bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting the outcome of severe ulcerative colitis: development of a novel risk score to aid early selection of patients for second‐line medical therapy or surgery
Authors: Ho G. T. , Mowat C. , Goddard C. J. R. , Fennell J. M. , Shah N. B. , Prescott R. J. , Satsangi J.
Published: May 2004

Background : The failure rate of medical therapy in severe ulcerative colitis is high. A risk index, to aid the identification of patients of not responding at an early stage to intravenous corticosteroid therapy, would be useful to facilitate second‐line treatment or surgery.

Methods : We recruited 167 consecutive patients with severe ulcerative colitis between January 1995 and March 2002; and employed multiple logistic regression to analyse parameters within the first 3 days of medical therapy. We applied statistical modelling to formulate a risk score according to the likelihood of medical failure.

Results : Sixty‐seven (40%) patients failed to respond to medical therapy. Multiple logistic regression analysis identified mean stool frequency and colonic dilatation within the first 3 days and hypoalbuminaemia as independent predictors of outcome (P < 0.001, 0.001 and 0.002 respectively). A numerical risk score was formulated based on these variables. Patients with scores of 0–1, 2–3 and ≥4 had a medical therapy failure rate of 11%, 43% and 85% respectively. Receiver–operator characteristic analysis of this score yielded area under curve of 0.88, with a sensitivity of 85% and specificity of 75% using score ≥4 in predicting non‐response.

Conclusion : This risk score allows the early identification of patients with severe ulcerative colitis who would be suitable for second‐line medical therapy or surgery.
Effect of splitting the dose of esomeprazole on gastric acidity and nocturnal acid breakthrough
Authors: Hammer J. , Schmidt B.
Published: May 2004

Background : Twice‐daily dosing is increasingly used to improve gastric acid control, although not all proton‐pump inhibitors are more effective when doses are split. Standard dose esomeprazole provides better gastric acid control than other standard dose proton‐pump inhibitors.

Aims : To compare the effect of standard dose esomeprazole (1 × 40 mg) with 20 mg b.d. on gastric acidity.

Methods : Thirteen healthy subjects participated in this crossover study, receiving esomeprazole 2 × 20 mg and 1 × 40 mg for 7 days in random order with a washout period of at least 7 days. Gastric 24‐h pH was measured on days 1, 2 and 6.

Results : Median gastric 24‐h pH was higher during 2  × 20 mg esomeprazole on day 2 (P < 0.01), no differences were detected on day 6. Night‐time gastric acid suppression was significantly improved by 2 × 20 mg esomeprazole on all study days (P < 0.05). Nocturnal acid breakthrough was observed on all study days in subjects receiving 1 × 40 mg, but in only 85% (first night), 64% (second night), and 45% of subjects (sixth night) with 2 × 20 mg (P < 0.05).

Conclusion : Splitting the esomeprazole dose improves initial acid suppression, this effect starts at the first night. Maximal benefit is achieved on day 2, while the effect on night‐time acid control is detectable during the entire first week of treatment.
New pharmacological agents for the treatment of gastro‐oesophageal reflux disease
Authors: Vakil N.
Published: May 2004

Proton pump inhibitors, which act at the terminal point of acid secretion – the H+, K+‐ATPase – are currently the most effective pharmacological treatments available for reflux disease. Despite the efficacy of the proton pump inhibitors, there is still potential for clinical improvement in gastro‐oesophageal reflux disease pharmacotherapy. Faster onset of complete acid inhibition and improved duration of efficacy are two potential areas for improvement A number of novel pharmaceutical agents are currently undergoing clinical evaluation for the treatment of gastro‐oesophageal reflux disease. These include transient lower oesophageal sphincter relaxation‐reducing agents, serotonergic agents/prokinetics, potassium‐competitive acid blockers, mucosal protectants, histamine H3 agonists and anti‐gastrin agents. One or more of these drug groups may represent the future medical therapy for gastro‐oesophageal reflux disease, should they prove effective in the clinical setting. This review summarizes the state of the art with these agents.
Comparative pharmacokinetics of equimolar doses of 5‐aminosalicylate administered as oral mesalamine (Asacol) and balsalazide: a randomized, single‐dose, crossover study in healthy volunteers1
Authors: Sandborn W. J. , Hanauer S. B. , Buch A.
Published: May 2004

Background : Existing pharmacokinetic data are insufficient to determine whether a delayed‐release formulation of mesalamine (Asacol) results in greater systemic exposure to 5‐aminosalicylic acid and its major metabolite N‐acetyl‐5‐aminosalicylic acid than a prodrug (balsalazide).

Aim : To determine the pharmacokinetic parameters of 5‐aminosalicylic acid and N‐acetyl‐5‐aminosalicylic acid from equimolar doses of 5‐aminosalicylic acid administered as Asacol and balsalazide.

Methods : Nineteen healthy volunteers completed an open‐label, single‐dose, randomized, crossover study comparing the pharmacokinetics of 5‐aminosalicylic acid and N‐acetyl‐5‐aminosalicylic acid from equimolar doses of 5‐aminosalicylic acid (800 mg) administered as Asacol (800 mg) and balsalazide (2250 mg). Plasma and urine samples were analysed for 5‐aminosalicylic acid, N‐acetyl‐5‐aminosalicylic acid, and balsalazide (urine only) using high‐performance liquid chromatography methods with mass spectrometric detection. Pharmacokinetic parameters assessed for 5‐aminosalicylic acid and N‐acetyl‐5‐aminosalicylic acid included: percentage of dose excreted in urine (Ae%), area under the plasma concentration–time curve (AUCtlast); and maximum plasma concentration (Cmax).

Results : The geometric mean total (5‐aminosalicylic acid and N‐acetyl‐5‐aminosalicylic acid) urinary excretion values (Ae%) of Asacol and balsalazide were 19.26 and 19.31% (P = 0.98). The geometric mean Ae% values of 5‐aminosalicylic acid for Asacol and balsalazide were 0.39 and 0.37% (P = 0.78); the geometric mean Ae% values of N‐acetyl‐5‐aminosalicylic acid for Asacol and balsalazide were 18.78 and 18.83% (P = 0.98). The geometric mean 5‐aminosalicylic acid AUC(tlast) values for Asacol and balsalazide were 3295 and 3449 ng h/mL (P = 0.85); the geometric mean N‐acetyl‐5‐aminosalicylic acid AUC(tlast) values for Asacol and balsalazide were 15 364 and 16 050 ng h/mL (P = 0.69). The geometric mean 5‐5‐aminosalicylic acid Cmax values for Asacol and balsalazide were 319 and 348 ng/mL (P = 0.80); the geometric mean N‐acetyl‐5‐aminosalicylic acid Cmax values for Asacol and balsalazide 927 and 1009 ng/mL (P = 0.67).

Conclusions : The systemic absorption of 5‐aminosalicylic acid and N‐acetyl‐5‐aminosalicylic acid from Asacol and balsalazide are comparable based upon plasma pharmacokinetic parameters and urinary excretion values.
Mutations in the NOD2/CARD15 gene in Crohn's disease are associated with ileocecal resection and are a risk factor for reoperation
Authors: Büning C. , Genschel J. , Bühner S. , Krüger S. , Kling K. , Dignass A. , Baier P. , Bochow B. , Ockenga J. , Schmidt H. H.‐J. , Lochs H.
Published: May 2004

Background : Mutations within the NOD2/CARD15 gene have recently been shown to be associated with Crohn's disease.

Aims : To investigate the clinical impact of the three common NOD2/CARD15 mutations in patients with Crohn's disease.

Methods : We investigated the prevalence of the three common NOD2/CARD15 mutations (Arg702Trp, Gly908Arg, 3020insC) in 180 patients with Crohn's disease, 70 patients with ulcerative colitis and 97 controls. In patients with Crohn's disease, prevalence of NOD2/CARD15 mutations were correlated to clinical and demographical parameters.

Results : In Crohn's disease patients, 35.6% carried at least one mutant allele of NOD2/CARD15 mutations compared with 14.3% of patients with ulcerative colitis (P = 0.006) and to 15.5% of controls (P = 0.0001). Genotype phenotype analyses revealed that NOD2/CARD15 mutations determined younger age at disease diagnosis (P = 0.03), ileal disease location (P = 0.01) and ileocecal resections (P = 0.0002). Interestingly, reoperation with resection of the anastomosis was significantly more frequent in patients with NOD2/CARD15 mutations (P = 0.01).

Conclusions : Our investigations support the current hypothesis that NOD2/CARD15 mutations are associated with a phenotype of Crohn's disease with younger age at diagnosis, ileal involvement, ileocecal resections and a high risk of postoperative relapse and reoperation. NOD2/CARD15 mutations might therefore be used to identify high risk patients for relapse prevention strategies.
Osteoclasts and giant cells: macrophage–macrophage fusion mechanism
Authors: Vignery Agnès
Published: May 2004

Membrane fusion is a ubiquitous event that occurs in a wide range of biological processes. While intracellular membrane fusion mediating organelle trafficking is well understood, much less is known about cell–cell fusion mediating sperm cell–oocyte, myoblast–myoblast and macrophage–macrophage fusion. In the case of mononuclear phagocytes, their fusion is not only associated with the differentiation of osteoclasts, cells which play a key role in the pathogenesis of osteoporosis, but also of giant cells that are present in chronic inflammatory reactions and in tumours. Despite the biological and pathophysiological importance of intercellular fusion events, the actual molecular mechanism of macrophage fusion is still unclear. One of the main research themes in my laboratory has been to investigate the molecular mechanism of mononuclear phagocyte fusion. Our hypothesis has been that macrophage–macrophage fusion, similar to virus–cell fusion, is mediated by specific cell surface proteins. But, in contrast with myoblasts and sperm cells, macrophage fusion is a rare event that occurs in specific instances. To test our hypothesis, we established an in vitro cell–cell fusion assay as a model system which uses alveolar macrophages. Upon multinucleation, these macrophages acquire the osteoclast phenotype. This indicates that multinucleation of macrophages leads to a specific and novel functional phenotype in macrophages. To identify the components of the fusion machinery, we generated four monoclonal antibodies (mAbs) which block the fusion of alveolar macrophages and purified the unique antigen recognized by these mAbs. This led us to the cloning of MFR (Macrophage Fusion Receptor). MFR was cloned simultaneously as P84/SHPS‐1/SIRPα/BIT by other laboratories. We subsequently showed that the recombinant extracellular domain of MFR blocks fusion. Most recently, we identified a lower molecular weight form of MFR that is missing two extracellular immunoglobulin (Ig) C domains. Shortly after we cloned MFR, CD47 was reported to be a ligand for P84/SIRPα. We have since generated preliminary results which suggest that CD47 interacts with MFR during adhesion/fusion and is a member of the fusion machinery. We also identified CD44 as a plasma membrane protein which, like MFR, is highly expressed at the onset of fusion. The recombinant soluble extracellular domain of CD44 blocks fusion by interacting with a cell‐surface binding site. We now propose a model in which both forms of MFR, CD44, and CD47 mediate macrophage adhesion/fusion and therefore the differentiation of osteoclasts and giant cells.
GB Virus C/Hepatitis G Virus (GBV‐C/HGV): still looking for a disease
Authors: Sathar M. A. , Soni P. N. , York D.
Published: May 2004

GB Virus C and Hepatitis G Virus (GBV‐C/HGV) are positive, single‐stranded flaviviruses. GBV‐C and HGV are independent isolates of the same virus. Transmission via the blood‐borne route is the commonest mode, although vertical and sexual transmission is well documented. GBV‐C/HGV is distributed globally; its prevalence in the general population is 10 fold higher in African countries than in non‐African countries. High prevalences of GBV‐C/HGV have been found in subjects with frequent parenteral exposure and in groups at high risk of exposure to blood and blood products. The clinical significance of human infection with GBV‐C/HGV is currently unclear. The virus can establish both acute and chronic infection and appears to be sensitive to interferon. Only some 12–15% of chronic Non‐A, B, C hepatitis cases are infected with GBV‐C/HGV. A direct association with liver pathology is still lacking and it is not yet clear as to whether GBV‐C/HGV is indeed a hepatotropic virus. Current evidence suggests that the spectrum of association of GBV‐C/HGV infection with extrahepatic diseases ranges from haematalogical diseases, aplastic anaemia, human immunodeficiency virus (HIV)‐positive idiopathic thrombocytopenia and thalassemia, through to common variable immune deficiency and cryoglobunemia.
Gene–environment interactions and the response to exercise
Authors: Montgomery Hugh , Brull David
Published: May 2004

Many of the symptoms of heart failure (breathlessness and fatigue) are not primarily due to reduced cardiac output, but relate to an impairment of peripheral muscle performance and metabolic efficiency. With regular training it is possible to increase skeletal muscle performance through improvements in muscle efficiency. Recent data suggest that such improvements may be modulated by local tissue renin‐angiotensin systems and, in particular, by the local activity of angiotensin‐converting enzyme (ACE). These findings might explain the remarkable benefits of ACE inhibition in the treatment of heart failure.
Collagen metabolism disturbances are accompanied by an increase in prolidase activity in lung carcinoma planoepitheliale
Authors: Karna Ewa , Surazynski Arkadiusz , Palka Jerzy A.
Published: May 2004

One of the consequences of neoplastic transformation is deregulation of tissue collagen metabolism. Although metalloproteinases initiate the breakdown of collagen in lung carcinoma, the final step of collagen degradation is mediated by prolidase (E.C.3.4.13.9). We investigated whether prolidase activity could reflect disturbances of collagen metabolism in human lung carcinoma planoepitheliale (Ca pl.). Ten human lung Ca pl. and 10 samples of normal lung parenchyma were compared with respect to prolidase activity and expression (western immunoblot), the content of collagen and collagen degradation products (free and bound hydroxyproline determination), β1 integrin subunit expression (western immunoblot) and collagenolytic activity (zymography). An increase in collagen content (66%, P < 0.05), free proline pool (50%, P < 0.05) and collagenolytic activity was accompanied by a significant increase in the prolidase activity (106%, P < 0.05) and its expression in Ca pl. No differences were found between Ca pl. and the control lung tissue with respect to β1 integrin expression. Prolidase activity may reflect disturbances in tissue collagen metabolism in lung Ca pl. and it may, therefore, serve as a sensitive marker of the disease.
Fluoride, calcium and magnesium intake in children living in a high‐fluoride area in Ethiopia. Intake through food
Authors: Malde M. K. , Zerihun L. , Julshamn K. , Bjorvatn K.
Published: May 2004

Summary.  Objective.  The aim of this study was to assess the daily dietary fluoride intake in children living in two neighbouring villages in the Wonji Shoa Sugar Estate, a rural part of the Ethiopian Rift Valley.

Methods.  The villages depended on water from different sources: Village A used either river water (Awash River, with 1·8 mg F‐/L) or ground water (2·1 mg F‐/L), while village K was served ground water with 14 mg F‐/L. Fifteen fully weaned children below the age of 5 years were selected in each of the villages. Over a four‐day period the total food intake for these children was assessed by using a duplicate portion technique. The food was analysed for fluoride by using a fluoride ion‐selective electrode after the dry ashing. Furthermore, the energy of the food was measured, as well as the calcium and magnesium contents (atomic absorption spectrometry after microwave digestion with nitric acid and hydrogen peroxide). The mothers gave a description of the ingredients used for preparing the food. Relevant background information concerning food habits, etc. was collected through a food frequency questionnaire.

Results.  This study shows that considerable amounts of fluoride may be retained in food prepared on high‐fluoride water. In village A, food contributed 2·3 mg F‐/day, while a dietary fluoride intake of 4·8 mg/day was found in children in village K. Interestingly, the sevenfold higher fluoride concentration of the water used for food preparation in village K compared to village A, gave only a doubling in fluoride intake through food. Calcium intake was relatively low while magnesium intake was above the recommended level.

Conclusion.  As the energy intake by both groups was low, some systematic underreporting might be suspected. Thus, the fluoride intake in the group may be even higher than what was actually found in this study.
Herbal medicine induced Stevens–Johnson syndrome: a case report
Authors: Chowdhury A. D. , Oda M. , Markus A. F. , Kirita T. , Choudhury C. R.
Published: May 2004

Summary.  A severe form of Erythema multiforme (EM), diagnosed as Stevens–Johnson syndrome (SJS) was detected in a 10‐year‐old Indian male child who took herbal medication of plant origin prescribed by a traditional healer for remission of his fever. The child developed a severe and florid form of mucocutaneous oral ulceration, severe ocular manifestations, along with marked constitutional disturbances and dehydration. An extensive literature search revealed few previous reports of herbal drug induced EM and SJS. In India, traditional therapy with herbal preparation (Ayurvedic medicine) is not uncommon.
Floating–Harbor Syndrome: case report and craniofacial phenotype characterization
Authors: De Benedetto M. S. , Mendes F. M. , Hirata S. , Guaré R. O. , Haddad A. S. , Ciamponi A. L.
Published: May 2004

Summary.  Floating–Harbor syndrome is a rare genetic disorder of unknown aetiology. It was described for the first time in 1973. The syndrome is characterized mainly by short stature, delay in speech development and characteristic facial features. This article describes a report of a case of the syndrome and emphasizes the oral aspects, including descriptions of soft tissues, teeth, occlusion, stage of dental development and findings on examination of the temporomandibular joint. The treatment provided and its outcome is also described. Hopefully this information will be compared with findings from other patients in the future to assist in clarifying the phenotype of the Floating–Harbor syndrome.
Comparison of the efficacy of chemomechanical caries removal (Carisolv‘) with that of conventional excavation in reducing the cariogenic flora
Authors: Azrak B. , Callaway A. , Grundheber A. , Stender E. , Willershausen B.
Published: May 2004

Summary.  Objectives.   The usage of minimally invasive procedures and attention to patient comfort are of great importance, especially for dental treatment in small children. This has led to the development of chemomechanical methods for caries removal. The aim of this study was to compare the efficacy of chemomechanical caries removal with that of conventional excavation in reducing the count of the cariogenic flora.

Design and setting.  Subjects for this study were chosen from children admitted to dental clinic for restorative procedures under general anaesthesia.

Samples and methods.  Twenty‐one children (mean age 43·5 ± 12·0 months) with early childhood caries were included in this study. Two primary teeth with comparable degrees of carious destruction were chosen in each child (n = 42) for caries removal with Carisolv‘ or by means of rotary instruments. Samples from carious dentine were taken with a sterile scraping instrument, then all softened dentine was removed and a second sample was taken. All samples (n = 84) were serially diluted and plated on two different nutrient agar plates.

Results.  After 24 h of incubation, colony forming units were determined for total bacterial counts and lactobacilli. Twelve per cent of the samples from carious dentine contained more than 106 bacteria, 23·8% contained more than 105 lactobacilli. Both methods of caries removal produced a statistically significant reduction in the bacterial counts (P = 0·0001). In at least 90·5% of the samples taken after the removal, the total bacterial count was below 102, and in 95·2% lactobacilli fell below 102.

Conclusion.  These results indicate that the efficacy of chemomechanical removal of carious dentine in children by means of Carisolv‘ is comparable to the results obtained by conventional methods, and thus might serve as a suitable alternative.
Lead levels in primary teeth of children living in Mexico City
Authors: Hernández‐Guerrero J. C. , Jiménez‐Farfán M. D. , Belmont R. , Ledesma‐Montes C. , Baez A.
Published: May 2004

Summary.  Objective.  The aim of this study was to discover the lead concentration in primary teeth extracted in the peripheral clinics of the Faculty of Dentistry, UNAM (Mexico City).

Design.  One hundred healthy primary teeth were collected from 2 to 13‐year‐old children (52 girls and 48 boys). Sixty‐six were maxillary teeth and 34 were mandibular teeth. Lead concentrations were measured by Graphite Furnace Atomic Absorption Spectrophotometry.

Results.  Our results indicate that lead concentration in the 10–13‐year‐old group (7·7 µg/g−1) was higher than in the other groups. Geometric mean lead concentration was higher in girls than in boys (7·3 µg/g−1 and 6·3 µg/g−1, respectively). Maxillary teeth had higher lead concentrations than mandibular teeth and primary canines showed the highest mean lead concentration followed by incisors and molars. Teeth from children living in the south‐east area (which according to the Mexico City's Pollution Center data is the more polluted area), presented the highest lead concentration but no statistically significant difference was found among teeth from the different areas.

Conclusions.  Our results suggest that age, gender and place of residence are not related to the lead concentration in human primary teeth. This fact seems to indicate the ubiquitous presence of lead in the whole atmosphere of Mexico City and suggests that zones of residence do not appear to influence tooth lead concentration.
Intentional replantation of an immature permanent lower incisor because of a refractory peri‐apical lesion: case report and 5‐year follow‐up
Authors: Shintani S. , Tsuji M. , Toyosawa S. , Ooshima T.
Published: May 2004

Summary.  We performed an intentional replantation of an immature lower incisor that had a refractory peri‐apical lesion. The incisor was extracted and the peri‐apical lesion was removed by curettage. The root canal of the tooth was then rapidly irrigated, and filled with a calcium hydroxide and iodoform paste (Vitapex®), after which the tooth was fixed with an arch wire splint. Five years later, no clinical or radiographic abnormalities were found, and the root apex was obturated by an apical bridge formation. A team of two dentists is essential to prevent a prolonged operation time, thus eliminating any of the causes of ankylosis. Furthermore, calcium hydroxide and iodoform paste, along with an arch wire splint retained with composite resin, led to good healing of the periodontal tissue after the intentional replantation. Our results indicate that intentional replantation is a useful method for an immature tooth with refractory peri‐apical problems.
Dental anxiety in a students’ paediatric dental clinic: children, parents and students
Authors: Peretz Benjamin , Nazarian Yaron , Bimstein Enrique
Published: May 2004

Summary.  Objective.  The purpose of the present study was to investigate the dental anxieties of children, parents and student caregivers in a dental school environment.

Methods.  Eighty‐eight children, parents and the dental students who treated the children were included in the study. They were asked to complete questionnaires which gathered information about demographics and dental anxiety using the Dental Anxiety Scale (DAS). Students were also asked to respond to a visual analogue scale (VAS) to assess their anxiety prior to treating children.

Results.  Significant differences were observed between the mean DAS of the children compared to the students (8·8 ± 3·9 and 7·3 ± 2·7, respectively), and between the scores of the parents and the students (8·3 ± 2·9 and 7·3 ± 2·7, respectively). No significance was noted between the mean DAS scores of the children and those of the parents. The number of children in family did not influence the mean DAS of the children. Parents’ age, education or place of birth did not influence the mean DAS of the parents or the children. The mean DAS of children who reacted excellently in previous treatments scored significantly lower in DAS compared with children who were fearful. Female dental students demonstrated higher DAS and VAS scores than male students. Students’ seniority, type of last treatment that they received, time since last treatment, parenthood or self‐ranking in class did not seem to significantly influence their DAS or VAS scores. A strong correlation in DAS scores between parents and children was found (r = 0·41, P = 0·0001). No correlation between children's and students’ DAS scores was found.

Conclusions.  Students’ dental anxiety, or their anxiety prior to treating a child, may not be directly associated with the child's dental anxiety. However, a positive correlation exists between parental and children's dental anxiety.
Aetiology, diagnosis and treatment of posterior cross‐bites in the primary dentition
Authors: Malandris M. , Mahoney E. K.
Published: May 2004

Summary.  Introduction.  Children who present with a posterior cross‐bite in the primary dentition may be predisposed to long‐term detrimental consequences if the condition is left untreated. Controversy exists in the literature as to the most appropriate time to treat this condition.

Objectives.  The aim of this review is to evaluate the need for correcting posterior cross‐bites in the primary dentition based on the current understanding of the aetiology, likelihood of self‐correction, and consequences of various forms of this malocclusion persisting into the mixed and permanent dentitions. A review of the reported treatment options for management of this condition is also presented.

Methods.  Literature pertaining to the epidemiology and management of posterior cross‐bites in the primary dentition are reviewed.

Conclusion.  Posterior cross‐bites in the primary dentition are relatively common and their causes are numerous. Because a significant proportion of posterior cross‐bites self‐correct beyond the primary dentition, routine correction in the primary dentition phase cannot be advocated. A unilateral posterior cross‐bite as a result of a functional displacement of the mandible is one of the few malocclusions which should be considered for correction in the primary dentition. Further research is needed in the management of this condition.
Recurrent aphthous ulcers in Fanconi's anaemia: a case report
Authors: Otan Feyza , Açikgöz Gokhan , Sakallioǧlu Umur , Özkan Burcu
Published: May 2004

Summary.  Fanconi's anaemia (FA) is an autosomal recessive disorder that is clinically characterized by aplastic anaemia, congenital malformations of the renal, cardiac, skeletal and skin structures, and an increased predisposition to malignancies. Patients with FA often present with bleeding and infection, which are symptoms related to thrombocytopenia and neutropenia. There are few reports of the oral manifestations of FA. We describe oral aphthous ulcerations in two siblings with FA. There was a rapid improvement and healing of ulcers after blood transfusions and increased haemoglobin levels. This may support the role of severe anaemia in oral ulcerations.
Effect of diode laser and fluoride varnish on initial surface demineralization of primary dentition enamel: an in vitro study
Authors: Santaella M. R. L. A. , Braun A. , Matson E. , Frentzen M.
Published: May 2004

Summary.  Introduction.  Previous investigations have demonstrated improved enamel caries resistance after laser irradiation. The purpose of this in vitro study was to assess the caries‐preventive potential of 809 nm diode laser treatment of the enamel of primary teeth compared to topical fluoride application.

Methods.  Eighty samples of sound primary teeth were embedded in plastic and stored in saline solution. The enamel surface of 80 samples was polished in an area of 2 × 2 mm. These tooth specimens were randomly assigned to one control and three test groups: (1) no treatment/control; (2) application of 0·1 mg of fluoride varnish (Duraphat®) for 6 h; (3) diode laser application (809 nm, 140 mJ, 50 Hz, Ø 600 µm fibre, contact mode, absorber, 1 min; ORA‐LASER01® I.S.T.); and (4) combined application – laser/fluoride varnish. Caries‐like lesions were created by pH‐cycling. After lesion formation, longitudinal sections were taken and examined by polarized light microscopy.

Results.  In the control group, all samples showed lesions up to 30 µm in depth. After laser application, lesions could be identified in 15 out of 20 samples. Topical fluoride treatment in groups 2 (varnish) and 4 (laser/varnish) completely inhibited the development of caries‐like lesions in all samples.

Conclusion.  In this in vitro investigation, topical fluoride treatment enhances the resistance of sound enamel of primary teeth more effectively than diode laser application.
Listening to young voices: challenges of research with adolescent mental health service users
Authors: CLAVEIROLE A.
Published: May 2004

Young people who have mental health problems and use the mental health services need to be consulted about their views regarding their experiences of care and treatment in the same way as adults do. Doing research with children and young people is relatively new but it is becoming more common and recent literature highlights a need to balance respect for their voices with responsibility for their best interests. This can be achieved by paying close attention to ethical and methodological issues throughout the course of every study. This paper reviews some of the issues involved in consultation research with adolescent mental health service users, and illustrates them with examples taken from an ongoing study into the experiences of young people in three Scottish child and adolescent mental health services.
Building a case for understanding the lived experiences of males who attempt suicide in Alberta, Canada
Authors: CUTCLIFFE J. R. , JOYCE A. , CUMMINS M.
Published: May 2004

Suicide is a serious public health concern in Alberta, with, on average, over 400 Albertans taking their own lives annually. The case for concern is even more pronounced when one considers that for younger Albertans (those aged less than 45 years), suicide is the second leading cause of death. While trends in rates of suicide fluctuate over time, it is important to note that suicide rates for males have been at least three times higher than the corresponding rates for females since the 1950s. Furthermore, these differences have increased so that, by the 1990s the rate for male suicide was four times higher than that of females. In addition, rates are increasing at a faster pace in younger cohorts. Despite the existence of numerous positivistically orientated studies, and the introduction of a range of strategies to help prevent suicide, significant reductions in suicide rates have not been achieved. Similarly, while there is a substantial literature on the issue of suicide in Canada, there remain many gaps in our knowledge. Our understanding of the experiences and the meanings attributed to these experiences that motivate contemporary Albertan males to attempt suicide is far from complete. In order to design interventions to help reduce the suicide rate, whether these are interventions at the preprimary, primary or secondary level of care, it is necessary to gain a more detailed and comprehensive understanding of this highly complex behaviour. Consequently, there is an urgent need to better understand the particular life experiences and the meanings that individuals attach to these experiences. Accordingly, this paper makes the case for the use of hermeneutic, phenomenological investigations, as a means to further elucidate the lived experiences of suicidal Alberta males.
Patient and nurse accounts of violent incidents in a Medium Secure Unit
Authors: HINSBY K. , BAKER M.
Published: May 2004

Most studies examining violence in a forensic setting have adopted a statistical approach to associate relevant predictors and the likelihood of violence. Views of patients and nurses have been a relatively neglected research area. This study explored patients’ and nurses’ accounts of violent incidents, considering similarities and differences in their narratives. Permission was obtained from the local National Health Service Research Ethics Board and the Research Ethics Committee of University of East London. Anonymized transcripts were produced from semi‐structured interviews conducted in a Medium Secure Unit with four nurses and four patients, who consented to talk at length with the first author about violent events they had witnessed on the Unit. Grounded theory analysis of the data generated a core category, ‘control’, and five constituent themes: the construction of identity of the perpetrator of violence; nurses’ dual role of caring and controlling; aspects of parentalism involved in control; following set policies and procedures; and segregation from mainstream society. Because of widespread social interest and media coverage in the topic, discursive examination was made of aspects of social context arising within the data. This study was small scale and exploratory, and further confirmatory research is needed. Nevertheless, clear contrasts between the nurse and patient accounts indicated tentative suggestions for training (including user involvement) and intervention in managing violent behaviour.
Anoda cristata control with glyphosate in narrow‐ and wide‐row soyabean
Authors: Puricelli E , Faccini D , Orioli G , Sabbatini M R
Published: May 2004

Experiments evaluated the effect of glyphosate rate and Anoda cristata density, on crop and weed biomass and weed seed production in wide (70 cm) and narrow rows (35 cm) glyphosate‐resistant soyabean (Glycine max). Soyabean density was higher at 35 cm row spacing as an increase in planting rate in narrow‐row soyabean is recommended for producers in Argentina. Soyabean biomass at growth stage V4 (four nodes on the main stem with fully developed leaves beginning with the unifoliate leaves) was higher when grown on narrow than in wide‐rows but was not affected by the presence of A. cristata. At growth stage R5 (seed initiation – seed 3 mm long in a pod at one of the four uppermost nodes on the main stem, with a fully developed leaf and full canopy development), crop biomass was greater in narrow rows compared with wide rows with 12 plants m−2 of A. cristata. In narrow‐row soyabean, a single application of a reduced rate of glyphosate maintained soyabean biomass at R5 and provided excellent weed control regardless of weed density. In wide‐row soyabean control was reduced at the high weed density. Regardless of row spacing, A. cristata biomass and seed production were severely reduced by half of the recommended dose rate of glyphosate but the relationship between biomass and seed production was not altered. Glyphosate rates as low as 67.5 g a.e. ha−1 in narrow rows or 540 g a.e. ha−1 in wide rows provided excellent control of A. cristata. To minimize glyphosate use, planting narrow‐row soyabean are effective where A. cristata density is low.
Integrated management of Striga hermonthica in sorghum using a mycoherbicide and host plant resistance in the Nigerian Sudano‐Sahelian savanna
Authors: Marley P S , Aba D A , Shebayan J A Y , Musa R , Sanni A
Published: May 2004

Striga hermonthica is a major biotic constraint to sorghum production in Nigeria, sometimes causing total yield loss. Recommendations for Striga management often include the use of cultural and agronomic practices, herbicides and host plant resistance when available. The use of biological control has not been commercialized. Fusarium oxysporum (isolate PSM 197)‐based mycoherbicide was used in combination with selected sorghums (the Striga‐resistant cultivar Samsorg 40, and the Striga tolerant landrace Yar'ruruka) as an Integrated Striga Management strategy (ISM) in on‐farm trials in the Sudano‐Sahelian savanna of Nigeria. Crop stands were significantly (P = 0.05) higher in ISM compared with non‐ISM plots on which the mycoherbicide was not applied. Similarly, ISM plots had significantly (P = 0.05) lower Striga counts than non‐ISM plots. Striga emergence was reduced by ISM by around 95%. Sorghum yields were 49.6% higher where integrated management was used. Cost benefit analysis of the ISM package shows that use of the mycoherbicide increased the profitability of sorghum production on Striga‐infested soils. Farmers’ preferences monitored during and after the trials highlighted the need for careful selection and integration of control components into an ISM package.
Size and composition of the weed seedbank after 7 years of different cover‐crop‐maize management systems
Authors: Moonen A C , Bàrberi P
Published: May 2004

The objective of this study was to obtain detailed information on the long‐term weed suppression potential of four winter soil cover types included in an arable crop system managed at various input levels. We used weed seedbank size and composition to assess weed suppression potential. A field experiment was established in 1993 as a split‐split‐plot design with four replications, including two tillage systems [a conventional system (CS) including ploughing in the cover crops and a low‐input system (LIS) including no tillage with surface mulching of the cover crops] in the main plots, three mineral nitrogen fertilization rates for the main crop in the sub‐plots and four soil cover types (main crop residue, rye, crimson clover and subterranean clover) in the sub‐sub‐plots. Seedbank sampling took place in winter 2000/01. The weed seedbank was analysed with the seedling emergence method. Data were analysed using anova and multivariate techniques. Results indicated that the seedbank density in the LIS was about five times higher than in the conventional input system. In the CS, use of a rye cover crop resulted in a lower seedbank density with respect to the crop residue treatment (−25%), whereas in the LIS the subterranean clover cover crop decreased weed seedbank density as compared with the other cover crops and the crop residue treatment (−22% on average). Differences in species composition were mainly related to tillage system. Implications for cover crop management and the development of sustainable cropping systems are discussed.
Spatial stability of Avena sterilis ssp. ludoviciana populations under annual applications of low rates of imazamethabenz
Authors: Barroso J , Fernàndez‐Quintanilla C , Ruiz D , Hernaiz P , Rew LJ
Published: May 2004

Long‐term experiments were conducted in two winter barley fields in central Spain to determine the spatial stability of Avena sterilis ssp. ludoviciana populations under annual applications of low rates of imazamethabenz herbicide. Weed density was sampled every year (over 5 years in the first field and over 3 years in the second) on the same grid locations prior to herbicide application. Although weed patches were stable in their location, weed density decreased in most of the years. In the first field, the populations decreased exponentially over the 5‐year period. The rates of population decline were dependent on the initial density of the population, being higher for the central core of the patches and lower for the low‐density areas. Under the conditions present in this experiment, it was possible to reduce heavy weed patches (up to 1200 seedlings m−2) down to relatively safe levels (18 seedlings m−2) in a period of 3 years using a density‐specific control programme, applying low rates of herbicides when weed densities were below a given level (1000 seedlings m−2). However, under adverse environmental conditions, half rates of the herbicide failed to control the weed populations adequately. The stability of the location of patches of A. sterilis ssp. ludoviciana suggest that weed seedling distributions mapped in one year are good predictors of future seedling distributions. However, the actual densities established each year will depend on the control level achieved the previous year and the climatic conditions present during the establishment period.
Resistance of Camelina microcarpa to acetolactate synthase inhibiting herbicides
Authors: Hanson B D , Park K W , Mallory‐Smith C A , Thill D C
Published: May 2004

An accession of Camelina microcarpa suspected to be resistant to sulfonylurea herbicides was identified in Oregon in 1998 field experiments. Greenhouse research confirmed that the putative resistant biotype was resistant to chlorsulfuron and metsulfuron on a whole plant level. Compared with the resistant (R) biotype, the susceptible (S) biotype was 1000 and 10 000‐fold more sensitive to metsulfuron and chlorsulfuron respectively. The R biotype was also resistant to other sulfonylurea, sulfonylaminocarbonyl‐triazolinone, imidazolinone and triazolopyrimidine herbicides. An in vivo enzyme assay indicated that acetolactate synthase (ALS) from the R plants required 111 times more chlorsulfuron to inhibit activity by 50% compared with the amount required to have a similar effect on ALS from S plants. Analysis of the nucleotide and amino acid sequences demonstrated that a single‐point mutation from G to T in the als1 gene conferred the change from the amino acid tryptophan to leucine at position 572 in the resistant biotype. This research confirmed that ALS inhibitor resistance in an Oregon accession of C. microcarpa is based on an altered target site conferred by a single‐point mutation.
Synergistic interactions between an exotic honeybee and an exotic weed: pollination of Lantana camara in Australia
Authors: Goulson D , Derwent L C
Published: May 2004

Lantana camara, a woody shrub originating in south and central America, is among the most widespread and troublesome exotic weeds of the old‐world tropics. It invades pasture, crops and native ecosystems, causing substantial economic losses and environmental degradation. In Australia alone, L. camara is currently estimated to cover c. 40 000 km2 . In glasshouse studies we demonstrate that L. camara requires cross‐pollination to set fruit, and that honeybee visits result in effective pollination. Field studies carried out in Queensland, Australia, suggest that fruit set is limited by pollinator abundance, and that the main pollinator of L. camara throughout a substantial portion of its Australian range appears to be the honeybee, Apis mellifera. Seed set was strongly correlated with honeybee abundance, and at many sites, particularly in southern Queensland, honeybees were the only recorded flower visitors. Of 63 sites that were visited, seed set was highest at five sites where only honeybees were present. Hives are frequently stationed within and adjacent to areas such as National Parks that are threatened by this noxious weed. Management of honeybee populations may provide a powerful tool for cost‐effective control of L. camara that has previously been overlooked. We suggest that there are probably many other weeds, both in Australia and elsewhere, that benefit from honeybee pollination.
Characterization of the Orobanche–Medicago truncatula association for studying early stages of the parasite–host interaction
Authors: Rodríguez‐Conde M F , Moreno M T , Cubero J I , Rubiales D
Published: May 2004

There is an increasing interest in the legume species Medicago truncatula as a model plant for structural and functional genomic studies that can be used to identify agronomically important genes in legumes. Field screening has shown very high levels of resistance to Orobanche crenata in M. truncatula. However, in vitro studies with O. crenata, Orobanche foetida, Orobanche ramosa and Orobanche minor showed useful variation among accessions at early stages of the parasite–host interaction. Significant differences were observed in the levels of germination of O. crenata and O. foetida seeds induced by different accessions of M. truncatula. Only limited germination was observed on accession SA‐4327. All accessions induced little O. ramosa and O. minor germination. Accessions also varied in the number of O. crenata and O. foetida attachments supported, with few developing on accession SA‐27774. The variation observed for induction of germination and of subsequent attachment will be useful to isolating and characterizing genes involved in the early stages of Orobanche–host plant interaction and for the study of the biosynthetic pathways of production for germination stimulants.
Visualization of the effect of a surfactant on the uptake of xenobiotics into plant foliage by confocal laser scanning microscopy
Authors: Liu Z Q , Gaskin R E , Zabkiwicz J A
Published: May 2004

A radiolabelling method is generally used to determine the foliar uptake of xenobiotics. This technique cannot provide any information on the localization of chemicals inside leaf tissues. The influence of an alcohol ethoxylate surfactant on the uptake of three fluorescent dyes, difluorofluorescein (hydrophilic), rhodamine B (moderately lipophilic) and a naphthalimide dye (lipophilic), into the leaves of three contrasting species, bean (Vicia faba), wheat (Triticum aestivum) and cabbage (Brassica oleracea), at 16 h after treatment was measured using a conventional wash‐off method and also visualized in vivo by confocal laser scanning microscopy (CLSM). Whereas the lipophilic dyes showed greater intrinsic uptake than the hydrophilic one, the enhancing effect of the surfactant on uptake was more pronounced for the latter. CLSM revealed that the presence of the surfactant increased the transport of difluorofluorescein into the epidermal cells of bean and wheat leaves, but not cabbage leaves. Rhodamine B showed greatest transcuticular diffusion in all three species, but most of the dye moved into the vacuole of the epidermal cells. The naphthalimide dye was strongly retained by the wax–cuticle layer of all species, even in the presence of the surfactant. CLSM has proven to be an attractive tool for studying xenobiotic diffusion. The results obtained using fluorescent dyes are believed to be applicable to the foliar uptake of herbicides.
Long time follow up of CD28− CD4+ T cells in living kidney transplant patients
Authors: Kato M , Ono Y , Kinukawa T , Hattori R , Kamihira O , Ohshima S
Published: May 2004

Abstract:  We previously reported that the CD28− CD4+ T cell subpopulation was expanded in the kidney allograft patients with long graft survival, although these T cells were rarely found in patients with graft survival <5 yr. To understand the CD28− CD4+ T cells in the long‐term acceptance of kidney allografts, we examined functions of this population and performed a 4 yr follow up study. Peripheral blood mononuclear cells (PBMC) were obtained from 47 long‐term living related kidney allograft recipients. CD28+ CD4+ and CD28− CD4+ T cells purified by cell sorting were analyzed for expression of V repertoire. Donor‐specific response was examined in mixed lymphocyte reaction (MLR). A follow up study with long‐term kidney allograft patients was performed for 4 yr about the rate of CD28− CD4+ T cells. Eleven patients were examined by MLRs against donors and third party. Four patients with a marked increase of CD28− CD4+ T cells showed the donor‐specific responses appeared to be lower when compared with third party‐specific responses. Freshly sorted CD28− CD4+ T cells showed a restricted V repertoire, whereas the V usage of CD28+ CD4+ T cells from the same patients was much diversified. Such difference in V repertoire was not evident between the two populations from healthy control. A follow up study showed the ratio of CD28− CD4+ T cells appeared to be lower in patients who were suspected of chronic rejection. These unusual CD4+ T cells might be related to the long‐term acceptance of human transplant allografts.