bluuebunny/crossref_metadata_2025 huggingface dataset:
Balance control, flexibility, and cardiorespiratory fitness among older Tai Chi practitioners
Authors: Hong Youlian , Li Jing Xian , Robinson P D
Published: July 2002

Background—Tai Chi Chuan (TTC) exercise has beneficial effects on the components of physical condition and can produce a substantial reduction in the risk of multiple falls. Previous studies have shown that short term TCC exercise did not improve the scores in the single leg stance test with eyes closed and the sit and reach test. There has apparently been no research into the effects of TCC on total body rotation flexibility and heart rate responses at rest and after a three minute step test.

Methods—In this cross sectional study, 28 male TCC practitioners with an average age of 67.5 years old and 13.2 years of TCC exercise experience were recruited to form the TCC group. Another 30 sedentary men aged 66.2 were selected to serve as the control group. Measurements included resting heart rate, left and right single leg stance with eyes closed, modified sit and reach test, total body rotation test (left and right), and a three minute step test.

Results—Compared with the sedentary group, the TCC group had significantly better scores in resting heart rate, three minute step test heart rate, modified sit and reach, total body rotation test on both right and left side (p<0.01), and both right and left leg standing with eyes closed (p<0.05). According to the American Fitness Standards, the TCC group attained the 90th percentile rank for sit and reach and total body rotation test, right and left.

Conclusion—Long term regular TCC exercise has favourable effects on the promotion of balance control, flexibility, and cardiovascular fitness in older adults.
Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function
Authors: Robinson Tristan M , Sewell Dean A , Casey Anna , Steenge Gery , Greenhaff Paul L
Published: July 2002

Background—The use of creatine (Cr) as a nutritional supplement to aid athletic performance has gained widespread popularity among athletes. However, concerns have recently been expressed over potentially harmful effects of short and long term Cr supplementation on health.

Methods—Forty eight young healthy subjects were randomly allocated to three experimental protocols aimed at elucidating any potential health risks associated with five days (20 g/day) to nine weeks (3 g/day) of Cr supplementation. Venous blood samples were collected before and after periods of Cr supplementation and were analysed for some haematological indices, and for indices of hepatic, muscular, and renal dysfunction.

Findings—All measured indices were well within their respective normal range at all times. Serum creatinine concentration tended to be increased the day after Cr supplementation. However, values had returned to baseline six weeks after the cessation of supplementation. These increases were probably attributable to increased creatinine production rather than renal dysfunction. No indication of impairment to the haematological indices measured, hepatic function, or muscle damage was apparent after Cr supplementation.

Interpretation—These data provide evidence that there are no obvious adverse effects of acute or more chronic Cr supplementation on the haematological indices measured, nor on hepatic, muscle, and renal function. Therefore there is no apparent health risk associated with Cr supplementation to healthy people when it is ingested in quantities that have been scientifically proven to increase muscle Cr stores.
The sliding stop: a technique of fielding in cricket with a potential for serious knee injury: Figure 1
Authors: Von Hagen Konrad , Roach Richard , Summers Bruce
Published: July 2002

The sliding stop method of fielding in cricket is gaining popularity in schools and club cricket through its frequent exposure on television. The case history is reported of a cricketer who suffered a torn medial meniscus in his knee, a rare cricketing injury, while performing this technique incorrectly in a club game. The correct method of performing the technique is described in coaching manuals but is not commonly instructed at club or school level. The sliding stop should be discouraged in school and for club cricketers unless appropriately coached.
The New Zealand rugby injury and performance project. VI. A prospective cohort study of risk factors for injury in rugby union football
Authors: Quarrie K L , Alsop J C , Waller A E , Bird Y N , Marshall S W , Chalmers D J
Published: July 2002

Objectives—Although the nature of rugby injury has been well documented, little is known about key risk factors. A prospective cohort study was undertaken to examine the association between potential risk factors and injury risk, measured both as an injury incidence rate and as a proportion of the playing season missed. The latter measure incorporates a measure of injury severity.

Methods—A cohort of 258 male players (mean (SD) age 20.6 (3.7) years) were followed through a full competitive season. At a preseason assessment, basic characteristics, health and lifestyle patterns, playing experience, injury experience, training patterns, and anthropometric characteristics were recorded, and then a battery of fitness tests were carried out.

Results—A multiple regression model identified grade and previous injury experience as risk factors for in season injury, measured as an injury incidence rate. A second model identified previous injury experience, hours of strenuous physical activity a week, playing position, cigarette smoking status, body mass index, years of rugby participation, stress, aerobic and anaerobic performance, and number of push ups as risk factors for in season injury, measured as proportion of season missed.

Conclusions—The findings emphasise the importance of previous injury as a predictor of injury incidence and of missing play. They also show the importance of considering both the incidence rate and severity of injury when identifying risk factors for injury in sport.
Quantitative heel ultrasound variables in powerlifters and controls
Authors: Jawed S , Horton B , Masud T
Published: July 2002

Objective—To compare by cross sectional study the quantitative heel ultrasound (QUS) variables broadband ultrasound attenuation (BUA) and velocity of sound (VOS) in male powerlifters and controls.

Methods—Twenty four powerlifters and 21 sedentary male controls were recruited to the study. All the powerlifters were members of the British Drug Free Powerlifting Association and actively competing at the time of the study. A questionnaire was completed by all those entered into the study. This included a history of smoking and an estimation of daily intake of alcohol and calcium. For the powerlifters, the number of years spent training and time spent training each week was also recorded. The QUS variables of all powerlifters and controls were measured using a Cubaclinical II (McCue) ultrasound scanner.

Results—The powerlifters had been training for a mean (SEM) of 10.6 (1.6) years and they trained for 6.5 (0.4) hours a week. The powerlifters were non-significantly older and had a significantly higher body mass index (BMI) than the controls. Calcium intake and consumption of alcohol and tobacco were similar in the two groups. The mean BUA in the powerlifters was a significant 9.5% (95% confidence interval 0.7 to 18.3%) higher than the controls (105v96 dB/MHZ) and 15.6% (95% confidence interval 6.8 to 24.4%) higher after adjustment using analysis of covariance for age, BMI, and alcohol and tobacco consumption (108v93 dB/MHZ). The mean VOS was similar in the two groups, but after adjustment it was significantly higher in the powerlifters (1671v1651 m/s, p<0.01).

Conclusions—The study shows the ability of heel ultrasound to discriminate between QUS variables in powerlifters and controls. The results indicate that the QUS variables BUA and VOS are significantly higher for powerlifters than for controls.
Biliary lipid composition in cholesterol microlithiasis
Authors: Fracchia M , Pellegrino S , Secreto P , Gallo L , Masoero G , Pera A , Galatola G
Published: July 2002

BACKGROUND

Little information is available on the pathogenesis of cholesterol microlithiasis, and it is not clear if biliary lipid composition in these patients is similar to changes seen in cholesterol gall stone patients.

AIMS

To measure biliary lipid composition in patients with cholesterol microlithiasis.

PATIENTS

Eleven patients with cholesterol microlithiasis, 20 cholesterol gall stone patients, and 17 healthy controls.

METHODS

Duodenal bile was collected in the fasting state during ceruletide infusion. Biliary cholesterol, phospholipids, and total bile acids were analysed by enzymatic assays, and conjugated bile acids by high pressure liquid chromatography.

RESULTS

Patients with microlithiasis had a cholesterol saturation index significantly higher than controls (mean value 1.30 (95% confidence interval 1.05–1.54)v0.90 (0.72–1.08)) but similar to gall stone patients (1.51 (1.40–1.63)). This was due to a significant decrease in per cent phospholipid (10.0% (7.1–12.8)) compared with controls (21.4% (18.1–24.6)) and gall stone patients (24.9% (20.5–29.3)). Per cent cholesterol was similar in patients with microlithiasis and controls (5.3% (4.5–6.1) and 5.6 % (4.3–6.8), respectively) but was significantly increased in gall stone patients (10.9% (9.3–12.4)). Bile acid composition in patients with microlithiasis was similar to controls whereas in gall stone patients deoxycholic acid was significantly increased: 27.3% (24.8–29.7)v19.0% (15.7–22.2) in controls and 20.6% (14.9–26.2) in patients with microlithiasis.

CONCLUSION

Patients with cholesterol microlithiasis have biliary cholesterol supersaturation, similarly to cholesterol gall stone patients. Whereas in the latter this is due to increased per cent cholesterol, in patients with microlithiasis this is caused by phospholipid deficiency, with normal per cent cholesterol and normal biliary bile acid composition.
Relationship between psychological state and level of activity of extrinsic gut innervation in patients with a functional gut disorder
Authors: Emmanuel A V , Mason H J , Kamm M A
Published: July 2002

BACKGROUND

Anxiety and depression are known to be associated with alterations in central autonomic activity, and this may manifest as a functional gut disturbance. However, the final expression of motility disturbance is non-specific and non-quantifiable. This study examines the relationship between psychological state and psychosocial functioning with a new direct measure of the level of activity of extrinsic autonomic gut innervation, rectal mucosal Doppler blood flow.

MATERIALS AND METHODS

Thirty four female patients (mean age 36 years, range 19–45) with constipation for greater than five years and 19 healthy women (mean age 38 years, range 21–60) were studied. They completed the general health questionnaire—28 point scale (GHQ-28; psychosocial functioning) and the Bem sex role inventory (BSRI; an index of women's psychological feelings about their own femininity). On the same day they underwent measurement of rectal mucosal Doppler blood flow, a new validated measure of the activity of gut extrinsic nerve innervation. Measurements were made during the follicular phase and in the fasted state.

RESULTS

Women with constipation scored higher on the total GHQ-28 score and the somatisation (p=0.05) and anxiety (p=0.05) subscales of the GHQ-28. There was a negative correlation between mucosal blood flow and GHQ somatisation subscale (r=−0.45, p<0.005), anxiety (r=−0.38, p<0.05), and depression (r=−0.40, p<0.01) scores in women with constipation. Although constipated women scored no higher than controls on the BSRI, there was a significant negative correlation between blood flow and BSRI score (r=−0.49, p<0.005) for constipated women.

CONCLUSIONS

General psychosocial function, somatisation, anxiety, depression, and feelings about female role are impaired in women with constipation and associated with altered rectal mucosal blood flow, a measure of extrinsic gut innervation. These findings suggest that psychological factors are likely to influence gut function via autonomic efferent neural pathways.
Osteoporosis in primary biliary cirrhosis revisited
Authors: Newton J , Francis R , Prince M , James O , Bassendine M , Rawlings D , Jones D
Published: July 2002

BACKGROUND

Primary biliary cirrhosis (PBC) is increasingly being diagnosed in the earlier non-cholestatic stages of disease. Accepted wisdom has been that PBC is frequently complicated by osteoporosis. Whether this association holds true for the broader spectrum of PBC patients now recognised has not as yet been studied.

AIMS

To examine the extent to which osteoporosis occurs more commonly in PBC patients than in normal individuals of the same age and sex.

DESIGN

Retrospective review of a large cohort of well characterised PBC patients.

PATIENTS

A total of 272 PBC patients with definite or probable PBC followed up for a mean of 10.1 years (total follow up 2726 patient years) who had at least one bone mineral density measurement (BMD).

RESULTS

In this unselected group of PBC patients, mean Z scores (number of SDs from age and sex matched normal mean values) at the neck of femur (NOF) and lumbar spine (LS) at first BMD measurement (7 (6) years after PBC diagnosis) were −0.1 (1.4) and 0.1 (1.4), respectively. At first BMD measurement, 18 PBC patients had Z scores less than −2.0 and 85 had T scores less than −2.5. No factors predictive of osteoporosis were found in affected patients. A total of 957 BMD measurements were performed (0.35 per patient year of follow up); 220 patients had two or more measurements. No patient went on to develop de novo osteoporosis during follow up. In the 51 patients (who were clinically representative of the whole group) who received no PBC or bone related treatment during follow up, %BMD changes per year at the NOF and LS were −1.6 (3.2) and 0.1 (2.2), respectively. No variance in this “natural” rate of BMD measurement was seen in patients receiving PBC modulating agents (including prednisolone and UDCA) or osteoporosis prophylaxis/therapy. Significant improvement at the LS was seen in patients undergoing liver transplantation.

CONCLUSIONS

Osteoporosis is not a specific complication of PBC.
Justified deception? The single blind placebo in drug research
Authors: Evans Martyn
Published: July 2002

“Run-in” and “washout” periods involving the withholding of medication are widely used in drug research trials in pursuit of both patient safety and scientific reliability. Such no-medication periods can be justified ethically provided that they are apparent to patients, who can thereby properly consent to undergoing them. Less widespread, but still common, is the practice of “single blinding” no-medication periods, concealing them from patients by means of placebo. Whilst all placebos involve a measure of concealment, their use is typically justified in drug research trials (i) by their preserving the uncertainty generated by the random allocation of different treatments within a drug trial; and (ii) by the researchers openly declaring both the randomisation process and the chances of receiving placebo. In the single blind placebo “run-in” or “washout”, neither of these conditions is met.

This paper considers three possible defences of the practice of using single blind placebo “run-ins” or “washouts” and finds them all to fail; the practice appears ethically unjustified.
Legal aspects of clinical ethics committees
Authors: Hendrick Judith
Published: July 2002

In an increasingly litigious society where ritual demands for accountability and “taking responsibility” are now commonplace, it is not surprising that members of clinical ethics committees (CECs) are becoming more aware of their potential legal liability. Yet the vulnerability of committee members to legal action is difficult to assess with any certainty. This is because the CECs which have been set up in the UK are—if the American experience is followed—likely to vary significantly in terms of their functions, procedures, composition, structures and authority. As a consequence it is difficult to generalise about the legal implications. Nevertheless, despite these difficulties this article will outline the broad legal principles governing the potential liability of committee members. It will also consider the relationship between CECs and the courts. It begins, however, with a brief analysis of the relationship between ethics and law in committee deliberations, and in particular of the role of law and legal expertise on CECs.
Is there a moral duty for doctors to trust patients?
Authors: Rogers W A
Published: July 2002

In this paper I argue that it is morally important for doctors to trust patients. Doctors' trust of patients lays the foundation for medical relationships which support the exercise of patient autonomy, and which lead to an enriched understanding of patients' interests. Despite the moral and practical desirability of trust, distrust may occur for reasons relating to the nature of medicine, and the social and cultural context within which medical care is provided. Whilst it may not be possible to trust at will, the conscious adoption of a trusting stance is both possible and warranted as the burdens of misplaced trust fall more heavily upon patients than doctors.
Voices to be heard—the many positions of a physician in Anton Chekhov's short story,A Case History
Authors: Puustinen Raimo
Published: July 2002

Anton Chekhov (1860-1904) dealt in many of his short stories and plays with various phenomena as encountered in everyday medical practice in late 19th century Russia. In A Case History (1898) Chekhov illustrates the physician's many positions in relation to his patient. According to Mikhail Bakhtin's philosophy of language, a speaker occupies a certain position from which he or she addresses the listener. A phenomenon may gain different meanings depending on the position from which it is addressed. In his story Chekhov describes how the patient was at first addressed solely from a medical point of view, without any relief to her suffering. Only when the physician was able to shift his position in a manner which offered the patient an opportunity to be heard as a person was she able to express the true nature of her illness and to find new ways for palliation and cure.
Evaluation of environmental bacterial contamination and procedures to control cross infection in a sample of Italian dental surgeries
Authors: Monarca Silvano , Grottolo Mario , Renzi Daniela , Paganelli Corrado , Sapelli Pierluigi , Zerbini Ilaria , Nardi Giuseppe
Published: July 2002

OBJECTIVES

To perform a pilot study on bacterial contamination in some dental surgeries (n=51) in a local health unit in Brescia (Lombardy Region, Italy) and to evaluate the procedures to control cross infection used by the personnel to reduce the risk of infection in dental practice.

METHODS

A survey was carried out by interviewing 133 dental personnel with a questionnaire on the procedures used to control infection. The autoclaves, chemical baths (chemiclaves), and ovens present in the surgeries were tested for sterilisation efficiency with a spore test, and already packed and sterilised instruments were randomly sampled and tested for sterility. Microbial contamination of air, surface, and dental unit water samples were also studied.

RESULTS

The dental personnel did not generally follow the principal procedures for infection control: 30% of personnel were not vaccinated against hepatitis B virus, infected instruments were often not decontaminated, periodic checks of autoclave efficiency were lacking, and the knowledge of disinfection mechanisms and procedures was incomplete. High bacteriological contamination of water at dental surgeries was often found and total bacteriological counts in air samples were high. Surface studies showed widespread bacterial contamination.

CONCLUSIONS

On the basis of these results, an educational programme for the prevention of infective hazards has been prepared and carried out. The results of this pilot study will be used for planning a national survey.
Risk of mortality, cancer incidence, and stroke in a population potentially exposed to cadmium
Authors: Elliott Paul , Arnold Richard , Cockings Samantha , Eaton Naomi , Järup Lars , Jones Jennifer , Quinn Mike , Rosato Michael , Thornton Iain , Toledano Mireille , Tristan Emma , Wakefield Jon
Published: July 2002

OBJECTIVES

To follow up mortality and cancer incidence in a cohort potentially exposed to cadmium and to perform a geographical (ecological) analysis to further assess the health effects of potential exposure to cadmium.

METHODS

The English village of Shipham has very high concentrations of cadmium in the soil. A previous cohort study of residents of Shipham in 1939 showed overall mortality below that expected, but a 40% excess of mortality from stroke. This study extends the follow up of the cohort for mortality to 1997, and includes an analysis of cancer incidence from 1971 to 1992, and a geographical study of mortality and cancer incidence. Standardised mortality and incidence ratios (SMRs and SIRs) were estimated with regional reference rates. Comparisons were made with the nearby village of Hutton.

RESULTS

All cause cohort mortality was lower than expected in both villages, although there was excess cancer incidence in both Shipham (SIR 167, 95% confidence interval (95% CI) 106 to 250) and Hutton (SIR 167, 95% CI 105 to 253). There was an excess of mortality from hypertension, cerebrovascular disease, and nephritis and nephrosis, of borderline significance, in Shipham (SMR 128, 95% CI 99 to 162). In the geographical study, all cause mortality in Shipham was also lower than expected (SMR 84, 95% CI 71 to 100). There was an excess in genitourinary cancers in both Shipham (SIR 160, 95% CI 107 to 239) and Hutton (SIR 153, 95% CI 122 to 192).

CONCLUSION

No clear evidence of health effects from possible exposure to cadmium in Shipham was found despite the extremely high concentrations of cadmium in the soil.
Job experience, work load, and risk of musculoskeletal disorders
Authors: Häkkänen M , Viikari-Juntura E , Martikainen R
Published: July 2002

OBJECTIVES

To investigate the effects of physical work load and job experience on morbidity from musculoskeletal disorders among trailer assembly workers.

METHODS

A longitudinal study was carried out in a trailer assembly factory with many new workers employed during the follow up. The sickness absence of 532 workers (160 experienced and 372 new (separately for the first year of employment and from the second year on)) was followed up. Exposure was assessed by job titles, visits, task descriptions, and some direct measurements. The associations between the explanatory variables and sick leave were assessed by log linear models.

RESULTS

A higher rate of sick leave due to disorders of the upper limbs was found for new workers compared with experienced ones, especially in the high work load group. Women had a higher rate than men. New male workers in physically strenuous tasks had a high rate of sick leave due to neck and shoulder disorders.

CONCLUSIONS

As being unaccustomed to work seems to increase the risk of musculoskeletal disorders, special attention should be paid to newly employed workers.
Prospective study of hepatic, renal, and haematological surveillance in hazardous materials firefighters
Authors: Kales S N , Polyhronopoulos G N , Aldrich J M , Mendoza P J , Suh J H , Christiani D C
Published: July 2002

OBJECTIVES

To evaluate possible health effects related to work with hazardous materials as measured by end organ effect markers in a large cohort over about 2 years, and in a subcohort over 5 years.

METHODS

Hepatic, renal, and haematological variables were analysed from 1996–98 in hazardous materials firefighters including 288 hazardous materials technicians (81%) and 68 support workers (19%). The same end organ effect markers in a subcohort of the technicians were also analysed (n=35) from 1993–98. Support workers were considered as controls because they are also firefighters, but had a low potential exposure to hazardous materials.

RESULTS

During the study period, no serious injuries or exposures were reported. For the end organ effect markers studied, no significant differences were found between technicians and support workers at either year 1 or year 3. After adjustment for a change in laboratory, no significant longitudinal changes were found within groups for any of the markers except for creatinine which decreased for both technicians (p<0.001) and controls (p<0.01).

CONCLUSIONS

Health effects related to work are infrequent among hazardous materials technicians. Haematological, hepatic, and renal testing is not required on an annual basis and has limited use in detecting health effects in hazardous materials technicians.
Smoking and mortality in 81 344 drivers in Guangzhou, China
Authors: Lam T H , Jiang C Q , Ho S Y , Zhang W S , Liu W W , He J M
Published: July 2002

Objectives: Previous studies on drivers focused on the effect of their exposure to vehicle exhaust and there is little evidence of the effect of smoking. This cohort analytical study aimed to examine the mortality of drivers relative to smoking and professional driving in Guangzhou, China.

Methods: Information on demographic characteristics, type of driver (professional and non-professional), smoking, and drinking were retrieved from medical records of drivers who applied for driving licences from March to December 1992. Vital status and causes of death of 81 344 men aged 30 or above were ascertained to the end of September 1999 (follow up, mean=7.14 years, median=7.17 years).

Results: At baseline, the mean (SD) age was 40.8 (5.6) years. One third were professional drivers; 49.0% were daily smokers. 858 Deaths were identified. The relative risk of overall mortality for ever smoking was 1.24 (95% confidence interval (95% CI) 1.07 to 1.44) after adjusting for age, alcohol drinking, education, and type of drivers. Compared with non-professional drivers, professional drivers had similar risks of death, and their relative risk of overall mortality for ever smoking was 1.35 (1.06 to 1.71).

Conclusions: Smoking is a more important cause of death than professional driving itself. The results show serious public health problems in the early stage of the tobacco epidemic and support urgent measures to help drivers stop smoking.
A cohort mortality and nested case-control study of French and Austrian talc workers
Authors: Wild P , Leodolter K , Réfrégier M , Schmidt H , Zidek T , Haidinger G
Published: July 2002

Objectives: To study whether the mortality from non-malignant and malignant respiratory diseases of workers employed in French and Austrian talc mines and mills is related to their long term occupational exposure.

Methods: Two historical cohorts were set up comprising all male subjects who had been working continuously for at least 1 year in a series of talc producing companies in France and Austria. The French cohort consisted of those employed at a site in the French Pyrenees and working between 1 January 1945 and 31 December 1994. The Austrian cohort consisted of the workers employed between 1 January 1972 and 31 December 1995 in one of four industrial sites in the Austrian Alps. The mortality within the cohorts was compared with local death rates. Two nested case-control studies focusing on non-malignant and malignant respiratory diseases were set up to estimate possible dose-response relations with cumulative exposure to talc dust based on an industry specific job exposure matrix.

Results: Mortality from lung cancer was in small excess in both cohorts (France, standardised mortality ratio (SMR) 1.23, 21 cases observed, 95% confidence interval (95% CI) 0.76 to 1.89; Austria, SMR 1.06, seven observed, 95% CI 0.43 to 2.19). A non-significant excess mortality was found for all non-malignant respiratory diseases in the French cohort due to a significant excess for pneumoconiosis (SMR 5.56, three observed, 95% CI 1.12 to 16.2). The case-control study of non-malignant respiratory disease showed an increased mortality in the highest exposure groups (odds ratio (OR) 2.5 for a cumulative exposure ≥800 y.mg/m3) with a significant trend (OR/100 y.mg/m31.08) with cumulative exposure to talc. On the contrary, no increasing trend could be found in the case-control study of lung cancer. This result must be interpreted considering the small cohort size. Adjustment on smoking and exposure to quartz did not influence these results to any extent.

Conclusions: The mortality from non-malignant respiratory disease was found to be related to high cumulative exposure to talc dust. The small excess in lung cancer does not seem to be attributable to talc.
Health and neuropsychological functioning of dentists exposed to mercury
Authors: Ritchie K A , Gilmour W H , Macdonald E B , Burke F J T , McGowan D A , Dale I M , Hammersley R , Hamilton R M , Binnie V , Collington D
Published: July 2002

Objectives: A cross sectional survey of dentists in the west of Scotland and unmatched controls was conducted to find the effect of chronic exposure to mercury on health and cognitive functioning.

Methods: 180 dentists were asked to complete a questionnaire that included items on handling of amalgam, symptoms experienced, possible influences on psychomotor function, and the 12 item general health questionnaire. Dentists were asked to complete a dental chart of their own mouths and to give samples of urine, hair, and nails for mercury analysis. Environmental measurements of mercury in dentists' surgeries were made and participants undertook a package of computerised psychomotor tests. 180 control subjects underwent a similar procedure, completing a questionnaire, having their amalgam surfaces counted, giving urine, hair, and nail samples and undergoing the psychomotor test package.

Results: Dentists had, on average, urinary mercury concentrations over four times that of control subjects, but all but one dentist had urinary mercury below the Health and Safety Executive health guidance value. Dentists were significantly more likely than control subjects to have had disorders of the kidney and memory disturbance. These symptoms were not significantly associated with urinary mercury concentration. Differences were found between the psychomotor performance of dentists and controls after adjusting for age and sex, but there was no significant association between changes in psychomotor response and mercury concentrations in urine, hair, or nails.

Conclusions: Several differences in health and cognitive functioning between dentists and controls were found. These differences could not be directly attributed to their exposure to mercury. However, as similar health effects are known to be associated with mercury exposure, it would be appropriate to consider a system of health surveillance of dental staff with particular emphasis on symptoms associated with mercury toxicity where there is evidence of high levels of exposure to environmental mercury.
Oral care of elderly patients: nurses' knowledge and views
Authors: Preston A J , Punekar S , Gosney M A
Published: July 2002

It is important that healthcare professionals caring for the elderly in hospitals have a core knowledge of the orodental care requirements of their patients. The aim of this study was to determine the knowledge and views of nurses working on acute and rehabilitation care of the elderly wards about orodental care. One hundred nurses and healthcare assistants took part in this questionnaire study of which 58 were qualified nurses and 70 had been employed on care of the elderly wards for two or more years. Although the majority of the respondents were registered with a dentist and attended regularly, 40 did have ‘some anxiety’ about visiting their dentist. Approximately half of the study population regularly gave advice to their patients about dental care but their knowledge of and reasons for providing oral care and advice was often incorrect. The group's understanding of the availability of dental treatment provided by the National Health Service was also often inaccurate. It was concluded that a better core knowledge of the orodental care of older patients is required by all healthcare professionals who care for this group. It is also important that individuals in whom anxiety is associated with their own dental experience do not neglect to give orodental health advice to their patients.
Histoplasmosis of the small bowel in patients with AIDS
Authors: Gumbs Milton A , Girishkumar Hanasoge , Yousuf Arshad , Levy Leo , Patel Mayank , Narasimha Vijay
Published: July 2002

Two cases of jejunal strictures caused by Histoplasma capsulatum in AIDS patients are presented. Both patients were intravenous drug abusers. One patient, who was being treated for Pneumocystis carnii pneumonia, presented with jejunal perforation and the other presented with lower gastrointestinal bleeding and intestinal obstruction. On exploration, both patients were found to have jejunal strictures; one had intestinal perforation, and the other had intestinal obstruction with ulcers and strictures resulting in gastrointestinal bleeding. In areas where it is endemic, histoplasmosis is rarely disseminated. Dissemination is most commonly seen in immunosuppressed patients. Dissemination and extrapulmonary histoplasmosis is now included in the case definition of AIDS.
Adult Still’s disease and respiratory failure in a 74 year old woman
Authors: Stoica G S , Cohen R I , Rossoff L J
Published: July 2002

A case of adult onset Still’s disease in an elderly woman, that was associated with severe respiratory failure and multiorgan dysfunction, is reported. Histopathology was confirmed on open lung biopsy.
Role of the human papilloma virus in the development of cervical intraepithelial neoplasia and malignancy
Authors: Jastreboff A M , Cymet T
Published: July 2002

Human papilloma virus (HPV) is a public health problem as a sexually transmitted disease and as a critical factor in the pathogenesis of various cancers. The clinical manifestations, epidemiology, and virology that are critical to understanding the process of cervical dysplasia and neoplasia are reviewed. A discussion of the cervical transformation zone and the classification of cervical dysplasia and neoplasia leads into the importance of the Papanicolaou smear in prevention of potentially devastating sequelae of this virus. The role of the immune system in the progression of the disease and how it relates to vaccines, as well as treatment and prevention of HPV, are reviewed.
Transient ischaemic attacks mimicking focal motor seizures
Authors: Schulz U G R , Rothwell P M
Published: July 2002

Limb shaking is an under-recognised form of transient ischaemic attack (TIA), which can easily be confused with focal motor seizures. However, it is important to distinguish limb shaking TIAs and focal seizures, as patients with this form of TIA almost invariably have severe carotid occlusive disease and are at high risk of stroke. A patient with limb shaking TIAs is presented in whom the diagnosis was missed.
Integrated karyotyping of sorghum by in situ hybridization of landed BACs
Authors: Kim Jeong-Soon , Childs Kevin L , Islam-Faridi M Nurul , Menz Monica A , Klein Robert R , Klein Patricia E , Price H James , Mullet John E , Stelly David M
Published: July 2002

The reliability of genome analysis and proficiency of genetic manipulation are increased by assignment of linkage groups to specific chromosomes, placement of centromeres, and orientation with respect to telomeres. We have endeavored to establish means to enable these steps in sorghum (Sorghum bicolor (L.) Moench), the genome of which contains ca. 780 Mbp spread across n = 10 chromosomes. Our approach relies on fluorescence in situ hybridization (FISH) and integrated structural genomic resources, including large-insert genomic clones in bacterial artificial chromosome (BAC) libraries. To develop robust FISH probes, we selected sorghum BACs by association with molecular markers that map near the ends of linkage groups, in regions inferred to be high in recombination. Overall, we selected 22 BACs that encompass the 10 linkage groups. As a prelude to development of a multiprobe FISH cocktail, we evaluated BAC-derived probes individually and in small groups. Biotin- and digoxygenin-labeled probes were made directly from the BAC clones and hybridized in situ to chromosomes without using suppressive unlabelled C0t-1 DNA. Based on FISH-signal strength and the relative degree of background signal, we judged 19 BAC-derived probes to be satisfactory. Based on their relative position, and collective association with all 10 linkage groups, we chose 17 of the 19 BACs to develop a 17-locus probe cocktail for dual-color detection. FISH of the cocktail allowed simultaneous identification of all 10 chromosomes. The results indicate that linkage and physical maps of sorghum allow facile selection of BAC clones according to position and FISH-signal quality. This capability will enable development of a high-quality molecular cytogenetic map and an integrated genomics system for sorghum, without need of chromosome flow sorting or microdissection. Moreover, transgeneric FISH experiments suggest that the sorghum system might be applicable to other Gramineae.Key words: integrated karyotyping, FISH, sorghum, BAC.
Bond behavior of high strength concrete under reversed pull-out cyclic loading
Authors: Alavi-Fard M , Marzouk H
Published: July 2002

Structures located in seismic zones require significant ductility. It is necessary to examine the bond slip characteristics of high strength concrete under cyclic loading. The cyclic bond of high strength concrete is investigated under different parameters, including load history, confining reinforcement, bar diameter, concrete strength, and the rate of pull out. The bond strength, cracking, and deformation are highly dependent on the bond slip behavior between the rebar and the concrete under cyclic loading. The results of cyclic testing indicate that an increase in cyclic displacement will lead to more severe bond damage. The slope of the bond stress  displacement curve can describe the influence of the rate of loading on the bond strength in a cyclic test. Specimens with steel confinement sustained a greater number of cycles than the specimens without steel confinement. It has been found that the maximum bond strength increases with an increase in concrete strength. Cyclic loading does not affect the bond strength of high strength concrete as long as the cyclic slip is less than the maximum slip for monotonic loading. The behavior of high strength concrete under a cyclic load is slightly different from that of normal strength concrete.Key words: bond, high strength, cyclic loading, bar spacing, loading rate, failure mechanism.
Evaluation of the properties of Toronto iron water mains and surrounding soil
Authors: Seica Michael V , Packer Jeffrey A , Grabinsky M WF , Adams Barry J
Published: July 2002

The problem of ageing water pipes manifesting leaks and breaks is common to municipalities throughout Canada, North America, and the world. Among them, the City of Toronto has been confronted with water main infrastructure problems, currently encountering a break rate of roughly two occurrences per week over a network of 5347 km. The appropriate corrective action, which aims to restore pipe integrity and prevent future breaks and leaks, should be decided based on a general knowledge of the state of deterioration of the water main network, a thorough understanding of the governing failure modes, and a clear identification of the problem areas. To achieve these goals, an extensive sampling and testing programme was undertaken by the University of Toronto in collaboration with the City of Toronto. The programme encompassed a period of three years, from 1998 to 2000, and involved the testing and analysis of 100 exhumed pipe samples, mostly cast iron, in the University's structural testing laboratories. The purpose of these tests was to ascertain the extent of material loss due to corrosion, the mechanical properties of the pipe material, and the mode of failure. Simultaneously, soil samples were extracted in the proximity of the sampled pipes, identified, and classified, and their corrosion aggressiveness was investigated through tests in the University's environmental and geotechnical engineering laboratories. The outcome of this interdisciplinary investigation, complemented by further research efforts, should lead to a clearer understanding of water main failure phenomena and contribute to the efforts of the many cities endeavouring to minimize the number of break occurrences and prioritize their maintenance and rehabilitation schedules.Key words: water mains, pipes, infrastructure, cast iron, ductile iron, corrosion, mechanical properties, soil properties, site sampling.
Towards a structure-function analysis of bovine lactoferricin and related tryptophan- and arginine-containing peptides
Authors: Vogel Hans J , Schibli David J , Jing Weiguo , Lohmeier-Vogel Elke M , Epand Raquel F , Epand Richard M
Published: July 2002

The iron-binding protein lactoferrin is a multifunctional protein that has antibacterial, antifungal, antiviral, antitumour, anti-inflammatory, and immunoregulatory properties. All of these additional properties appear to be related to its highly basic N-terminal region. This part of the protein can be released in the stomach by pepsin cleavage at acid pH. The 25-residue antimicrobial peptide that is released is called lactoferricin. In this work, we review our knowledge about the structure of the peptide and attempt to relate this to its many functions. Microcalorimetry and fluorescence spectroscopy data regarding the interaction of the peptide with model membranes show that binding to net negatively charged bacterial and cancer cell membranes is preferred over neutral eukaryotic membranes. Binding of the peptide destabilizes the regular membrane bilayer structure. Residues that are of particular importance for the activity of lactoferricin are tryptophan and arginine. These two amino acids are also prevalent in "penetratins", which are regions of proteins or synthetic peptides that can spontaneously cross membranes and in short hexapeptide antimicrobial peptides derived through combinatorial chemistry. While the antimicrobial, antifungal, antitumour, and antiviral properties of lactoferricin can be related to the Trp/Arg-rich portion of the peptide, we suggest that the anti-inflammatory and immunomodulating properties are more related to a positively charged region of the molecule, which, like the alpha- and beta-defensins, may act as a chemokine. Few small peptides are involved in as wide a range of host defense functions as bovine and human lactoferricin.Key words: lactoferricin, penetratin, tryptophan, arginine, membrane perturbation, fluorescence spectroscopy, NMR spectroscopy, microcalorimetry.
Glycine and alanine dehydrogenase activities are catalyzed by the same protein inMycobacterium smegmatis: upregulation of both activities under microaerophilic adaptation
Authors: Usha Veeraraghavan , Jayaraman Ramesh , Toro Juan Carlos , Hoffner Sven E , Das Kaveri S
Published: July 2002

Microaerophilic adaptation has been described as one of the in vitro dormancy models for tuberculosis. Studies on Mycobacterium tuberculosis adapted to low oxygen levels showed an enhancement of glycine dehydrogenase (deaminating) activity. We studied the physiology of the fast-growing, nonpathogenic strain of Mycobacterium smegmatis ATCC 607 under low oxygen by shifting the actively growing M. smegmatis cells to static microaerophilic growth conditions. This shifting of M. smegmatis culture resulted in a similar phenomenon as seen with M. tuberculosis, i.e., elevated glycine dehydrogenase activity. Further purification of glycine dehydrogenase from M. smegmatis demonstrated glyoxylate amination, but failed to demonstrate glycine deamination, even in the purified fraction. Moreover, the purified protein showed pyruvate amination as well as L-alanine deamination activities. By activity staining, the protein band positive for glyoxylate amination demonstrated only pyruvate amination in the presence of NAD. Absence of glycine deamination activity strongly suggested that alanine dehydrogenase of M. smegmatis was responsible for glyoxylate amination in the cell lysate. This was further confirmed by demonstrating the similar level of upregulation of both glyoxylate and pyruvate amination activities in the cell lysate of the adapted culture.Key words: Mycobacterium smegmatis, glycine dehydrogenase, microaerophilic adaptation, alanine dehydrogenase.
The effects of silvicultural disturbances on cryptogam diversity in the boreal-mixedwood forest
Authors: Newmaster Steven G , Bell F Wayne
Published: July 2002

In northern forests, cryptogams (spore producing plants) occupy a key position in forest ecosystem diversity and function. Forest harvesting and silvicultural practices have the potential to reduce cryptogam diversity. This project uses four blocks that were mechanically site prepared, planted with a single conifer species, and subsequently subjected to five conifer release treatments: (1) motor-manual cleaning, (2) mechanical brush cutting, (3) aerial application of triclopyr, (4) aerial application of glyphosate, and (5) control (untreated clearcut). Five 10 × 10 m subplots were installed in each of the five treatment plots and the uncut forest on the four blocks. Botanical surveys were conducted before and 15 years after treatments. Species richness and abundance, Shannon's and Heip's indices, and rank abundance diagrams clearly show that richness and abundance were affected by silvicultural treatments. Vegetation management treatments resulted in significant reductions in cryptogam diversity, to the point that only a few colonists and drought-tolerant species remained. Cryptogam diversity was ranked in the following order: forest > clearcut > mechanical clearing > herbicide treatment. Herbicide treatments had the greatest initial effect on species richness, species abundance, and diversity indices. Cryptogam diversity showed signs of recovery 5 years after treatments. Missed strips (untreated areas) within a clearcut provided a refuge for remnant communities of forest cryptogams that could play a key role in the rehabilitation forest diversity.
ON THE CLIQUE-WIDTH OF SOME PERFECT GRAPH CLASSES
Authors: GOLUMBIC MARTIN CHARLES , ROTICS UDI
Published: July 2002

Graphs of clique–width at most k were introduced by Courcelle, Engelfriet and Rozenberg (1993) as graphs which can be defined by k-expressions based on graph operations which use k vertex labels.

In this paper we study the clique–width of perfect graph classes.

On one hand, we show that every distance–hereditary graph, has clique–width at most 3, and a 3–expression defining it can be obtained in linear time. On the other hand, we show that the classes of unit interval and permutation graphs are not of bounded clique–width. More precisely, we show that for every [Formula: see text] there is a unit interval graph In and a permutation graph Hn having n2 vertices, each of whose clique–width is at least n. These results allow us to see the border within the hierarchy of perfect graphs between classes whose clique–width is bounded and classes whose clique–width is unbounded.

Finally we show that every n×n square grid, [Formula: see text], n ≥ 3, has clique–width exactly n+1.