
Authors: Kayanja F. I. B.
Published: August 2004

Uganda is rich in aquatic ecosystems. Commercial fishing involves an off‐take that may not be ultimately sustainable. Aquatic ecosystems, like the forests, are under pressure. Forests, for many years to come, will remain the main source of energy for the people. They also continue to be cleared to make way for agricultural use of the land. Research for development must address problems of this kind as they are at the heart of the development process.
Diversity and distribution of sedges on multivariate environmental gradients
Authors: Ssegawa P. , Kakudidi E. , Muasya M. , Kalema J.
Published: August 2004

Relationships between environmental factors and the distribution patterns of sedges were studied in the wetland important bird areas of Uganda. Vegetation data were collected using the transect and quadrat methods. Four quadrats were located at each sampling point at 10 m intervals along the transect from dry land to open water. Relative abundances of sedges were recorded in each quadrat. Inventory sampling was done to record species that were not recorded on the transects so as to generate near complete species lists. Human influences on vegetation such as harvesting, fire and vegetation modification were examined along the transects. Soil samples were collected along the transects for analysis of P, K, Na, Ca, Mg and organic matter. Other parameters recorded from water samples included water levels, pH and water conductivity. Rainfall and altitude were also recorded. Canonical correspondence analysis was used to correlate the relative abundances of the species to measured environmental variables. Linear correlation of the environmental variables with principal components indicated that water levels, altitude and rainfall were major factors that influenced the abundance and occurrence of sedges in the different bird areas. Sedge distribution patterns are a function of local geological and edaphic factors; and human‐induced exogenous disturbances.
The role of satellite water bodies in the evolution and conservation of Lake Victoria Region fishes
Authors: Mwanja W. W.
Published: August 2004

The Lake Victoria Region (LVR) can rightly be regarded as one of the sites of the world's worst vertebrate species extinction of the twentieth century. The LVR, which includes Lakes Victoria, Kyoga, Edward and George, and numerous small satellite lakes around each of the main lakes, originally contained over 500 species of fish. As a result of human influence, including the establishment of a commercial fishery and the introduction of several exotic species, hundreds of endemic species have gone extinct in this evolutionarily young system. Recently, it was discovered that part of the apparently extinct fish biodiversity from the main lakes continues to exist in several of the minor satellite lakes around the main lakes. The findings of the ecological survey of the fish species of the satellite lakes are summarized and results of some preliminary genetic analysis are discussed. Major genetic and ecological changes in the fish fauna that have taken place in the LVR fishery are highlighted. Emphasis is put on the importance of the minor lakes in conserving the endangered fish species of the entire region, and their role as preserves of the history of the LVR. The findings allude to the historical importance of minor satellite lakes as ‘life boats’ and natural refugia for the fishes of the LVR, a region historically characterized by geological and climatic volatility.
Some aspects of wild robusta coffee seedling growth in Kibale National Park, Uganda
Authors: Oryem‐Origa H. , Kasenene J. M. , Magambo M. J. S.
Published: August 2004

The growth of wild robusta coffee (Coffea canephora Froehner) seedlings was monitored on the forest understorey in Kibale National Park. Various aspects of seedling growth were measured from plots with three different levels of ground vegetation cover.

Coffee seedling growth was influenced by the three different treatments. For instance, the removal of ground vegetation cover enhanced seedling exposure to light. This in turn promoted leaf formation, expansion, and general seedling growth as was exhibited by the positive trends in the derived growth characteristics.

The survival of coffee seedlings was also better in cleared plots than in those with intact ground vegetation cover.
Folk plant classification by communities around Kibale National Park, Western Uganda
Authors: Kakudidi E. K.
Published: August 2004

This investigation records the folk conceptualization of the living world with special reference to classification of plants. Six life form categories are described along with characters of typical instances. Below the major folk taxonomic life forms, categories occur that in some cases correspond to botanical rank of genus. The meaning of 43 local names are given, of which the base meaning of 23 species is utility, 12 is morphology, seven is ecology and five is chemistry.
Ecological recovery of an afromontane forest in south‐ western Uganda
Authors: Lejju J. B.
Published: August 2004

A study of the regeneration of an afromontane forest was carried out in Mgahinga Gorilla National Park (MGNP), south‐western Uganda. The area landscape has been subjected to agricultural encroachment for the last 50 years. The landscape was changed by terracing and removing the indigenous vegetation and replacing it with exotic tree species. Stratified random sampling was employed in sampling the vegetation. There was a significant difference in species richness and density in the three habitat types. The natural forest supported the highest stem density (75%) and the lowest stem density (4%) was recorded under exotic woodlots. Seedlings (<2 cm, diameter at breast height) accounted for the majority of juveniles in the three habitats. The natural forest had the highest density (24,625 seedlings ha−1) and exotic woodlots supported the lowest stem density (1350 seedlings ha−1). The level of regeneration in the encroachment area is influenced by the intensity of cultivation and soil nutrients. The advanced growth beneath the exotic woodlots, especially black wattle (Acacia mearnsii) and Eucalyptus sp. stands is relatively impoverished. This condition beneath the exotic species suggests that a low diverse community of native species is able to exploit this environment.
Forest fragmentation and primates' survival status in non‐reserved forests of the ‘Kampala area’, Uganda
Authors: Baranga D.
Published: August 2004

Previous primate studies have concentrated on the effects of forest disturbance on primate populations residing mainly in natural forest reserves. The present study was conducted in 20 non‐reserved forest patches in the ‘Kampala area’, a forest‐savanna‐agricultural mosaic, to investigate the effects of forest fragmentation on the distribution and survival status of arboreal primates in the patches. Mpanga Forest Reserve, as the nearest to the forest patches, was used as a control. Primate census data revealed that the black‐and‐white colobus (Colobus guereza) was restricted in its distribution while redtail monkeys (Cercopithecus ascanius schmidti) were cosmopolitan. There was no significant relationship between forest patch size and red‐tail population size, number of groups and group density decreased. Of the trees sampled, 70% were food species while 30% were nonfood species. Basal area of food tree species significantly increased with forest patch size (R2 = 0.5885) but its relationship with red‐tail population size and group density (B = −0.42784, R2 = 0.18305, P > 0.05) was not significant.
Red‐tail monkey groups in forest patches outside the protected area system in the ‘Kampala area’
Authors: Baranga D.
Published: August 2004

This study was conducted in the ‘Kampala area’, a forest‐savanna‐agricultural mosaic, and was aimed at investigating the ecology and survival of the red‐tail monkey, Cercopithecus ascanius schmidti in fragmented forest patches outside the protected area system. The relationship between habitat variables and red‐tail monkeys' distribution and other demographic factors were investigated. The average group size for red‐tail monkeys in the forest patches was 11.9, while that in Mpanga Forest Reserve it was 23.2. Most of the red‐tail monkey groups had breeding females but there were small populations with no breeding females. The number of breeding females and young varied in different forest patches with the breeding sex ratio ranging from 0 to 1:3. The residential status of red‐tails in the patches was partly influenced by the presence of the vervet monkey and the intensity of human activities in the vicinity.
Aspects of the physico‐chemical environment of the Rwenzori rivers, Uganda
Authors: Busulwa H. S. , Bailey R. G.
Published: August 2004

A number of permanent rivers flow from the well‐watered Rwenzori Mountains, which form part of the wider catchment of the River Nile. A study was carried out on the physical and chemical aspects of three rivers on the Ugandan side and in particular the Mubuku–Bujuku system where access up to 4200 m a.s.l. is possible, to assess changes with altitude. At high altitudes above the foothills gradients were steep with frequent waterfalls and cascades over bedrock, boulders and unstable cobbles. The water was cold, between 4 and 14 °C, well oxygenated and dilute with conductivities generally less than 100uS/cm and pH values of 6.3–6.5. Below 1750 m a.s.l. streams are characterized by lessening gradients, wider dimensions, continuing unstable boulder and stony beds but also sand banks, and on the flats some muddy substrates. There is continued predominance of turbulent flow with rapids and riffles, but with an increasing occurrence of smooth glides and occasional backwaters and quieter margins. The water temperature is warm between 12 and 24 °C with generally raised ionic concentrations of about 200uS/cm, but still of a low order of magnitude. It rains with variable intensity in the mountains through the year with some noticeable rains during the dry season. The study suggests that altitude related factors such as the increasing physical harshness including decreasing temperatures from downstream to upstream would be responsible for governing the distribution of biota including fish.
Observations on the biology of Nile tilapia, Oreochromis niloticus L., in two Ugandan crater lakes
Authors: Bwanika G. N. , Makanga B. , Kizito Y. , Chapman L. J. , Balirwa J.
Published: August 2004

In this study, we compare the diet, life history characters and abundance of Nile tilapia (Oreochromis niloticus) stocks between two crater lakes in western Uganda (Lake Nyamusingiri and Lake Kyasanduka) that differ in their history of fishing pressure. Both lakes support native fish communities, but also harbour populations of introduced O. niloticus. Lake Nyamusingiri was characterized by a higher relative and absolute abundance (CPUE) of haplochromine cichlids and a lower abundance of O. niloticus than in Lake Kyasanduka. In addition, the O. niloticus population in Lake Nyamusingiri exhibited a smaller mean size and a lower relative abundance of juveniles than in Lake Kyasanduka. These differences may reflect, at least in part, heavy exploitation of O. niloticus in this lake, as compared with Lake Kyasanduka where fishing was banned in 1988. In both lakes, the maximum size and size at maturity was small relative to other larger water bodies in the region. The Nile tilapia in both lakes were primarily herbivorous; with phytoplankton dominating the diet. In general, the condition of O. niloticus in the crater lakes was low relative to other larger lakes in the region. The low catch per unit effort of O. niloticus in Lake Nyamusingiri (7.8%) relative to Lake Kyasanduka (54.9%) suggests that overexploitation of the fishery is occurring, calling for careful monitoring and management of the system.
Primary production and decomposition of Loudetia phragmitoides (A. Peter) in the littoral wetland of a small satellite lake (L. Nabugabo, Uganda)
Authors: Okot‐Okumu J.
Published: August 2004

Loudetia phragmitoides (A. Peter) C.E. Hubbard is one of the dominant grass species occupying the Lake Nabugabo littoral wetlands, another prominent species being Miscanthedium violaceum (K. Schum) Robyns. Lake Nabugabo is a satellite lake, about 5 km to the west of Lake Victoria. It is a unique ecosystem, which is nutrient poor due to the highly leached ancient soils in the catchment. To determine the significance of wetland functions on the open lake ecosystem, the primary production and biomass decomposition process in the wetland of the dominant grass species, Loudetia phragmitoides were assessed. A biomass yield of 1638 gm−2 and an average primary production rate of 941 gm−2 year−1 were obtained for the Nabugabo wetland. Litter decomposed faster in the open lake compared with the littoral wetland with half of the litter weight lost in 110 and 321 days, respectively. Phosphorus leached more rapidly from decomposing litter compared with nitrogen. The study found that wetland dominant grass species can be an important nutrient reservoir and that the decomposition process in the wetland is influenced by the flooding regime, which exports significant nutrients (nitrogen and phosphorus) to the open lake. The importance of the littoral wetland to the overall ecology of the Nabugabo ecosystem is discussed.
Cultural and social uses of plants from and around Kibale National Park, Western Uganda
Authors: Kakudidi E. K.
Published: August 2004

This investigation records 89 species are used for 26 cultural and social purposes. The highest numbers of plants are used in wedding ceremonies (25 species), followed by those used against witchcraft (18), religious ceremonies (15), while the others range between 1–9 species. Whole plants contributed 24.8%, followed by leaves (24%), stems (22%), seeds (12.8%) flowers and bark (5.5% each), rhizomes (1.8%) and leaf sheath, root and friut with 0.9% each. Some plants have multiple uses such as Cymbopogon nardus with seven uses. Ficus natalensis, F. ovata, Hibiscus fuscus and Phoneix reclinata with four uses each. A total of nine species have three uses each, 19 species with two uses each, and 56 species with one use each.
Gram‐positive rods prevailing in teeth with apical periodontitis undergoing root canal treatment
Authors: Chávez de Paz L. E. , Molander A. , Dahlén G.
Published: August 2004

Aims  To identify Gram‐positive rods from root canals of teeth with apical periodontitis and to examine their associations with other species.

Methodology  Consecutive root canal samples (RCSs) from 139 teeth undergoing root canal treatment were analyzed prospectively for cultivable microbes. Gram‐positive rods in the first RCS submitted after chemo‐mechanical preparation were categorised to genus level by selective media and gas–liquid chromatography (GLC), and identified to species level by sodium dodecyl sulphate‐polyacrylamide gel electrophoresis (SDS‐PAGE). Associations between organisms were measured by odds ratios (OR).

Results  In the first samples submitted a total of 158 Gram‐positive rods, 115 Gram‐positive cocci, 26 Gram‐negative rods and 9 Gram‐negative cocci, were identified. At genus levels Gram‐positive rods were classified into: Lactobacillus spp. (38%), Olsenella spp. (18%), Propionibacterium spp. (13%), Actinomyces spp. (12%), Bifidobacterium spp. (13%) and Eubacterium spp. (6%). The most frequent species were Olsenella uli, Lactobacillus paracasei and Propionibacterium propionicum. In subsequent samples taken during treatment, Gram‐positive rods were also identified, although the number of strains was considerably reduced. Positive associations were observed between members of the genus lactobacilli and Gram‐positive cocci (OR>2).

Conclusions  Olsenella uli and Lactobacillus spp. predominated over other Gram‐positive rods. A possible association exists between Lactobacillus spp. and Gram‐positive cocci in root canals of teeth with apical periodontitis receiving treatment.
Shaping ability of ProFile and K3 rotary Ni‐Ti instruments when used in a variable tip sequence in simulated curved root canals
Authors: Ayar L. R. , Love R. M.
Published: August 2004

Aim  To compare the shaping ability of ProFile and K3 rotary Ni‐Ti instruments when used in a variable tip sequence in simulated curved root canals with different curvature and radius.

Methodology  ProFile or K3 .06 taper instruments were used to prepare simulated canals of 20° curvature and 5 mm radius (n = 10) and 30° curvature and 3 mm radius canals (n = 10) in resin blocks. All canals were prepared to an apical size 40 at 0.5 mm from the canal terminus using a variable tip crown‐down sequence. Pre‐ and postinstrumentation digital images were recorded, and an assessment of the canal shape was determined using a computer image analysis program. The material removal from the inner and outer wall of the canal was measured at 28 measuring points, beginning 0.5 mm from the end‐point of the canal and the data compared using the Mann–Whitney U‐test.

Results  In 20° and 30° canals both instruments significantly removed more (P < 0.05) material on the outer wall than the inner wall in the apical half of the canal. For ProFile files there was no significant difference in the amount of material removed on the outer canal wall between the 20° and 30° canals. However, in the K3 groups significantly more (P < 0.05) outer canal wall was removed in the apical area in 20° canals. When comparing both instruments the results showed that in 20° canals K3 instruments removed more outer and inner canal wall than ProFile instruments (P < 0.05) but that there was no significant difference (P > 0.05) between the instruments in 30° canals.

Conclusion  Within the limitation of this study, both rotary nickel‐titanium instruments prepared a well‐shaped root canal with minimal canal transportation.
Pulpal necrosis with sickle cell anaemia
Authors: Demirbaş Kaya A. , Aktener B. O. , Ünsal Ç.
Published: August 2004

Aim  To investigate radiographic manifestations of sickle cell anaemia (SCA) and whether or not a pulpal necrosis may develop without a pathological history.

Methodology  Thirty‐six patients with homozygous SCA were evaluated, and a further 36 individuals without SCA were included in the study as a control group. All 72 patients participating in the study ranged between the ages of 16 and 40 years. General and dental histories of the individuals were recorded. Electrical pulp test, percussion and thermal tests were applied to all the teeth having no restorations. Orthopantomograms of all the subjects were taken. Data obtained from questionnaires, sensitivity tests and radiographic examinations were evaluated by chi‐square and Fischer's exact test.

Results  Fifty‐one (6%) of the teeth having no restorations or history of trauma were determined as being nonvital in the SCA group. In 30 (83%) of these patients orofacial and dental pain with no obvious cause was detected and in 24 (67%) of the patients the quality of the bone tissue as examined radiologically had deteriorated. In eight (22%) of the patients cortical thinning and irregularity in the mandible was noted. A statistically significant difference between the SCA and control groups (P < 0.05) was found in terms of pulpal sensitivity and radiological findings.

Conclusion  SCA is a genetic and systemic disease which may cause pulp necrosis without necessarily having an identifiable aetiology. SCA causes radiographically observable differences in jaw structure especially in the mandible.
Periosteal grafts as barriers in periradicular surgery: report of two cases
Authors: Tobón‐Arroyave S. I. , Domínguez‐Mejía J. S. , Flórez‐Moreno G. A.
Published: August 2004

Aim  To describe the usefulness of periosteal grafts as barriers for bone regeneration in periradicular surgery when advanced periodontal breakdown occurs.

Summary  The treatment of advanced periodontal breakdown as a result of an associated endodontic lesion constitutes a multifaceted challenge to the clinician. If the source of the irritation cannot be removed by orthograde endodontic treatment, nonsurgical and surgical endodontic/periodontal intervention may be required. Two cases with suppurative chronic apical periodontitis with apicomarginal communication are described. Clinical and radiological evaluations were completed immediately prior to surgery, a week later and every 2 months after surgery for 10 months. Both patients were treated using split‐thickness flaps and lateral displacement of the periosteum prior to suturing, in order to close the communication between the oral and the periapical surroundings. A remission of the clinical signs and symptoms, and successful healing in the short‐term were achieved in these cases.

Key learning points 

Periapical and periodontal lesions are closely related through pathways of communication.

Disruption of the cortical plate and the presence of dentoalveolar sinus tracts can have a deleterious effect on the regeneration process after periradicular surgery.

The adoption of supplementary periodontal surgical techniques may help to solve some of the difficulties in the healing process in periradicular surgery.

Periosteal grafts have been shown to have the potential to stimulate bone formation when used as a graft material.
The efficacy of ultrasonic irrigation to remove artificially placed dentine debris from different‐sized simulated plastic root canals
Authors: Lee S.‐J. , Wu M.‐K , Wesselink P. R.
Published: August 2004

Aim  To investigate the influence of diameter and taper of root canals on the effectiveness of ultrasonic irrigation to remove artificially placed dentine debris from simulated uninstrumented extensions in simulated root canals.

Method  Three groups of standard canals were cut in resin blocks using either size 20, .04 taper ProFile instruments, size 20, .06 Greater Taper (GT) rotary instruments or size 20, .08 GT instruments, respectively. Each resin block was then split longitudinally through the canal, forming two halves. In one canal wall, a standard groove 4 mm in length was cut 2–6 mm from the apical end of the canal, to simulate uninstrumented canal extensions. Each groove was filled with dentine debris mixed with 2% NaOCl to simulate a situation when dentine debris accumulates in the uninstrumented canal extensions. Each canal was reassembled by joining the two halves of the resin block by means of wires and sticky wax. In each canal ultrasonic irrigation was performed for 3 min using 2% NaOCl as irrigant. Before and after irrigation, images of each half of the canal with a groove were taken using a microscope and a digital camera, after which they were scanned into a PC as TIFF images. The quantity of dentine debris in the groove was evaluated using a scoring system: the higher the score, the larger the amount of debris remaining. The score data were analysed by means of Kruskal–Wallis and Mann–Whitney U‐tests.

Results  After ultrasonic irrigation, the debris score for the size 20, .04 taper group was significantly higher than that for the size 20, .06 group (P = 0.040) and the size 20, .08 group (P = 0.006) groups. However, no significant difference was found between the size 20, .06 and the size 20, .08 groups (P = 0.320).

Conclusion  In simulated plastic root canals, the diameter and taper of root canal influenced the effectiveness of ultrasonic irrigation to remove artificially placed dentine debris.
Shaping ability of ProTaper nickel‐titanium files in simulated resin root canals
Authors: Calberson F. L. G. , Deroose C. A. J. G. , Hommez G. M. G. , De Moor R. J. G.
Published: August 2004

Aim  To determine the shaping ability of ProTaper instruments in simulated root canals.

Methodology  Forty canals with four different shapes in terms of angle (20° and 40°) and position of curvature (straight section before curve: 8 and 12 mm) were enlarged according to the recommendations of the manufacturer with the finishing files F1, F2 and F3 to full working length. Preoperative and postoperative pictures, recorded using a digital camera, were superimposed and aberrations recorded. Measurements were carried out at five different points: at the canal orifice (O); half‐way to the orifice in the straight section (HO); beginning of the curve (BC); apex of the curve (AC); end‐point (EP).

Results  Ten instruments deformed (nine F3 and one S1, all in canals with straight section of 8 mm), one instrument fractured. There were significant differences between the various canal shapes for the amount of resin removed from the inner curve at all points (O: P < 0.05; HO: P = 0.001; BC, AC and EP: P < 0.001); and for the resin removed on the outer curve at points HO, AC and EP (P < 0.001). Mean transportation was towards the inner aspect of the curve in all canal types at points BC, towards the outer aspect at the end‐point of preparation (EP) in all canals with 12 mm straight section. In 8 mm straight section canals, four danger zones were found; in 12 mm straight section canals three zips were present. The canal aberrations were produced following the use of the F2 and F3 instruments. There were no aberrations following the use of the F1 instrument.

Conclusions  Under the conditions of this study, ProTaper instruments performed acceptable tapered preparations in all canal types. When using F2 and F3 in curved canals, care should be taken to avoid excessive removal at the inner curve, leading to danger zones. In addition, care should also be taken to avoid deformation of the F3 instrument.
Effectiveness of electrochemically activated water as an irrigant in an infected tooth model
Authors: Gulabivala K. , Stock C. J. R. , Lewsey J. D. , Ghori S. , Ng Y.‐L. , Spratt D. A.
Published: August 2004

Aim  To test the effectiveness of electrochemically activated aqueous solutions in the debridement of Enterococcus faecalis biofilms in root canals of extracted teeth.

Methodology  Extracted, human, single‐rooted teeth (198) assembled into 11 sets (n = 18) with matching anatomical characteristics were randomly assigned to eight experimental groups. After decoronation, the root canals were prepared to a standard size. Enterococcus faecalis biofilms were grown in the root canals of autoclaved, individually mounted teeth over 48 h. Electrolysed saline collected as anolyte at the anode and catholyte at the cathode were the test agents. The four ultrasonication and four without ultrasonication irrigant groups included: neutral anolyte (NA) (pH 6.5), acidic anolyte (AA) (pH 3.0), catholyte (C) (pH 11.5) and C alternated with neutral anolyte (C/NA). Phosphate‐buffered saline (PBS) with and without ultrasonication formed negative and NaOCl (3%) positive control groups. After irrigation, root canal samples were serially diluted, cultured and enumerated. The data were analysed as ratios of residual colony‐forming units (CFUs) in PBS versus the test irrigants and using multivariate regression.

Results  The NA and NA (ultrasonicated, U), C/NA and AA (U) groups had significantly (α = 0.05) less and C (U) and C/NA (U) significantly (α = 0.05) more bacteria (CFUs mL−1) compared with their respective PBS controls. Ultrasonicated C/NA had significantly (α = 0.05) higher CFU counts than the nonultrasonicated solution. Other comparisons between ultrasonic and nonultrasonic groups were not significant. Of the nonultrasonicated groups, C/NA and NA were most effective, whilst of the ultrasonicated groups, AA and NA were most effective. None of these was as effective as 3% NaOCl.

Conclusions  All but two groups (AA and C) were significantly different from their PBS controls. There was a significant difference between the C/NA groups with and without ultrasonication but not between other combinations. NA (U) and AA (U) were the most effective test solutions but NaOCl (3%) gave by far the highest bacterial kills.
Scandinavian research in anaesthesiology 1981–2000: visibility and impact in EU and world context
Authors: Skram U. , Larsen B. , Ingwersen P. , Viby‐Mogensen J.
Published: August 2004

Background:  We wished to assess the development in number and impact of publications in anaesthesiology and intensive care medicine from 1981 to 2000 in the four Scandinavian countries: Sweden, Norway, Finland, and Denmark. For comparison, we also analyzed data from the UK and the Netherlands.

Methods:  Publication and citation data from 1981 to 2000 were gathered from National Science Indicators (2001), covering 33 journals indexed in Current Contents. Data were analyzed in running 5‐year periods. The following informetric indicators were used: absolute number of publications; absolute number of citations; absolute citation impact (average number of citations per publication per 5‐year period); citation impact relative to the European Union and the world; and the percentage of cited papers from each country.

Results:  The annual number of publications from Denmark was stable over the 20‐year period. Sweden increased its production by 35%, while the remaining four countries showed increases from 100% to 146%. Thus, Sweden and Denmark lost visibility within the European Union (EU) and in world context. The EU and world citation shares of Finland and Norway increased slightly, whereas those of Sweden, Denmark, the UK, and the Netherlands all declined significantly. The absolute citation impact (ACI) increased for all the four Scandinavian countries. The ACI of the Netherlands did not change and was surpassed by all the Scandinavian countries by 1994–98, while the UK finished below the other five countries.

Conclusions:  (1) The annual number of publications from Sweden, Norway, Finland, the UK, and the Netherlands increased after the late eighties, whereas the net publication output from Denmark was stagnant over the 20‐year period investigated; (2) the international publication and citation visibility of Finland and Norway increased slightly, as opposed to the significant decrease seen by the other four countries; (3) judging from the increase in absolute and relative citation impact and in the percentage of cited papers, the recognition of publications from the four Scandinavian countries increased over the past 20 years.
NF‐κB involvement in the induction of high affinity CAT‐2 in lipopolysaccharide‐stimulated rat lungs
Authors: Huang C.‐J. , Tsai P.‐S. , Lu Y.‐T. , Cheng C.‐R. , Stevens B. R. , Skimming J. W. , Pan W. H. T.
Published: August 2004

Background:  Endotoxemia stimulates nitric oxide (NO) biosynthesis through induction of inducible NO synthase (iNOS). Cellular uptake of l‐arginine, the sole substrate for iNOS, is an important mechanism regulating NO biosynthesis by iNOS. The isozymes of type‐2 cationic amino acid transporters, including CAT‐2, CAT‐2A, and CAT‐2B, constitute the most important pathways responsible for trans‐membrane l‐arginine transportation. Therefore, regulation of CAT‐2 isozymes expression may constitute one of the downstream regulatory pathways that control iNOS activity. We investigated the time course of enzyme induction and the role of nuclear factor‐κB (NF‐κB) in CAT‐2 isozymes expression in lipopolysaccharide‐(LPS) treated rat lungs.

Methods:  Adult male Sprague–Dawley rats were randomly given intravenous injections of normal saline (N/S), LPS, LPS plus NF‐κB inhibitor pre‐treatment (PDTC, dexamethasone, or salicylate), or an NF‐κB inhibitor alone. The rats were sacrificed at different times after injection and enzyme expression and lung injury were examined. Pulmonary and systemic NO production were also measured.

Results:  LPS co‐induced iNOS, CAT‐2, and CAT‐2B but not CAT‐2A expression in the lungs. Furthermore, NF‐κB actively participated in LPS‐induction of iNOS, CAT‐2, and CAT‐2B. LPS induced pulmonary and systemic NO overproduction and resulted in lung injuries. Attenuation of LPS‐induced iNOS, CAT‐2, and CAT‐2B induction significantly inhibited NO biosynthesis and lessened lung injury.

Conclusion:  NF‐κB actively participates in the induction of CAT‐2 and CAT‐2B in intact animals. Our data further support the idea that CAT‐2 and CAT‐2B are crucial in regulating iNOS activity.
Analgesic effects of preincisional administration of dextromethorphan and tenoxicam following laparoscopic cholecystectomy
Authors: Yeh C‐C. , Wu C‐T. , Lee M‐S. , Yu J‐C. , Yang C‐P. , Lu C‐H. , Wong C‐S.
Published: August 2004

Background:  Pre‐incisional treatment with either N‐methyl‐D‐aspartate (NMDA) receptor antagonists or non‐steroidal anti‐inflammatory drugs (NSAIDs) improves postoperative pain relief. This study examines the effect on postlaparoscopic cholecystectomy (LC) pain of a combination of dextromethorphan (DM), a NMDA‐receptor antagonist, and tenoxicam, a NSAID, given preoperatively.

Methods:  Eighty‐eight ASA I or II patients scheduled for LC were entered into a randomized, double‐blind study and randomly allocated to one of four groups. Controls received 20 mg (4 ml) of chlorpheniramine maleate (CPM) IM and 4 ml of normal saline (N/S) IV. Group DM received 40 mg of DM (containing 20 mg of CPM) IM and 4 ml of N/S IV. Group T were given CPM 20 mg IM, and tenoxicam 40 mg (4 ml) IV. Group DM + T were given DM 40 mg (containing 20 mg of CPM) IM, and tenoxicam 40 mg IV. All treatments were given 30 min before skin incision. Analgesic effects were evaluated by Visual Analog Scale (VAS) pain scores at rest and during coughing, at 1, 2, 4, 12, 24 and 48 h after surgery. The time to the first request for meperidine for pain relief, and total meperidine consumption, were recorded for 48 h after surgery.

Results:  Compared to controls, patients given DM and DM + T first requested meperidine significantly later, had lower meperidine consumption, made fewer requests for meperidine, and had lower pain scores. There were significant differences between the DM + T and T groups at 2 and 4 h in both resting and incident VAS pain scores, the incidence of meperidine requests and the time to first meperidine injection. There were significant differences between groups DM and T at 1 h for resting pain and at 2 and 4 h for incident pain. Except for a significant difference in the incident pain score 1 h after surgery, there were no other differences in pain scores between the DM and DM + T groups. Neither synergistic nor antagonistic interaction was observed between DM and tenoxicam.

Conclusions:  The results suggest that pretreatment with DM, but not tenoxicam, provides significant pre‐emptive analgesia for postoperative pain management in patients after LC surgery. Combining DM and tenoxicam also gives good pain relief.
The Association between Heart Rate, Heart Rate Variability, Endocrine and Behavioural Pain Measures in Horses Suffering from Laminitis*
Authors: Rietmann T. R. , Stauffacher M. , Bernasconi P. , Auer J. A. , Weishaupt M. A.
Published: August 2004

The objective of this study was to compare the stress response of horses suffering from laminitis after short‐ and long‐term treatment with the intent to evaluate power spectral analysis of heart rate variability (HRV) for pain monitoring. Data were collected from 19 horses with acute or chronic exacerbating laminitis without known primary disease before and after treatment with non‐steroidal anti‐inflammatory drugs (NSAID). Recordings were carried out the day after admission to the equine hospital. Measurements were repeated on day 7 of the treatment. The recorded parameters included a clinical orthopaedic index (OLPI: Obel‐grade plus hoof tester score), frequency of weight‐shifting between contralateral limbs, mean beat‐to‐beat interval (R‐R) duration, standard deviation of continuous R‐R intervals, low‐ (LF) and high‐frequency (HF) components of HRV, sympatho‐vagal balance (LF/HF), and plasma concentration of cortisol, adrenalin and noradrenalin. The LF represents mainly sympathetic influences on the heart whereas HF is mediated by the parasympathetic tone. Weight‐shifting and OLPI decreased significantly with treatment. The LF normalized units (n.u.) decreased after NSAID from 60.41 ± 21.42 to 51.12 ± 19.81 and was 49.33 ± 22.64 on day 7, whereas HF n.u. increased from 35.07 ± 20.02 to 43.14 ± 18.30 and was 45.98 ± 23.00 on day 7. Hormone levels showed no tendency to change with treatment. The OLPI was only correlated with LF/HF, LF and HF (R = 0.57, 0.55 and −0.54 respectively). Significant negative correlations existed between HFn.u. and weight‐shifting frequency (R = −0.37), HFn.u. and adrenalin (R = −0.47), and HFn.u. and noradrenalin (R = 0.33). The LFn.u. only correlated positively with adrenalin. Cortisol levels were poorly associated with the other parameters. Determination of the sympatho‐vagal influences on cardiac function may offer complementary information for reliable assessment of pain and may represent a valuable alternative method to catecholamine measurements.