bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluoride ingestion from toothpaste: background to European Union‐funded multicentre project
Authors: O'Mullane Denis M. , Cochran Judith A , Whelton Helen P.
Published: April 2004

Abstract ‐  As in most other established market economies throughout the world the prevalence of dental caries has declined in most Member States of the European Union (EU). There is evidence that the increased use of fluoride toothpaste has been a major factor in this improvement. Recently there has been increasing debate on the alleged link between increased use of fluoride toothpaste, particularly by infants and young children, and increased levels of enamel fluorosis. Central to these discussions are two issues, namely measurement of the amount of fluoride ingested by infants and young children and measurement of enamel opacities including fluorosis. The aims of the project described in this special issue addressed these two measurement issues. Seven EU Partners participated. Standardized methods for recording the amount of fluoride ingested when using fluoride toothpaste were developed and used in the seven sites. Similarly a standardized photographic method for recording enamel opacities, including fluorosis, was developed.
A review of fluorosis in the European Union: prevalence, risk factors and aesthetic issues
Authors: Whelton Helen P. , Ketley Clare E. , McSweeney Fiona , O'Mullane Denis M.
Published: April 2004

Abstract ‐  Fluoride has played a key role in caries prevention for the past 50 years but excessive ingestion of fluoride during tooth development may lead to dental fluorosis. Throughout Europe many vehicles have been, and are currently, employed for optimal fluoride delivery including drinking water, toothpaste, fluoride supplements, salt and milk. Several indices, both descriptive and aetiological, have been developed and used for measuring fluorosis. This factor, combined with the lack of use of a standardized method for measurement of fluorosis, has made comparison between studies difficult and assessment of trends in fluorosis prevalence unreliable. Overall the evidence would appear to indicate, however, that diffuse enamel opacities are more prevalent in fluoridated than in nonfluoridated communities and that their prevalence at the very mild level may be increasing. In addition to fluoridated drinking water, risk factors for fluorosis include inadvertent ingestion of fluoride toothpaste and the inappropriate use of fluoride supplements. The risk is of aesthetic concern primarily during the period of enamel development of the permanent central incisors, although this largely appears to be a cosmetic rather than a public‐health issue. It is concluded that there is a need to co‐ordinate studies measuring fluorosis throughout Europe and that development of a standardized photographic method would be useful. Furthermore, the aesthetic importance of fluorosis needs to be determined in more detail in each country in the light of each country's respective risk factors and dental health policies.
A standardized photographic method for evaluating enamel opacities including fluorosis
Authors: Cochran Judith A. , Ketley Clare E. , Sanches Leonor , Mamai‐Homata E. , Oila Anna‐Maria , Árnadóttir Inga B. , Van Loveren Cor , Whelton Helen P. , O'Mullane Denis M.
Published: April 2004

Abstract ‐  Objectives: The objective of this study was to demonstrate the reproducibility of a standardized photographic technique for recording fluorosis when used by a group of epidemiologists as part of a large multicentred European study. Methods: Studies were first carried out to develop the equipment specification and photographic method. The author (JAC) was then trained and calibrated in this method. She was then responsible for the training and calibration of examiners from a further six European study sites. The method involved taking two transparencies of the permanent maxillary central incisors of 8‐year‐old children, the first after 8 s while the teeth were still wet and the second after 105 s when the teeth had been allowed to dry out naturally. Data were collected at a central location during a training/calibration exercise and subsequently, during the conduct of a large study to measure fluorosis prevalence, at the seven sites. Intra‐ and interexaminer reproducibility of the photographic method were measured by grading the transparencies produced by all the examiners according to the DDE and TF indices. Results: The time period in which the transparencies were taken was to within 4 s among the examiners. Transparencies scored according to the TF index gave a range of Kappa values of 0.45‐0.66 for intraexaminer reliability and 0.32‐0.55 for interexaminer reliability. When using the DDE index Kappa values ranged from 0.43 to 0.70 for intraexaminer reliability and from 0.34 to 0.69 for interexaminer reliability. Conclusion: The photographic method was mostly robust and reproducible when used by epidemiologists from seven European study sites.
Development of a standardized method for comparing fluoride ingested from toothpaste by 1.5‐3.5‐year‐old children in seven European countries. Part 2: Ingestion results
Authors: Cochran Judith A. , Ketley Clare E. , Duckworth Ralph M. , Van Loveren Cor , Holbrook W Peter , Seppä Liisa , Sanches Leonor , Polychronopoulou Argy , O'Mullane Denis M.
Published: April 2004

Abstract ‐ Objectives:To develop a standardized method for measuring the variables affecting fluoride ingestion from toothpaste in young children between the ages of 1.5 and 3.5 years, and to use the method at seven European sites.Methods:Random samples of children were invited to take part in the study. Parents who gave consent were visited at home. The children brushed their teeth using the toothpaste brand and toothbrush type currently in use. The difference between the fluoride dispensed onto the toothbrush and the fluoride recovered after accounting for losses was deemed to be the fluoride ingested. Details of other oral health‐care habits were collected by questionnaire. For each child, the fluoride concentration of the toothpaste used was measured in the laboratory, from which an estimate of total daily fluoride ingestion was made.Results:There was considerable variation between countries in the types of toothpaste used and in the amounts of toothpaste applied and ingested. The amount of fluoride ingested ranged from 0.01 to 0.04 mg fluoride per kg of body weight per day.Conclusion:The amount of fluoride ingested that is likely to be a risk factor for the development of dental fluorosis during tooth formation is equivocal and was found to vary widely between European countries. There appears to be a need for clearer health messages regarding the use of fluoridated toothpaste by young children.
Fluoride ingestion from toothpaste: fluoride recovered from the toothbrush, the expectorate and the after‐brush rinses
Authors: Van Loveren Cor , Ketley Clare E. , Cochran Judith A. , Duckworth Ralph M. , O'Mullane Denis M.
Published: April 2004

Abstract ‐  Objectives: The aim of this study was to determine the effects of rinsing and spitting on fluoride ingestion from toothpaste during normal oral‐hygiene procedures of younger children, and hence to make recommendations on rinsing during toothbrushing. Methods: The brushing habits of 166 Dutch and 185 Irish children between 1.5 and 3.5 years were observed during home visits. The weight of the toothpaste tube was determined before and after use. After brushing, the toothbrush and any associated expectorate and rinses, combined with any toothpaste spilled during the brushing procedures, were collected. The amounts of fluoride retained on the toothbrush and in the associated expectorate and rinses were measured. Results: Over 90% of the Dutch children used a special toddlers' toothpaste with ≤500 ppm F. Eleven per cent of the younger (<2.5 years) Dutch children and 22% of the older children rinsed after brushing. Of the Irish children approximately 52% used a children's toothpaste containing around 500 ppm F. Of the younger Irish children 31% spat without rinsing, while another 31% rinsed during or after brushing. For the older Irish children, these percentages were 14 and 70%, respectively. On average, 22% of the fluoride dispensed on the toothbrush was retained on the brush after brushing irrespective of the rinsing and spitting behaviour of the children. The maximum ingestible amount of fluoride from toothpaste assuming no rinsing or spitting was calculated. Conclusions: Fluoride ingestion from toothpaste is significantly reduced by rinsing and/or spitting during toothbrushing. Recommendations that younger children use small amounts of toothpaste (< 0.5 g) and that children using toothpaste with ≥ 1000 ppm F rinse their mouths after brushing continue to be valid.
Risk factors for periodontitis in HIV+ patients
Authors: Alpagot Tamer , Duzgunes Nejat , Wolff Larry F. , Lee Aaaron
Published: April 2004

Objective:  The purpose of this study was to identify risk factors for periodontitis associated with human immunodeficiency virus (HIV) infection.

Methods:  A total of 152 HIV+ patients were recruited from the CARE clinic at the University of the Pacific School of Dentistry. Clinical measurements (gingival index, plaque index, bleeding index, probing depth, and attachment loss), gingival crevicular fluid (GCF) and subgingival plaque samples were taken from eight sites of each patient at baseline and 6‐month visits. GCF neutrophil elastase was determined by measurement of p‐nitroanalide resulting from hydrolysis of an elastase‐specific peptide. GCF β‐glucuronidase was determined by release of 4‐methylumbelliferone from hydrolysis of a specific substrate. A bacterial concentration fluorescence immunoassay was used to detect periodontopathic bacteria in subgingival plaque samples.

Results:  Viral load, age, smoking pack‐years, Fusobacterium nucleatum, Prevotella intermedia, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, neutrophil elastase, and β‐glucuronidase were significantly correlated with clinical measurements (0.0001 < p < 0.05). Significantly higher levels of elastase, β‐glucuronidase, F. nucleatum, P. intermedia, and A. actinomycetemcomitans were found at progressing sites than in non‐progressing sites (0.001 < p < 0.05).

Conclusions:  These data indicate that age, smoking pack‐years, viral load, F. nucleatum, P. intermedia, A. actinomycetemcomitans, elastase, and β‐glucuronidase are risk factors for periodontitis in HIV+ patients.
The influence of short‐term diabetes mellitus and insulin therapy on alveolar bone loss in rats
Authors: Holzhausen Marinella , Garcia Daniele Fakoury , Pepato Maria Teresa , Marcantonio Elcio
Published: April 2004

Background:  It is well known that the multiple direct and indirect consequences of hyperglycemia in diabetic individuals have been linked to a number of abnormal host effector mechanisms that could lead to an increased risk of developing periodontal disease.

Objective:  The aim of this study was to investigate the effect of short‐term experimental diabetes and insulin therapy on the severity of alveolar bone loss in rats, and the effect of experimental periodontitis on glycemic control.

Methods:  Seventy‐two male Wistar rats were divided into four groups: group I animals were submitted to dental ligature around lower right first molars (ligated); group II consisted of streptozotocin (STZ)‐diabetic, ligated rats; group III represented STZ‐diabetic, unligated rats; and group IV consisted of insulin‐treated (6 U/day), STZ‐diabetic, ligated rats. Blood glucose of all diabetic rats was monitored at regular intervals. Standardized digital radiographs were taken after killing at 7, 15 and 30 days to measure the amount of bone loss about the mesial root surface of the first molar tooth in each rat.

Results:  No significant (p < 0.05) changes in plasma glucose levels of insulin‐treated diabetic rats were found among the different examinations after the beginning of insulin therapy. Rats from group II showed significantly greater increases in mean plasma glucose levels at 15 and 30 days after ligature placement compared with rats from group III (p < 0.05). Furthermore, in spite of the significant alveolar bone loss progression that was observed in groups I, II and IV (p < 0.00001; two‐way anova), no significant differences among these groups regarding the severity of bone loss (p = 0.77) and no significant interaction between treatment group and time (p = 0.81) were found.

Conclusions:  Within the limits of this study, it can be suggested that the severity of periodontal disease was not affected by short‐term diabetes, and that experimental periodontitis increased blood glucose levels in uncontrolled diabetic rats.
Reassessing the Insurance Effect: A Qualitative Analysis of Fertility Behavior in Senegal and Zimbabwe
Authors: LeGrand Thomas , Koppenhaver Todd , Mondain Nathalie , Randall Sara
Published: April 2004

A number of prominent demographers have recently reiterated the argument that a lasting mortality decline is a key determinant of the fertility transition. Of the main hypothesized pathways linking fertility to mortality, the one least studied is the insurance hypothesis: the notion that, in high‐mortality contexts, people decide to have more children in order to anticipate possible future child deaths and lessen the risks of having too few surviving offspring. In‐depth interviews and focus groups from Zimbabwe and Senegal are used to examine this hypothesis and to extend it into a broader theory of reproductive decision making under uncertainty. Whereas insurance strategies are frequent in Zimbabwe and occur in urban Senegal, in the higher‐mortality settings—the rural Senegalese site and the recent past described by respondents in Zimbabwe and urban Senegal—deliberate fertility‐limitation strategies are rare. The data depict fundamental changes in attitudes, strategies, and behaviors concerning family size over time and, in Senegal, over space. Important reproductive goals and risks extend far beyond numbers of children and mortality. Parents seek to have healthy, successful children for many reasons including companionship, descendants, and old‐age support. Diverse investments in child quality (their education, health, etc.) and quantity (numbers of births) are the main means to attain these goals and, less recognized by demographers, are also important ways for parents to manage uncertainty in family‐building outcomes; the “classic” insurance mechanism is only one, often minor, aspect of the quantity option.
Women Entrepreneurs in Romania, Poland, and the United States: Cultural and Family Influences on Strategy and Growth
Authors: Gundry Lisa K. , Ben-Yoseph Miriam
Published: April 2004

This study investigated the impact of culture and family on the strategies, opportunities, and barriers to growth for women entrepreneurs from Romania, Poland, and America. The purpose of this research was twofold: to gather information on women entrepreneurs cross-culturally and to construct and integrate the perspective of the woman business owner in relation to the broader family and cultural context in which she is located. A design incorporating qualitative and quantitative measures was used to collect in-depth information in the language of the entrepreneurs. A discussion of strategic similarities and differences and entrepreneurial and organizational characteristics is presented.
Exploring the Overlap of Family and Business Demands: Household and Family Business Managers' Adjustment Strategies
Authors: Miller Nancy J. , Fitzgerald Margaret A. , Winter Mary , Paul Jennifer
Published: April 2004

This study divided households in which at least one member is involved in managing a family business into two groups: those in which one individual performs two roles, family manager and business manager, and those in which two different individuals perform the two roles. The study compares adjustment strategies that the two groups use to manage the overlap of business and family demands within and across the two family types. Findings suggest that the individual performing dual roles is more likely than two separate managers to make adjustments by bringing the household responsibilities to the business and the business responsibilities home.
Family Business and Family Change: Individual Autonomy, Democratization, and the New Family Business Institutions
Authors: Gilding Michael
Published: April 2004

The renewed attention to family business in western societies is usually attributed to a past lack of attention to the subject because of its private character and to the resurgence of family business in the context of economic restructuring. This paper argues that there is a third reason for the renewed attention to family business, namely, the changing character of the family institution. In particular, there are broad trends toward the pursuit of individual autonomy and democratization in family relationships. A qualitative study of high-wealth stakeholders in Australian family businesses found that the principles of individual autonomy and democratization presented challenges for family business solidarity and continuity. These challenges gave rise to new family business institutions designed to facilitate communication and trust. These institutions are at the center of the renewed attention to family business in western societies.
Interview with Sampath Durgadas
Authors: Karofsky Paul I.
Published: April 2004

In November 1998, Paul I. Karofsky visited with several family-owned and -managed businesses in India. The powerful cultural and family influences on family-owned enterprises sparked his desire to interview Sampath Durgadas, a visiting professor and consultant to family businesses at the Institute of Management in Bangalore. Over a 12-year period, Mr. Durgadas conducted extensive experiential research on the nature of transition in three family-owned companies. Although the focus of his work is on the four South Indian states of India, he traveled widely throughout the country. His book, entitled Inheriting the Mantle: Managing Succession in Indian Family Business , is under publication by Sage Publications New Delhi.
Work-Family Conflict and Emotional Well-Being in American Family Businesses
Authors: Karofsky Paul , Millen Robert , Yilmaz Mustafa R. , Smyrnios Kosmas X. , Tanewski George A. , Romano Claudio A.
Published: April 2004

Theorists have argued that the workplace is an important component of individuals' lives, but the relationships between work and other areas of life (e.g., family, health) are not yet well understood. This study surveyed American family business owners to investigate life span, organizational work, and quality of life issues. In questionnaire responses from 156 owners, it was found that measures of frustration and after-hours work were highly significant predictors of anxiety, and a measure of accomplishment was a highly significant predictor of positive outlook toward the future. These findings may have important implications for family-work practices of business owners given that the ways in which people respond to work affect personal happiness, work effectiveness, and society.
Family Firms, Plural Forms of Governance, and the Evolving Role of Trust
Authors: Steier Lloyd
Published: April 2004

Trust plays an important role in the governance of most organizations. For the family firm, trust represents a particularly important source of strategic advantage. For example, in the early stages of firm development, the trust indigenous in most family relationships allows firms to reduce transaction costs substantially. As family firms evolve, so does the optimal role of trust as a governance mechanism. Ironically, in some cases, what was once a very resilient trust is replaced by an atmosphere of fragile trust or even distrust and an important source of strategic advantage is lost. As family firms naturally evolve, a major transitional task for them is optimizing the changing role of trust in firm governance. Using research-based case examples, this paper seeks to further the understanding of the dynamics of trust as a governance mechanism and source of competitive advantage within family firms.
Interview with Ernie Boch Jr
Authors: Karofsky Paul I.
Published: April 2004

Ernie Boch Jr. is the son of Ernie Boch, owner of the billion dollar New England Boch Enterprises. Ernie Boch Jr., vice-president of Boch Enterprises, takes a more laid back approach to this family business of automobile dealerships than his father, an extremely high-profile entrepreneur. After his father brings the customer through the door, Ernie Boch Jr. focuses on servicing him. In this interview with Ernie Boch, Jr., Paul I. Karofsky explores the history of the company and what makes it unique as well as Ernie Boch Jr.'s career track. Ernie Boch Jr. discusses how he differs from his father, plans for succession, and the enduring values and philosophy of this successful family business. He also reflects on the company's continuing success—his commitment to Boch Enterprises' long-standing philosophy of being No. 1, and his effort to bring the company into the modern age through technology.
A glucocorticoid‐induced Na+ conductance in human airway epithelial cells identified by perforated patch recording
Authors: Clunes M. T. , Butt A. G. , Wilson S. M.
Published: April 2004

The perforated patch recording technique was used to investigate the effects of dexamethasone (0.2 μm, 24–30 h), a synthetic glucocorticoid, on membrane conductance in the human airway epithelial cell line H441. Under zero current clamp conditions this hormone induced amiloride‐sensitive depolarization of the membrane potential (Vm). Lowering external Na+ to 10 mm by replacing Na+ with N‐methyl‐d‐glucammonium (NMDG+) also hyperpolarized the dexamethasome‐treated cells, whilst replacing Na+ with Li+ caused a small depolarization. Although Vm was insensitive to amiloride in control cells, NMDG+ substitution caused a small hyperpolarization and so an amiloride‐insensitive cation conductance is present. Replacing Na+ with Li+ had no effect on Vm in such cells. Voltage clamp studies of dexamethasone‐treated cells showed that the amiloride‐sensitive component of the membrane current reversed at a potential close to the Na+ equilibrium potential (ENa), and replacing Na+ with K+ caused a leftward shift in reversal potential (VRev) that correlated with the corresponding shift in ENa. Lowering [Na+]o to 10 mm, the concentration in the pipette solution, by substitution with NMDG+ shifted VRev to 0 mV, whilst replacing Na+ with Li+ caused a rightward shift. Exposing dexamethasone‐treated cells to a cocktail of cAMP‐activating compounds (20 min) caused a ∼2‐fold increase in amiloride‐sensitive conductance that was associated with no discernible change in ionic selectivity and an 18 mV depolarization. Dexamethasone thus induces the expression of a selective Na+ conductance with a substantial permeability to Li+ that is subject to acute regulation via cAMP. These data thus suggest that selective Na+ channels underlie cAMP‐regulated Na+ transport in airway epithelia.
Splenorenal reflex modulates renal blood flow in the rat
Authors: Hamza Shereen M. , Kaufman Susan
Published: April 2004

We have previously shown that the splenorenal reflex controls renin release through splenic afferent and renal sympathetic nerves. We proposed that this reflex would also affect renal blood flow (RBF). RBF was measured in male Long Evans rats using transit‐time flow probes. There were no significant differences between any of the experimental groups with respect to baseline values of RBF (8.9 ± 0.4 ml min−1, n= 25) or mean arterial pressure (MAP, 98.7 ± 2.5 mmHg, n= 25). Splenic venous pressure was selectively raised (from 7.9 ± 0.6 to 21.6 ± 0.3 mmHg, n= 25) in anaesthetized rats by partial ligation of the splenic vein. This caused an immediate fall in RBF (−2.1 ± 0.2 ml min−1, n= 7) and in MAP (−12.4 ± 2.8 mmHg, n= 7). The fall in RBF, but not the fall in blood pressure, was attenuated by renal denervation (ΔRBF: − 0.7 ± 0.1 ml min−1, n= 6), splenic denervation (ΔRBF: −0.8 ± 0.1 ml min−1, n= 6) and close renal arterial injection of the α1‐adrenergic blocker phenoxybenzamine (12.5 μg; ΔRBF: −0.8 ± 0.1 ml min−1, n= 6). Renal conductance fell only in the intact control group, i.e. the residual fall in RBF in the denervated and phenoxybenzamine‐treated animals could be attributed to the fall in MAP. We also showed that splenic vein occlusion increased both splenic afferent (from 3.0 ± 0.3 to 6.6 ± 0.6 spikes s−1, n= 5) and renal efferent (from 24.8 ± 2.0 to 50.2 ± 4.9 spikes s−1, n= 9) nerve activity. We conclude that obstruction to splenic venous outflow, such as would occur in portal hypertension, initiates increased splenic afferent nerve activity and renal vasoconstriction through the splenorenal reflex, as well as a fall in blood pressure. We propose that this contributes to the renal and cardiovascular dysfunction observed in portal hypertension.
FUZZY ORDERING OF FUZZY NUMBERS
Authors: BUCKLEY JAMES J. , ESLAMI ESFANDIAR
Published: April 2004

In this paper we are interested in determining the fuzzy ordering, from smallest to largest, of any finite set of fuzzy numbers. We investigate two methods: (1) using a weak fuzzy ordering; and (2) using a strong fuzzy ordering. Employing a strong fuzzy ordering we show that any finite set of fuzzy numbers has a unique ranking from smallest to largest.
Proinflammatory cytokines TNF-α and IFN-γ alter laminin expression under an apoptosis-independent mechanism in human intestinal epithelial cells
Authors: Francoeur Caroline , Escaffit Fabrice , Vachon Pierre H. , Beaulieu Jean-François
Published: April 2004

Laminins are basement membrane molecules that mediate cell functions such as adhesion, proliferation, migration, and differentiation. In the normal small intestine, laminin-5 and -10 are mainly expressed at the base of villus cells. However, in Crohn's disease (CD), a major redistribution of these laminins to the crypt region of the inflamed ileal mucosa has been observed, suggesting a possible relationship between laminin expression and cytokine and/or growth factor production, which is also altered in CD. The aim of this study was to test the hypothesis that proinflammatory cytokines can modulate laminin expression by intestinal epithelial cells. The effect of TNF-α, IFN-γ, IL-1β, IL-6, and transforming growth factor (TGF)-β was analyzed on the expression of laminins in the normal human intestinal epithelial crypt (HIEC) cell line. When treated with a single cytokine, HIEC cells secreted small amounts of laminin-5 and -10. Only TNF-α and TGF-β induced a slight increase in the secretion of these laminins. However, in combination, TNF-α and IFN-γ synergistically stimulated the secretion of both laminin-5 and -10 in HIEC cells. Transcript analyses suggested that the upregulation of the two laminins might depend on distinct mechanisms. Interestingly, the TNF-α and IFN-γ combination was also found to significantly promote apoptosis. However, the effect of cytokines on the secretion of laminins was maintained even after completely blocking apoptosis by inhibiting caspase activities. These results demonstrate that laminin production is specifically modulated by the proinflammatory cytokines TNF-α and IFN-γ in intestinal epithelial cells under an apoptosis-independent mechanism.
Early mitral deceleration and left atrial stiffness
Authors: Marino Paolo , Faggian Giuseppe , Bertolini Paolo , Mazzucco Alessandro , Little William C.
Published: April 2004

Left ventricular (LV) filling deceleration time (DT) is determined by the sum of atrial and ventricular stiffnesses ( KLA+ KLV). If KLA, however, is close to zero, then DT would reflect KLVonly. The purpose of this study was to quantify KLAduring DT. In 15 patients, KLVwas assessed, immediately after cardiopulmonary bypass, from E wave DT as derived from mitral tracings obtained by transesophageal echocardiography and computed according to a validated formula. In each patient, a left atrial (LA) volume curve was also obtained combining mitral and pulmonary vein (PV) cumulative flow plus LA volume measured at end diastole. Time-adjusted LA pressure was measured simultaneously with Doppler data in all patients. KLAwas then calculated during the ascending limb of the V loop and during DT. LA volume decreased by 7.3 ± 6.5 ml/m2during the first of mitral DT, whereas LV volume increased 9.4 ± 8.4 ml/m2(both P < 0.001). There was a small amount of blood coming from the PV during the same time interval, with the cumulative flow averaging 3.2 ± 2.4 ml/m2( P < 0.001). Mean LA pressure was 10.0 ± 5.1 mmHg, and it did not change during DT [from 7.8 ± 4.3 to 8.0 ± 4.3 mmHg, not significant (NS)], making KLA, which averaged 0.46 ± 0.39 mmHg/ml during the V loop, close to zero during DT [ KLA(DT): from −0.002 ± 0.08 to −0.001 ± 0.031 mmHg/ml, NS]. KLV, as assessed noninvasively from DT, averaged 0.25 ± 0.32 mmHg/ml. In conclusion, notwithstanding the significant decrement in LA volume, KLAdoes not change and can be considered not different from zero during DT. Thus KLAdoes not affect the estimation of KLVfrom Doppler parameters.
A regulated apical Na+conductance in dexamethasone-treated H441 airway epithelial cells
Authors: Ramminger S. J. , Richard K. , Inglis S. K. , Land S. C. , Olver R. E. , Wilson S. M.
Published: April 2004

Treating H441 cells with dexamethasone raised the abundance of mRNA encoding the epithelial Na+channel α- and β-subunits and increased transepithelial ion transport (measured as short-circuit current, Isc) from <4 μA·cm−2to 10–20 μA·cm−2. This dexamethasone-stimulated ion transport was blocked by amiloride analogs with a rank order of potency of benzamil ≥ amiloride > EIPA and can thus be attributed to active Na+absorption. Studies of apically permeabilized cells showed that this increased transport activity did not reflect a rise in Na+pump capacity, whereas studies of basolateral permeabilized cells demonstrated that dexamethasone increased apical Na+conductance ( GNa) from a negligible value to 100–200 μS·cm−2. Experiments that explored the ionic selectivity of this dexamethasone-induced conductance showed that it was equally permeable to Na+and Li+and that the permeability to these cations was approximately fourfold greater than to K+. There was also a small permeability to N-methyl-d-glucammonium, a nominally impermeant cation. Forskolin, an agent that increases cellular cAMP content, caused an ∼60% increase in Isc, and measurements made after these cells had been basolaterally permeabilized demonstrated that this response was associated with a rise in GNa. This cAMP-dependent control over GNawas disrupted by brefeldin A, an inhibitor of vesicular trafficking. Dexamethasone thus stimulates Na+transport in H441 cells by evoking expression of an amiloride-sensitive apical conductance that displays moderate ionic selectivity and is subject to acute control via a cAMP-dependent pathway.
Alpha-1 Adrenoceptor Agonists Generate a “Fast” NMDA Receptor-Independent Motor Rhythm in the Neonatal Rat Spinal Cord
Authors: Gabbay H. , Lev-Tov A.
Published: April 2004

Noradrenaline, a potent activator of rhythmogenic networks in adult mammals has not been reported to produce functional rhythmic patterns in isolated spinal cords of newborn rats. We now show that a “fast” (cycle time: 1–4 s) transient rhythm was induced in sacrococcygeal (SC) and rostral-lumbar spinal segments of the neonatal rat by bath-applied noradrenaline. The fast rhythm was blocked by 1 μM of the α1-adrenoceptor antagonist prazosin but not by 1–20 μM of the α2-adrenoceptor blocker yohimbine, it could be initiated and maintained by α1-adrenoceptor agonists, and it was accompanied by a slow nonlocomotor rhythm. Transection at the lumbosacral junction abolished the fast-thoracolumbar (TL) rhythm while the fast-SC and slow-TL rhythms were unaffected. The N-methyl-d-aspartate (NMDA) receptor antagonist 2-amino-5-phosphonopentanoic acid (AP5) abolished the slow- and did not interrupt the fast rhythm. Thus α1-adrenoceptor agonists induce an NMDA receptor-independent rhythm in the SC cord and modulate NMDA receptor-dependent rhythmicity in TL segments. Injection of current steps into S2 and flexor-dominated L2 motoneurons during the fast rhythm revealed a 20–30% decrease in input-resistance ( RN), coinciding with contralateral bursting. The RN of extensor-dominated L5 motoneurons did not vary with the fast rhythm. The rhythmic fluctuations of RN in L2 motoneurons were abolished, but the alternating left-right pattern of the fast rhythm was unchanged in midsagittally split TL cords. We suggest that the locomotor generators were not activated during the fast rhythm, that crossed-inhibitory pathways activated by SC projections controlled the rhythmic decrease in RN in L2 motoneurons, and that the alternating pattern of the split TL cord was maintained by excitatory SC projections.
Ratio of Shear to Load Ground-Reaction Force May Underlie the Directional Tuning of the Automatic Postural Response to Rotation and Translation
Authors: Ting Lena H. , Macpherson Jane M.
Published: April 2004

This study sought to identify the sensory signals that encode perturbation direction rapidly enough to shape the directional tuning of the automatic postural response. We compared reactions to 16 directions of pitch and roll rotation and 16 directions of linear translation in the horizontal plane in freely standing cats. Rotations and translations that displaced the center of mass in the same direction relative to the feet evoked similar patterns of muscle activity and active ground-reaction force, suggesting the presence of a single, robust postural strategy for stabilizing the center of mass in both rotation and translation. Therefore we postulated there should be a common sensory input that encodes the direction of the perturbation and leads to the directional tuning of the early electromyographic burst in the postural response. We compared the mechanical changes induced by rotations and translations prior to the active, postural response. The only consistent feature common to the full range of rotation and translation directions was the initial change in ground-reaction force angle. Other variables including joint angles, ground-reaction force magnitudes, center of pressure, and center of mass in space showed opposite or nonsignificant changes for rotation and translation. Change in force angle at the paw reflects the ratio of loading force to slip force, analogous to slips during finger grip tasks. We propose that cutaneous sensors in the foot soles detect change in ground-reaction force angle and provide the critical input underlying the directional tuning of the automatic postural response for balance.
Progress of Age-Related Changes in Properties of Motor Units in the Gastrocnemius Muscle of Rats
Authors: Sugiura Miho , Kanda Kenro
Published: April 2004

The mechanical properties of individual motor units in the medial gastrocnemius muscle, as well as the whole muscle properties and innervating motor nucleus, were investigated in dietary-restricted, male Fischer 344/DuCrj rats at ages of 4, 7, 12, 21/22, 27, 31, and 36 mo. The tetanic tension of the type S units continuously increased until the age of 36 mo. Those of type FF and FR units declined from 21/22 to 27 mo of age but did not change further while the whole muscle tension decreased greatly. The atrophy of muscle fibers, the decline in motoneuron number and axonal conduction velocity, and the decrease in the posttetanic potentiation of twitch contraction of motor units seemed to start after 21/22 mo of age and were accelerated with advancing age. Prolongation of twitch contraction time was evident for only type S and FR units in 36-mo-old rats. The fatigue index was greatly increased for type FF units in 36-mo-old rats. These findings indicated that the progress of changes in various properties occurring in the senescent muscle was different in terms of their time course and degree and also dependent on the types of motor unit. The atrophy and decrease in specific tension of muscle fibers affected the decline in tension output of motor units. This was effectively compensated for by the capture of denervated muscle fibers over time.
Relationship Between Selective Cyclooxygenase-2 Inhibitors and Acute Myocardial Infarction in Older Adults
Authors: Solomon Daniel H. , Schneeweiss Sebastian , Glynn Robert J. , Kiyota Yuka , Levin Raisa , Mogun Helen , Avorn Jerry
Published: April 2004

Background—

Although cyclooxygenase-2 inhibitors (coxibs) were developed to cause less gastrointestinal hemorrhage than nonselective nonsteroidal antiinflammatory drugs (NSAIDs), there has been concern about their cardiovascular safety. We studied the relative risk of acute myocardial infarction (AMI) among users of celecoxib, rofecoxib, and NSAIDs in Medicare beneficiaries with a comprehensive drug benefit.

Methods and Results—

We conducted a matched case-control study of 54 475 patients 65 years of age or older who received their medications through 2 state-sponsored pharmaceutical benefits programs in the United States. All healthcare use encounters were examined to identify hospitalizations for AMI. Each of the 10 895 cases of AMI was matched to 4 controls on the basis of age, gender, and the month of index date. We constructed matched logistic regression models including indicators for patient demographics, healthcare use, medication use, and cardiovascular risk factors to assess the relative risk of AMI in patients who used rofecoxib compared with persons taking no NSAID, taking celecoxib, or taking NSAIDs. Current use of rofecoxib was associated with an elevated relative risk of AMI compared with celecoxib (odds ratio [OR], 1.24; 95% CI, 1.05 to 1.46;
P
=0.011) and with no NSAID (OR, 1.14; 95% CI, 1.00 to 1.31;
P
=0.054). The adjusted relative risk of AMI was also elevated in dose-specific comparisons: rofecoxib ≤25 mg versus celecoxib ≤200 mg (OR, 1.21; 95% CI, 1.01 to 1.44;
P
=0.036) and rofecoxib >25 mg versus celecoxib >200 mg (OR, 1.70; 95% CI, 1.07 to 2.71;
P
=0.026). The adjusted relative risks of AMI associated with rofecoxib use of 1 to 30 days (OR, 1.40; 95% CI, 1.12 to 1.75;
P
=0.005) and 31 to 90 days (OR, 1.38; 95% CI, 1.11 to 1.72;
P
=0.003) were higher than >90 days (OR, 0.96; 95% CI, 0.72 to 1.25;
P
=0.8) compared with celecoxib use of similar duration. Celecoxib was not associated with an increased relative risk of AMI in these comparisons.

Conclusions—

In this study, current rofecoxib use was associated with an elevated relative risk of AMI compared with celecoxib use and no NSAID use. Dosages of rofecoxib >25 mg were associated with a higher risk than dosages ≤25 mg. The risk was elevated in the first 90 days of use but not thereafter.
Incidence and Case Fatality Rates of First-Ever Stroke in a Black Caribbean Population
Authors: Corbin David O.C. , Poddar Vishal , Hennis Anselm , Gaskin Angela , Rambarat Cecil , Wilks Rainford , Wolfe Charles D.A. , Fraser Henry S.
Published: April 2004

Background and Purpose—

Estimation of stroke incidence among black populations outside the USA and the UK has been hampered by the lack of community-based studies. We aimed to document the incidence of first-ever stroke in Barbados, a Caribbean island with a population of 268 000 people.

Methods—

A national community-based prospective register of first-ever strokes, using multiple overlapping sources of notification, was established.

Results—

During the first year, 352 patients (95.2% black) were registered, 142 males and 210 females (59.7%), with a mean age of 72.5 years (range 24 to 104; SD 14.8). Cerebral infarction (IS) occurred in 81.8%, intracerebral hemorrhage (ICH) in 11.9%, subarachnoid hemorrhage (SAH) in 2.0%, whereas 4.3% of strokes were unclassified (UC). The crude annual incidence rate for the black population was 1.40 (95% CI: 1.25,1.55) per 1000 (1.35 standardized to the European population) for all strokes, 1.20 (1.07,1.34) for IS, 0.18 (0.12,0.23) for ICH, and 0.03 (0.01,0.05) for SAH. Lacunar infarction (LACI) accounted for 50.7% of IS among the black population, whereas 15.6% and 26.8% were caused by total anterior circulation infarction (TACI) and partial anterior circulation infarction (PACI), respectively. At 7 and 28 days, respectively, case fatality rates for blacks were 13.1% and 27.8% for all strokes, 46.3% and 58.5% for ICH, 7.6% and 21.7% for IS, 32.6% and 65.1% for TACI, and 2.1% and 9.0% for LACI.

Conclusions—

Stroke incidence among the black population of Barbados is lower than among African-origin populations in the USA and UK. Lacunar infarction is the predominant stroke subtype.
Parathyroid Hormone-Related Peptide Is Required for Increased Trabecular Bone Volume in Parathyroid Hormone-Null Mice
Authors: Miao Dengshun , Li Jiarong , Xue Yingben , Su Hanyi , Karaplis Andrew C. , Goltzman David
Published: April 2004

We investigated the relative contributions of PTH and PTHrP to the skeletal phenotype of mice deficient in PTH (PTH−/−). PTH−/− mice and PTH−/− mice lacking one allele encoding PTHrP (PTH−/−PTHrP+/−) were compared. Both mutants displayed similar biochemical abnormalities of hypoparathyroidism, but skeletal PTHrP mRNA and protein were decreased in PTH−/−PTHrP+/ − mice. PTH−/− mice had increased trabecular bone volume with diminished bone turnover. PTHrP haploinsufficiency reduced trabecular bone of the PTH−/− mice to levels below those in wild-type animals by decreasing osteoprogenitor cell recruitment, enhancing osteoblast apoptosis, and diminishing bone formation. The results show that the increased trabecular bone volume in PTH-deficient mice is due to diminished PTH-induced osteoclastic bone resorption and persistent PTHrP-stimulated osteoblastic bone formation. They also illustrate the changing role of PTHrP during bone development, demonstrate its bone- forming function in the postnatal state, and support its pharmacological potential as an anabolic agent.
Structural variant of the intergenic internal ribosome entry site elements in dicistroviruses and computational search for their counterparts
Authors: HATAKEYAMA YOSHINORI , SHIBUYA NORIHIRO , NISHIYAMA TAKASHI , NAKASHIMA NOBUHIKO
Published: April 2004

The intergenic region (IGR) located upstream of the capsid protein gene in dicistroviruses contains an internal ribosome entry site (IRES). Translation initiation mediated by the IRES does not require initiator methionine tRNA. Comparison of the IGRs among dicistroviruses suggested that Taura syndrome virus (TSV) and acute bee paralysis virus have an extra side stem loop in the predicted IRES. We examined whether the side stem is responsible for translation activity mediated by the IGR using constructs with compensatory mutations. In vitro translation analysis showed that TSV has an IGR-IRES that is structurally distinct from those previously described. Because IGR-IRES elements determine the translation initiation site by virtue of their own tertiary structure formation, the discovery of this initiation mechanism suggests the possibility that eukaryotic mRNAs might have more extensive coding regions than previously predicted. To test this hypothesis, we searched full-length cDNA databases and whole genome sequences of eukaryotes using the pattern matching program, Scan For Matches, with parameters that can extract sequences containing secondary structure elements resembling those of IGR-IRES. Our search yielded several sequences, but their predicted secondary structures were suggested to be unstable in comparison to those of dicistroviruses. These results suggest that RNAs structurally similar to dicistroviruses are not common. If some eukaryotic mRNAs are translated independently of an initiator methionine tRNA, their structures are likely to be significantly distinct from those of dicistroviruses.
Setting Customer Expectation in Service Delivery: An Integrated Marketing-Operations Perspective
Authors: Ho Teck H. , Zheng Yu-Sheng
Published: April 2004

Service firms have increasingly been competing for market share on the basis of delivery time. Many firms now choose to set customer expectation by announcing their maximal delivery time. Customers will be satisfied if their perceived delivery times are shorter than their expectations. This gap model of service quality is used in this paper to study how a firm might choose a delivery-time commitment to influence its customer expectation, and delivery quality in order to maximize its market share. A market share model is developed to capture (1) the impact of delivery-time commitment and delivery quality on the firm's market share and (2) the impact of the firm's market share and process variability on delivery quality when there is a congestion effect. We show that the choice of the delivery-time commitment requires a proper balance between the level of service capacity and customer sensitivities to delivery-time expectation and delivery quality. We prove the existence of Nash equilibria in a duopolistic competition, and show that this delivery-time commitment game is analogous to a Prisoners' Dilemma.
Glucose Toxicity
Authors: Yki-Järvinen Hannele
Published: April 2004

Chronic hyperglycemia is not only a marker of the diabetes state but also a factor that itself worsens the diabetic state by impairing glucose‐induced insulin secretion and insulin sensitivity. In patients with type 1 diabetes, maintenance of excellent glycemic control early in the course of the disease prolongs remission by preserving insulin secretion and normalizing insulin sensitivity. In these patients, chronic hyperglycemia can be regarded as a major cause for peripheral insulin resistance. Consequently, if excellent glycemic control is achieved, insulin sensitivity is normal. In patients with type 2 diabetes, glucose toxicity concept is likely to explain at least part of the beneficial effects of exogenous insulin therapy and weight loss on endogenous insulin secretion and insulin sensitivity.
Dietary Management of Diabetes Mellitus: Japanese Guidance and Methodology
Authors: Baba Shigeaki , Nambu Seiki
Published: April 2004

The Japanese diet is widely known to be a healthy one, with a low risk for causing cardiovascular disease. Historically rooted, Japanese gastronomic culture is unique, and includes a wide variety of foodstuffs, original flavoring recipes, and fermentation methods. A distinctive Food Guide Pyramid for Japanese people and a meal log chart, evaluating eight major treatment assessments, have been created to aid dietary guidance. The results are represented diagrammatically in this chapter, with each of the treatment assessments being scored. Straightforward to understand, this guidance is stress‐free for the patient and helps ensure that the patient follows the appropriate dietary regimen.

Since diabetes treatment not only involves blood glucose level monitoring, but also the evaluation of the disease's complications course, the treatment assessments are made on a 3–6‐months timeframe. The case study results indicate that the dietary guidance based on the Food Guide Pyramid is useful and beneficial for treatment of the disease.
The Pathology of Diabetic Neuropathy
Authors: Thomas P. K.
Published: April 2004

The chapter attempts to describe the expected diversed underlying pathological alterations in patients with diabetes mellitus and to relate the changes to the clinical syndromes.
Nonretinal Ocular Complications of Diabetes Mellitus
Authors: Rand Lawrence I. , Cavallerano Jerry D. , Aiello Lloyd M.
Published: April 2004

All structures of the eye are susceptible to the deleterious effects of diabetes mellitus. Early diagnosis and treatment of diabetes mellitus, identification of ocular abnormalities, and patient education can mitigate many of these effects.
Self‐Organized Complex Patterning: Langmuir–Blodgett Lithography
Authors: Lenhert S. , Zhang L. , Mueller J. , Wiesmann H. P. , Erker G. , Fuchs H. , Chi L.
Published: April 2004

Self‐patterning monolayer films prepared by the Langmuir–Blodgett technique have been used as resists for anisotropic chemical etching of Si 〈100〉. The resulting topographies are transferred onto polymer surfaces to guide the growth of biological cells. This method allows rapid and simple nanolithography of complex nanopatterns over large areas.