bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuromedin U Neurones in the Rat Nucleus of the Tractus Solitarius are Catecholaminergic and Respond to Peripheral Cholecystokinin
Authors: Ivanov T. R. , Le Rouzic P. , Stanley P. J. , Ling W.‐Y. , Parello R. , Luckman S. M.
Published: June 2004

Centrally administered neuromedin U (NMU) has profound effects on food intake and energy expenditure. In the rat, central expression of NMU mRNA is confined to the brainstem and the hypothalamus/pituitary, while mRNA for the receptor NMU2R is expressed in the hypothalamus and hippocampus, as well as in the lining of the ventricular system, but not in the brainstem. We demonstrate that a subpopulation of catecholaminergic neurones in the brainstem nucleus of the tractus solitarius contain NMU and are activated by the gut‐derived peptide, cholecystokinin. This is consistent with NMU neurones having an anorectic action, probably via their interaction with other neurones in the paraventricular hypothalamus.
Association of caries and treatment experiences with subjective symptoms of temporomandibular disorders in female adolescents
Authors: Takehara J. , Honda O. , Morita M.
Published: June 2004

summary  A 2‐year cohort study of subjective symptoms of temporomandibular disorders (TMD) was performed. A total of 229 female adolescents, all 15 years of age, completed questionnaires and underwent dental examinations at baseline, 1‐ and 2‐year follow‐up surveys. The questionnaire included questions on typical TMD symptoms; i.e. temporomandibular joint (TMJ) noise, tiredness in jaws, pain on jaw movements, and difficulty in mouth opening. The relative risk was computed to determine the relationships of the baseline number of filled teeth (FT) and decayed, missing and filled teeth (DMFT) increment with the incidence of TMD. The percentage of subjects with one or more subjective symptoms at 17 years of age was 30·6%, significantly higher than the percentages at 15 (17·0%) and 16 (19·7%) years of age (P < 0·01). The symptom‐emerging rate of TMJ noise during the 2‐year period was 13·5%, which was the highest among the rates of possible subjective symptoms. Individuals with a 2‐year increment in DMFT of ≥2 had a 2·14‐times increased risk of experiencing mild symptoms, and individuals with baseline FT of ≥3 had 2·41‐times increased risk of experiencing mild or severe subjective symptoms. The results of this study showed that TMD symptoms occurred in a relatively high percentage of female adolescents during the 2‐year period and suggested that DMFT is one factor affecting the incidence of TMD.
Frequency spectrum of condylar movement in clinically normal subjects, using an amorphous sensor
Authors: Ioi H. , Counts A. L.
Published: June 2004

summary  The purpose of this study was to determine the properties of the frequency spectrum produced by condylar movements in normal subjects, by the use of an amorphous sensor. The gender‐matched sample consisted of white people (17 males and 17 females, aged 25·8 ± 2·5 and 25·5 ± 2·8 years, respectively) who had no subjective or objective symptoms related to temporomandibular joint sounds. Bilateral condylar and jaw movements were recorded simultaneously. The results showed that the mean ± standard deviation (s.d.) for the mean frequency of condylar movement during the opening and closing phases was 45·0 ± 5·2 and 47·0 ± 3·5 Hz, respectively. The mean ± s.d. for the peak frequency of condylar movement during the opening and closing phases was 46·6 ± 8·0 and 49·7 ± 4·5 Hz, respectively. Significant correlations existed between the left and right sides in the mean frequency as well as the peak frequency during the opening phase. However, there were no significant correlations between the left and right sides in the mean frequency or the peak frequency during the closing phase. These results suggest that the frequency spectrum of normal condylar movement can be obtained when using the amorphous sensor.
A comparison of fracture strength of yttrium‐oxide‐ partially‐stabilized zirconia ceramic crowns with varying core thickness, shapes and veneer ceramics
Authors: Sundh A. , Sjögren G.
Published: June 2004

summary  The fracture strengths of stylized all‐ceramic crowns manufactured using an yttrium‐oxide‐partially‐stabilized (Y‐TZP) zirconia ceramic core (Denzir) veneered with lithium disilicate glass‐ceramics (IPS Empress 2 or IPS Eris) were evaluated. The Denzir cores were manufactured in two ways: either with different thickness in different parts of the restoration, called an ‘adapted Denzir core’; or with a uniform core thickness of 0·5 mm. IPS Empress 2 all‐ceramic crowns served as reference. There was no significant difference between the crowns with an ‘adapted Denzir core’ veneered with the two brands of glass‐ceramics. No significant difference was seen between the crowns with a 0·5 mm Denzir core veneered with the two brands of glass‐ceramics. The crowns with an ‘adapted Denzir core’ exhibited significantly higher values than those with a 0·5 mm Denzir core and than the IPS Empress 2 crowns used as reference. No significant differences were seen among the IPS Empress 2 crowns used as reference and the crowns with a 0·5 mm Denzir core. The mode of failure varied among the Empress 2 crowns and the crowns with a core of a Y‐TZP zirconia ceramic. Long‐term studies are necessary to assess the clinical performance of this restorative system.
The release of ions by compomers under neutral and acidic conditions
Authors: Nicholson J. W. , Czarnecka B.
Published: June 2004

summary  Three commercial compomers have been studied for their interaction with aqueous solutions (i.e. water at pH 5·9 and lactic acid at pH 2·7). Light‐cured discs of these materials (12·8 diameter × 1 mm depth; Dyract AP, Compoglass F and F2000) were prepared and stored in 5 cm3 of either water or lactic acid at pH 2·7. After 1 week, mass changes, pH changes and ion‐release were determined. For the specimens stored in water, the effect of maturation under neutral conditions was studied by continuing storage for 3 months, followed by storage in lactic acid for a further week after which ion release and pH change were determined. Student's t‐test was used to determine statistical significance of any changes observed. All three cured compomers absorbed water and altered the pH of the solutions, though this was statistically significant only in lactic acid. They were found to release Na, Ca, Sr, Al, Si, P and F ions, with greater amounts being released in acidic conditions than neutral ones. More fluoride was released in acid than in water, but the proportion of free (uncomplexed) fluoride to bound (complexed) fluoride was much lower than in neutral conditions. This was attributed to the formation of strong complexes with aluminium. Maturing specimens for 3 months made very little difference to their interaction with the acid solution, except for the total release of fluoride, which was some two to three greater than from the immature specimens.
Measurement of the setting expansion of phosphate‐bonded investment materials: Part II – An evaluation of the Casting‐Ring Test at 10 laboratories
Authors: Lloyd C. H. , Yearn J. A. , Cowper G. A. , Gentens K.
Published: June 2004

summary  The Casting‐Ring Test has the potential to fulfil the requirement for a reliable ‘Standard’ test to measure the setting expansion of phosphate‐bonded investment materials. The purpose of this study was to investigate the reproducibility of the measurements and the value that is produced at 10 test sites. The Casting‐Ring Test apparatus, three phosphate‐bonded investment products and one ring liner product were sent to the 10 participants, together with a detailed test protocol. Participants were asked to use their normal vacuum mixers. Reproducibility at individual sites was good. However, there were significant differences between test sites for the mean setting expansions, attributed to the range of vacuum mixers employed. From these results, the Casting‐Ring Test appears to satisfy the requirements for adoption as an ISO standard test. The effect produced by different vacuum‐mixer models would be manifest in any test. Not only does this have implications when determining the value of setting expansion for product information, but such a range of setting expansions will also be reproduced during production of moulds in commercial dental laboratory practice. However, for any specific product and vacuum‐mixer combination, the setting expansion will be consistent and will not vary from mould to mould.
Distribution of fimA genotypes of Porphyromonas gingivalis in subjects with various periodontal conditions
Authors: Missailidis C. G. , Umeda J. E. , Ota‐Tsuzuki C. , Anzai D. , Mayer M. P. A.
Published: June 2004

Fimbria encoded by the gene fimA is considered one of the main factors in the colonization of the oral cavity by Porphyromonas gingivalis. Allelic variation in fimA led to the classification of strains of P. gingivalis into six genotypes. The occurrence of P. gingivalis was determined by polymerase chain reaction using 16S rRNA primers in 302 subgingival samples obtained from 102 Brazilian subjects exhibiting different periodontal conditions. Distribution of fimA genotypes was assessed in 146 P. gingivalis positive samples by polymerase chain reaction using primers pairs homologous to the different fimA genes. P. gingivalis was detected in 51 of 57 (89.4%) patients with periodontal attachment loss, in six of 20 gingivitis patients (30.0%) and in two of 25 (8.0%) subjects with a healthy periodontium. Variant type II was the only type detected in 53 sites (39.3%), distributed among 19 periodontitis patients (37.3%) and in one patient with no periodontal destruction. Type Ib was the second most prevalent genotype in periodontitis patients (19.6%). Genotype V was not detected in the studied population. Type IV was the most commonly type found among gingivitis patients, either alone or in combination with other genotypes. Multiple genotypes were detected in nine sites (6.1%). A fimA genotype was not identified in 26 sites (17.8%) of 146 sites positive for P. gingivalis, suggesting that other alleles of fimA not yet sequenced may be prevalent in this population. These data demonstrated that P. gingivalis type II strains followed by type Ib are more prevalent in periodontitis patients from a multiracial population in Brazil, suggesting an increased pathogenic potential of these types.
Detection of Epstein–Barr virus in saliva by real‐time PCR
Authors: Idesawa M. , Sugano N. , Ikeda K. , Oshikawa M. , Takane M. , Seki K. , Ito K.
Published: June 2004

The purpose of this investigation was to assess the salivary levels of Epstein–Barr virus (EBV) in patients with periodontitis using real‐time PCR. EBV was detected in 16 out of 33 (48.5%) periodontitis patients and in 3 out of 20(15%) healthy subjects. The baseline mean values for bleeding on probing in EBV‐positive patients were significantly higher than those in EBV‐negative patients. A significant decrease in EBV levels was observed after initial periodontal treatment. Our findings indicate that levels of EBV in saliva may reflect the status of periodontal inflammation.
Alkyl hydroperoxide peroxidase subunit C (ahpC) protects against organic peroxides but does not affect the virulence of Porphyromonas gingivalis W83
Authors: Johnson N. A. , Liu Y. , Fletcher H. M.
Published: June 2004

The cloned Porphyromonas gingivalis alkyl hydroperoxide reductase (ahpC) gene complemented an ahpC defect in Escherichia coli. To study the role of ahpC in protecting against oxidative stress in P. gingivalis a 1.8 kb fragment containing the ahpC gene was amplified from the chromosome of P. gingivalis W83. This gene was insertionally inactivated using the ermF‐ermAM antibiotic resistance cassette and used to create a ahpC‐deficient mutant by allelic exchange. One mutant strain, designated FLL141, demonstrated no change in the growth rate, black pigmentation, beta‐hemolysis or level of proteolytic activity compared to the parent strain. Although P. gingivalis FLL141 was more sensitive to hydrogen peroxide than the parent strain, there was no change in its virulence potential in the mouse model compared to the wild‐type strain. These findings suggest that the ahpC gene plays a role in peroxide resistance in P. gingivalis but does not contribute significantly to virulence.
Modulation of the antibody response by Porphyromonas gingivalis and Fusobacterium nucleatum in a mouse model
Authors: Gemmell E. , Bird P. S. , Ford P. J. , Ashman R. B. , Gosling P. , Hu Y. , Seymour G. J.
Published: June 2004

Successive immunization of mice with Fusobacterium nucleatum and Porphyromonas gingivalis has been shown to modulate the specific serum IgG responses to these organisms. The aim of this study was to investigate these antibody responses further by examining the IgG subclasses induced as well as the opsonizing properties of the specific antibodies. Serum samples from BALB/c mice immunized with F. nucleatum (gp1‐F), P. gingivalis (gp2‐P), P. gingivalis followed by F. nucleatum (gp3‐PF) F. nucleatum followed by P. gingivalis (gp4‐FP) or saline alone (gp5‐S) were examined for specific IgG1 (Th2) and IgG2a (Th1) antibody levels using an ELISA and the opsonizing properties measured using a neutrophil chemiluminescence assay. While IgG1 and IgG2a subclasses were induced in all immunized groups, there was a tendency towards an IgG1 response in mice immunized with P. gingivalis alone, while immunization with F. nucleatum followed by P. gingivalis induced significantly higher anti‐P. gingivalis IgG2a levels than IgG1. The maximum light output due to neutrophil phagocytosis of P. gingivalis occurred at 10 min using nonopsonized bacteria. Chemiluminescence was reduced using serum‐opsonized P. gingivalis and, in particular, sera from P. gingivalis‐immunized mice (gp2‐P), with maximum responses occurring at 40 min. In contrast, phagocytosis of immune serum‐opsonized F. nucleatum demonstrated peak light output at 10 min, while that of F. nucleatum opsonized with sera from saline injected mice (gp5‐S) and control nonopsonized bacteria showed peak responses at 40 min. The lowest phagocytic response occurred using gp4‐FP serum‐opsonized F. nucleatum. In conclusion, the results of the present study have demonstrated a systemic Th1/Th2 response in mice immunized with P. gingivalis and/or F. nucleatum with a trend towards a Th2 response in P. gingivalis‐immunized mice and a significantly increased anti‐P. gingivalis IgG2a (Th1) response in mice immunized with F. nucleatum prior to P. gingivalis. Further, the inhibition of neutrophil phagocytosis of immune serum‐opsonized P. gingivalis was modulated by the presence of anti‐F. nucleatum antibodies, while anti‐P. gingivalis antibodies induced an inhibitory effect on the phagocytic response to F. nucleatum.
Role of Candida albicans polymorphism in interactions with oral epithelial cells
Authors: Villar C. C. , Kashleva H. , Dongari‐Bagtzoglou A.
Published: June 2004

Background:  Candida albicans is a polymorphic organism which undergoes morphologic transition between yeast, pseudohyphal and hyphal forms. The ability of C. albicans to change from yeast to filamentous types is a major virulence determinant of this organism. However, the exact role of hyphal transformation in establishing oral mucosal infection is still poorly understood.

Methods:  In this study we used mutants with defects in filamentation, as well as oral strains, which differ in their capacity to form true hyphae, to examine the role of hyphal transformation in the interactions of C. albicans with oral epithelial cells in vitro. These interactions included the ability of these strains to adhere to and injure epithelial cells, as well as their ability to trigger a proinflammatory cytokine response.

Results:  We found that strains SC5314 and ATCC28366 formed true hyphae on epithelial cells, whereas strain ATCC32077 and the tup1/tup1 mutant formed only pseudohyphae. Double mutant efg1/efg1cph1/cph1 grew exclusively as blastospores. We also found that yeast and pseudohyphal strains showed reduced adherence capacity to oral keratinocytes and caused minimal cell damage. Moreover, we showed that both yeast and pseudohyphal forms have a strongly attenuated proinflammatory phenotype, since they failed to induce significant interleukin (IL)‐1α and IL‐8 responses by oral epithelial cells.

Conclusions:  Germination of C. albicans into true hyphae is particularly important in the interactions with oral epithelial cells in vitro.
Dietary prevention of allergic diseases in infants and small children.
Authors: Muraro Antonella , Dreborg Sten , Halken Susanne , Høst Arne , Niggemann Bodo , Aalberse Rob , Arshad Syed H. , Berg Andrea von , Carlsen Kai‐Håkon , Duschén Karel , Eigenmann Philippe , Hill David , Jones Catherine , Mellon Michael , Oldeus Göran , Oranje Arnold , Pascual Cristina , Prescott Susan , Sampson Hugh , Svartengren Magnus , Vandenplas Yvan , Wahn Ulrich , Warner Jill A. , Warner John O. , Wickman Magnus , Zeiger Robert S.
Published: June 2004

The role of primary prevention of allergic diseases has been a matter of debate for the last 40 years. In order to shed some light into this issue a group of experts of the Section of Pediatrics EAACI critically reviewed the existing literature on the subject. The design of observational and interventional studies was evaluated with relevance to the important factors influencing outcome of studies on allergy development/prevention. In this analysis the statements of evidence as defined by WHO were applied. Best evidence of recommendations are those fulfilling the criteria for statements category 1 and 2 and grade of recommendations A and B as proposed by WHO. This survey include target group for dietary prevention and methods and diagnostic criteria of atopic dermatitis, asthma and food allergy for prevention studies.
Clinical applications of real‐time PCR for diagnosis and treatment of human cytomegalovirus infection in children
Authors: Chen Fen Hua , Samson Karen Thursday , Chen Hong , Pan Si Nian , He Zheng Xian , Iikura Yoji , Shioda Seija
Published: June 2004

There are many methods of detecting human cytomegalovirus (HCMV) infection. So far, the quantitative polymerase chain reaction (PCR) has been very useful not only in aiding in the diagnosis of HCMV but also in determining the severity and predicting HCMV infection. However, it is time‐consuming and labor intensive. Real‐time PCR (RT‐PCR) is an exception, for it allows rapid quantification of HCMV DNA load. Our group used this method for detecting and monitoring HCMV and compared it with the diagnostic criterion recommended by the Pediatric Branch of Chinese Medical Association, in 45 children suspected of having HCMV infection. The response to two types of antiviral treatment on HCMV DNA load was also monitored in HCMV hepatitis cases. RT‐PCR was positive in 30 cases while the diagnostic criterion, which includes enzyme‐linked immunosorbent assay (ELISA) and/or conventional PCR, was positive in 32 cases. The decrease in the HCMV DNA load was achieved earlier in the modified treatment group compared with the conventional treatment group. A 103 copies/ml of HCMV DNA load of is a useful cut‐off value in predicting patients who will have symptoms of the disease. RT‐PCR can be used not only in detecting HCMV but also in monitoring response to antiviral treatment and risk of having symptoms of the disease.
Childhood severe acute respiratory syndrome, coronavirus infections and asthma
Authors: Van Bever Hugo P. , Chng Seo Yi , Goh Daniel Y.
Published: June 2004

Severe acute respiratory syndrome (SARS) is a new infectious disease caused by a novel coronavirus. Children appear to be less susceptible to the SARS coronavirus, although the other non‐SARS coronaviruses can cause respiratory infections in adults and in children of all ages. The exact reasons as to why SARS preferentially affects adults, and not children, are still unknown. Many hypotheses exist and need to be explored. During the outbreak of SARS, there did not appear to be an increase in asthma exacerbations in children.
Penicillin sensitivity among children without a positive history for penicillin allergy
Authors: Cetinkaya Feyzullah , Cag Yakup
Published: June 2004

To establish the prevalence of positive penicillin skin tests among outpatients without any drug reaction history. Skin testing was performed in 147 children (aged 6–13 years) who had had received a penicillin preparation at least three times in the last 12 months without any allergic reaction. Before testing, detailed pediatric and allergy history were learned and then all children were tested with benzyl penicilloyl polylysin (PPL) and mixture of minor antigenic determinants. The test procedures were made epidermally and intradermally subsequently in every subject. The overall frequency of positive skin reactions to penicillin antigens was 10.2%. A mild systemic reaction was observed in one of the children during testing with PPL. We concluded that frequent use of penicillin and other β‐lactam antibiotics leads to sensitization of children in our study population despite these children seem to be asymptomatic during testing time.
IgE testing in capillary blood
Authors: Stapel Steven O. , Eysink Petra E. D. , de Vrieze Janny , Aalberse Rob C.
Published: June 2004

Serologic IgE testing is generally performed using serum, obtained by venepuncture. We tested whether paper‐absorbed and eluted capillary blood, obtained by a less invasive method (finger prick) could be used for allergy testing in young children. This was performed by comparative IgE testing, using paper‐absorbed blood/serum and serum. Practical applicability of the procedure was tested by assaying paper‐absorbed and eluted blood, obtained from 640 children with complaints of prolonged coughing, for IgE to airborne allergens. We found that IgE testing, using paper‐absorbed/eluted material and serum yields virtually identical results (mean ratio for positive samples: 1.01, 95% confidence interval: 0.58–1.75). Blood spot testing revealed that sensitization to inhalant allergens is not uncommon in preschool children (13% positive radioallergosorbent test [RAST] tests), which means that this procedure is a useful method for assaying allergic sensitization in children.
Serum leptin level in children with atopic dermatitis‐treated topical steroids
Authors: Bostanci İlknur , Atli Özlem , Çelebı Nermin , Taşar Ayşin , Alpkarakoç Esra , Dallar Yıldız
Published: June 2004

Leptin, the obese gene product, is a 16‐kDa peptide hormone secreted by adiposities. Systemic administration of exogenous glucocorticoids has been found to increase circulating leptin levels. In this study, we aimed to assess serum leptin in children with atopic dermatitis (AD)‐treated with local steroids. Twenty children with AD were included during the 2001–2002 time period. The study was conducted prospectively. Atopy was defined as the presence of at least one aeroallergen‐specific immunoglobulin E (IgE) antibody. Serum leptin was determined using a commercially available radioimmunoassay kit with 3.4–8.3% intra‐assay and 3.0–6.2% interassay coefficients of variation, and 0.5 ng/ml sensitivity. Fourteen boys and six girls with AD, the mean age of the patients was 3.1 ± 2.2. Forty‐three percentage of the family histories for atopy were positive, 60% of the cases passive smoking histories were positive. In seven patients the aeroallergen‐specific IgE were positive. All 20 patients treated clobetasone 17‐butirate (0.05%). There was no significant difference in serum leptin between patients (mean ± s.d.: 4.6 ± 3.8), and controls (mean ± s.d.: 6.2 ± 3.6) (p > 0.05). Local steroid does not influence circulating leptin levels, suggesting that regulation of body weight is unaffected.
Allergy to banana in a 5‐month‐old infant
Authors: Moreno‐Ancillo Álvaro , Domínguez‐Noche Carmen , Gil‐Adrados Ana C. , Cosmes Pedro M.
Published: June 2004

Food proteins can sensitize the infants via different sources. A 5‐month‐old boy suffered three episodes of generalized urticaria 20 min after the ingestion of a fruit purée containing apple, banana and orange. Skin testing showed positive results to banana and chestnut. Other tests were negative. The value of specific immunoglobulin E (Pharmacia CAP‐FEIA, Uppsala, Sweden) to banana was 58 KU/l, to orange was 9.7 KU/l, to chestnut was 5.6 KU/l and to latex was 1.6 KU/l. Orange, apple and latex products were well tolerated. He never had eaten chestnut. The parents rejected a banana challenge test. The route of sensitization in our case might be via placenta, breast‐milk, and inadvertent oral intake of food or even via inhalation. An early frequent exposure to banana allergens was considered a possibility factor for the development of banana sensitization. We found that the banana consumption during pregnancy and lactation by the mother of our patient was greater than usual. It is not frequent to find so high levels of sensitization to any fruit in first year of life. In our case, latex, chestnut and orange sensitizations did not seem to be clinically relevant. However, latex and foods known to cross‐react with banana antigens should be given to banana‐sensitive individuals with great caution.
Safety and efficacy of oral fexofenadine in children with seasonal allergic rhinitis – a pooled analysis of three studies
Authors: Meltzer Eli O. , Scheinmann Pierre , Rosado Pinto Jose E. , Bachert Claus , Hedlin Gunilla , Wahn Ulrich , Finn Albert F. , Ruuth Erik
Published: June 2004

Allergic rhinitis is one of the most common clinical conditions in children; however, data regarding the safety of antihistamines in children with seasonal allergic rhinitis are limiting. To evaluate the safety and efficacy of fexofenadine in children with seasonal allergic rhinitis, data were pooled from three, double‐blind, randomized, placebo‐controlled, parallel‐group, 2‐week trials in children (6–11 year) with seasonal allergic rhinitis. All studies assessed fexofenadine HCl 30 mg b.i.d.; two studies included fexofenadine HCl at 15 and 60 mg b.i.d. Patients (and investigators) reported any adverse events during the trial. Physical examinations, including measurements of vital signs and laboratory tests, were performed. Efficacy assessments (total symptom score and individual symptom scores) were evaluated. Exposure to fexofenadine HCl 30 mg b.i.d. and to any fexofenadine dose exceeded 10,000 and 17,000 patient days, respectively. Incidences of adverse events, and discontinuations because of adverse events, were low and similar across treatment groups. In the placebo group, 24.4% of subjects reported adverse events compared with 24.1% for fexofenadine HCl 30 mg b.i.d., and 28.4% for all fexofenadine‐treated groups. The most common adverse event overall was headache (4.3% placebo; 5.8% fexofenadine HCl 30 mg b.i.d.; and 7.2% any fexofenadine doses). Treatment‐related adverse events were similar across treatment groups with no sedative effects. Fexofenadine HCl 30 mg b.i.d. was significantly superior to placebo in reducing the total symptom score and all individual seasonal allergic rhinitis symptoms, including nasal congestion (p < 0.05). Fexofenadine, at doses of up to 60 mg b.i.d., is safe and non‐sedating, and fexofenadine HCl 30 mg b.i.d. effectively reduces all seasonal allergic rhinitis symptoms in children aged 6–11 years.
Classification of perinatal deaths: Development of the Australian and New Zealand classifications
Authors: Chan A , King JF , Flenady V , Haslam RH , Tudehope DI
Published: June 2004

Abstract:  Classifications of perinatal deaths have been undertaken for surveillance of causes of death, but also for auditing individual deaths to identify suboptimal care at any level, so that preventive strategies may be implemented. This paper describes the history and development of the paired obstetric and neonatal Perinatal Society of Australia and New Zealand (PSANZ) classifications in the context of other classifications. The PSANZ Perinatal Death Classification is based on obstetric antecedent factors that initiated the sequence of events leading to the death, and was developed largely from the Aberdeen and Whitfield classifications. The PSANZ Neonatal Death Classification is based on fetal and neonatal factors associated with the death. The classifications, accessible on the PSANZ website (http://www.psanz.org), have definitions and guidelines for use, a high level of agreement between classifiers, and are now being used in nearly all Australian states and New Zealand.
Should routine childhood immunizations be compulsory?
Authors: Isaacs D , Kilham HA , Marshall H
Published: June 2004

Abstract:  Routine childhood immunizations are compulsory in a small number of countries, including the United States of America. Arguments used to justify making immunizations compulsory include enhancing the health of the community and treating as paramount the rights of the child to be protected against vaccine‐preventable diseases. But compulsory immunization infringes the autonomy of parents to make choices about child rearing, an autonomy which we generally respect unless doing so seriously endangers the child's health. We present a historical review and ethics discussion on whether routine childhood immunizations should be compulsory. We conclude that, for both ethical and practical reasons, routine immunization should not be compulsory if adequate levels of immunization can be achieved by other means.
Sigmoidoscopy in children with chronic lower gastrointestinal bleeding
Authors: Mandhan P
Published: June 2004

Objective:  This study was done to assess the role of rigid sigmoidoscopy in diagnosis and prognosis of children with chronic and minor lower gastrointestinal bleeding.

Methods:  Retrospective review of the clinical notes of children under 15 years of age with minor and chronic lower gastrointestinal bleeding who had rigid sigmoidoscopy and biopsy between October 1998 and April 2002 at Liaquat Medical College Hospital, Hyderabad, Pakistan. Demographic data, clinical presentation, morbidity, sigmoidoscopic and histopathological findings were analysed to determine the role of rigid sigmoidoscopy in the management of rectal bleeding in children.

Results:  A total of 229 sigmoidoscopic examinations were carried out in 207 children with a mean age of 6 years. Seventy‐seven per cent (160) of children were symptomatic for a year or more. Causes of bleeding were juvenile colorectal polyps (155 cases; 75%), non‐specific proctitis (38 cases; 18%), solitary rectal ulcer (seven cases; 3.5%), lymphoid nodular hyperplasia (six cases, 3%) and foreign body (betel nuts) impaction (one case; 0.5%). Polyps were mostly in the rectosigmoid region and solitary in 136 (88%) children. All polyps were removed by rigid sigmoidoscopy. Histological examination of 137 polyps revealed juvenile type in 136 (99%) cases and low‐grade dysplastic changes in one patient. Non‐specific proctitis (n = 38) was confirmed histologically in 92% (n = 35) of cases and it was self‐limiting in 86% of cases. Other findings include solitary rectal ulcer in seven, lymphoid nodular hyperplasia in six and telangiectasic (pyogenic) granuloma in one patient.

Conclusion:  Rigid sigmoidoscopy was useful in diagnosis, treatment and prognostic evaluation of children with chronic and minor lower gastrointestinal bleeding. Final diagnosis was confirmed by histopathology.
Measurement of resting energy expenditure in infants
Authors: Bines JE , Truby HD
Published: June 2004

Objective:  The method for measurement of basal metabolic rate (BMR) using indirect calorimetry in adults is well established but is impractical in infants.

Methods:  In this prospective study energy expenditure was measured using indirect calorimetry in 14 infants when sleeping and when lying quietly awake.

Results:  Sleeping metabolic rate (SMR) was lower than energy expenditure (EE) measured in the same infants in a quiet resting state (mean difference [SD]: 297 [162] kJ/d; P < 0.005; 55 [33.4] kJ/kg per day; P < 0.005). The correlation within individuals suggests that these differences are related to the level of arousal. Awake EE, but not SMR, was significantly greater than estimated BMR using the FAO/WHO/UNU predictive equation.

Conclusions:  In infants, the level of arousal during measurement of EE can significantly impact on the interpretation of EE results. A standardized method for the measurement of EE in infants using indirect calorimetry is proposed.
Intussusception in neonates: Analysis of 14 Japanese patients
Authors: Ueki I , Nakashima E , Kumagai M , Tananari Y , Kimura A , Fukuda S , Hashimoto T
Published: June 2004

Objective:  To clarify the clinical features and pathogenesis of intussusception in neonates.

Methods:  Fourteen neonates were diagnosed with intussusception between June 1974 and January 2001. Patients were divided into two groups according to whether or not signs were present on the first day of life. The clinical features were interrelated with the pathological findings.

Results:  All six patients in the group whose signs were present on the first day of life also had intestinal atresia or malrotation. Among patients whose signs began less than 24 h after birth, five of eight patients suffered hypoxia. Moreover, it was very difficult to establish the diagnosis of intussusception, particularly in the group of late‐onset type intussusception.

Conclusions:  Hypoxic events may play a crucial aetiologic role in the pathogenesis of late‐onset neonatal intussusception.
Paediatric Tolosa‐Hunt syndrome
Authors: Yeung MC , Kwong KL , Wong YC , Wong SN
Published: June 2004

Abstract:  Tolosa‐Hunt syndrome is characterized by a dull, persistent pain around the affected eye, ophthalmoplegia and, sometimes, involvement of other cranial nerves passing through the cavernous sinus. Corticosteroid administration is valuable in the treatment and frequently has a dramatic effect. We report a boy with Tolosa‐Hunt syndrome who fails to respond to the initial steroid treatment. The role of the MRI in the management of this condition is discussed.
Personality disorder comorbidity among patients with bipolar I disorder in remission
Authors: Tamam Lut , Ozpoyraz Nurgul , Karatas Gonca
Published: June 2004

Background:

Comorbid personality disorders have been shown to be a prominent factor affecting symptom severity and course in bipolar disorder (BD) patients. Bipolar patients with personality disorder had more relapses, poorer prognosis and worse treatment response than those without an axis II diagnosis.

Objective:

We evaluated the prevalence rate of comorbid personality disorder in 74 bipolar I disorder cases who were in remission and tried to elucidate the possible relationship between comorbid axis II disorders and prognosis, severity and treatment features of BD cases.

Methods:

Diagnosis of all personality disorder comorbidities was evaluated using the Structured Clinical Interview for DSM-III-R Axis-II Disorders (SCID-II), while the general psychopathology level was assessed using the Symptom Check List (SCL-90-R). A questionnaire for acquiring sociodemographic and clinical variables was also used.

Results:

Sixty-two per cent of bipolar I patients in this sample had at least one comorbid axis II disorder. The most common comorbid cluster of personality disorder was cluster C (48.6%), followed by cluster A (25.7%) and cluster B (20.3%) personality disorders. Assessment of demographic and clinical variables revealed that bipolar patients with comorbid personality disorder were mainly female, had multiple affective episodes, and had attempted suicide more often than patients without personality disorder.

Conclusions:

The results of this study suggest that comorbid personality disorder might alter the course of BD and result in a poorer prognosis and more severe psychopathology. Further prospective controlled studies minimizing the bias of interviewers and other confounding factors would help us to understand the pure impact of personality disorder on the course of BD, its prognosis and response to treatment.
Simultaneous Deficiency in CD28 and STAT6 Results in Chronic Ectoparasite-Induced Inflammatory Skin Disease
Authors: Liu Qian , Arseculeratne Cristin , Liu Zhugong , Whitmire Jeannette , Grusby Michael J. , Finkelman Fred D. , Darling Thomas N. , Cheever Allen W. , Swearengen James , Urban Joseph F. , Gause William C.
Published: June 2004

A mouse lacking CD28, a T-cell costimulatory molecule, and STAT6, a transcription factor that mediates interleukin-4 (IL-4) signaling, was developed from parental CD28- and STAT6-deficient mice. STAT6/CD28−/−BALB/c mice that were 8 weeks old had a normal phenotype, and IL-4 production was induced following infection with nematode parasites. Unexpectedly, when they were between 4 and 8 months old, all mice examined spontaneously developed severe chronic dermatitis associated with pronounced numbers ofDemodexectoparasites. In addition, pronounced CD4 and CD8 T-cell infiltrates in the dermis and subcutaneous fat, increased serum immunoglobulin G2a levels, and lymphadenopathy associated with increased gamma interferon and IL-12 expression were observed. Single-knockout siblings lacking either CD28 or STAT6 had a phenotype similar to that of BALB/c wild-type controls. To distinguish whether the ectoparasiteDemodexor the Th1 immunity was the proximal cause of the inflammatory skin disease, STAT6/CD28−/−mice were treated with a miticide that eliminated the ectoparasites. This treatment markedly reduced the severity of the dermatitis and the associated lymphoid infiltrates. These findings suggest that ubiquitous ectoparasites, which are generally considered to be commensal, may contribute to disease when specific molecules required for an effective Th2 response are blocked.
Identification of
Porphyromonas gingivalis
Genes Specifically Expressed in Human Gingival Epithelial Cells by Using Differential Display Reverse Transcription-PCR
Authors: Park Yoonsuk , Yilmaz Özlem , Jung Il-Young , Lamont Richard J.
Published: June 2004

Porphyromonas gingivalis
, one of the causative agents of adult periodontitis, can invade and survive within host epithelial cells. The molecular mechanisms by which
P. gingivalis
induces uptake and adapts to an intracellular environment are not fully understood. In this study, we have investigated the genetic responses of
P. gingivalis
internalized within human gingival epithelial cells (GECs) in order to identify factors involved in invasion and survival. We compared the differential display of arbitrarily PCR-amplified gene transcripts in
P. gingivalis
recovered from GECs with the display of transcripts in
P. gingivalis
control cultures. Over 20 potential differentially expressed transcripts were identified. Among these,
pepO
, encoding an endopeptidase, and genes encoding an ATP-binding cassette (ABC) transporter and a cation-transporting ATPase were upregulated in GECs. To investigate the functionality of these gene products, mutants were generated by insertional inactivation. Compared to the parental strain, mutants of each gene showed a significant reduction in their invasion capabilities. In addition, GEC cytoskeletal responses to the mutants were distinct from those induced by the parent. In contrast, adhesion of the mutant strains to GECs was not affected by lack of expression of the gene products. These results suggest that PepO, a cation-transporting ATPase, and an ABC transporter are required for the intracellular lifestyle of
P. gingivalis
.
A Limited Antigen-Specific Cellular Response Is Sufficient for the Early Control of
Mycobacterium tuberculosis
in the Lung but Is Insufficient for Long-Term Survival
Authors: Turner Joanne , Dobos Karen M. , Keen Marc A , Frank Anthony A. , Ehlers Stefan , Orme Ian M. , Belisle John T. , Cooper Andrea M.
Published: June 2004

Mice that were transgenic for a T-cell receptor (TCR) specific for ovalbumin peptide
323-339
(DO11.10) were able to survive an infection with
Mycobacterium tuberculosis
for approximately 80 days. This limited early control of infection was associated with gamma interferon production, inducible nitric oxide synthase expression within the lung, and an influx of clonotypic lymphocytes. The control of
M. tuberculosis
was lost in DO11.10 mice bred in a
rag
mutant background, demonstrating that the immune responsiveness was recombinase dependent and likely to be associated with the expression of an alternative α TCR by DO11.10 mice. A characterization of the antigen specificity in DO11.10 TCR transgenic mice demonstrated that the specificity was limited and dominated by the 26-kDa (Rv1411c) lipoprotein of
M. tuberculosis
. This study identifies this lipoprotein as an important and potent inducer of protective T cells within the lungs of mice infected with
M. tuberculosis
and therefore as a possible target for vaccination.
ITIH4 (Inter-Alpha-Trypsin Inhibitor Heavy Chain 4) Is a New Acute-Phase Protein Isolated from Cattle during Experimental Infection
Authors: Piñeiro M. , Andrés M. , Iturralde M. , Carmona S. , Hirvonen J. , Pyörälä S. , Heegaard P. M. H. , Tjørnehøj K. , Lampreave F. , Piñeiro A. , Alava M. A.
Published: June 2004

We have isolated from calf serum a protein with an apparent
M
r
of 120,000. The protein was detected by using antibodies against major acute-phase protein in pigs with acute inflammation. The amino acid sequence of an internal fragment revealed that this protein is the bovine counterpart of ITIH4, the heavy chain 4 of the inter-alpha-trypsin inhibitor family. The response of this protein in the sera was determined for animals during experimental bacterial and viral infections. In the bacterial model, animals were inoculated with a mixture of
Actinomyces pyogenes
,
Fusobacterium necrophorum
, and
Peptostreptococcus indolicus
to induce an acute-phase reaction. All animals developed moderate to severe clinical mastitis and exhibited remarkable increases in ITIH4 concentration in serum (from 3 to 12 times the initial values, peaking at 48 to 72 h after infection) that correlated with the severity of the disease. Animals with experimental infections with bovine respiratory syncytial virus (BRSV) also showed increases in ITIH4 concentration (from two- to fivefold), which peaked at around 7 to 8 days after inoculation. Generally, no response was seen after a second infection of the same animals with the virus. Because of the significant induction of the protein in the animals in the mastitis and BRSV infection models, we can conclude that ITIH4 is a new positive acute-phase protein in cattle.
Use of a Continuous-Flow Anaerobic Culture To Characterize Enteric Virulence Gene Expression
Authors: Ruiz-Perez Fernando , Sheikh Jalaluddin , Davis Suzanne , Boedeker Edgar C. , Nataro James P.
Published: June 2004

We developed an in vitro culture method to characterize the expression of bacterial genes under conditions mimicking the colonic environment. Our culture system (the intestinal simulator) comprised a continuous-flow anaerobic culture which was inoculated with fecal samples from healthy volunteers. As a test organism, we employed enteroaggregative
Escherichia coli
(EAEC), an emerging diarrheal pathogen that is thought to cause infection in both the small and large intestines. After the simulator culture achieved equilibrium conditions, we inoculated the system with prototype EAEC strain 042 and assessed the expression of three EAEC virulence-related genes. We focused particularly on expression of
aggR
, which encodes a global transcriptional regulator of EAEC virulence factors, and two AggR-regulated genes. By using real-time quantitative reverse transcription-PCR, we showed that
aggR
expression in the simulator is increased 3- to 10-fold when 042 is grown under low-pH (5.5 to 6.0) conditions, compared with results with neutral pH (7.0). Interestingly, however, this effect was seen only when the strain was grown in the presence of commensal bacteria. We also found that expression of
aggR
is 10- to 20-fold higher at low NaCl concentrations, and this effect was also observed only in the presence of commensal bacteria. Using coculture and conditioned-media experiments, we identified specific strains of
Enterococcus
and
Clostridium
that upregulated
aggR
expression; in contrast, strains of
Lactobacillus
and
Veillonella
downregulated
aggR
expression. Our data provide new insights into regulation of virulence genes in EAEC and suggest the utility of intestinal simulation cultures in characterizing enteric gene regulation.
Intramolecular Dimerization Is Required for the Chlamydia-Secreted Protease CPAF To Degrade Host Transcriptional Factors
Authors: Dong Feng , Sharma Jyotika , Xiao Yanming , Zhong Youmin , Zhong Guangming
Published: June 2004

We previously identified a chlamydial protein designated CPAF (chlamydia protease/proteasome-like activity factor) that is secreted into host cell cytosol for degrading host transcription factors required for major histocompatibility complex antigen expression. Here we report that CPAF, synthesized as a 70-kDa proprotein, is processed into two fragments (designated CPAFn and CPAFc) to form intramolecular dimers that are much more stable than the naïve CPAF. Precipitation with antibodies that recognized CPAF dimers removed the proteolytic activity responsible for degrading host transcription factor RFX5 from chlamydia-infected host cell cytosol, while precipitation with antibodies that recognized free CPAF fragments alone did not remove this activity. Separation of CPAFn from CPAFc resulted in a loss of proteolytic activity. Furthermore, neither expressed full-length CPAF that was not processed nor coexpressed CPAFn and CPAFc fragments that failed to form dimers degraded RFX5. These observations demonstrate that intramolecular dimerization is required for CPAF to degrade host transcription factors, a strategy that is utilized by an obligate intracellular bacterial species to evade host defenses.
Functional Analysis of the
Streptococcus gordonii
DL1 Sialic Acid-Binding Adhesin and Its Essential Role in Bacterial Binding to Platelets
Authors: Takahashi Yukihiro , Yajima Ayako , Cisar John O. , Konishi Kiyoshi
Published: June 2004

Bacterial recognition of host sialic acid-containing receptors plays an important role in microbial colonization of the human oral cavity. The sialic acid-binding adhesin of
Streptococcus gordonii
DL1 was previously associated with the
hsa
gene encoding a 203-kDa protein. The predicted protein sequence consists of an N-terminal nonrepetitive region (NR1), including a signal sequence, a relatively short serine-rich region (SR1), a second nonrepetitive region (NR2), a long serine-rich region (SR2) containing 113 dodecapeptide repeats, and a C-terminal cell wall anchoring domain. In the present study, the contributions of SR1, NR2, and SR2 to Hsa-mediated adhesion were assessed by genetic complementation. Adhesion of an
hsa
chromosomal deletion mutant to sialic acid-containing receptors was restored by plasmids containing
hsa
constructs encoding Hsa that lacked either the N- or C-terminal portion of SR2. In contrast,
hsa
constructs that lacked the coding sequences for SR1, NR2, or the entire SR2 region failed to restore adhesion. Surface expression of recombinant Hsa was not affected by removal of SR1, NR2, or a portion of SR2 but was greatly reduced by complete removal of SR2. Wheat germ agglutinin, a probe for Hsa-specific glycosylation, reacted with recombinant Hsa lacking SR1, NR2, or SR2 but not with recombinant Hsa lacking both SR1 and SR2. Significantly, the aggregation of human platelets by
S. gordonii
DL1, an interaction implicated in the pathogenesis of infective endocarditis, required the expression of
hsa
. Moreover, neuraminidase treatment of the platelets eliminated this interaction, further supporting the hypothesis that Hsa plays an essential role in the bacterium-platelet interaction.