bluuebunny/crossref_metadata_2025 huggingface dataset:
Image analysis of skin scaling using D‐Squame® samplers: comparison with clinical scoring and use for assessing moisturizer efficacy
Authors: Black D. , Boyer J. , Lagarde J. M.
Published: January 2006

Synopsis

The severity of scaling disorders can be evaluated objectively using the D‐Squame® technique coupled with image analysis. The parameters of scaling derived using this approach need to be clinically relevant and should have greater discrimination than visual grading. Improvements to an existing method that fulfil these requirements are presented. Three scaling parameters were calculated using image analysis of digitized video‐captured images of obliquely lit D‐Squame® samples. These parameters were compared to clinical scores of scaling made by five observers from photographs of the same areas sampled with D‐Squame®. In addition, two clinical studies were carried out to assess moisturizer effects on different degrees of xerosis, and to compare two different moisturizer preparations. The three scaling parameters gave correlation coefficients, r, between 0.6 and 0.75 when compared with global clinical scores of scaling. Significant reductions in all parameters were observed with 2 weeks of moisturizer use on lower leg skin with marked xerosis compared to an untreated control. The same moisturizer had a similar effect on milder xerosis of the forearm, and showed a greater decrease than a moisturizer with lower glycerol content. Increases in skin hydration, as measured with a corneometer, were also seen in both clinical studies, and corresponded well with D‐Squame® results. Differences in the degrees of scaling between these two anatomical sites were also detected with this technique. In a previous publication, the same technique was shown to be repeatable and reproducible; in the current article its correlation with clinical observations of scaling or flaking skin has been demonstrated.
The suppressive effect of apricot kernel extract on 5α‐Androst‐16‐en‐3‐one generated by microbial metabolism*
Authors: Mikoshiba S. , Takenaka H. , Okumura T. , Someya K. , Ohdera M.
Published: January 2006

Synopsis

Body odours are generated from dead skin cells and secreted materials, such as sweat and sebum, through the metabolism of microorganisms living on the skin. Volatile steroids, key compounds in body odours, are also generated through the metabolism of microorganisms. These volatile steroids strengthen the intensity of the overall body malodour and are sensed differently by males and females. Females are more sensitive than males to volatile steroids, especially 5α‐androst‐16‐en‐3‐one (androstenone). To regulate body odours that are especially unpleasant for women, we devised an androstenone‐generation model using the metabolism of Corynebacterium xerosis, which is one of the bacteria living on the axillary skin. Using this model, we studied the suppressive effect of plant extracts on the generation of androstenone. We found that apricot kernel extract (AKE) had the most positive effect among the plant extracts to which we applied the model. However, although AKE did suppress androstenone generation, it did not show any bactericidal effect. Using the cell‐free system, AKE also suppressed the generation of androstenone. In conclusion, we found that AKE suppressed the generation of androstenone, which is especially unpleasant for women, and the mechanism was not bactericidal but metabolic inhibition. The results of these studies provide new understanding of the regulation of androstenone, which, in turn, should lead to the development of novel deodorant systems.
Adaptive response of the skin to UVB damage: role of the p53 protein
Authors: Verschooten L. , Declercq L. , Garmyn M.
Published: January 2006

Synopsis

Different adaptation mechanisms like heat shock response, cell cycle arrest and DNA repair, melanin pigmentation and thickening of the epidermis are present in the human skin to protect against the adverse effects of solar UV irradiation. When DNA damage is beyond repair, cells undergo apoptosis to prevent their replication. We discuss the current knowledge on these different adaptation mechanisms to UVB damage, the most energetic fraction of solar UV that reaches the skin. As p53 protein, the guardian of the genome, plays a key role in protective response to genotoxic damage, its role in this adaptive response of the skin to UV will be further discussed.
Production of the Tissue Inhibitor of Metalloproteinase‐2 (TIMP‐2) and Evaluation of Its Potential as Anti‐Aging Active
Authors: Schütz R. , König B. , Hochstrasser B. , Stolz P. , Imfeld D.
Published: January 2006

Collagen‐degrading matrix metalloproteinases (MMPs) show increased activities predominantly in UV‐irradiated skin as well as in chronologically aged skin. MMPs are therefore reasoned to be associated with the degenerative alterations in the collagenous dermal extracellular matrix, which in turn may accelerate the signs of skin aging such as wrinkle formation and skin sagging. In normal physiological processes MMP activity is controlled by the endogenous tissue inhibitors of metalloproteinases (TIMPs). Here we report the biotechnological production of the human‐identical inhibitor TIMP‐2 and its evaluation as an anti‐aging active through attenuation of the degenerative MMP activity. The recombinant TIMP‐2 polypeptide selectively inhibited MMPs in vitro which are involved in aging processes and showed efficient IC50 values in the low nanomolar range. Topical application of formulated TIMP‐2 on skin explants with subsequent UVB irradiation (2‐3 MED) resulted in an almost quantitative protection against collagen degradation. Thus, our biotechnological production of TIMP‐2 leads to the active broad‐spectrum MMP inhibitor that reduces excessive MMP activity and thereby preserves the structural integrity of collagen network.

A poster of this work was presented at the 23rd IFSCC Congress 2004, Orlando, Florida, USA.
Optical Properties of Skin Gloss and Development of a »Mizumizushii« Look Makeup Foundation
Authors: Nishimura H. , Takasukam Y. , Yamamoto M.
Published: January 2006

In Japan, the term »mizumizushii« is used to describe a quality of »beauty«. We studied »apparently mizumizushii‐looking skin« and tried to develop makeup products that »make the skin look mizumizushii« which is one of the characteristics of beauty. To accomplish this what constitutes »mizumizushii‐looking skin« and »non mizumizushii‐looking skin« first had to be defined. Hence, sensory evaluations were performed on 100 women. The results showed that these panelists could be classified into two groups: 25 women »having mizumizushii‐looking skin« and 75 women »having skin without a mizumizushii look«. Further, it was revealed that the »skin without a mizumizushii look« could be classified into two groups, those with dry‐looking skin and those with excessively oily‐looking skin. We then succeeded in qualitatively classifying the appearance of the skin of these three groups on the basis of the difference in a value obtained for optical properties analyzed under specified conditions. Moreover, results of studies on possible qualitative classification of these groups using Z1, the newly discovered optical parameter for optical properties of the skin, showed an apparent relationship with the surface morphology (homogeneity on a micron scale). Based on the findings on the optical properties of »mizumizushii‐looking skin«, we designed a makeup film imparting the »mizumizushii look«, which in turn led to the development a »mizumizushii look« makeup foundation.
Membrane Structured Solid Nanoparticles – A Novel Nanotechnology for Delivery of Cosmetic Active Ingredients
Authors: Dahms G. H.
Published: January 2006

Lipid nanoparticles have a structure similar to that of nanoemulsions. Their size ranges typically from 50 to 1000 nm. They differ from nanoemulsions in that the lipid core is a solid. The matrix consists of solid lipids or mixtures of lipids. Over the past years it has been demonstrated that solid lipid nanoparticles appear to be a promising drug carrier system for the future. Their occlusion properties reduce transepidermal water loss and can enhance penetration of active ingredients through the stratum corneum. As with all new technologies, some problems with the solid lipid nanoparticle technology need to be solved. One major problem is the homogeneous incorporation of amphiphilic active ingredients into the crystal matrix of the nanoparticles. Actives with an amphiphilic character like tocopherol or retinol cannot be kept homogeneously distributed in the wax structure during the emulsification process. Due to their hydrophilic head group they accumulate at the exterior layer of the nanoparticles together with the surfactant system used. Consequently, homogeneous release over time is not guaranteed and a burst release has to be expected. A second disadvantage is the manufacturing process. Solid lipid nanoparticles can be produced only under high pressure conditions. Also the concentration of the solid particles in the dispersion, which is added to an emulsion, is quite low. To overcome these problems membrane structured solid nanoparticles (MSSN) have been developed. These MSSN systems consist of liquid crystalline membrane systems with extremely low surfactant concentrations. The lateral movement of actives is controlled by amphiphilic solid actives such as ceramides and solid emollients. This guarantees maintenance of the advantageous properties of solid lipid nanoparticles such as retarded release of actives and their protection against chemical decomposition, but it also allows the homogeneous incorporation of amphiphilic actives. Membrane structured solid nanoparticles are produced using a continuous three‐phase emulsification technique. This allows protection of heat‐sensitive actives against decomposition. The concentration of nanoparticles in the MSSN dispersion can be kept higher than 60% (w/w). Even at these concentrations the nanodispersions keep their flow properties. As a result, they can be easily incorporated into the final formulation.
A National Web‐Based Survey of Sunscreen Products as a Tool for Industry Self‐Regulation, Consumer Awareness Campaigns and Marketing
Authors: Summers B. , Summers R. S. , Muller E.
Published: January 2006

The objective of the work was to test a web‐based tool in the collection and presentation of data for our regular sunscreen surveys and to develop, test and conduct a web‐based survey of sunscreen products, with instant data reporting. After the Photobiology Laboratory at MEDUNSA was approached by SurveyIT to pilot a new web‐based data collection and reporting tool, companies were contacted via e‐mail and invited to visit a secure web‐based site to complete the provided questionnaire. Data collection and processing were greatly simplified by the new approach. The survey gleaned responses from 18 companies on 31 brands with a total of 110 primary sunscreen products. The data revealed a reduction in the number of companies marketing sunscreens in South Africa compared with the previous year, despite an increase in the volume of sunscreen sales. Ninety‐eight percent of the products were claimed to be in vivo SPF tested. Fifty‐seven percent of the products had undergone in vitro SPF testing for determination of their UVA protection. Fifty‐one percent of the products were claimed to be water‐resistant. Octyl methoxycinnamate was the most popular UV filter (88% of products), followed by benzophenone‐3 (60%). Butyl methoxydibenzoylmethane was in 52% of the products and surprisingly only 29% of the products contained titanium dioxide. The major conclusions are that the data collection tool was a success and that sunscreens are becoming more widely used and more thoroughly tested in South Africa.
Development of Oil‐Type Make‐up Remover Prepared with Polyglycerol Fatty Acid Esters
Authors: Iwanaga T. , Uchida K. , Takeuchi N. , Abe Y.
Published: January 2006

We developed an oil‐based make‐up remover still having a cleansing function even in a bath by utilizing polygycerol fatty acid esters, which are widely used in food industry fields. The polyglycerol fatty acid esters that have superior self‐emulsification were synthesized by adjusting the molar ratio of fatty acids and polyglycerols. The phase diagrams were constructed to recognize the cleansing mechanism. In the phase diagram of a water/surfactant/oil system, W/O type microemulsion that solubilizes a small amount of water forms near the surfactant‐oil axis. Regarding the washing process as proceeding from surfactant‐oil axis toward water vertex in the phase diagram, it is supposed that this is the reason why the ordinary remover cannot be used in the presence of water. It was found that the amount of solubilized water could be increased by adding middle‐chain alcohols as co‐surfactants in the present system. By utilizing a polyglycerol ester of the middle‐chain fatty acid instead of such alcohols, the amount of water dissolving in the microemulsion remarkably increased like the added alcohol system. Consequently, the make‐up remover containing the polyglycerol ester of the middle‐chain fatty acid could be used even in a bath, and easily removed the oil soil, dispersed in water as fine emulsion droplet.
Methodology for Evaluation of Skin Transparency and the Efficacy of an Essence That Can Improve Skin Transparency
Authors: Masuda Y. , Kunizawa N. , Takahashi M.
Published: January 2006

Transparency of the skin is an important factor for realizing beautiful skin, but there is only a visual sensory evaluation method by a beauty specialist. It is unclear how skin physiological characteristics can give transparency. Our purpose is to establish an objective method for evaluating the transparency of the skin and to develop a special cosmetics product which can enhance skin transparency, after investigating the mechanism of the skin characteristics which yield transparency. We developed an optical instrument that could independently measure a diffuse reflection as well as a specular reflection by assembling a polarizing filter in a gonio‐spectrum photometer. We analyzed the relationship among skin transparency, specular reflection light and diffuse reflection light. It was shown that there was a strong positive correlation between the skin transparency and the intensity of the diffuse reflection light (r = 0.699) and no correlation between the skin transparency and the intensity of the specular reflection light (r = 0.190). The results of partial least squares (PLS) analysis of the skin transparency and the skin physiological characteristics showed that a highly transparent skin has a fine skin surface texture with a high hydration of stratum corneum, a low melanin content and a low hemoglobin content. On the basis of these results, we developed an essence that can improve skin texture and blood flow, reduce melanin content, and increase the moisture in the stratum corneum. After eight weeks’ usage of this product by consumer panels (n = 30), it was confirmed that the skin transparency was improved by the increase of the intensity of the diffuse reflection light by gonio‐spectrum photometer measurement and by consumers’ self‐assessment.
A novel method for visualizing hair lipids at the cell membrane complex: Argon sputter etching/scanning electron microscopy1
Authors: Masukawa Y. , Shimogaki H. , Manago K. , Imokawa G.
Published: January 2006

Hair lipids localized at the cell membrane complex (CMC) play a part in chemical diffusion, cell cohesion, and mechanical strength. There is no method currently available to visualize hair lipids at the CMC. We found that scanning electron microscopy (SEM) of a transversely polished hair plane followed by argon sputter etching (ASE) provides a specific characteristic image consisting of circular patterns (CP) and stitch patterns (SP) at the cortex. Both the CP and the SP are formed as convex structures and are associated with melanin granules and the CMC, respectively. While the convex formation of the CP is not affected by any treatments tested, that of the SP disappeared following treatment of hair fibers with organic solvents and reappeared following incubation of the solvent‐treated hair fibers with melting lipids, which suggests that the hair lipids are responsible for the convex SP. Other treatments, such as chemical fixation, thin sectioning, and pre‐/post‐incubation of the hair plane, reduce or abolish the convex formation of the SP. These findings suggest that the following pathway leads to the convex formation of SP during ASE: (i) joule heat is generated on the surface by violent collisions of argon ions, (ii) melting CMC lipids ooze out from the inside to the surface, and (iii) CMC lipids that have oozed out are chemically changed, leading to the final convex formation of the SP. With ASE‐SEM, visualization of hair lipids as convex structures of SP should enable us to characterize the fine structure and localization of hair lipids and to clarify the roles and functions of the CMC of human hair.
The dynamics of moonlighting in Russia1
Authors: Guariglia Alessandra , Kim Byung‐Yeon
Published: January 2006

This paper uses the Russian Longitudinal Monitoring Survey (RLMS) to analyse the dynamics of moonlighting by the working‐age population. We find that moonlighting is transitory and that a desire to switch jobs expressed in the past is positively related to moonlighting in the present and to actual job changes in the future. We also find that workers who moonlighted as self‐employed in the past represent 26.5 percent of the new self‐employed. These results suggest that moonlighting in Russia can be seen as an effective incubator for setting up new self‐employed businesses, thereby providing long‐term benefits for the economy.
Monetary integration in the ex‐Soviet Union: A ‘union of four’?*
Authors: Chaplygin Vladimir , Hallett Andrew Hughes , Richter Christian
Published: January 2006

The governments of four ex‐Soviet countries recently discussed forming a currency union. To examine the economic feasibility of this proposition, we use conventional techniques and show that the arrangement is likely to find it difficult to handle the lack of structural symmetry, the asymmetric pattern of shocks, and the lack of market flexibility among the potential participants. Moreover, the union would be a unilateral one. It would require an unusual degree of political commitment to survive. Nonetheless, there are some subtleties in the timing and pattern of mutual dependence between Russia and Kazakhstan, and to a lesser extent in Belarus, which may reduce the strain from a currency union in those countries. Otherwise, the black market will have to provide the necessary market flexibility.
Investment decisions and the soft budget constraint
Authors: Colombo Emilio , Stanca Luca
Published: January 2006

This paper investigates the investment behaviour of a large panel of Hungarian firms in the period 1989–99, in order to assess the impact of institutional and regulatory changes on the efficiency of credit allocation. We find that the role of financial factors for investment decisions has changed significantly after the introduction of major financial reforms, and that firms were affected differently depending on their ownership type. Reforms have hardened the budget constraint of private domestic firms, particularly small ones, and reduced informational problems for foreign‐owned firms. State‐owned firms remained subject to a soft budget constraint. In particular, small state firms became more sensitive to financial conditions, whereas large state firms were unaffected and kept operating under a soft budget constraint.
Optimal speed of transition with a shrinking labour force and under uncertainty*
Authors: Luca Bruno Randolph
Published: January 2006

In the 1990s – during the restructuring of large state enterprises – Central European economies experienced high unemployment. Social policy expenditures, particularly targeted to the non‐employed, grew faster than expected due to the need to finance the out‐of‐the‐labour categories. In 1992, after the Passive Labour Market Policies’ reforms, the pace of transition decelerated. Unemployment dynamics, speed of transition and non‐employment policies are modelled based on the assumption that the labour force is shrinking over time. Dismissed workers have the opportunity to choose an outside‐option alternative to labour force participation. Individual uncertainty is assumed in a first phase of transition, while aggregate uncertainty – generating opposition to restructuring – is modelled in a second phase. The model predicts a slowdown in the speed of transition.
New knowledge extraction technique using probability for case‐based reasoning: application to medical diagnosis
Authors: Park Yoon‐Joo , Kim Byung‐Chun , Chun Se‐Hak
Published: January 2006

Abstract: Case‐based reasoning (CBR) has been used in various problem‐solving areas such as financial forecasting, credit analysis and medical diagnosis. However, conventional CBR has the limitation that it has no criterion for choosing the nearest cases based on the probabilistic similarity of cases. It uses a fixed number of neighbors without considering an optimal number for each target case, so it does not guarantee optimal similar neighbors for various target cases. This leads to the weakness of lowering predictability due to deviation from desired similar neighbors. In this paper we suggest a new case extraction technique called statistical case‐based reasoning. The main idea involves a dynamic adaptation of the optimal number of neighbors by considering the distribution of distances between potential similar neighbors for each target case. In order to do this, our technique finds the optimal distance threshold and selects similar neighbors satisfying the distance threshold criterion. We apply this new method to five real‐life medical data sets and compare the results with those of the statistical method, logistic regression; we also compare the results with the learning methods C5.0, CART, neural networks and conventional CBR. The results of this paper show that the proposed technique outperforms those of many other methods, it overcomes the limitation of conventional CBR, and it provides improved classification accuracy.
A novel method of comparing the healing properties of two hydrogels in chronic leg ulcers
Authors: De La Brassinne M , Thirion L , Horvat L‐IL
Published: January 2006

Skin ulcers on the legs have a chronic, relapsing course and are often a significant management challenge. Novel methods of measuring and comparing the effects of different treatments can be of assistance in addressing this situation. A clinical pilot study using original methods was undertaken to compare the healing properties of the alginate gel Flaminal® (test) and the hydrocolloid gel Intrasite® (control) on chronic leg ulcers. The study was performed over a period of 28 days with two parallel groups of 10 patients. Both the surface (acetate tracing and planimetry) and the volume (Jeltrate® mould impression and weighting) of each wound were measured at baseline and after 7, 14 and 28 days of treatment. On both parameters results were superior with the test product compared to the control, with volume reduction being the first parameter to change. Between groups, difference in wound volume reduction was detected as early as day 7 whereas difference in surface reduction was clearly apparent only at day 28. Correlation between wound surface and volume reductions was also better in the test group (r = 0.843 vs. 0.421) than in the control. In conclusion, this pilot study suggests that combining wound surface and volume evaluations allows a more precise analysis of the healing process in venous leg ulcers and that this method is able to detect very early differences in treatments even with limited sample size.
Intravenous cidofovir treatment for recalcitrant warts in the setting of a patient with myelodysplastic syndrome
Authors: Gröne D , Treudler R , De Villiers EM , Husak R , Orfanos CE , Zouboulis ChC
Published: January 2006

Cidofovir is an acyclic nucleoside phosphonate with broad‐spectrum activity against DNA viruses, including human papilloma virus (HPV). However, data on the efficacy of cidofovir in an immunosuppressive setting remain contradictory. We report for the first time on the promotion of the healing of recalcitrant warts in a patient with myelodysplastic syndrome with intravenous cidofovir treatment.
The alteration of sister chromatid exchange frequencies in Behçet's disease with and without HLA‐B51
Authors: Ikbal M , Atasoy M , Pirim I , Aliagaoglu C , Karatay S , Erdem T
Published: January 2006

Background  The analysis of sister chromatid exchange (SCE) is a cytogenetic technique used to show DNA damage as a result of an exchange of DNA fragments between sister chromatids. It is known that there is an increased SCE frequency in Behçet's disease (BD).

Objective  To investigate whether human leucocyte antigen (HLA)‐B51‐positive patients with Behçet's disease exhibit higher SCE frequencies than those without HLA‐B51.

Methods  Lymphocytes from 75 patients (38 women, 37 men) and from 50 controls (28 women, 22 men) were cultured in darkness for 72 h in the presence of bromodeoxyuridine. Metaphase chromosomes were stained with a fluorescence plus Giemsa technique after a standard harvest procedure. For HLA‐B51 typing, DNA was extracted from ethylenediaminetetraacetic acid blood samples and HLA‐B5 allele genotyping was performed by the polymerase chain reaction (PCR)–sequence specific primer method.

Results  Thirty‐nine of 75 patients with BD (52%) and 15 of 50 controls (30%) were found HLA‐B51‐positive. The SCE frequencies in HLA‐B51‐positive patients were higher than in HLA‐B51‐negative ones (P < 0.001), whereas no difference was detected in the control group.

Conclusion  This study revealed that there was a significant association between elevated SCE frequencies and existence of HLA‐B51 patients with BD.
A new formulation of an occlusive dressing containing betamethasone valerate 0.1% in the treatment of mild to moderate psoriasis
Authors: Pacifico A , Daidone R , Peris K
Published: January 2006

Background  Betamethasone valerate (BMV) is a medium‐potency corticosteroid commonly used for the treatment of chronic psoriasis. Although occlusion has been shown to enhance the efficacy of BMV treatment, no ready‐to‐use occlusive BMV formulation is currently approved for the market.

Methods  Forty‐two patients with mild to moderate psoriasis and with symmetrical lesions were treated with BMV 0.1% tape and BMV 0.12% cream for 30 days in a half‐side distribution. Both treatments resulted in a significant clinical improvement. Efficacy and tolerability were evaluated by comparison of pre‐treatment and post‐treatment psoriasis area and severity index and self‐administered psoriasis area and severity index scores, and by comparison of the changes from baseline in clinical appearance and hydration.

Results  Lesions treated with BMV 0.1% tape showed higher reductions from baseline in the psoriasis area and severity index and the self‐administered psoriasis area and severity index scores (61.7% and 59.3%, respectively), compared with lesions treated with BMV 0.12% cream (39.5% and 34.0%, respectively). No serious local or systemic treatment‐related adverse effects were reported.

Conclusions  Our results indicate a higher efficacy of BMV 0.1% tape compared with BMV 0.12% cream in the treatment of mild to moderate chronic plaque psoriasis.
Detection of human papillomavirus type 34 in Bowen's disease on the pubic area
Authors: Hara H , Honda A , Suzuki H , Matsukura T
Published: January 2006

We describe an 86‐year‐old man with Bowen's disease on the pubic area. The lesion was clinically a black‐brownish keratotic nodule resembling seborrheic keratosis. Histopathological findings showed those of Bowen's disease and harboured human papillomavirus type 34 DNA. Genital, but not skin, human papillomaviruses are responsible for Bowen's disease on the skin.
Effect of topical calcipotriol, betamethasone dipropionate and their combination in the treatment of localized vitiligo
Authors: Kumaran MS , Kaur I , Kumar B
Published: January 2006

Background  Treatment of vitiligo is a challenge. Steroids are known to be effective but are associated with serious adverse effects. Many uncontrolled studies have shown calcipotriol to be a promising therapeutic modality in vitiligo.

Objective  To conduct a randomized trial to evaluate the effect of topical calcipotriol ointment (0.005%) and betamethasone dipropionate (0.05%) cream, given alone or in combination, in treatment of localized vitiligo.

Methods  Forty‐nine patients with vitiligo affecting 5% of their skin were recruited. Patients were randomized into three groups. Group I patients were treated with betamethasone dipropionate (0.05%) cream twice daily. Group II patients were treated with calcipotriol ointment (0.005%) twice daily, and group III with betamethasone dipropionate (0.05%) in the morning and calcipotriol (0.005%) in the evening.

Results  Forty‐five patients completed the study period of 3 months with 15 patients in each group. No patient achieved excellent (> 75%) pigmentation. Marked (50% to 75%) repigmentation was observed in 2 (13.3%), 1 (6.7%) and 4 (26.7%) patients in groups I, II and III, respectively. Moderate (25–50%) repigmentation was observed in 7 (46.7%), 5 (33.3%) and 7 (46.7%) patients in groups I, II and III, respectively. Patients with < 25% pigmentation were termed as minimal pigmentation or no response. The mean time for initial pigmentation to appear was 9.04 ± 2.0 weeks in group I, 10.18 ± 1.6 weeks in group II and 5.17 ± 2.4 weeks in group III (P < 0.01). The acquired pigmentation in the lesions was more stable in group III as compared with patients in groups II and I (P < 0.01). Side‐effects in the form of atrophy and lesional burning sensations were more common in group I when compared with groups II and III (P < 0.05).

Conclusion  Combined therapy appeared to give a significantly faster onset of repigmentation along with better stability of the achieved pigmentation and with lesser number of side‐effects.
Parent gender and assessment of infant life quality
Authors: Holm EA , Esmann S , Jemec GBE
Published: January 2006

Objectives  The primary objective was to examine the influence of parents’ gender on the assessment of quality of life among infants with atopic dermatitis. The secondary objective was to examine the psychological factors affecting the assessment.

Methods  Questionnaires were completed by 28 couples, as a basis for gender comparison. Data were gathered on disease severity, confidence of treatment, Major Depression Index (MDI), Spielberger Trait Anxiety Inventory (STAI) and the Infants’ Dermatitis Quality of Life Index (IDQOL).

Results  The mothers’ scores were higher than those of fathers for all assessments, although differences were not statistically significant. Significant correlations were found between MDI and severity assessment for mothers only and between MDI and STAI for both genders. Multiple linear regression analysis suggested gender differences in the proposed model, where only depression was appearing statistically significant (P = 0.029).

Conclusion  Our data presented suggest that no significant gender‐dependent differences occur in parents’ overall severity assessment of the eczema in their children, but the influence of the different factors studied is not equal in the two sexes. Future instruments aimed at surrogate assessment of disease severity in children by their parents should take this into account and provide explicit testing of possible gender differences.
NOVEL AND RAPIDLY DIVERGING INTERGENIC SEQUENCES BETWEEN TANDEM REPEATS OF THE LUCIFERASE GENES IN SEVEN DINOFLAGELLATE SPECIES1
Authors: Liu Liyun , Hastings J. Woodland
Published: January 2006

Tandemly arranged luciferase genes were previously reported in two dinoflagellates species, but their intergenic regions were strikingly different and no canonical promoter sequences were found. Here, we examined the intergenic regions of the luciferase genes of five other dinoflagellate species along with those of the earlier two. In all cases, the genes exist in multiple copies and are arranged tandemly, coding for proteins of similar sizes and sequences. However, the 5′ untranslated region, 3′ untranslated region, and intergenic regions of the seven genes differ greatly in length and sequence, except for two stretches that are conserved in the intergenic regions of two pairs of phylogenetically close species. Microsatellites and minisatellites were detected in the intergenic sequences of four species, Alexandrium affine (H. Inoue & Y. Fukuyo) E. Balech, A. tamarense (Lebour) E. Balech, Protoceratium reticulatum (Claparède & Lachmann) Butschli, and Pyrocystis lunula (Schütt) Schütt, the first three of which have unusually high percentages of particular sets of dinucleotides. Most remarkably, the P. reticulatum intergenic region is almost exclusively made up of 19 nearly identical repeats of an 11‐nucleotide sequence. Dinoflagellate luciferase intergenic regions bear similarities to ribosomal genes and to some protein‐encoding genes in trypanosomes, both of which are transcribed by RNA polymerase I. It is possible that the transcription of the dinoflagellate genes are catalyzed by an RNA polymerase with novel properties.
Effectiveness of a Geriatric Medical Student Scholars Program: A Qualitative Assessment
Authors: Goldenhar Linda M. , Kues John R.
Published: January 2006

In 2003, the University of Cincinnati College of Medicine initiated a 4‐year Geriatric Medical Student Scholars (GMSS) program in which a selected group of 14 medical students participated in a variety of extracurricular geriatrics‐related activities such as one‐on‐one mentoring and discussion groups. These students were also required to compose journal entries describing GMSS program‐related activities using a semistructured on‐line computer program designed specifically for this purpose. The reflective journals, in combination with the American Geriatrics Society (AGS) competencies, were used to evaluate the degree to which the GMSS program achieved its goal of enhancing students' understanding of the complex health and social challenges facing older adults. Using a confirmatory qualitative analysis strategy, the AGS competencies served as an a priori codebook to evaluate the student journal entries. Of the original 53 AGS competencies identified as being relevant for a first‐ or second‐year medical student, 74% were used at least one time, and only 26% were never used. These findings strongly suggest that the GMSS program successfully moved this group of first‐ and second‐year medical students closer to at least understanding the content of many of the AGS competencies by providing them with geriatrics‐related experiences and a geriatrics‐related framework they could draw on when participating in curricular and extracurricular activities. The findings also point to the potential value of using reflective journaling as a tool for conducting process evaluation of medical education interventions.
Electronic Medical Record Reminder Improves Osteoporosis Management After a Fracture: A Randomized, Controlled Trial
Authors: Feldstein Adrianne , Elmer Patricia J. , Smith David H. , Herson Michael , Orwoll Eric , Chen Chuhe , Aickin Mikel , Swain Martha C.
Published: January 2006

OBJECTIVES: Osteoporosis treatment rates after a fracture are low. This study evaluated methods to increase guideline‐recommended osteoporosis care postfracture.

DESIGN: Participants were randomly assigned to usual care or one of two interventions. Analysis of primary outcomes used electronic data and linear regression.

SETTING: A Pacific Northwest nonprofit health maintenance organization.

PARTICIPANTS: Female patients aged 50 to 89 who suffered a fracture in 1999 and had not received bone mineral density (BMD) measurement or medication for osteoporosis (n=311) and their primary care providers (n=159).

INTERVENTION: Patient‐specific clinical guideline advice to the primary care provider delivered by electronic medical record (EMR) message or electronic reminder to the provider plus an educational letter mailed to the patient.

MEASUREMENTS: BMD measurement and osteoporosis medication.

RESULTS: At 6 months, provider reminder resulted in 51.5% of patients receiving BMD measurement or osteoporosis medication, provider reminder plus patient education resulted in 43.1%, and usual care resulted in 5.9% (P<.001). The effect of provider advice combined with patient education was not significantly different from provider advice alone (P=.88). Patients aged 60 to 69 were 18% (95% confidence interval=3–34) more likely to receive BMD measurement or an osteoporosis medication than those aged 80 to 89.

CONCLUSION: Patient‐specific postfracture advice to the provider through an EMR message significantly increased BMD measurement and osteoporosis medication. As EMRs become more widespread, this intervention could improve osteoporosis management for many postfracture patients. Future research should identify barriers to and facilitators of care for older, high‐risk patients.
Influence of Aging and Denture Use on Liquid Swallowing in Healthy Dentulous and Edentulous Older People
Authors: Yoshikawa Mineka , Yoshida Mitsuyoshi , Nagasaki Toshikazu , Tanimoto Keiji , Tsuga Kazuhiro , Akagawa Yasumasa
Published: January 2006

OBJECTIVES: To clarify the influence of aging and denture use on swallowing in healthy edentulous people aged 75 and older.

DESIGN: A cross‐sectional research design was used with participants from Hiroshima University Hospital, Hiroshima University, and Hiroshima City.

SETTING: Participants were examined in Hiroshima University Hospital, Hiroshima, Japan.

PARTICIPANTS: Thirteen edentulous elderly volunteers (7 male, 6 female; aged 75–86, mean age 81.2) and 19 dentulous elderly volunteers (12 male, 7 female; aged 80–87, mean age 81.2) as a control group participated in this study. Participants reported no clinical symptoms relating to dysphagia, neurological impairments, or degenerative diseases.

MEASUREMENTS: Participants were asked to swallow a 10‐mL barium sulfate solution three times. Edentulous older people were asked to swallow the solution while wearing dentures and with dentures removed. Functional swallowing was recorded on cine‐film with a digital subtraction angiography system. Lateral cinefluorography images were obtained from seated subjects. Using a cine‐projector, visual images were evaluated qualitatively and quantitatively.

RESULTS: No participants exhibited aspiration. The occurrence of laryngeal penetration in the edentulous older people not wearing dentures was the only significant difference (P<.05).

CONCLUSION: Only laryngeal penetration differed significantly between edentulous older people not wearing their dentures and dentulous older people.
Delirium and Its Motoric Subtypes: A Study of 614 Critically Ill Patients
Authors: Peterson Josh F. , Pun Brenda T. , Dittus Robert S. , Thomason Jason W. W. , Jackson James C. , Shintani Ayumi K. , Ely E. Wesley
Published: January 2006

OBJECTIVES: To describe the motoric subtypes of delirium in critically ill patients and compare patients aged 65 and older with a younger cohort.

DESIGN: Prospective cohort study.

SETTING: The medical intensive care unit (MICU) of a tertiary care academic medical center.

PARTICIPANTS: Six hundred fourteen MICU patients admitted during a process improvement initiative to monitor levels of sedation and delirium.

MEASUREMENTS: MICU nursing staff assessed delirium and level of consciousness in all MICU patients at least once per 12‐hour shift using the Confusion Assessment Method for the Intensive Care Unit and the Richmond Agitation‐Sedation Scale. Delirium episodes were categorized as hypoactive, hyperactive, and mixed type.

RESULTS: Delirium was detected in 112 of 156 (71.8%) subjects aged 65 and older and 263 of 458 (57.4%) subjects younger than 65. Mixed type was most common (54.9%), followed by hypoactive delirium (43.5%) and purely hyperactive delirium (1.6%). Patients aged 65 and older experienced hypoactive delirium at a greater rate than younger patients (41.0% vs 21.6%, P<.001) and never experienced hyperactive delirium. Older age was strongly and independently associated with hypoactive delirium (adjusted odds ratio=3.0, 95% confidence interval=1.7–5.3), compared with no delirium in a model that adjusted for other important determinants of delirium including severity of illness, sedative medication use, and ventilation status.

CONCLUSION: Older age is a strong predictor of hypoactive delirium in MICU patients, and this motoric subtype of delirium may be missed in the absence of active monitoring.
In vitro calculus detection with a moved smart ultrasonic device
Authors: Meissner Grit , Oehme Bernd , Strackeljan Jens , Kocher Thomas
Published: January 2006

Study objective: The objective of subgingival instrumentation of periodontally diseased root surfaces is to remove the adhering microbial biofilm and calcified deposits. Recently, we have described an automated calculus detection system under static conditions. Clinically however, the tip of the system has to be moved over tooth surfaces. It was thus necessary to study the entire system in motion.

Methods: The detection device is based on a conventional dental piezoelectric ultrasonic handpiece with a conventional scaler insert. The impulse response of the mechanical oscillation system is analysed by a fuzzy logic‐based computerized algorithm, which classifies various surfaces. The present study investigates dental surface recognition properties of the new system with the tip being moved over teeth surfaces in vitro. Following a training set of 7977 measurements (3960 calculus, 4017 cement) on 200 extracted teeth, 1363 measurements were conducted on 34 teeth unknown to the system.

Results: The surfaces cementum and calculus were correctly classified in 78% within the training set and in 81% within the set unknown, with a κ value of 0.68.

Conclusion: It was shown that this method of automatic recognition of tooth surfaces is able to distinguish between different tooth surfaces in vitro independently from tip movements.
Effect of rhPDGF‐BB on bone turnover during periodontal repair
Authors: Sarment David P. , Cooke Jason W. , Miller Sarah E. , Jin Qiming , McGuire Michael K. , Kao Richard T. , McClain Pamela K. , McAllister Bradley S. , Lynch Samuel E. , Giannobile William V.
Published: January 2006

Purpose: Growth factors such as platelet‐derived growth factor (PDGF) exert potent effects on wound healing including the regeneration of periodontia. Pyridinoline cross‐linked carboxyterminal telopeptide of type I collagen (ICTP) is a well‐known biomarker of bone turnover, and as such is a potential indicator of osseous metabolic activity. The objective of this study was to evaluate the release of the ICTP into the periodontal wound fluid (WF) following periodontal reconstructive surgery using local delivery of highly purified recombinant human PDGF (rhPDGF)‐BB.

Methods: Forty‐seven human subjects at five treatment centres possessing chronic severe periodontal disease were monitored longitudinally for 24 weeks following PDGF regenerative surgical treatment. Severe periodontal osseous defects were divided into one of three groups and treated at the time of surgery with either: β‐tricalcium phosphate (TCP) osteoconductive scaffold alone (active control), β‐TCP+0.3 mg/ml of rhPDGF‐BB, or β‐TCP+1.0 mg/ml of rhPDGF‐BB. WF was harvested and analysed for local ICTP levels by radioimmunoassay. Statistical analysis was performed using analysis of variance and an area under the curve analysis (AUC).

Results: The 0.3 and 1.0 mg/ml PDGF‐BB treatment groups demonstrated increases in the amount of ICTP released locally for up to 6 weeks. There were statistically significant differences at the week 6 time point between β‐TCP carrier alone group versus 0.3 mg/ml PDGF‐BB group (p<0.05) and between β‐TCP alone versus the 1.0 mg/ml PDGF‐BB‐treated lesions (p<0.03). The AUC analysis revealed no statistical differences amongst groups.

Conclusion: This study corroborates the release of ICTP as a measure of active bone turnover following local delivery of PDGF‐BB to periodontal osseous defects. The amount of ICTP released from the WF revealed an early increase for all treatment groups. Data from this study suggests that when PDGF‐BB is delivered to promote periodontal tissue engineering of tooth‐supporting osseous defects, there is a direct effect on ICTP released from the wound.
Gingivitis, dental caries and tooth loss: risk factors for cardiovascular diseases or indicators of elevated health risks
Authors: Ylöstalo P. V. , Järvelin M. R. , Laitinen J. , Knuuttila M. L.
Published: January 2006

Objectives: The results of earlier studies connecting dental diseases to cardiovascular diseases are inconsistent. Our aim in this cross‐sectional study was to investigate whether there are associations of dental diseases and diagnosed angina pectoris among the 1966 Northern Finland Birth Cohort.

Materials and Methods: A postal questionnaire was sent to all cohort members in 1997–1998. The number of replies totalled 8690. Angina pectoris was determined by asking whether the respondent had been diagnosed with angina pectoris. Gingivitis, dental caries and tooth loss were determined on the basis of self‐reported gingival bleeding, presence of dental caries and six or more missing teeth.

Results: We found overall associations of gingivitis (odds ratio (OR) 1.52, confidence interval (CI) 1.04–2.22), dental caries (OR 1.50, CI 1.04–2.18) and tooth loss (OR 1.53, CI 0.69–3.42) with the presence of angina pectoris. The associations were modified by gender and socioeconomic status. In addition, gingivitis, dental caries and tooth loss were also associated with several cardiovascular risk factors.

Conclusion: There were associations of self‐reported gingivitis, dental caries and tooth loss with angina pectoris. However, the associations between dental diseases and cardiovascular risk factors suggest that the associations may be because of confounding.
Anti‐gingivitis effect of a dentifrice containing bioactive glass (NovaMin®) particulate
Authors: Tai Bao Jun , Bian Zhuan , Jiang Han , Greenspan David C. , Zhong Jipin , Clark Arthur E. , Du Min Quan
Published: January 2006

Background: The objective of this pilot clinical trial was to evaluate the anti‐gingivitis and anti‐plaque effects of a dentifrice containing bioactive glass (NovaMin®) compared with a placebo control dentifrice in a 6 weeks clinical study.

Methods: The study design was a randomized, double‐blinded, controlled clinical trial. One hundred volunteers took part in the study and were matched for plaque index (PLI), gingival bleeding index (GBI), age and gender. The protocol was reviewed and approved by the Ethical Committee of the University. The subjects received a supragingival prophylaxis to remove all plaque, calculus and extrinsic stain. Following the baseline examination, subjects were instructed to brush with their assigned dentifrice and toothbrush. The PLI and GBI were determined for the baseline and 6 weeks. The data were analysed using a repeated‐measures anova conducted on the two dependent measures to compare the effect between the test and control group.

Results: Ninety‐five subjects finished the study. The results showed that the PLI (baseline=1.54, 6 weeks=1.29) and GBI (baseline=1.14, 6 weeks=0.47) were significantly reduced, respectively, over the 6 weeks period in the test group (p<0.001 for each measure). There was a 58.8% reduction in gingival bleeding and a 16.4% reduction in plaque growth. There was no difference of the PLI (baseline=1.60, 6 weeks=1.57) and GBI (baseline=1.18, 6‐week=1.02) over the 6 week period in the control group.

Conclusion: This study demonstrated that a dentifrice containing NovaMin® significantly improves oral health as measured by a reduction in gingival bleeding and reduction in supragingival plaque compared with a negative dentifrice over the 6 weeks study period.