bluuebunny/crossref_metadata_2025 huggingface dataset:
Ein einfaches weich strukturvariables Anti-Windup
Authors: Ortseifen Andreas , Adamy Jürgen
Published: March 2012

Dieser Beitrag stellt eine neue, nichtlineare Anti-Windup-Maßnahme für lineare Systeme vor, die auf der weich strukturvariablen Zustandsregelung mittels impliziter Ljapunov-Funktionen basiert. Durch die variable Struktur des Anti-Windup (AW) kann zum einen die Regelgüte im Vergleich zu linearen AW-Ansätzen beträchtlich gesteigert werden. Der Vorteil gegenüber existierenden strukturvariablen AW-Strategien ist zum anderen ein geringerer Entwurfsaufwand und eine einfacher zu implementierende Regelstrategie bei gleicher Regelgüte, wie anhand eines Beispiel demonstriert wird.
Hardware-in-the-Loop Simulation von Hydraulikventilen mit virtuellen Verbrauchern
Authors: Trachte Adrian , Albrecht Andreas
Published: March 2012

Um Mobilhydraulikventile anwendungsnah ohne großen Aufwand zu testen, wird hier das Konzept der Hardware-in-the-Loop (HiL) Simulation verwendet. Die Rückwirkungen der Last auf das Ventil werden über eine Druckregelung aufgeprägt. Da in der Anwendung aufgrund von ziehenden Lasten auch Unterdrücke auftreten können, muss sowohl Unter- als auch Überdruck geregelt werden. Im Artikel wird dazu ein HiL-Konzept und eine nichtlineare strukturumschaltende Druckregelung vorgestellt. Abschließend werden experimentelle Daten einer HiL-Simulation gezeigt und mit Messungen am realen System verglichen.
Anomaly Detection at “supersonic” Speed
Authors: Grozea Cristian , Laskov Pavel
Published: March 2012

Anomaly-based methods of intrusion detection are gaining increasing interest among IT-security practitioners. Unlike the traditional intrusion detection systems (IDS) based on pattern matching they are capable of detecting previously unknown attacks without any knowledge about attack signatures. For practical deployment, not only accuracy but also the computational performance is crucial. A deployed IDS must be able to process traffic volumes of several Gbps, which is typical for network infrastructure nodes. Most of the previously proposed anomaly-based IDS have not specifically addressed performance issues. Moreover, it has been widely believed that no anomaly-based system with full analysis of packet payload can reach a “sound barrier” of 1 Gbps. In this contribution, we show that using a careful selection of algorithms and common parallelization techniques, the performance of well over 1 Gbps is possible for a wide range of methods based on a metric embedding of packet/connection payloads. After a brief introduction to the embedding techniques, we describe the specific algorithms and data structures for a high-performance implementation of such methods. We present experiments on large-scale traces of real network traffic that demonstrate that processing rates of over 4 Gbps can be attained by our methods on commodity multi-core processors.
Automatic Adaptation of User Interfaces to Cultural Preferences
Authors: Reinecke Katharina
Published: March 2012

Our culture strongly affects which Web sites we perceive as beautiful and usable, and we are less likely to engage with those that we don´t. With today´s Internet users coming from a variety of cultural backgrounds, it is not realistic to provide one interface design that is perceived as appealing by everyone. We therefore developed an approach to cultural adaptivity, which enables an automatic composition of personalized interfaces by taking into account a user´s current and former countries of residences. To exemplify the approach, we created a Web application that offers more than 115000 different versions of its interface in order to adequately adapt to various combinations of different national cultures. Our evaluations of the Web application with participants from Rwanda, Switzerland, and Thailand, as well as with multicultural users from all over the world, demonstrated that the approach is able to anticipate 61% of user preferences on average (compared to 33% that the system achieved when randomly generating its interfaces). Moreover, the results of an experiment with 41 multicultural participants showed that they were significantly faster with their personalized version compared to a standard US interface, they needed fewer clicks to complete tasks, and made fewer errors. These results were also supported by participants´ subjective impressions of appeal and work efficiency, showing that cultural adaptivity is a feasible way to increase the user experience for a multicultural audience.
Use of recombinant human parathyroid hormone in hypocalcemic cardiomyopathy
Authors: Ballane Ghada T , Sfeir Jad G , Dakik Habib A , Brown Edward M , El-Hajj Fuleihan Ghada
Published: March 2012

Hypocalcemia secondary to hypoparathyroidism is a rare cause of congestive heart failure. However, its early recognition and treatment lead to significant improvement in cardiac function. We report a middle-aged woman presenting with symptoms of heart failure with a serum calcium level of 3.7 mg/dl and a serum inorganic phosphate level of 17.6 mg/dl 22 years after subtotal thyroidectomy. Besides calcium and calcitriol supplementation, she was the first patient with severe hypocalcemic cardiomyopathy to be given off-label recombinant human parathyroid hormone (PTH) because of an elevated serum calcium–phosphate product. We discuss the management and outcome of the patient and then present a brief review of similar previously reported cases. We also describe the pivotal role of calcium ion and the potential role of PTH in maintaining myocardial contractility, effective natriuresis, and possible pathogenic mechanisms contributing to heart failure secondary to hypocalcemia and hypoparathyroidism.
A SDHB malignant paraganglioma with dramatic response to temozolomide–capecitabine
Authors: Nozières Cécile , Walter Thomas , Joly Marie-Odile , Giraud Sophie , Scoazec Jean-Yves , Borson-Chazot Françoise , Simon Chantal , Riou Jean-Paul , Lombard-Bohas Catherine
Published: March 2012

Ten percent of paragangliomas are malignant and one-third occurs in a genetic background. We report a case of succinate dehydrogenase subunit B (SDHB)-related malignant paraganglioma with dramatic response to temozolomide and capecitabine regimen (decrease in tumor size of 70% with RECIST criteria). Tumor cells harbored a new mutation in SDHB gene and showed aberrant hypermethylation of O6-methylguanine-DNA-methyltransferase promoter. Our report suggests the importance of molecular predictive factors of response for the selection of chemotherapeutic as well as targeted agents. This observation points to a possible genotype response to treatment relationships, which could help to design tailor-made treatments in the future.
The Outcome of ELBW Infants Treated With NCPAP and InSurE in a Resource-Limited Institution
Authors: Kirsten Gerhardus Francois , Kirsten Cheryl Linda , Henning Philippus Arnold , Smith Johan , Holgate Sandi Lee , Bekker Adrie , Kali Gugulabatembunamahlubi Tenjiwe Jabulile , Harvey Justin
Published: March 2012

BACKGROUND AND OBJECTIVE:

Nasal continuous positive airway pressure (NCPAP) plus intubation, surfactant, and extubation (InSurE) with the option of back-up ventilation for those infants for whom noninvasive ventilatory support failed resulted in a significant increase in survival in extremely low birth weight (ELBW) infants. The authors sought to determine the outcome of ELBW infants treated with NCPAP and InSurE in a neonatal high care ward with limited back-up ventilation.

METHODS:

Three hundred eighteen inborn infants with birth weight 500–1000 g and gestational age ≥25 weeks who were admitted to the neonatal high care ward were included in this observational study. InSurE was administered to infants with respiratory distress syndrome on NCPAP who had severe in-drawing and recession, apneic spells, or an Fio2 >0.4 within 1 hour of birth.

RESULTS:

Two hundred twelve (68.6%) infants could be treated with NCPAP only and 97 (31.4%) required InSurE. Seventeen infants were admitted to the NICU; 90%, 87%, and 74.8% of the infants survived until day 3, 7, and discharge, respectively. Only 2 infants developed a pneumothorax and 2 had chronic lung disease. Seventy-nine percent of the infants of ≥750 g or >26 weeks’ gestation survived to discharge compared with 56% and 60% of the infants of <750 g or ≤26 weeks’ gestation, respectively. Maternal antenatal steroid administration contributed significantly to the survival of the infants (P = 0.0017, odds ratio 2.7, 95% confidence interval 1.44–5.07).

CONCLUSIONS:

The use of NCPAP and InSurE in a neonatal high care ward with limited resources can improve the survival of ELBW infants. Maternal antenatal steroid administration contributed significantly to survival.
Language Functions in Preterm-Born Children: A Systematic Review and Meta-analysis
Authors: van Noort-van der Spek Inge L. , Franken Marie-Christine J. P. , Weisglas-Kuperus Nynke
Published: March 2012

BACKGROUND AND OBJECTIVE:

Preterm-born children (<37 weeks’ gestation) have higher rates of language function problems compared with term-born children. It is unknown whether these problems decrease, deteriorate, or remain stable over time. The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age.

METHODS:

Computerized databases Embase, PubMed, Web of Knowledge, and PsycInfo were searched for studies published between January 1995 and March 2011 reporting language functions in preterm-born children. Outcome measures were simple language function assessed by using the Peabody Picture Vocabulary Test and complex language function assessed by using the Clinical Evaluation of Language Fundamentals. Pooled effect sizes (in terms of Cohen’s d) and 95% confidence intervals (CI) for simple and complex language functions were calculated by using random-effects models. Meta-regression was conducted with mean difference of effect size as the outcome variable and assessment age as the explanatory variable.

RESULTS:

Preterm-born children scored significantly lower compared with term-born children on simple (d = –0.45 [95% CI: –0.59 to –0.30]; P < .001) and on complex (d = –0.62 [95% CI: –0.82 to –0.43]; P < .001) language function tests, even in the absence of major disabilities and independent of social economic status. For complex language function (but not for simple language function), group differences between preterm- and term-born children increased significantly from 3 to 12 years of age (slope = –0.05; P = .03).

CONCLUSIONS:

While growing up, preterm-born children have increasing difficulties with complex language function.
Clinical Presentation of Intoxication Due to Synthetic Cannabinoids
Authors: Cohen Joanna , Morrison Sephora , Greenberg Jeffrey , Saidinejad Mohsen
Published: March 2012

Synthetic cannabinoids are relatively novel substances of abuse. The use of these compounds among adolescents and young adults has been increasing, making it important for pediatric providers to be familiar with the presenting signs and symptoms of intoxication. We describe three case presentations of reported synthetic cannabinoid intoxication and provide a brief discussion of these compounds.
Prenatal Methamphetamine Exposure and Childhood Behavior Problems at 3 and 5 Years of Age
Authors: LaGasse Linda L. , Derauf Chris , Smith Lynne M. , Newman Elana , Shah Rizwan , Neal Charles , Arria Amelia , Huestis Marilyn A. , DellaGrotta Sheri , Lin Hai , Dansereau Lynne M. , Lester Barry M.
Published: March 2012

OBJECTIVE:

We evaluated behavior problems in children who were prenatally exposed to methamphetamine (MA) at ages 3 and 5 years.

METHODS:

The Infant Development, Environment, and Lifestyle study, a prospective, longitudinal study of prenatal MA exposure and child outcome, enrolled subjects postpartum in Los Angeles, California; Honolulu, Hawaii; Des Moines, Iowa; and Tulsa, Oklahoma. Prenatal exposure was determined by maternal self-report and/or meconium results. Exposed and comparison groups were matched on race, birth weight, public health insurance, and education. Mothers in the comparison group denied use and had a negative meconium screen for amphetamines. Prenatal exposures to tobacco, alcohol, or marijuana occurred in both groups. At ages 3 and 5 years, 330 children (166 exposed and 164 comparison) were assessed for behavior problems by using the caregiver report on the Child Behavior Checklist. General linear mixed models were used to determine the effects of prenatal MA exposure, including heavy exposure (≥3 days per week), age, and the interaction of exposure and age on behavior problems with adjustment for other drugs of abuse and environmental risk factors.

RESULTS:

MA exposure was associated with increased emotional reactivity and anxious/depressed problems at both ages and externalizing and attention-deficit/hyperactivity disorder problems by age 5 years. Heavy exposure was related to attention problems and withdrawn behavior at both ages. There were no effects of MA on the internalizing or total behavior problems scales.

CONCLUSIONS:

This first report of behavior problems in patients as young as 3 years associated with MA exposure identifies an important public health problem. Continued follow-up can inform the development of preventive intervention programs.
Congruence of Reproductive Concerns Among Adolescents With Cancer and Parents: Pilot Testing an Adapted Instrument
Authors: Quinn Gwendolyn P. , Knapp Caprice , Murphy Devin , Sawczyn Kelly , Sender Leonard
Published: March 2012

OBJECTIVE:

To identify whether a health-related quality of life (HRQoL) instrument intended to capture reproductive concerns is sensitive and appropriate for adolescent patients with cancer.

METHODS:

Pilot testing was completed by administering a 10-item instrument designed to identify reproductive concerns of female adolescent patients with cancer aged 12–18. Parents were also asked to predict their daughters’ responses. Fourteen patients and parents participated. The main outcome measures were language, relevance, accuracy, sensitivity, and missing content regarding the HRQoL instrument. Two pediatric hospitals and 1 local support group for patients and survivors served as the setting for this study.

RESULTS:

The majority of parents provided inaccurate predictions of their daughters’ responses regarding their reproductive concerns. Overall, parents underestimated their daughters’ concerns because the majority of adolescents reported a strong desire for future parenthood whereas parents expected their daughters to be satisfied with survivorship.

CONCLUSIONS:

Adolescent patients with cancer have strong reproductive concerns; however, this may not be captured on current HRQoL instruments and may be further neglected due to parents’ unawareness. Discussions should be encouraged with adolescent patients before beginning treatment regarding their concerns and values about parenting in the future and cannot rely on parent-proxy reports.
Limitations and Opportunities of Transcutaneous Bilirubin Measurements
Authors: Bosschaart Nienke , Kok Joke H. , Newsum Astrid M. , Ouweneel Dagmar M. , Mentink Rosaline , van Leeuwen Ton G. , Aalders Maurice C. G.
Published: March 2012

OBJECTIVE:

Although transcutaneous bilirubinometers have existed for over 30 years, the clinical utility of the technique is limited to a screening method for hyperbilirubinemia, rather than a replacement for invasive blood sampling. In this study, we investigate the reason for this limited clinical value and address possibilities for improvement.

METHODS:

To obtain better insight into the physiology of bilirubin measurements, we evaluated a transcutaneous bilirubinometer that determines not only the cutaneous bilirubin concentration (TcB) but also the blood volume fraction (BVF) in the investigated skin volume. For 49 neonates (gestational age 30 ± 3.1 weeks, postnatal age 6 [4–10] days) at our NICU, we performed 124 TcB and 55 BVF measurements.

RESULTS:

The TcB correlated well with the total serum bilirubin concentration (TSB) (r = 0.88) with an uncertainty of 55 µmol/L. The BVF in the measured skin volume ranged between 0.1% and 0.75%.

CONCLUSIONS:

The performance of our bilirubinometer is comparable to existing transcutaneous devices. The limited clinical value of current bilirubinometers can be explained by the low BVF in the skin volume that is probed by these devices. Because the TcB depends for over 99% on the contribution of extravascular bilirubin, it is a physiologically different parameter from the TSB. Hence, the standard method of evaluation that compares the TcB to the TSB is insufficient to fully investigate the clinical value of transcutaneous bilirubinometers, ie, their predictive value for kernicterus. We suggest that the clinical value may be improved considerably by changing either the method of evaluation or the technological design of transcutaneous bilirubinometers.
Shifts in BMI Category and Associated Cardiometabolic Risk: Prospective Results From HEALTHY Study
Authors: Marcus Marsha D. , Foster Gary D. , El ghormli Laure , Baranowski Tom , Goldberg Linn , Jago Russell , Linder Barbara , Steckler Allan , Treviño Roberto
Published: March 2012

OBJECTIVES:

To evaluate shifts across BMI categories and associated changes in cardiometabolic risk factors over 2.5 years in an ethnically diverse middle school sample.

METHODS:

As part of HEALTHY, a multisite school-based study designed to mitigate risk for type 2 diabetes, 3993 children participated in health screenings at the start of sixth and end of eighth grades. Assessments included anthropometric measures, blood pressure, and glucose, insulin, and lipids. Students were classified as underweight, healthy weight, overweight, obese, or severely obese. Mixed models controlling for school intervention status and covariates were used to evaluate shifts in BMI category over time and the relation between these shifts and changes in risk factors.

RESULTS:

At baseline, students averaged 11.3 (±0.6) years; 47.6% were boys, 59.6% were Hispanic, and 49.8% were overweight or obese. Shifts in BMI category over time were common. For example, 35.7% of youth who were overweight moved to the healthy weight range, but 13% in the healthy weight range became overweight. BMI shifts were not associated with school intervention condition, household education, or youth gender, race/ethnicity, pubertal status, or changes in height. Increases in BMI category were associated with worsening of cardiometabolic risk factors, and decreases were associated with improvements. Boys who increased BMI category were more vulnerable to negative risk factor changes than girls.

CONCLUSIONS:

There are substantial shifts across BMI categories during middle school that are associated with clinically meaningful changes in cardiometabolic risk factors. Programs to promote decreases in BMI and prevent increases are clearly warranted.
Decline in Infantile Hypertrophic Pyloric Stenosis in Germany in 2000–2008
Authors: de Laffolie Jan , Turial Salmai , Heckmann Matthias , Zimmer Klaus-Peter , Schier Felix
Published: March 2012

BACKGROUND AND OBJECTIVE:

The incidence of infantile hypertrophic pyloric stenosis (IHPS) is highly variable over time and geographic regions. A decline in IHPS incidence was recently reported in Sweden, the United States, Denmark, and Scotland. In Sweden, the IHPS decline seemed to be concurrent with a declining incidence in sudden infant death syndrome (SIDS), which suggested a common cause; the latter was attributed to campaigns against the prone sleeping position. We investigated the time course of the IHPS incidence in all German federal states (N = 16) between 2000 and 2008. We examined correlations between the IHPS incidence and the SIDS incidence.

METHODS:

Data were extracted from the public report of health (Gesundheitsberichterstattung des Bundes). We collected the numbers of IHPS (International Classification of Diseases, 10th Revision [ICD-10], code 40.0), SIDS (ICD-10, R95), and live births (LB; male/female) in each federal state for 2000–2008.

RESULTS:

The IHPS incidence declined in Germany from 2000 (3.2086/1000 LB [range: 1.67–5.33]) to 2008 (2.0175/1000 LB [1.74–3.72]; P = .005). The recorded incidence was highly variable in different federal states and over time. The SIDS incidence also declined during the same time period (2000, median: 0.759/1000 LB [interquartile range: 0.54–1.029]; 2008, median: 0.416/1000 LB [interquartile range: 0.285–0.6485]; P = .0255). However, the SIDS regional distribution was different from that of IHPS.

CONCLUSIONS:

The IHPS incidence declined by ∼38% nationwide. A parallel decline in SIDS displayed a different pattern in regional distribution; thus, a common cause was unlikely. The regional differences indicated that etiologic factors remained unresolved.
Carbohydrate deficient transferrin in doping and non-doping sportsmen
Authors: Szabó György , Fraenkel Emil , Szabó Gergely , Keller Éva , Bajnóczky István , Jegesy Andrea , Huszár András , Dinya Elek , Lengyel Gabriella , †Fehér János
Published: March 2012

The determination of carbohydrate deficient transferrin (CDT) concentration is primarily used in social security studies as a proof of regular alcohol consumption exceeding the amount of 60 grams per day. Aims: The present study was performed to investigate into how carbohydrate deficient transferrin CDT values in serum are affected by the so-called food supplements and chemicals included in doping lists. Methods: The investigation was carried out in 15 bodybuilders of two sport clubs and in 10 boxers. All sportsmen were males. In both groups serum carbohydrate deficient transferrin (CDT%), median red blood cell volume and (MCV) gamma-glutamyl-transpeptidase (GGT) values were measured. Results: The authors found a significant difference between the two groups only in carbohydrate deficient transferrin CDT% that was the CDT% value in bodybuilders was twice as high as in boxers. Conclusion: Not all the details of the specificity of carbohydrate deficient transferrin (CDT) concentration are known, however, the remarkably high sensitivity of the method makes it suitable and probably cost-financially effective for serving as a pre-screening tool in doping tests. Orv. Hetil., 2012, 153, 514–517.
Anomalous Diffusion of Intrinsic Defects in K+ Implanted ZnO using Li as Tracer
Authors: Vines L. , Neuvonen P.T. , Kuznetsov A. Yu. , Wong-Leung J. , Jagadish C. , Svensson B.G.
Published: March 2012

Potassium (K) ions have been implanted in hydrothermally grown ZnO to a dose of 1 × 1015 cm-2, followed by isochronal annealing in a tube furnace (30min) and by rapid thermal annealing (30s) on two separate samples. For annealing temperatures below 700°C, only a minor redistribution of Li is observed behind the projected range of the K+ ions. At temperatures between 700 and 750°C, however, both annealing treatments show a wide region behind the implantation peak which is depleted of Li, and this depletion is used as a tracer to monitor diffusion of intrinsic defects like the Zn interstitial. The results are interpreted as Zn interstitials being released from the implanted region in a burst at temperatures above ∼700°C, followed by rapid migration, replacement of Li on Zn site through the kick-out mechanism, and migration of Li away from the active region.
Incorporation of chromium-tanned leather residue in mortars
Authors: de Oliveira Andrade Jairo José , Mattje Viviane
Published: March 2012

To protect the environment there is worldwide pressure to establish sustainable conditions for all kinds of industrial processes. In the leather industry, tanning is the main process used to protect the hide from environmental effects such as heat and microbial degradation. In Brazil, 60% of the leather that is processed comes from an area in the state of Rio Grande do Sul called Vale dos Sinos, which has approximately 90 tanneries and accounts for 30% of Brazilian leather exports. Studies show that 30% of the leather processed in tanneries is rejected, especially after the shaving process, in which many chemical products are used. Chromium-tanned leather has been used for many decades in the manufacturing of a large variety of leather products for personal use. This process generates liquid and solid waste containing chromium salts that are discharged as effluents into the environment, mainly in water and into the ground. Some solutions can be used to minimise the amount of chromium residue, such as the increase of material fixation due to the control of pH, the recycling of chrome tanning liquors to reduce the discharge into wastewater, the pyrolysis of material for the production of activated carbon and use in Portland cement clinker production. In order to contribute with another alternative for the disposal of this residue, the present study evaluated the incorporation of the residue into mortars. Three mortar mixture proportions were studied, each one with five levels of sand replacement by residue. Tests were conducted in order to verify the mortar properties, in the fresh and hardened state and the evaluation of total and chrome VI. The results showed that there is potential for using chromium-tanned leather residue in civil engineering and that technical, economic and environmental benefits can be obtained.
Improved testing of species traits–environment relationships in the fourth‐corner problem
Authors: ter Braak Cajo J. F. , Cormont Anouk , Dray Stéphane
Published: March 2012

The fourth‐corner problem entails estimation and statistical testing of the relationship between species traits and environmental variables from the analysis of three data tables. In a 2008 paper, S. Dray and P. Legendre proposed and evaluated five permutation methods for statistical significance testing, including a new two‐step testing procedure. However, none of these attained the correct type I error in all cases of interest. We solve this problem by showing that a small modification of their two‐step procedure controls the type I error in all cases. The modification consists of adjusting the significance level from to α or, equivalently, of reporting the maximum of the individual P values as the final one. The test is also applicable to the three‐table ordination method RLQ.
Periodontal Disease in HIV Seropositive Patients and Its Relation to Lymphocyte Subsets
Authors: Martínez‐Canut P. , Guarinos J. , Bagán J.V.
Published: March 2012

This study was performed to determine the type of periodontal pathology found in a group of HIV+ patients and its relation to serum levels of CD4. The sample consisted of 101 individuals: intravenous drug users (84%), homosexuals (7%), and heterosexuals (10%). Each patient was examined clinically and radiographically. Periodontal clinical parameters included gingival index and probing depth and loss of attachment on four sites per tooth. Severity of disease was defined as the most severe lesion found: gingivitis, or early, moderate, or advanced periodontitis. CD4 counts were determined on 64 of these patients. Associations between severity of the disease and gender and CD4 counts were analyzed using the Mantel Haenszel chi square test, while associations between severity and age and CD4/CD8 ratio were analyzed using the Kruskal‐Wallis test. No disease was found in 14.8% of the sample, gingivitis was found in 21.8%, early periodontitis in 43.6%, moderate periodontitis in 10.9%, and advanced periodontitis in 8.9%. Linear gingival erythema (LGE) was seen in 17.8% of all patients and necrotizing periodontitis (NUP) in 4.9%. No statistically significant differences were observed between the severity of the disease and CD4 counts. J Periodontol 1996;67:33–36.
Gingival Langerhans' Cells in Type I Diabetes Mellitus
Authors: Günhan Meral , Günhan Omer , Celasun Bülent , Azal Ömer , Bostanci Hamit
Published: March 2012

Langerhans' cells (LCs) are intraepithelial immunocompetent cells. Changes in the number of LCs occur in inflammatory and autoimmune diseases. In this study, the number of gingival LCs in patients with type I diabetes mellitus was compared with those of normal individuals using immunohistochemical methods. Gingival biopsies were obtained from 20 type I diabetics and 10 healthy individuals. Anti‐CD1 positive LCs formed an intraepithelial network and showed a marked increase in type I diabetics. This increase was not related to diabetic age. The number of LCs was proportional to the density of subepithelial inflammatory cells. Our findings suggest that LCs may play a role in the development of diabetic gingivitis. J Periodontol 1996;67:37–40.
Comparative Study of a Bioresorbable and a Non‐Resorbable Membrane in the Treatment of Human Buccal Gingival Recessions
Authors: Roccuzzo Mario , Lungo Marco , Corrente Giuseppe , Gandolfo Sergio
Published: March 2012

Twelve patients with bilateral comparable gingival recessions were treated using a split mouth design, to compare the relative success of root coverage by two regenerative procedures. The areas of recession treated were Class I or II according to Miller's classification and caused either an esthetic problem and/or root sensitivity. The symmetrical defects, on the maxillary canines, 4 mm or deeper, were randomly assigned in each patient to surgical procedures with either a bioresorbable matrix barrier (test) or a non‐resorbable expanded polytetrafluoroethylene membrane (control). Gingival recession, clinical attachment level, probing depth, and extension of keratinized tissue were measured at baseline and at 6 months postsurgically. Both procedures resulted in significant root coverage (P < 0.0001) and attachment gain (P < 0.0001). The gingival recession decreased from 4.75 ± 0.22 mm to 0.83 ± 0.24 mm and from 4.75 ± 0.22 mm to 0.75 ± 0.22 mm, corresponding to a mean root coverage of 82.4% and 83.2%, at the test and control sites respectively. The average clinical attachment gain was 4.33 ± 0.44 mm at the test sites compared to 4.42 ± 0.48 mm for the non‐resorbable barrier. No significant changes were found for probing depth and keratinized tissue. Data analysis did not demonstrate any significant difference between the two procedures for any of the variables included. However, a questionnaire given to each patient revealed the single‐step surgery to be the patients' choice. J Periodontol 1996;67:7–14.
Pyogenic Granuloma Associated With Guided Tissue Regeneration: A Case Report
Authors: Fowler Edward B. , Cuenin Michael F. , Thompson Stevan H. , Kudryk Val L. , Billman Michael A.
Published: March 2012

A pyogenic granuloma is an exuberant growth of granulation tissue secondary to irritation. Intraorally, it can present with a wide array of clinical appearances, ranging from a sessile lesion to an elevated mass. Pyogenic granulomas generally are soft, painless, and deep red to reddish‐purple in color. They are usually 0.5 to 1.0 cm in diameter, more common in females, and often found on the keratinized tissue. This case is interesting because the pyogenic granuloma was found associated with guided tissue regeneration and the lingual alveolar mucosa. The lesion arose after demineralized freeze dried bone allograft and an expanded polytetrafluoroethylene (ePTFE) membrane were utilized to repair osseous defects. Five weeks after surgery, the patient presented for routine follow‐up where suppuration associated with the membrane was noted along with an exophytic growth of the lingual alveolar mucosa. The ePTFE membrane was removed alone with an excisional biopsy of one of the growths. By 10 days after the removal of ePTFE, the lesion spontaneously healed. Histologic evaluation of the tissue was consistent with a pyogenic granuloma. This is the first case in the literature of a pyogenic granuloma associated with a routine guided tissue regenerative surgery using a non‐resorbable membrane and allograft. J Periodontol 1996;67:1011–1015.
The Free Rotated Papilla Autograft: A New Bilaminar Grafting Procedure for the Coverage of Multiple Shallow Gingival Recessions
Authors: Tinti Carlo , Parma‐Benfenati Stefano
Published: March 2012

The aim of this clinical pilot study is to evaluate the possibility and, from a statistical point of view, the predictability of a new mucogingival technique. The purpose of this surgical procedure is to cover the exposed buccal root surface with less than 5 mm clinical probing attachment loss either in corono‐apical or mesio‐distal aspects. This surgical procedure is particularly indicated in either single or multiple gingival recessions with perfectly preserved mesial and distal interproximal osseous crests, and with a papillary dimension not inferior to the defect which needs to be treated. A sharp incision is performed at a 90° angle to the vestibule, following the mucogingival line. A sharp dissection is accomplished to create a partial thickness envelope flap on the underlying alveolar mucosa. The epithelium from the facial aspect of the papilla is debrided with a full thickness approach, the facial papillary tissue is removed from the underlying tissue bed. The papilla is then reversed in such a way that the base of the papilla is at the cemento‐enamel junction (CEJ) and the apex is at the base of the gingival recession area. The papilla is then sutured in place and completely covered by a coronally displaced partial thickness flap. The results obtained either as root coverage, or as an aesthetic result, may be considered positive. This procedure has the decided advantage of a single surgical site, avoiding any palatal patient discomfort, good color compatibility with adjacent tissue, and healing by primary intention. J Periodontol 1996;67:1016–1024.
A Histologic Evaluation of Retrieved Hydroxyapatite‐Coated Blade‐Form Implants Using Scanning Electron, Light, and Confocal Laser Scanning Microscopies
Authors: Takeshita Fumitaka , Ayukawa Yasunori , Iyama Shinji , Suetsugu Tsuneo , Kido Mizuho A.
Published: March 2012

We histologically examined seven hydroxyapatite‐coated (HA) blade implants removed from patients. Four of them radiologically showed severe bone loss and were easily removed with an elevator. Three radiologically showed vertical bone loss and were removed by surgical procedure. Our histological evaluation indicated that coating separation from the HA implants had occurred, and HA coating resorption by bone tissues was suspected in an implant left in situ for 8 years. Several multinucleated giant cells were seen with a few released particles of HA coating at the point lacking bone contact with the HA coating. The presence of microorganisms on and in the HA coating layer was also noted. J Periodontol 1996;67:1034–1040.
Dental Caries and Tooth Loss in Adolescents With Early‐Onset Periodontitis
Authors: Albandar Jasim M. , Brown L. Jackson , Löe Harald
Published: March 2012

The aim of this study was to assess the caries experience and tooth loss over 6 years in subjects with early‐onset periodontitis as compared to their matched controls, and to describe the characteristics of teeth lost during this period. A multi‐stage probability sample representing 8th to 12th grade U.S. schoolchildren were screened during the 1986/1987 school year to identify subjects with early‐onset periodontitis (cases). The examination included measuring the clinical attachment level, presence of caries and dental restorations, and tooth loss. A random sample of controls without earlyonset periodontitis were selected for a follow‐up examination and were matched to cases on gender, race, age, and geographic location. A total of 266 subjects, with a mean age of 16 years at baseline, were examined during the 1992/1993 school year and were classified into localized (LJP) and generalized juvenile periodontitis (GJP), incidental attachment loss (IAL), and control groups. Whites had more caries experience than Blacks and Hispanics, but there were no significant differences in tooth loss between the ethnic groups. The LJP and the IAL groups, respectively, had higher and lower overall caries experience than the control group. The LJP group had a significantly higher number of missing teeth at follow‐up, and exhibited more extensive tooth mortality during 6 years than the control group. The GJP group also showed more tooth loss than the control group, but the difference was not statistically significant. In the LJP, GJP, IAL, and control groups, respectively, 43%, 32%, 26%, and 18% of the subjects lost teeth over 6 years due to disease. The findings showed differences in caries activity between the early‐onset periodontitis groups and a variation by race. The findings suggest that loss of periodontal support was the principal cause for tooth loss in the LJP and GJP groups, and that dental caries was the principal cause for tooth extraction in the IAL and the control groups. J Periodontol 1996;67:960–967.
Early‐Onset Periodontitis: Progression of Attachment Loss During 6 Years
Authors: Brown L. Jackson , Albandar Jasim M. , Brunelle Janet A. , Löe Harald
Published: March 2012

We studied the pattern of progression of early‐onset periodontitis and the change in the extent and severity of the periodontal condition in adolescents who were followed for 6 years. In a national survey of the oral health of U.S. children, 14,013 adolescents were examined clinically in 1986/1987 to assess the periodontal attachment loss of teeth. Individuals with early‐onset periodontitis within this population were identified and classified into localized juvenile periodontitis (LJP), generalized juvenile periodontitis (GJP), and incidental attachment loss (IAL) groups. Ninety‐one subjects, 13 to 20 years old at baseline, were examined 6 years later. They included 51 males and 40 females; and 72 Blacks, 6 Hispanics, and 13 Whites. They were clinically re‐examined and then reclassified according to their periodontal status at follow‐up. The severity and extent of these diseases continued to increase during the study period. In teeth that were affected at baseline, the lesions had progressed to include deeper portions of the periodontium, and more of the teeth unaffected at baseline exhibited periodontal attachment loss at followup, thus changing the disease characteristics and the basis for the clinical classification. Of the individuals classified with LJP at baseline, 62% continued to have LJP 6 years later and 35% developed GJP. Of those classified with GJP initially, all but two (82%) continued to have GJP at follow‐up. Among the IAL group, 28% of subjects developed LJP or GJP, and 30% were reclassified in the no attachment loss group. Molars and incisors were the teeth most often affected in all three groups. The mean change in attachment loss over 6 years in the LJP, GJP, and IAL groups was 0.45, 1.12, and 0.13 mm, respectively. The present findings demonstrate the limitations of the currently used morphological criteria in the classification of early‐onset periodontitis. The findings also suggest that the difference between LJP and GJP is in the number and type of teeth involved, and that the two classifications progress similarly, with some cases of LJP developing into GJP. J Periodontol 1996;67:968–975.
Intraoral Transmission and the Colonization of Oral Hard Surfaces
Authors: Quirynen M. , Papaioannou W. , van Steenberghe D.
Published: March 2012

The sterile abutments of 2‐stage implants offer a unique model to study intraoral transmission and bacterial colonization patterns in the oral cavity. This study aimed to examine, by means of differential phase contrast microscopy, parameters that influence the intra‐oral colonization of these abutments. In part one, 159 partially edentulous patients were examined to determine the influence on the microbial composition around implants of the following parameters: 1) the relative location of the teeth in relation to the implants; 2) the microbial composition of the subgingival plaque around these teeth; and 3) the frequency of deep pockets around the natural dentition. The results indicate that the subgingival flora around the implants harbored more spirochetes and motile rods when teeth were present in the same jaw (P < 0.05) and/or when the pockets around them harbored a pathogenic flora (P < 0.05). In part two, the impact of periodontitis around the remaining teeth and of probing depth around the implants on the composition of the peri‐implant subgingival flora was investigated. Thirty‐one partially edentulous implant patients were classified according to their periodontal condition into 3 groups: healthy (n = 17), chronic periodontitis (n = 11), and refractory periodontitis (n = 3). The samples from deep pockets (≥ 4 mm) around implants showed significant increases in the total proportion of spirochetes and motile organisms when compared to samples from healthy subjects (1.2%) or in chronic periodontitis patients (21.0%), or to patients suffering from refractory periodontitis (31.5%). For shallow pockets (< 4 mm) significant differences were only detected between subjects with a healthy periodontium (1.0%) or chronic periodontitis (2.4%), and refractory periodontitis cases (19.7%). The present findings confirm the transmission of microorganisms from teeth to implants, and thereby highlight the importance of periodontal health around the natural dentition before as well as after implant installation. J Periodontol 1996;67:986–993.
Alterations in Phagocyte Function and Periodontal Infection
Authors: Daniel Michael A. , Van Dyke Thomas E.
Published: March 2012

A review of phagocytic cells–polymorphonuclear leukocytes and monocytes–in the inflammatory process is presented. Examples of phagocyte defect‐related pathology serve as a framework for understanding the role of these cells in periodontal infection. The role of alterations in neutrophil function in localized juvenile periodontitis is presented as a model system for understanding periodontal pathology as a result of host‐related functional abnormalities. Two topical alternative hypotheses for periodontal breakdown are presented in which. macrophage control of the chronic lesion is altered by an absence of T cells or the influence of bacterial superantigens. J Periodontol 1996;67:1070–1075.
Response to Periodontal Therapy in Diabetics and Smokers
Authors: Grossi Sara G. , Skrepcinski Fred B. , DeCaro Thomas , Zambon Joseph J. , Cummins Diane , Genco Robert J.
Published: March 2012

Diabetics and smokers are two patient groups at high risk for periodontal disease who also exhibit impaired wound healing and, therefore, constitute two different groups in whom the relationship between host‐parasite interaction, outcome of periodontal therapy, and systemic factors is best represented. The results of two independent clinical trials involving treatment of periodontal disease in diabetics and smokers are presented. A new treatment regimen‐for the management of periodontal disease associated with diabetes mellitus is proposed. This treatment approach incorporates both antimicrobial agents and pharmacological modulation of the host response. Elimination of periodontal infection and reduction of periodontal inflammation in diabetic patients resulted in a significant short‐term reduction in the concentration of glycosylated hemoglobin (HbA1c). Control of chronic infections and modulation of the host response offer a new therapeutic approach in the management of patients with both diabetes and periodontal disease. The effect of smoking on periodontal healing is also discussed. The clinical and microbiological response of smokers to non‐surgical periodontal therapy is compared to non‐smokers. In addition, possible mechanisms whereby diabetes mellitus and cigarette smoking increase the severity of periodontal disease are discussed. J Periodontol 1996;67:1094–1102.
Effects of Oral Flora on Platelets: Possible Consequences in Cardiovascular Disease
Authors: Herzberg Mark C. , Meyer Maurice W.
Published: March 2012

During episodes of dental bacteremia, viridans group streptococci encounter platelets. Among these microorganisms, certain Streptococcus sanguis induce human and rabbit platelets to aggregate in vitro. In experimental rabbits, circulating streptococci induced platelets to aggregate, triggering the accumulation of platelets and fibrin into the heart valve vegetations of endocarditis. At necropsy, affected rabbit hearts showed ischemie areas. We therefore hypothesized that circulating S. sanguis might cause coronary thrombosis and signs of myocardial infarction (MI). Signs of MI were monitored in rabbits after infusion with platelet‐aggregating doses of 4 to 40 × 109 cells of S. sanguis 133‐79. Infusion resulted in dose‐dependent changes in electrocardiograms, blood pressure, heart rate, and cardiac contractility. These changes were consistent with the occurrence of MI. Platelets isolated from hyperlipidemic rabbits showed an accelerated in vitro aggregation response to strain 133‐79. Cultured from immunosuppressed children with septic shock and signs of disseminated intravascular coagulation, more than 60% of isolates of viridans streptococci induced platelet aggregation when tested in vitro. The data are consistent with a thrombogenic role for S. sanguis in human disease, contributing to the development of the vegetative lesion in infective endocarditis and a thrombotic mechanism to explain the additional contributed risk of periodontitis to MI. J Periodontol 1996;67:1138–1142.
Metal Substrates Influence the Release of Glycosaminoglycan and Transforming Growth Factor β by Human Bone Cells
Authors: Locci Paola , Becchetti Ennio , Pugliese Mariano , Rossi Leonardo , Lilli Cinzia , Calvitti Mario , Staffolani Nicola
Published: March 2012

Bone cells derived from human jaw were isolated from expiants and grown in vitro. Subcultures were cultured on plastic (control) and metal substrates for 24 and 48 hours in medium containing 3H‐glucosamine and labeled glycosaminoglycan (GAG) accumulation was measured. In bone cells cultured on metal substrates there was an evident reduction in the synthesis and secretion of radiolabeled macromolecules compared to bone cells‐cultured on plastic. Moreover, the accumulation of single GAG classes was specific for each substrate tested. The results showed that titanium was the only metal substrate studied in which the percentage of individual GAG classes remained the same as control cultures. GAG reduction was due to a decreased synthesis and not to an increased degradation as shown by the decrement of exoglycosidase activity. The metals also reduced the activity of transforming growth factor β (TGFβ), measured using interleukin‐1 assay method, a factor involved in the various phases of bone remodeling; in this case, too, cells grown on titanium showed the highest TGFβ activity compared to the other metal substrates studied. The results indicate that the substrate to which the cells adhere do exhibit specific differences in GAG composition and TGFβ activity. The differences observed may be important during in vivo events such as guided tissue regeneration and bone deposition. J Periodontol 1996;67:1260–1266.