bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms for Quick and Variable Responses
Authors: Summers Cliff H.
Published: April 2003

Dominant and subordinate males produce neuroendocrine stress responses during aggressive social interaction. In addition, stress responsiveness has both acute and chronic temporal components. A neurochemical marker that distinguishes social status and aggression by temporal and regional differentiation is the activity of serotonergic nuclei and terminals. A unique model for distinguishing the relationships among the neuroendocrine machinery of stress, social status and behavior is the lizard Anolis carolinensis. Dominant males exhibit more aggression and have temporally advanced serotonergic responses. Chronic serotonergic activity is associated with subordinate social status and reduced aggression. Acute and chronic serotonergic responses occur in both dominant and subordinate males, and are distinguished temporally. This provides a fundamental question that may elucidate basic differences in behavior: What causes temporally advanced serotonergic activity in response to stress in dominant males? Secondarily, what is the neural basis for the acute and chronic responses? The neural mechanisms for transduction of the relevant behavioral signals are very plastic. Behavioral experience and visual stimuli can produce very rapid responses. Faster and greater responsiveness may be stimulated by restraint stress, social stress and the absence of social sign stimuli (e.g. eyespots of the lizard Anolis carolinensis). Stress response machinery provides regulatory factors necessary to modify social behavior, and to adapt it for specific contexts. Serotonergic activity is rapidly modified by glucocorticoids and GABA, and also by CRF under conditions of previous stress or in combination with AVP. Advancing acute elevation of serotonergic activity may be a distinguishing characteristic of dominant males. Social events add contextual conditioning to brain transmitter activity, with social information processed in a distributed fashion. Medial amygdala manifests delayed serotonergic response compared to hippocampus and nucleus accumbens, and is therefore a good candidate to mediate chronic stress responsiveness. Limiting or delaying acute effects, in addition to chronic serotonergic activity, may be the distinguishing characteristics of subordinate males. Monoamines, glucocorticoids, testosterone, CRF, AVP, AVT, play neuromodulatory roles producing context appropriate behavior.
Social and Neural Modulation of Sexual Plasticity in Teleost Fish
Authors: Bass Andrew H. , Groberb Matthew S.
Published: April 2003

Teleost fishes are the ‘champions’ of sexual plasticity among vertebrates. Several species have two male reproductive morphs with distinct suites of behavioral, somatic, neuronal, endocrinological, and life history traits. Here, we consider recent studies of the social and neural modulation of sexual plasticity for such species with a focus on two neuropeptides, gonadotropin releasing hormone (GnRH) and arginine vasotocin (AVT, teleostean analogue of mammalian arginine vasopressin). The major premise of this review is that phenotypic changes in GnRH and AVT expression in the brain can orchestrate events leading to changes in either sexual status or the expression of morph specific display behaviors important in reproduction.
Lateralization of Minicolumns in Human Planum temporale Is Absent in Nonhuman Primate Cortex
Authors: Buxhoeveden Daniel P. , Switala Andrew E. , Litaker Mark , Roy Emil , Casanova Manuel F.
Published: April 2003

Gross analyses of large brain areas, as in MRI studies of macroanatomical structures, average subtle alterations in small regions, inadvertently missing significant anomalies. We developed a computerized imaging program to microscopically examine minicolumns and used it to study Nissl-stained slides of normal human, chimpanzee, and rhesus monkey brains in a region of the planum temporale. With this method, we measured the width of cell columns, the peripheral neuropil space, the spacing density of neurons within columns, and the Gray Level index per minicolumn. Only human brain tissue revealed robust asymmetry in two aspects of minicolumn morphology: wider columns and more neuropil space on the left side. This asymmetry was absent in chimpanzee and rhesus monkey brains.
11-Ketotestosterone Inhibits the Alternative Mating Tactic in Sneaker Males of the Peacock Blenny, Salaria pavo
Authors: Oliveira Rui F. , Carneiro Luis A. , Gonçalves David M. , Canario Adelino V.M. , Grober Matthew S.
Published: April 2003

In the peacock blenny, Salaria pavo, a species with courtship sex-role reversal, smaller, younger males mimic the courtship behavior and the nuptial coloration of females in order to get access to nests during spawning and to parasitize egg fertilization from nest-holder males. Later in their life, sneakers transform both morphologically and behaviorally into nest-holder males. In the present paper we investigate the activational role of 11-ketotestosterone (KT), the most potent androgen in most teleost species, to promote the switch between tactics in sneaker males of S. pavo. Sneakers were implanted either with KT or with control (i.e. castor oil) silastic implants. A week after implantation they were subjected to a set of behavioral tests and morphometric measurements. KT treatment promoted the differentiation of secondary sex characters, such as the anal glands, and inhibited the expression of female courtship behavior. KT-treated sneakers also showed a trend toward less frequent display of female nuptial coloration. There was no effect of KT treatment on the expression of typical nest-holder male behavior. Finally, there was no effect of KT treatment on the number or soma size of arginine vasotocin neurons in the preoptic area, which are often associated with the expression of vertebrate sexual behavior. Thus, KT seems to play a key role in mating tactic switching by inhibiting the expression of female courtship behavior and by promoting the development of male displaying traits (e.g. anal glands). The lack of a KT effect on behavior typical of nest-holding males and vasotocinergic preoptic neurons suggests that a longer time frame or other endocrine/social signals are needed for the initiation of these traits in males that are switching tactics.
Relevance of Adenosine Deaminase and Lysozyme Measurements in the Diagnosis of Tuberculous Pericarditis
Authors: Aggeli Constadina , Pitsavos Christos , Brili Stella , Hasapis Dimitrios , Frogoudaki Alexandra , Stefanadis Christodoulos , Toutouzas Pavlos
Published: April 2003

Objective: To assess the value of pericardial fluid adenosine deaminase (ADA) and pericardial lysozyme (Lys) as tools in diagnosing tuberculous pericarditis. Methods: Forty-one patients (age range 17–77 years) with significant pericardial effusion were included in the study. Diagnostic pericardiocentesis and pericardial biopsy were performed while serum and pericardial fluid ADA and Lys were measured in all patients. Grouping of patients resulted as follows: group I = 7 patients with tuberculous pericarditis; group II = patients with neoplastic pericarditis; group III = 30 patients with idiopathic pericarditis. Results: Pairwise multiple comparison procedures revealed a significant difference of ADA in group I versus group III (p < 0.05) but not versus group II. Furthermore, pericardial Lys in group I was higher than in groups II and III (p < 0.05). A strong correlation between pericardial ADA and Lys was found (r = 0.733, p = 0.01) for all the patients. Receiver operating curves showed a value of 72 U/l as cutoff point of pericardium ADA, with a sensitivity of 100% and a specificity of 94% in the diagnosis of tuberculous pericarditis. Similarly for pericardial Lys, a value of 6.5 µg/dl had a sensitivity and specificity of 100 and 91.17%, respectively. Conclusions: Both measurements of pericardial ADA and Lys need to be taken into account when attempting the early diagnosis of tuberculous pericarditis.
Antiarrhythmic Agents in Facilitating Electrical Cardioversion of Atrial Fibrillation and Promoting Maintenance of Sinus Rhythm
Authors: Marcus Gregory M. , Sung Ruey J.
Published: April 2003

Atrial fibrillation (AF) is a prevalent arrhythmia associated with significant morbidity and mortality. Electrical cardioversion of AF is a potentially definitive treatment, but as little as 67% of patients may be successfully cardioverted and, after normal sinus rhythm (NSR) is achieved, AF often recurs. Class IA, IC, and III antiarrhytmic agents are used for both facilitation of electrical cardioversion and subsequent maintenance of NSR. The mechanisms of these agents may be related to suppressing automaticity, prolonging the wavelength of reentrant wavelets, and preventing electrical remodeling. The possibility of proarrhythmia and other adverse effects complicates use of these drugs, and no large trials have been completed to elucidate definite indications. Several factors may predict failure with electrical cardioversion alone (duration of AF, atrial size, age, underlying disease, and factors that affect transthoracic impedance), calling for empiric pharmacotherapy to facilitate cardioversion. For this purpose, class IA agents hold some promise, evidence for class IC agents is conflicting, and class III agents are the most effective. Adverse effects are rare given the short course before cardioversion, but ibutilide, the most efficacious in this regard, may be proarrhythmic after only a single dose. In promoting maintenance of sinus rhythm, antiarrhythmics across the different classes have similar efficacies: NSR may be maintained in ∼40–65% of patients compared to ∼30–35% with placebo at 1 year. Amiodarone is distinct in its success, with ∼60–80% of patients remaining in NSR. For all of these agents, long-term therapy may lead to proarrhythmia or other substantial adverse effects. Finally, a serial antiarrhythmic strategy may be effective, with maintenance of NSR and minimal adverse effects ultimately achieved by trial and error.
Interpretation of High Wedge Pressure on Exercise in Patients with Chronic Obstructive Pulmonary Disease
Authors: Chabot François , Schrijen Francine , Poincelot Françoise , Polu Jean-Marie
Published: April 2003

In a retrospective review of patients subjected to right heart catheterization, case records from 109 consecutive patients with chronic obstructive pulmonary disease (COPD) and wedge pressure ≧15 mm Hg on exercise were analyzed. Patients were separated into group 1, resting wedge pressure (Pw) <15 mm Hg and difference between Pw and right atrial pressure (Pra) change on exercise <5 mm Hg (n = 54), group 2, same Pw at rest but increase in Pw on exercise ≧5 mm Hg, being higher than that of Pra (n = 34), and group 3, Pw ≧15 mm Hg at rest (n = 21). The occurrence of left heart disease increased from group 1 to group 3 (19, 53 and 71%, respectively), and the slope of the Pw/stroke index relationship was lowest in group 3. High Pw on exercise can be explained by the pressure rise in the cardiac fossa associated with lower lobe gas trapping in group 1, which showed the most severe airflow limitation, decreased left ventricular compliance in group 2, and heart failure in group 3.
Comparative Evaluation of Thermodilution and Gated Blood Pool Method for Determination of Right Ventricular Ejection Fraction at Rest and during Exercise
Authors: Perings Stefan M. , Perings Christian , Kelm Malte , Strauer Bodo E.
Published: April 2003

Background: Since the development of a Swan-Ganz thermodilution ejection fraction catheter several studies have been published which compare this technique for obtaining right ventricular ejection fraction (RVEFTD) with alternative methods. However, the reliability of RVEFTD measurements under exercise conditions remains undetermined. Therefore, the aim of the present study was a comparative evaluation of RVEFTD with the established gated blood pool method (RVEFGBP) under exercise conditions. Methods and Results: Twenty-two patients with different cardiac diseases underwent right heart catheterization, including RVEFTD and simultaneous RVEFGBP determination at rest and during supine bicycle exercise. Linear regression analysis showed a significant correlation between RVEFTD and RVEFGBP at rest (r = 0.73, p ≤ 0.0005) and during exercise (r = 0.74, p ≤ 0.0005). A Wilcoxon analysis showed a high probability of agreement of RVEFTD and RVEFGBP at rest and exercise (level of significance for error of the 0 hypothesis of 95.9/73.3%). Conclusion: The thermodilution ejection fraction catheter provides a useful device for reliable, repetitive and safe RVEF measurements, not only at rest but also under exercise conditions. This seems to be clinically important, because by it means RVEF, as a sensitive parameter of primary or secondary right ventricular dysfunction, can be determined in the course of standard right heart catheterization.
The Relationship of Left Ventricular Mass to Endothelium-Dependent Vasodilation of the Brachial Artery in Patients with Hypertension
Authors: Motoyama Takeshi , Kawano Hiroaki , Hirai Nobutaka , Tsunoda Ryusuke , Moriyama Yasushi , Miyao Yuji , Sakamoto Tomohiro , Yoshimura Michihiro , Kugiyama Kiyotaka , Yasue Hirofumi , Ogawa Hisao
Published: April 2003

Although echocardiographically determined left ventricular mass and geometry predict cardiovascular morbid events in patients with hypertension, the mechanisms underlying this relation are unclear. There is considerable evidence that endothelium-dependent vasodilation is impaired in patients with hypertension. Thus, endothelial dysfunction may contribute to the mechanism that causes cardiovascular morbid events. This study was designed to examine the relationship between left ventricular geometry and endothelial function in patients with hypertension. The percentage increase in brachial arterial diameter during reactive hyperemia was examined by a high-resolution ultrasound technique in 49 patients with hypertension and 64 normotensive subjects. Patients with hypertension had an impairment of the percentage increase in brachial arterial diameter during reactive hyperemia and an increase in thiobarbituric acid-reactive substances (TBARS) compared to normotensive subjects (percentage increase in diameter 5.6 ± 3.0 vs. 8.0 ± 2.5%, p < 0.001; TBARS levels 6.1 ± 1.3 vs. 5.3 ± 1.0 nmol/ml, p < 0.001). In patients with hypertension, there was a significant correlation between the left ventricular mass index and the percentage increase in brachial arterial diameter during reactive hyperemia (r = –0.583, p < 0.001), and the percentage increase in brachial arterial diameter during reactive hyperemia varied with the pattern of left ventricular geometry (normal ventricular geometry: 7.7 ± 2.6%; concentric remodeling: 5.2 ± 2.3%; eccentric hypertrophy: 4.2 ± 1.8%; concentric hypertrophy: 2.9 ± 2.6%). We conclude that (1) flow-mediated endothelium-dependent vasodilation in the brachial artery is impaired in patients with hypertension, (2) a relationship exists between the left ventricular mass index and flow-mediated endothelium-dependent vasodilation in the brachial artery in patients with hypertension and (3) increased oxidative stress may play a role in the endothelial dysfunction in patients with hypertension.
Autonomic Patterns Preceding and Following Accelerated Idioventricular Rhythm in Acute Myocardial Infarction
Authors: Chiladakis John A. , Pashalis Athanasios , Patsouras Nikolaos , Manolis Antonis S.
Published: April 2003

Introduction: We have investigated the potential relationship between cardiac autonomic activity and accelerated idioventricular rhythm (AIVR) in response to reperfusion in the setting of an acute myocardial infarction (AMI) through spectral analysis of heart rate variability (HRV). Methods and Results: We studied 16 patients with AMI who developed spontaneous sustained AIVR after initiation of intravenous thrombolysis. Sympathovagal interactions were evaluated by analysis of the low- (LF) and high-frequency (HF) spectral components of HRV for each 5-min interval over the 30-min periods preceding and following AIVR. The occurrence of AIVR was related to the ST-segment elevation resolution and the angiographic evidence of restored coronary flow to assess timely reperfusion and sustained coronary artery patency. The analysis of spectral components over time revealed combined responses of both autonomic limbs preceding and following AIVR, which were not followed by corresponding changes in heart rate. Ten minutes before AIVR, there was a characteristic continuous increase in LF, in the setting of a concomitant withdrawal of HF, suggestive of a progressive sympathetic predominance. After the end of AIVR, the opposite pattern was found with an increased HF and decreased LF, indicative of parasympathetic rebound overactivity. All patients showed signs of fast reperfusion and complete restoration of coronary flow. Conclusion: Our results indicate that reperfusion-induced AIVR is modulated by sympathetic stimulatory effects, whereas a counterregulatory vagal response seems to exert a profound effect upon its suppression. Clinically, the occurrence of early sustained AIVR appears to offer reliable information about both timely reperfusion and sustained and effective coronary artery patency.
Abnormal Heart Rate Recovery after Exercise: A Comparison with Known Indicators of Increased Mortality
Authors: Desai Milind Y. , de la Peña-Almaguer Erasmo , Mannting Finn
Published: April 2003

Background: Abnormal heart rate (HR) recovery at 1 min after exercise (≤12 beats) was recently suggested to be a predictor of all cause and cardiac mortality. Aim: This study aimed to (1) correlate HR recovery at 1 min after exercise with known exercise and myocardial perfusion markers of increased cardiac mortality, and (2) compare the known exercise and myocardial perfusion markers of increased cardiac mortality between patients with a normal and abnormal HR recovery at 1 min after exercise. Methods: One hundred patients with known or suspected coronary artery disease referred for exercise stress testing (ETT) were prospectively enrolled. Percent, ETT time peak HR, HR reserve, summed stress score (SSS), extent of stress (SE%) and reversible perfusion abnormalities (RE%) were recorded in every patient. Results: There was poor correlation with markers of myocardial ischemia or infarction [SSS (r = 0.15), SE% (r = 0.05), RE% (r = 0.12), all p = n.s.] but highly significant correlation between HR recovery at 1 min after exercise and chronotropic variables [ETT time (r = 0.56), peak HR (r = 0.65), HR reserve % (r = 0.64), all p < 0.001]. Patients on β-blockers had significantly more incidence of an abnormal HR recovery at 1 min after exercise, compared to patients not on β-blockers (88 vs. 56%, p < 0.01). Conclusion: Abnormal HR recovery at 1 min after exercise has no correlation with known myocardial perfusion markers of increased cardiac mortality. Patients with an abnormal HR recovery do not appear to have an increased incidence or more severe myocardial infarction or ischemia. However, there is a strong correlation between HR recovery at 1 min after exercise and the chronotropic variables during exercise.
Long-Term Changes in Collagen Formation Expressed by Serum Carboxyterminal Propeptide of Type-I Procollagen and Relation to Left Ventricular Function after Acute Myocardial Infarction
Authors: Poulsen Steen H. , Høst Nis B. , Egstrup Kenneth
Published: April 2003

The purpose of this study was to investigate the long-term sequential changes in serum levels of the carboxyterminal propeptide of type-I procollagen (s-PICP), which is a marker of type-I collagen synthesis, and to assess its clinical value in relation to left ventricular (LV) function and prognosis following acute myocardial infarction (AMI). Forty-eight consecutive patients with their first AMI and 15 control subjects were studied. Patients with AMI were stratified according to the changes in s-PICP levels between days 1 and 90 (ΔPICP) and divided into group I with ≤16.0 µg/l or group II with >16.0 µg/l. Patients in group II were characterized by LV dilatation, no improvement in ejection fraction and development of impaired diastolic filling from day 1 to 360, findings which were in contrast to group I. Cox regression analysis identified changes in s-PICP of >16.0 µg/l as an independent predictor of cardiac death or heart failure during follow-up. In conclusion, ΔPICP relates to long-term changes in LV function and size, and provides prognostic information following AMI.
Dipyridamole Myocardial Perfusion Tomography in Patients with Severe Aortic Stenosis
Authors: Demirkol Mehmet Onur , Yaymacı Bengi , Debeş Hakan , Başaran Yelda , Turan Fikret
Published: April 2003

Patients with aortic stenosis (AS) may have classic angina pectoris. The safety of exercise testing in adults with AS is controversial and, in fact, exercise testing in such patients is considered to be contraindicated especially in severe aortic stenosis (SAS). Furthermore, exercise testing has low specificity in uncovering coronary artery disease (CAD) in patients with AS, because the baseline ECG is frequently abnormal. We wished to assess the safety and diagnostic accuracy of dipyridamole stress myocardial perfusion tomography (DMPT) in the detection of CAD in patients with SAS. Methods: The study included 30 patients with SAS (mean aortic valve area 0.57 ± 0.09 cm2). All patients underwent dipyridamole myocardial perfusion scintigraphy (SPECT), coronary arteriography and catheterization, as well as Doppler echocardiography. Myocardial perfusion tomography was applied with 99mTc hexakis-2-methoxyisobutyl isonitrile (MIBI) by a single day rest-dipyridamole infusion protocol. Hemodynamic, electrocardiographic and clinical responses were compared with those of 50 control patients without AS. Results: Hemodynamic responses during dipyridamole stress tests demonstrated no significant differences between the controls and the AS patients in the following parameters: systolic blood pressure, heart rate, rate-pressure product or incidence of headache, chest pain, dyspnea, flushing and dizziness. A reversible perfusion defect was observed in 10 patients with DMPT. The existence of coronary lesions was determined by coronary arteriography in 8 of 10 patients (sensitivity 100%, specificity 91%). Conclusion: The results showed that DMPT is well tolerated, even by patients with SAS and is of high diagnostic value in assessing CAD.
In situ Evaluation of Different Remineralization Periods to Decrease Brushing Abrasion of Demineralized Enamel
Authors: Attin Thomas , Knöfel Swantje , Buchalla Wolfgang , Tütüncü Rengin
Published: April 2003

The aim of the present in situ study was to evaluate the effect of different periods of intraoral remineralization to decrease the susceptibility of previously demineralized enamel against toothbrushing abrasion. Six human enamel specimens (A–F) were recessed in the buccal aspects of each of eight intraoral appliances which were worn for 21 days by 8 panelists. Demineralization of the samples was performed twice a day extraorally in the acidic beverage Sprite Light for 90 s. Subsequently, the enamel specimens were brushed at different times. Specimen A was brushed immediately after the demineralization. The remaining samples B–E were brushed after the intraoral appliances had been worn for various periods of remineralization: specimen B, 10 min; C, 20 min; D, 30 min and E, 60 min, respectively. Specimen F was only demineralized and remineralized, but not brushed. After 21 days, enamel wear was measured with a laser profilometer. The following values (mean ± standard deviation) were obtained: specimen A, 6.78±2.71 µm; B, 5.47±3.39 µm; C, 6.06±3.18 µm; D, 5.43±2.58 µm; E 4.78±2.57 µm, and F 0.66±1.11 µm. Analysis of variance revealed a significant influence of remineralization period on abrasive wear. However, even after a remineralization period of 60 min the wear was significantly increased as compared to the demineralized, but not brushed control. It is concluded that (1) abrasion resistance of softened enamel increases with remineralization period and (2) at least 60 min should elapse before toothbrushing after an erosive attack.
Salivary Concentrations of Urea Released from a Chewing Gum Containing Urea and how These Affect the Urea Content of Gel–Stabilized Plaques and Their pH after Exposure to Sucrose
Authors: Dawes C. , Dibdin G.H.
Published: April 2003

The objectives were to: (1) determine the salivary concentrations of urea during 20 min chewing of a sugar–free gum containing 30 mg of urea; (2) measure the degree to which this urea would diffuse into a gel–stabilized plaque; (3) study the effect of the urea on the fall and subsequent rise in pH (Stephan curve) on exposure to 10% sucrose for 1 min; (4) model the measurements 2 and 3 mathematically. In point 1, the salivary urea concentration of the 12 subjects peaked at 47 mmol/l in the first 2 min of gum chewing, falling within 15 min to the unstimulated salivary concentration of 3.4 mmol/l. Recovery of urea from the saliva averaged 81.5%. ‘Plaques’ of 1% agarose or 67% dead bacteria in agarose accumulated urea from the saliva roughly as expected, whereas those plaques containing 8% live and 59% dead Streptococcus vestibularis showed negligible accumulation. Computer modelling showed this difference to be due to urease of live bacteria breaking down the urea as rapidly as it entered the plaque. Simulation of the effect of gum chewing subsequent to initiation of a Stephan curve in the latter type of plaque showed a rapid rise in pH but then a fall again on return to unstimulated conditions. This fall had not been seen in previous studies, with Streptococcus oralis, nor was it predicted by the computer modelling. Neither experimental simulation nor computer modelling suggested that chewing urea–containing gum before exposure to sucrose would have any effect on a subsequent Stephan curve. Thus chewing gum is only likely to inhibit caries when it is chewed after consumption of fermentable carbohydrate, rather than before.
Caries Data Collected from Public Health Records Compared with Data Based on Examinations by Trained Examiners
Authors: Hausen H. , Kärkkäinen S. , Seppä L.
Published: April 2003

Collecting data for dental caries studies is costly. In countries where uniform patient records are available for virtually the whole population, it is tempting to use them as a data source. Our aim was to compare data collected from patient records to those obtained by trained examiners. In 1992 and 1995, dentists who were specially trained and calibrated examined random samples of 12– and 15–year–olds living in two towns in Finland. The dental record of each child was obtained from public dental clinics, the dental status was entered into a computer file, and the DMFS value was calculated. Data were available for 824 children. In the two data sets, 1.3% of the tooth surfaces were recorded differently (DMF vs. sound) with the related ĸ value being 0.70. In two thirds of the discrepancies, the reason was that a filling was marked in only one of them, which confirms the known difficulty in discerning a white filling. For 48% of the subjects, the DMFS values calculated from the two sets of data were equal. The difference was 1 and 2 surfaces for 28 and 11%, respectively. Public health dentists had almost equally often registered more and less DMF surfaces compared to trained examiners. The results suggest that data collected from public health records are not decisively inferior to those obtained from examinations by trained examiners. In large enough settings, data obtained from patient records could possibly be used as a replacement for separate surveys.
Mutans Streptococci, Lactobacilli and Caries Experience in Cystic Fibrosis Homozygotes, Heterozygotes and Healthy Controls
Authors: Aps J.K.M. , van Maele G.O.G. , Claeys G. , Martens L.C.
Published: April 2003

Mutans streptococci (MS) and lactobacillus (LB) counts (CRT Bacteria chair–side test) were compared and correlated with the respective caries experience (DMF) of cystic fibrosis (CF) homozygotes (n = 20), CF heterozygotes (n = 20) and healthy controls (n = 20). Each group of subjects was divided into two equal age groups: group A <20 years and group B >20 years. No significant differences were found regarding DMF between the three groups. CF heterozygotes had a significantly higher DMF–S than CF homozygotes (p = 0.040). This was also found in age group B (p<0.02), where it also counted for DMF–T (p<0.01). When in age group B, CF heterozygotes and controls were combined as one group, it was found that they had a significantly higher DMF–T (p = 0.031) and DMF–S (p = 0.008) than CF homozygotes. No significant differences in LB counts between the three groups were observed. CF homozygotes and those in age group A had significantly (p = 0.018 and p = 0.015) more low MS counts. LB and MS counts were positive and significantly correlated with DMF–T/–S in CF homozygotes and in the combined group of CF heterozygotes with controls (p≤0.05 and ≤0.001). No correlations between bacterial counts and DMF were observed in CF heterozygotes. It can be concluded that despite the fact that CF homozygotes behave as high caries risk individuals, they did not have significantly more dental decay. More research is required in order to explore salivary, dietary and medication influences.
Effect of Long–Term Consumption of a Probiotic Bacterium, Lactobacillus rhamnosus GG, in Milk on Dental Caries and Caries Risk in Children
Authors: Näse L. , Hatakka K. , Savilahti E. , Saxelin M. , Pönkä A. , Poussa T. , Korpela R. , Meurman J.H.
Published: April 2003

Lactobacillus rhamnosus GG, ATCC (LGG), has shown antagonism to many bacteria including mutans streptococci. This randomized, double–blind, placebo–controlled intervention study was designed to examine whether milk containing LGG has an effect on caries and the risk of caries in children when compared with normal milk. 594 children, 1–6 years old, from 18 municipal day–care centres were included. The children received the milk with meals from coded containers 5 days a week in the day–care centres for 7 months. The children’s oral health was recorded at baseline and at the end, using WHO criteria. The caries risk was calculated based on clinical and microbiological data, comprising mutans streptococcus levels from dental plaque and saliva. The risk was classified as high if the child had a dmft/DMFT or initial caries score >0, and a mutans streptococcus count ≧105 CFU/ml. The results showed less dental caries in the LGG group and lower mutans streptococcus counts at the end of the study. LGG was found to reduce the risk of caries significantly (OR = 0.56, p = 0.01; controlled for age and gender, OR = 0.51, p = 0.004). The effect was particularly clear in the 3– to 4–year–olds. Thus, milk containing the probiotic LGG bacteria may have beneficial effects on children’s dental health.
Caries Experience and Caries Increments at 10 Years of Age
Authors: Mattila M.-L. , Rautava P. , Paunio P. , Ojanlatva A. , Hyssälä L. , Helenius H. , Sillanpää M.
Published: April 2003

The aim of the study was to examine the caries experience of 10–year–olds as measured with dmft/DMFT, to explain how caries increases by the age of 10 years, and which factors would explain caries increments. The setting was a representative population sample of first–born children in southwestern Finland. Dental health at 10 years of age was found to be good in 45%, fairly good in 40% and poor in 15% of the children. The caries index remained stable in 23% of carious children from 7 to 10 years of age. Daily consumption of sweets at the age of 3 years (OR 2.7; 95% CI 1.5–4.8; p < 0.001) was associated with a caries increment between 7 and 10 years of age (both deciduous and permanent teeth). This daily consumption of sweets and a child’s late bedtime (OR 1.9; 95% CI 1.1––3.1; p = 0.023) were explanatory factors in the permanent teeth alone. In the deciduous teeth, mother’s previous caries and child’s earlier tooth brushing habits were explanatory factors of caries. As hypothesized, all five significant factors remaining in the final logistic regression analysis were family–related. Parental ability to care for and educate a child could be seen in dental health still at the age of 10 years. The family–related factors which were associated with caries should be emphasized much more comprehensively in everyday dental health care practice.
Comparative Study to Quantify Demineralized Enamel in Deciduous and Permanent Teeth Using Laser– and Light–Induced Fluorescence Techniques
Authors: Ando Masatoshi , van der Veen Monique H. , Schemehorn Bruce R. , Stookey George K.
Published: April 2003

Caries is a disease that affects both deciduous and permanent dentitions. Caries progresses more rapidly in deciduous enamel than in permanent enamel. Therefore, new caries diagnostic methods need to be tested on the deciduous teeth as well. Quantitative laser–induced fluorescence (QLF I) as well as the quantitative light–induced fluorescence (QLF II) seem promising for the quantification of mineral loss from dental caries but have only been tested on the permanent dentition. The objective of this study was to determine and compare the ability of QLF I and QLF II to quantify mineral loss from carious lesions in both deciduous and permanent teeth. Thirty sound deciduous and 30 sound permanent teeth were cleaned and divided into three groups each containing 10 deciduous and 10 permanent teeth. Windows on the buccal or labial enamel surfaces were demineralized for 48, 72, or 96 h. Images of demineralized enamel were captured using QLF I and QLF II. The images were analyzed to determine the mean change in fluorescence radiance (ΔF, %). The teeth were then sectioned for assessment of lesion depth (µm) and integrated mineral loss (IML, vol% ×µm) using transverse microradiography (TMR), as the ‘gold standard’ for lesion analysis. The results indicated a good correlation for ΔF between QLF I and QLF II in both deciduous (r = 0.96) and permanent teeth (r = 0.98). There was a good correlation between ΔF and TMR (lesion depth and IML) in deciduous teeth (r = 0.76 and 0.84 with QLF I, r = 0.81 and 0.88 with QLF II). In permanent teeth, the correlation between ΔF and TMR (lesion depth and IML) was lower than in deciduous teeth (r = 0.07 and 0.53 with QLF I, r = 0.15 and 0.62 with QLF II). From these results it can be concluded that either QLF method is capable of quantifying mineral loss in early carious lesions in deciduous teeth. Moreover, under the conditions of this study, the use of either QLF method to quantify mineral loss in early carious lesions in deciduous teeth is slightly more accurate than in permanent teeth.
Antithrombotic Drugs:Insights f rom Cardiology
Authors: Meyer Beat J.
Published: April 2003

The primary purpose of this overview is to provide an update on the newer antiplatelet drugs evaluated in clinical trials and introduced in clinical practice of modern cardiology. Despite the remarkable clinical developments with the use of new antiplatelet drugs, several fundamental issues remain unresolved. Some of the observed safety/efficacy problems in major clinical trials can be directly attributed to the lack of careful phase II studies where issues such as monitoring, pharmacological profiles, and individual response variations were not considered sufficiently. Nevertheless, none of the available antiplatelet agents meet all the criteria of an ideal antiplatelet agent. Aspirin has been the standard reference agent in cardiovascular disease. However, it is a weak and nonselective antiplatelet compound and is unable to interfere substantially with the thrombogenic activity of a fresh mural thrombus of a stenosed vessel. The newer antiplatelet drug classes such as the ADP receptor blockers (ticlopidine, clopidogrel) and the platelet glycoprotein IIb/IIIa receptor inhibitors produce their therapeutic effects by distinct mechanisms which differ from aspirin. Large clinical trials have documented their efficacy in acute coronary syndromes associated with intracoronary thrombus formation. The future challenge is to evaluate long-term treatment strategies which are equally safe but distinctly more effective than aspirin, e.g. a combination therapy with aspirin and clopidogrel or oral GP IIb/IIIa receptor antagonists.
Type III Collagen Deficiency in a Family with Intracranial Aneurysms
Authors: van den Berg Jan S. P. , Limburg Martien , Pals Gerard , Arwert Fre , Westerveld Andries
Published: April 2003

We present a family with 2 female cousins with intracranial aneurysms and type III collagen deficiency. DNA analysis revealed no mutations in the COL3A1 gene, encoding type III collagen, and including the segment encoding the C-propeptide of type III collagen. The 2 patients with low type III collagen production and intracranial aneurysms had inherited different type III collagen alleles. The type III collagen deficiency in this family may results from defects during posttranslational modification or from an altered collagen metabolism.
Linear Hyperintensity Objects on Magnetic Resonance Imaging Related to Hypertension
Authors: Hiroki Masahiko , Miyashita Kotaro
Published: April 2003

Linear hyperintensity lesions, which are sometimes recognized in the cerebral white matter on T2-weighted magnetic resonance (MR) images, have never been studied from the clinical viewpoint. We refer to these lesions as linear hyperintensity objects (LHOs) and have investigated them quantitatively. Twenty-six consecutive patients underwent routine 1.5-Tesla MR imaging. LHOs were found in 24 patients. We measured the width and number of LHOs at the upper corona radiata level on T2-weighted images (repetition time: 4,500.0 ms, echo time: 96.0 ms) using a scale loupe. The diameters were significantly correlated with the stages of hypertension (WHO classification). The LHOs may associated with the dilated perivascular spaces of cortical medullary arteries and may become an indicator for hypertensive small vessel disease.
Intravenous Thrombolysis in Proximal Middle Cerebral Artery Occlusion
Authors: Schneweis Susanne , Grond Martin , Neveling Michael , Schmülling Susanne , Rudolf Jobst , Heiß Wolf-Dieter
Published: April 2003

Subgroup analyses of data from an open-label study of intravenous recombinant tissue plasminogen activator (rt-PA) administered to stroke patients were performed. Clinical outcome and incidence of intracranial hemorrhage were evaluated in 20 patients diagnosed by transcranial Doppler ultrasound as having proximal middle cerebral artery (MCA) occlusion. Additionally early infarct signs and size of final infarction were assessed. A favorable outcome (mRS 0–2) was seen in 30% of all patients. The incidence of symptomatic intracranial hematoma (10%) in patients with proximal MCA occlusion was higher than the overall hemorrhage rate of intravenous rt-PA treatment, but comparable to the data on intra-arterial thrombolysis in this stroke subgroup. All patients except 1 developed ischemic infarction in the MCA territory. Intravenous rt-PA treatment within 3 h may also be effective in patients with proximal MCA occlusion. The risk of intracerebral hematoma does not seem to be greater than in intra-arterial thrombolysis.
Marfan’s Syndrome and Multiple Extracranial Aneurysms
Authors: Sztajzel R. , Hefft S. , Girardet C.
Published: April 2003

Dissecting aneurysms of the extracranial cervical arteries in Marfan’s syndrome are most frequently caused by the extension of aortic dissection. Spontaneous and isolated aneurysms limited to the major extracranial cervical arteries have also been reported in Marfan’s syndrome, although very rarely. In these cases, the aneurysms are usually asymptomatic or may present as a pulsatile mass. Transient ischemic attacks (TIAs) or strokes, associated with isolated extracranial aneurysms, have not been mentioned in Marfan’s syndrome. We report a patient with Marfan’s syndrome presenting with TIAs in whom we detected a saccular aneurysm of the vertebral artery as well as bilateral fusiform aneurysms of the internal carotid arteries.
Retinal Ischemia and Embolism
Authors: Babikian Viken , Wijman Christine A.C. , Koleini Behrooz , Malik Salman N. , Goyal Naveen , Matjucha Ippolit C.A.
Published: April 2003

Objectives: To identify the most likely mechanisms of retinal ischemia and embolism in a hospital-referred population, and to determine the frequency of recurrent vascular events during the 3-month period following initial presentation. Methods: Consecutive patients presenting to 2 tertiary medical centers and their outpatient clinics were prospectively enrolled over a 22-month period. Eligible patients presented with histories of transient or permanent monocular visual loss, or had evidence of asymptomatic retinal embolism on routine ophthalmological examination. They underwent a rapid and standardized evaluation that included imaging studies as well as blood tests, and follow-up was obtained at 1 and 3 months. Results: Seventy-seven patients were enrolled. Enrollment diagnoses consisted of amaurosis fugax (n = 32), asymptomatic retinal embolism (n = 34), and central or branch retinal artery occlusion (n = 11). Eight different presumed etiologies of retinal artery distribution embolism or hypoperfusion were identified. Extracranial internal carotid artery occlusion or more than 50% stenosis was observed in 17/77 (22.1%) cases, making it the largest etiologic subgroup. Uncommon but treatable conditions were identified in 8/77 (10.4%) patients, and an etiologic diagnosis could not be made in 35/77 (45.5%) patients. Recurrent events occurred in, respectively, 14/77 (18.2%) and 6/73 (8.2%) patients at the 1- and 3-month follow-ups. They included 2 infarcts and 2 deaths; ischemic events of the retina were more common than those involving the brain. Conclusion: Severe stenosis of the extracranial internal carotid artery is the most common identified condition associated with retinal ischemia and embolism, but a variety of other, potentially treatable, conditions can be diagnosed if appropriate and specific evaluations are conducted. The frequency of recurrent vascular ischemic events is highest during the 1st month of follow-up and decreases during the 2nd and 3rd months. Recurrences range from relatively innocuous episodes of amaurosis fugax to vascular death.
Post-Stroke Depression, Antidepressant Treatment and Rehabilitation Results
Authors: Paolucci Stefano , Antonucci Gabriella , Grasso Maria Grazia , Morelli Daniela , Troisi Elio , Coiro Paola , De Angelis Domenico , Rizzi Francesco , Bragoni Maura
Published: April 2003

The aim of this study was to assess the specific influence of poststroke depression (PSD) on both basal functional status and rehabilitation results. We performed a case-control study in 290 stroke inpatients, matched for age (±1 year) and onset admission interval (±3 days) and divided in two groups according to the presence (PSD+) or absence (PSD–) of PSD. All PSD+ patients were treated with antidepressants (AD), mainly with fluoxetine. PSD+ patients, despite similar severity of stroke, showed greater disability in coping with activities of daily living (ADL) on admission and greater disability both in ADL and mobility at discharge than PSD– patients. Although both groups exhibited similar average functional improvement during rehabilitation, PSD– patients were nearly twice as likely to show excellent recovery both on ADL and mobility as PSD+ patients (OR = 1.95, 95% CI = 1.01–3.75 and OR = 2.23, 95% CI = 1.14–4.35, respectively). All AD drugs improved depressive symptoms. Few relevant side effects were observed: fluoxetine was discontinued in 2 patients because of insomnia and in 2 patients because of nausea; paroxetine was stopped in 1 patient because of nausea and dry mouth. Our results confirm the unfavorable influence of PSD on functional outcome, despite pharmacological treatment.
Incidence of Adult Brain Arteriovenous Malformation Hemorrhage in a Prospective Population-Based Stroke Survey
Authors: Stapf Christian , Labovitz Daniel L. , Sciacca Robert R. , Mast Henning , Mohr Jay P. , Sacco Ralph L.
Published: April 2003

Background: Brain arteriovenous malformations (AVMs) represent a potential source of intracranial hemorrhage, especially in young adults, but prospective population-based incidence data on AVM hemorrhage are lacking. We investigated the incidence of first-ever AVM hemorrhage in adults based on population data from the Northern Manhattan Stroke Study (NOMASS). Methods: NOMASS is a prospective, population-based, stroke incidence survey collecting all hospitalized and nonhospitalized cases with first-ever (incident) stroke over the age of 20 in a ZIP code-defined area. All patients undergo CT and/or MR brain imaging and clinical data are systematically collected from the medical records. For this study, data on all cases with incident intracranial hemorrhage, i.e. any intracerebral, intraventricular and/or subarachnoid hemorrhage, occurring between July 1, 1993 and June 30, 1997 were used. Patients with intracranial hemorrhage due to trauma, tumor or intracranial vascular malformations other than a previously unknown AVM were excluded from the study. Results: Of the 207 patients diagnosed with a first-ever intracranial hemorrhage, 3 cases (1.4%) with an underlying brain AVM were identified. The crude incidence rate for first-ever AVM hemorrhage in our adult population was 0.55 per 100,000 person-years (95% confidence interval 0.11–1.61). Conclusions: Our results support prior findings from retrospective surveys. Population-based studies providing a prospective design for AVM detection and diagnosis are needed to confirm the data.
Quantitative Immunohistochemical Analysis of the Expression of CD31 during Lung Development in the Rat
Authors: Marszalek Andrzej , Daa Tsutomu , Kashima Kenji , Nakayama Iwao , Yokoyama Shigeo
Published: April 2003

The CD31 antigen, known also as the platelet/endothelial cell adhesion molecule 1, has been shown to be a good marker for monitoring the formation of the vasculature in mammals. Available evidence suggests that the expression of CD31 is regulated during embryonal and fetal development. The aim of the present study was to evaluate the changes in the expression of CD31 during the development of the rat lung. We studied samples of lung tissue from rat fetuses (17, 19 and 21 days after conception), newborns (1, 3, 5, 7, 14 and 21 days after birth) and adult animals. The tissue samples from rats in the various age groups were divided into sets, with all age groups being represented in every set. After immunohistochemical localization of the antigen, the amount of chromogen deposited after the immunoreaction (defined in terms of optical density; OD) was evaluated by image analysis in the various sets. Measurements were obtained twice from each set, and the results were reproducible (paired t test, α = 0.05). We subjected the results of measurements from all sets to an analysis of variance (ANOVA). The amount of chromogen (OD) decreased from fetal day 19 to 5 days after delivery and then increased again. The decrease in the level of expression of CD31 on days 3 and 5 after delivery was significant (p < 0.0001).