bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluorescein filling defects of the optic nerve head in normal tension glaucoma, primary open‐angle glaucoma, ocular hypertension and healthy controls
Authors: Plange Niklas , Kaup Marion , Huber Klaudia , Remky Andreas , Arend Oliver
Published: December 2005

Background: To evaluate fluorescein filling defects of the optic nerve head in normal tension glaucoma (NTG), primary open‐angle glaucoma (POAG), ocular hypertension (OHT) and controls.

Methods: Forty patients with NTG (mean age 55 ± 10 years), 40 patients with POAG (mean age 55 ± 11 years), 40 patients with OHT (mean age 53 ± 13 years), and 40 age‐matched controls (mean age 54 ± 11 years) were included in a prospective study. Video fluorescein angiograms were performed by means of a scanning laser ophthalmoscope. The extent of absolute filling defects of the optic nerve head was assessed (as a percentage of the disc area) using digital image analysis. Visual fields were tested by automatic static perimetry (Humphrey Field Analyzer, programme 24‐2).

Results: Absolute filling defects were significantly larger in patients with NTG (12.2 ± 15.5%) and POAG (12.9 ± 13.1%) compared to patients with OHT (1.2 ± 3.6%) and healthy controls (0.1 ± 0.5%) (p < 0.0001). The area under the receiver operating characteristic (ROC) curve was 0.806 for NTG vs healthy controls, and 0.812 for POAG vs OHT. Absolute filling defects are significantly correlated to the global indices mean deviation (r = −0.63,p < 0.0001), pattern standard deviation (r = 0.61,p < 0.0001), and corrected pattern standard deviation (r = 0.62,p < 0.0001) and significantly correlated to horizontal (r = 0.50,p < 0.0001) and vertical (r = 0.53,p < 0.0001) cup‐to‐disc‐ratios.

Conclusions: Fluorescein filling defects of the optic disc representing capillary dropout are present in NTG and POAG. The extent of these filling defects is correlated to visual field loss and morphological damage. Fluorescein angiography may be useful in the diagnosis and management of NTG and POAG.
Spatial frequency content of the Cardiff and related acuity tests
Authors: Charman W. N.
Published: December 2005

In the Cardiff acuity test, simple pictures on an otherwise neutral grey card are defined by borders consisting of a relatively broad white band flanked by black bands each half the width of the white band. Higher levels of acuity correspond to the ability to detect figures defined by narrower borders, the figure size remaining constant. It is sometimes implied that the acuity limit corresponding to each card can be equated with different levels of grating resolution, the total width of the border corresponding to the overall grating period. It is shown that although the spatial frequency spectra of the Cardiff figures, like those of other vanishing optotypes, lack very low‐frequency components, they have a complex two‐dimensional form. The figures have wide spatial bandwidth and no well‐defined discrete frequency components. As a result, the relationship between measured Cardiff and grating acuity will vary somewhat, depending upon the particular optical, neural or other deficits of the individual being tested.
Using 3D computer simulations to enhance ophthalmic training
Authors: Glittenberg C. , Binder S.
Published: December 2005

Purpose:  To develop more effective methods of demonstrating and teaching complex topics in ophthalmology with the use of computer aided three‐dimensional (3D) animation and interactive multimedia technologies.

Methods:  We created 3D animations and interactive computer programmes demonstrating the neuroophthalmological nature of the oculomotor system, including the anatomy, physiology and pathophysiology of the extra‐ocular eye muscles and the oculomotor cranial nerves, as well as pupillary symptoms of neurological diseases. At the University of Vienna we compared their teaching effectiveness to conventional teaching methods in a comparative study involving 100 medical students, a multiple choice exam and a survey.

Results:  The comparative study showed that our students achieved significantly better test results (80%) than the control group (63%) (diff. = 17 ± 5%, p = 0.004). The survey showed a positive reaction to the software and a strong preference to have more subjects and techniques demonstrated in this fashion.

Conclusion:  Three‐dimensional computer animation technology can significantly increase the quality and efficiency of the education and demonstration of complex topics in ophthalmology.
Error classification in community optometric practice – a pilot project
Authors: Steele C. F. , Rubin G. , Fraser S.
Published: December 2005

Objective:  A pilot study was conducted to undertake a baseline assessment of errors reported in community optometric practice. The feasibility and acceptability of a method for recording staff‐reported errors in optometric community practice was investigated.

Design:  An anonymous self‐reporting system was introduced in order to collect information regarding errors/untoward events in community optometric practice.

Setting:  UK community optometric practice.

Main outcome measures:  Classification of errors according to a previously published study pertaining to general medical practice in the same geographical area.

Results:  Thirty‐six notebooks were distributed to 10 participating community optometric practices. At the end of the 1 month study period the note books were returned and the 439 entries made were classified into seven categories: optical prescriptions (18.2%), communication (35.5%), administrative (15%), appointments (2.3%), equipment (11.9%), clinical (10.3%) and other (6.9%).

Conclusion:  A previously developed classification of errors in general medical practice was found to be equally applicable to community optometric practice. This study forms the basis of providing an acceptable and practical methodology, which can be applied by Primary Care Trusts (PCTs) when developing their risk management strategy to include optometry.
Growth of the cornea from infancy to adolescence
Authors: Ronneburger Ariel , Basarab Jennifer , Howland Howard C.
Published: December 2005

The intraocular distance and iris diameter of children and young adolescents were measured, with the aid of a measuring microscope, from photographs of their faces. True intraocular distance was measured with an intraocular caliper at the same time that the photographs were taken. These data were then compiled and horizontal visible iris diameters (HVIDs) were calculated. An equation was derived from the optics of the Gullstrand model eye to calculate horizontal corneal diameter (HCD) from HVID. Comparisons of HVIDs revealed no significant correlation with age in either a regression plot of cross‐sectional data for subjects aged 1 month to 1 year, or all subjects whose ages ranged from 1 month to adolescence. Additional longitudinal data for 13 individuals, who had been photographed as both an infant (mean = 3.4 months) and as an older child or adolescent (mean = 8.6 years), were then compiled and HVIDs for these subjects at two different ages were compared. A Wilcoxon signed rank test revealed a small but significant amount of growth, 0.318 mm (p‐value = 0.013), in the HVIDs over a mean age difference of 8.3 years for individuals measured twice during their lifetimes. The regression equation for this growth was: HVID = 10.52 (±0.095 S.E.) + 0.0305 (±0.014) × Age (years). From a comparison of data from earlier literature and our own measurements, we conclude that, after birth, the fastest growth of the cornea must occur during the first few months of life.
Indicators for sustainable energy development: An initiative by the International Atomic Energy Agency
Authors: Vera I. A. , Langlois L. M. , Rogner H. H. , Jalal A. I. , Toth F. L.
Published: December 2005

Since 1999, the International Atomic Energy Agency (IAEA) has been leading a multinational, multi‐agency effort to develop a set of energy indicators useful for measuring progress on sustainable development at the national level. This effort has included the identification of major relevant energy indicators, the development of a framework for implementation and the testing of the applicability of this tool in a number of countries. To achieve these goals, the IAEA has worked closely with other international organizations, leaders in energy and environmental statistics and analysis including the United Nations Department of Economic and Social Affairs (DESA), the International Energy Agency (IEA), Eurostat and the European Environment Agency (EEA). Also, the IAEA completed a three‐year coordinated research project for the implementation and testing of the original set of indicators in seven countries — Brazil, Cuba, Lithuania, Mexico, the Russian Federation, the Slovak Republic and Thailand. This article provides an overview of the IAEA programme on Indicators for Sustainable Energy Development (ISED) and highlights its experiences and accomplishments.
Evaluation of energy policy in Cuba using ISED
Authors: Pérez David , López I. , Berdellans I.
Published: December 2005

This article discusses the development of Cuba's energy sector in the last half century, especially the last 25 years, emphasizing social, economic, environmental and institutional aspects. Energy use is evaluated with the indicators for sustainable energy development (ISED) developed by the International Atomic Energy Agency (IAEA) and applied by the authors, based on data series from Cuba's National Office of Statistics. Cuba's economy and energy sector have undergone important changes, particularly in the 1990s during the crisis that resulted from the termination of the country's special trade relations with former socialist countries. Based on an analysis of Cuba's economy and energy situation, a number of policies were selected for evaluation, including those aimed to reduce energy import dependence, increase the share of renewable energy sources and improve energy efficiency. The effects of these policies are evaluated in view of sustainable energy development. The article concludes with an evaluation of recent progress towards sustainable energy development in Cuba, and outlines future options for the country.
Indicators for sustainable energy development in Mexico
Authors: Medina‐Ross José Antonio , Mata‐Sandoval Juan C. , López‐Pérez Roberto
Published: December 2005

This article presents a summary of a study on the application to the Mexican energy sector of a core set of indicators for sustainable energy development (ISED), developed by the International Atomic Energy Agency (IAEA). The study focused on the elaboration of socio‐economic and environmental indicators related to energy production and use, and was aimed at assessing Mexico's existing energy policies and identifying strategies and possible policies that could bring about improvements in major priority areas: energy intensity, atmospheric emissions, energy import dependency and use of renewables. While positive trends have been observed in relation to energy intensity and atmospheric emissions, Mexico is becoming more dependent on imports of gasoline, natural gas and other high‐value secondary energy sources, while exporting significant amounts of primary fuels, such as crude oil. Also, no significant increase has been observed in the use of renewable sources of energy. Social, economic and environmental policies need to be formulated for the energy sector and related investments (public and private) reinforced so that all economic sectors have access to energy from cleaner and more diverse sources.
Indicators for sustainable energy development in Lithuania
Authors: Streimikiene Dalia
Published: December 2005

This article summarizes some of the results from the application of the indicators for sustainable energy development (ISED) tool for analyzing Lithuania's energy sector, in terms of trends, setting energy policy goals and monitoring progress towards these goals. This experience illustrates the potential applicability of the ISED methodology for energy policy development in economies in transition, using Lithuania as an example. The article presents a summary of the results achieved and conclusions arrived at from the analysis of six priority areas in the context of the research project coordinated by the International Atomic Energy Agency, and provides recommendations for the development of sustainable energy policy using the ISED approach.
Monitoring the sustainability of Russia's energy development
Authors: Aslanyan Garegin , Molodtsov Sergey , Iakobtchouk Vitali
Published: December 2005

This article presents an assessment of Russia's energy sector, its current state and planned future direction. The analysis of Russia's energy trends is based on a set of indicators for sustainable energy development (ISED), developed under the leadership of the International Atomic Energy Agency (IAEA). The article discusses Russia's Energy Strategy to 2020, and outlines major developments and challenges of the country's energy system. Russia's energy priorities, captured in the Strategy to 2020, emphasize securing a stable and uninterrupted energy supply; reducing energy intensity and improving energy efficiency; developing the domestic energy resource base; reducing negative environmental impacts; and ensuring affordable energy for the poorer segments of the population. Energy needs and challenges are discussed in relation to the three aspects of sustainability as defined in Agenda 21: economic, social and environmental. Concerns are expressed regarding environmental repercussions of energy development, in particular since Russia's 1998 economic rebound. There are also concerns, despite the economic recovery, that anticipated increases in energy tariffs may exceed the affordability of poorer segments of the population.
Energy indicators and sustainable development: The International Energy Agency approach
Authors: Unander Fridtjof
Published: December 2005

The International Energy Agency (IEA), together with the International Atomic Energy Agency (IAEA), UN‐DESA, Eurostat and the European Environmental Agency, has recently published a comprehensive joint‐agency overview of energy indicators for sustainable development. The IEA's contribution to this publication is based on the IEA energy indicator approach. This approach has been developed and used by the IEA over a number of years. The indicators advocated by the IEA are relatively disaggregated to allow for meaningful analysis of sustainability issues in the energy sector. Using a decomposition approach helps reveal the causal links between human/economic driving forces, energy use and emissions. This article presents examples of IEA's work with indicators and an overview of the methodology used, including an explanation of the link to sustainable development. It also provides an example of a simplified indicator analysis of India, to illustrate the importance of improved data systems in developing indicators that can provide meaningful policy analysis.
Relative Contribution of Inbreeding Depression and Eroded Adaptive Diversity to Extinction Risk in Small Populations of Shore Campion
Authors: VILAS CARLOS , SAN MIGUEL EDUARDO , AMARO RAFAELA , GARCIA CARLOS
Published: December 2005

Abstract: To study the relative importance of inbreeding depression and the loss of adaptive diversity in determining the extinction risk of small populations, we carried out an experiment in which we crossed and self‐fertilized founder plants from a single, large population of shore campion (Silene littoreaBrot.). We used the seeds these plants produced to colonize 18 new locations within the distribution area of the species. The reintroduced populations were of three kinds: inbred and genetically homogeneous, each made up of selfed seed from a single plant; inbred and mixed, made up of a mixture of selfed seeds from all founder plants; and outbred and mixed, made up of a mixture of seeds obtained in outcrosses between the founders. We compared the inbred homogeneous populations with the inbred mixed to measure the effect of genetic diversity among individuals and the inbred mixed with the outbred mixed to measure the effect of inbreeding. Reintroduction success was seriously limited by inbreeding, whereas it was not affected by genetic diversity. This observation and the nonsignificant interaction between family and reintroduction location for individual plant characters suggest that the fixation of overall deleterious genes causing inbreeding depression posed a more serious threat to the short‐term survival of the populations than the loss of genes involved in genotype and environment interactions. Thus, reintroduction success was related to adaptive diversity. Preventing such fixation might be the most important consideration in the genetic management and conservation of shore campion populations.
Formation of Social Acceptability Judgments and Their Implications for Management of Rare and Little‐Known Species
Authors: STANKEY GEORGE H. , SHINDLER BRUCE
Published: December 2005

Abstract: Effective policies for management of rare and little‐known species (RLKS) must be not only scientifically valid and cost‐effective but also consistent with prevailing social beliefs and values. Limited public awareness of RLKS, however, constrains efforts to frame such policies. Lacking public support, resistance to RLKS programs is likely, particularly when other uses and values are affected. The challenge lies in understanding how public judgments are formed, sustained, and altered. Although the lack of public support often is attributed to inadequate understanding of the scientific bases for policies, research indicates that judgments derive from a complex, albeit poorly understood, suite of factors, including context, trust, esthetics, and personal history. Steps that can enhance public understanding of RLKS management include (1) clarifying the rationale and impacts of policies on the species, (2) specifying the contextual setting, (3) outlining specific actions to be taken, and (4) identifying when and where policies will be employed. Failure to foster understanding and support will leave management dominated by conflict and continued species loss.
A Spatially Explicit Decision Support Model for Restoration of Forest Bird Habitat
Authors: TWEDT DANIEL J. , UIHLEIN WILLIAM B. , BLAINE ELLIOTT A.
Published: December 2005

Abstract:  The historical area of bottomland hardwood forest in the Mississippi Alluvial Valley has been reduced by >75%. Agricultural production was the primary motivator for deforestation; hence, clearing deliberately targeted higher and drier sites. Remaining forests are highly fragmented and hydrologically altered, with larger forest fragments subject to greater inundation, which has negatively affected many forest bird populations. We developed a spatially explicit decision support model, based on a Partners in Flight plan for forest bird conservation, that prioritizes forest restoration to reduce forest fragmentation and increase the area of forest core (interior forest >1 km from “hostile” edge). Our primary objective was to increase the number of forest patches that harbor >2000 ha of forest core, but we also sought to increase the number and area of forest cores >5000 ha. Concurrently, we targeted restoration within local (320 km2) landscapes to achieve ≥60% forest cover. Finally, we emphasized restoration of higher‐elevation bottomland hardwood forests in areas where restoration would not increase forest fragmentation. Reforestation of 10% of restorable land in the Mississippi Alluvial Valley (approximately 880,000 ha) targeted at priorities established by this decision support model resulted in approximately 824,000 ha of new forest core. This is more than 32 times the amount of core forest added through reforestation of randomly located fields (approximately 25,000 ha). The total area of forest core (1.6 million ha) that resulted from targeted restoration exceeded habitat objectives identified in the Partners in Flight Bird Conservation Plan and approached the area of forest core present in the 1950s.
Uniformity of the Fluid Flow Velocities Within Hollow Fiber Membranes of Blood Oxygenation Devices
Authors: Mazaheri Ali R. , Ahmadi Goodarz
Published: December 2005

Abstract:  A finite volume‐based computational model was developed to investigate the uniformity of the fluid flow across the hollow fiber membranes in blood oxygenation devices. A two‐dimensional annular cross section of a blood oxygenation device including about 3300 hollow fiber membranes was used in the computation model. The equations governing the steady incompressible laminar flow in the blood oxygenation device were solved numerically and the results were compared with those obtained from the equivalent porous medium approximation. For the porous medium approximation, the Ergun equation was used for evaluating the permeability. The simulation results showed that the fluid molecules spend about six times longer in the fiber bundle region than that in its equivalent porous medium approximation model. The computational model also provides a more detailed fluid flow pattern in the membrane compartment of the blood oxygenator.
The Pivot Wash in Two Impeller Modes for the Baylor/Miwatec Centrifugal Blood Pump
Authors: Yamane Takashi , Kodama Takayuki , Nishida Masahiro , Maruyama Osamu , Yamamoto Yoshiro , Shinohara Toshiyuki , Motomura Tadashi , Nosé Yukihiko
Published: December 2005

Abstract:  A centrifugal blood pump with a double pivot impeller and an eccentric inlet port is being developed as an implantable artificial heart by the Baylor College of Medicine and Miwatec Co. Ltd. Flow visualization measurements were conducted to compare the flow around the pivot for two impeller operational modes: the top and the bottom contact modes. In the top contact mode, one‐way flow in the pivot gap due to the eccentric vortex was observed, and sufficient wall shear rate to prevent thrombus formation was attained around the bottom pivot for over 1400 rpm. Computational fluid dynamic analyses confirmed that the causes of the eccentric vortex were the inlet eccentricity and the pressure imbalance in the volute.
Out‐of‐Center Extracorporeal Membrane Oxygenation for Adult Cardiogenic Shock Patients
Authors: Huang Shu‐Chien , Chen Yih‐Sharng , Chi Nai‐Hsin , Hsu Jiun , Wang Chih‐Hsien , Yu Hsi‐Yu , Chou Nai‐Kuan , Ko Wen‐Je , Wang Shoei‐Shen , Lin Fang‐Yue
Published: December 2005

Abstract:  Patients with cardiogenic shock refractory to conventional management require advanced mechanical circulatory support such as extracorporeal membrane oxygenation (ECMO). In hospitals lacking ECMO facilities, interhospital transportation is necessary for further patient management. Thirty‐one adult cardiac patients, who were transported to our hospital by our ECMO transport team between January 1998 and July 2004, were enrolled in this study. The median transportation distance was 200 km (range: 3–300 km). During transportation, the ECMO circuit per se and the patients did not have complications. Of the 31 patients, 20 (64.2%) were weaned off ECMO or bridged to ventricular assist devices and 10 patients (32.1%) survived to discharge. Delayed transfer (>2 days) and high organ dysfunction score were associated with poor outcomes. The survival rate was similar to that of our in‐hospital group (survival rate: 32.8%, n = 64). In conclusion, adult cardiogenic shock patients requiring interhospital ECMO transport had a reasonable chance of survival.
The Possibility of a Veno–Arterial Bypass System Using the Abiomed BVS 5000
Authors: Sezai Akira , Shiono Motomi , Nakata Kin‐ichi , Hata Mitsumasa , Taoka Makoto , Negishi Nanao , Sezai Yukiyasu
Published: December 2005

Abstract:  Effect of Abiomed BVS 5000 (Cardiovascular Inc., Danvers, MA, U.S.A) has been reported for mechanical assist circulation in cardiogenic shock. However, this pump is generally used as a ventricular assist device, not as a device for veno‐arterial bypass. Therefore, we evaluated its effectiveness through an experiment. The left anterior descending branch of pigs’ heart was ligated to prepare a model of acute myocardial infarction, and after the onset of cardiogenic shock, circulation was initially supported for 30 min using the BVS 5000, followed by support for another 30 min using a Gyro pump (Gyro, Kyocera, Inc., Kyoto, Japan). Subsequently, circulation was additionally supported for 30 min using both a Gyro and an intra‐aortic balloon pump (IABP) (Tokai Medical Inc., Aichi, Japan) (Gyro + IABP). Circulation was supported in each group at 30‐min intervals in the reversed order of assisted circulation. Although the mean aortic pressure, pump flow, and total flow were not significantly different among the three setups, the pulse pressure was 48.2 ± 3.3, 12.2 ± 2.2, and 29.9 ± 3.8 mm Hg in Abiomed, Gyro, and Gyro + IABP, respectively. Although neither coronary arterial nor myocardial blood flow showed significant differences among the three setups, the renal arterial blood flow was significantly larger in BVS 5000 compared to the other two setups. In this study, we selected an α‐cube (Platium Cube NCVC 6000, Edwards Research Medical Inc., Salt Lake City, UT, U.S.A.), which is considered as an oxygenator that produces minimum pressure loss. Therefore, the pulsatile flow we obtained with the Abiomed was maintained even after we started using the oxygenator. The pulsatile flow had positive effects on renal circulation and peripheral circulation.
Democracy and Deceit: Regulating Appearances of Corruption
Authors: Warren Mark E.
Published: December 2005

While corruption has long been recognized as an appropriate object of regulation, concern with appearances of corruption is of recent origin, coinciding with declining trust in government in the mid‐ to late‐1960s. The reasoning that would support regulations of appearances, however, remains flawed, as it depends upon a “public trust” model of public service that is incomplete and often misplaced when applied to political representatives. The justification for regulating appearances is unambiguous, however, from the perspective of democratic theory. Democratic institutions of representation depend upon the integrity of appearances, not simply because they are an indication of whether political representatives are upholding their public trust, but because they provide the means through which citizens can judge whether, in particular instances, their trust is warranted. Representatives, institutions, and ethics that fail to support public confidence in appearances disempower citizens by denying them the means for inclusion in public judgments. These failures amount to a corruption of democratic processes.
Outcomes in adulthood for children with foetal growth retardation. A linkage study from the Nord‐Trøndelag Health Study (HUNT) and the Medical Birth Registry of Norway
Authors: Berle J. Ø. , Mykletun A. , Daltveit A. K. , Rasmussen S. , Dahl A. A.
Published: December 2005

Objective:  The aims were to examine the long‐term functional outcome and risk of mood disorders in adulthood in individuals with foetal growth retardation.

Method:  In a prospective cohort study of 7806 individuals aged 20–30 years, using linked data from the Health Survey of Nord‐Trøndelag (HUNT‐2) and the Medical Birth Registry of Norway, we studied the long‐term effects of being born with a birth weight below the 10th percentile for gestational age (SGA).

Results:  SGA individuals had lower educational level (OR: 1.33), lower socioeconomic functioning level (OR: 1.77) and more frequent reported mood disorder in adulthood (OR: 1.26). Analyses of a substratum of infants born at term showed almost identical results.

Conclusion:  Foetal growth retardation measured as SGA shows a moderate risk for lower education and socioeconomic level and for anxiety and/or depression in young adulthood. Issues concerning interventions for children at risk should be considered.
Differential effects of systemic metronidazole and amoxicillin on Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in intraoral habitats
Authors: Flemmig T. F. , Milián E. , Kopp C. , Karch H. , Klaiber B.
Published: December 2005

Abstract. 48 adult patients with untreated periodontitis harboring subgingival Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis were randomly assigned to receive full mouth scaling alone (control) or scaling with systemic metronidazole plus amoxicillin and supragingival irrigation with chlorhexidine digluconate (test). Subgingival plaque and swab samples from tongue, tonsils, and buccal mucosa were taken at baseline, 10 days and 3, 6, 9, and 12 months. A. actinomycetemcomitans was detected in the oral cavity, i.e., subgingival plaque and/or mucous membranes. Less frequently in test patients compared to controls at 9 and 12 months (p<0.01. whereas, the intraoral detection frequency of P. gingivalis was significantly reduced only 10 days following therapy (p<0.001). At any time after therapy. A. actinomycetemcomitans was not detected intraorally in 5 of 10 (50%) test and 1 of 13 (8%) control patients harboring this pathogen at baseline; P. gingivalis was not detected in only 1 of 18 (6%) test and none of the 17 control patients harboring this pathogen at baseline. Although the data indicated that the assessed antimicrobial therapy may suppress A. actinomycetemcomitans from the entire oral cavity below detectable levels over a minimum of 12 months. P. gingivalis persisted or reoccurred.
Effects of a fibrin‐fibronectin sealing system on proliferation and type I collagen synthesis of human PDL fibroblasts in vitro
Authors: Fabris Giovanna , Trombelli Leonardo , Schincaglia Gian Pietro , Cavallini Rosy , Calura Giorgio , del Senno Laura
Published: December 2005

Abstract. Fibrin glue (FG) is an agent widely used in many surgical disciplines for achieving hemostasis and tissue adhesion. The aim of this investigation was to determine the effectiveness of a highly concentrated FG (Tissucol®) on the growth and phenotypic expression of human periodontal ligament (PDL)fibroblasts. PDL fibroblast strains were established from cells scraped from PDL, and cultured in the presence and absence of FG for 48 and 72 h. Cell proliferation was studied by counting cells and mitoses, and by immunocytochemical detection of the proliferation‐associated Ki‐67 nuclear antigen. Type‐I collagen production was assessed by radioimmunological assay of the procollagen C‐terminal peptide. Results showed that FG treatment was compatible with PDL fibroblast growth and type‐I collagen synthesis, although a reduced trend in cell proliferation and collagen production was found in FG‐supplemented cultures compared to control cultures. We conclude that FG may represent a suitable substrate for supporting PDL fibroblast growth and function.
The use of 0.2% chlorhexidine in the absence of a structured mechanical regimen of oral hygiene following the non‐surgical treatment of periodontitis
Authors: Christie Philip , Claffey Noel , Renvert Stefan
Published: December 2005

Abstract. The aim of the present study was to evaluate a 0.2% chlorhexidine mouthrinse following the non‐surgical treatment of advanced human periodontitis in the absence of a structured mechanical oral hygiene regimen. 10 patients and a total of 1483 sites were used. Recordings for plaque, bleeding, pocket depth and attachment levels were made at baseline and at 3, 6, 9, and 12 months. Debridement was performed under local anaesthesia. No instruction or reinforcement in mechanical ocal hygiene procedures was given at any time. However, at each visit the patients were instructed in the 2× daily use of 0.2% chlorhexidine mouthwash. The plaque indices, scored as % of sites with removable deposits, showed negligible improvement from baseline scores of 80%‐100% for all categories of initial probing depth. Mean bleeding score was reduced to 10–20% irrespective of initial probing pocket depth, site location or tooth surface location. Sites ≥7 mm at baseline demonstrated a reduction in mean probing pocket depth of 3.9 mm and a gain in mean probing attachment level of 2.5 mm. Moderately deep sites (4–6.5 mm) demonstrated a reduction in mean probing pocket depth of 2 mm and a gain in mean probing attachment level of 0.8 mm. Shallow sites (≤3.5 mm) demonstrated a reduction in mean probing pocket depth of 0.5 mm and a loss in mean probing attachment level of 0.2 mm. Site‐specific attachment level analysis demonstrated that over 80% of losing sites were shallow with low bleeding frequency, indicating that the loss of attachment may have occurred for reasons other than inflammatory periodontal disease. The results indicate that chlorhexidine can be used as an adjunct to inadequate mechanical oral hygiene over an observation period of 1 year.
Cathepsin B, α2‐macroglobulin and cystatin levels in gingival crevicular fluid from chronic periodontitis patients
Authors: Chen H. Y. , Cox S. W. , Eley B. M.
Published: December 2005

Abstract. Gingival crevicular fluid (GCF) was collected from 16 molar and premolar sites in each of 20 chronic periodontitis patients before and after periodontal therapy using filter paper strips. These were eluted individually into buffer for determination of cathepsin B and its endogenous inhibitors, α2‐macroglobulin and cystatin. Cathepsin B activity was assayed with a fluorogenic peptide substrate, α2‐macroglobulin by enzyme‐linked immunosorbent assay and cystatin activity by inhibition of papain. Total amounts of enzyme and inhibitor per GCF sample decreased after treatment and correlated positively with pocket depth and gingival, bleeding and plaque indices. These comparisons were nearly always statistically significant for pooled site data and sometimes so for mean patient values. The amounts of α2‐macroglobulin and cystatin were greater than those of cathepsin B and, surprisingly, enzyme and inhibitor levels correlated positively with each other. Experiments with purified reagents, however, demonstrated that the cathepsin B: α2‐macroglobulin complex was still active against the low molecular weight substrate and that cystatin levels in GCF are probably insufficient to inhibit the enzyme substantially. These factors may explain why GCF cathepsin B activity reflects the clinical status of periodontal lesions and has been identified in another study as a promising indicator of disease progression.
Characterisation of bioadhesives for periodontal and oral mucosal drug delivery
Authors: Needleman Ian G. , Martin Gary P. , Smales Frederick C.
Published: December 2005

Abstract. Whilst there is keen interest in developing improved drug delivery devices to the periodontal pocket and oral mucosa, there are few reports which have examined the physical properties of gels and semi‐solid formulations which favour retention and bioadhesion in situ. Hydration and rheological properties appear to be of prime importance in this context and this study aimed to correlate the measurement of these properties with observed bioadhesion, both in vitro and in vivo. Three candidate bioadhesives were selected from previous experiments which had used in vitro organ culture models. These were chitosan, xanthan gum and poly (ethylene oxide) aqueous formulations. Hydration rates with various media were determined in specially constructed cells, Rheological properties were measured using a controlled stress rheometer under carefully regulated conditions. These findings were also correlated with in vivo assessments in the periodontal pocket and oral mucosa. The results demonstrated that three formulations with differing bioadhesive properties also possessed widely different physical characteristics. Hydration experiments indicated a direct relationship between the rate of hydration and bioadhesion or retention. Rheological studies suggested that possession of a gel structure could be an important determinant of retention where shear displacing forces are present in vivo. e.g. the oral mucosa. Furthermore, these studies indicated that formulations which could demonstrate resistance to changes in rheological properties on hydration would also favour retention in situ. Physical characterisation therefore appears to have an important place in screening polymeric formulations prior to clinical testing in the periodontal pocket and oral mucosa.
Longitudinal changes in TCRB variable gene expression and markers of gingival inflammation in experimental gingivitis
Authors: Preshaw P. M. , Geatch D. R. , Lauffart B. , Jeftcoat M. K. , Taylor J. J. , Heasman P. A.
Published: December 2005

Abstract. The aim of this study was to gain information of the cellular and molecular events which occur during the development of experimental gingivitis and to determine whether such changes occur in the presence or absence of alveolar bone resorption. Clinical, radiographic, biochemical and immunological variables were monitored in a 3‐week, single‐centre, experimental gingivitis study of 10 healthy volunteers. Following screening and professional prophylaxis to achieve visibly healthy gingival status, subjects abstained from all oral hygiene practises in one maxillary (test) quadrant for a period of 21 days. At days 0 and 21, in test and (contralateral) control quadrants, % bleeding on controlled pressure probing (% BOP) was calculated, and radiographic alveolar bone status was assessed using bilateral standardised vertical bite‐wing radiographs and digital subtraction radiography (DSR) analysis. In test quadrants, gingival crevicular fluid (GCF) was sampled from 4 sites per subject with Periopaper strips, and prostaglandin E2 (PGE2) levels measured using an enzyme immunoassay (EIA) kit. At days 0, 7 and 21, one interdental papilla was surgically excised from the test quadrant, and the expression of T cell receptor B variable (TCRBV) genes was investigated using a reverse transcription‐polymerase chain reaction (RT‐PCR) procedure. At days 0, 7 and 21, peripheral blood lymphocytes (PBL) were isolated and additionally investigated for TCRBV gene expression. Following 21 days of plaque accumulation in test quadrants, a statistically significant increase in % BOP scores confirmed the presence of gingival inflammation (p<0.001). DSR analysis revealed that there were no significant alveolar bone changes in either the test or control quadrants between days 0 and 21 (P > 0.05). EIA analysis of GCF samples identified a significant decrease in mean GCF PGE2 concentrations from day 0 to day 21 (P<0.05). RT‐PCR analysis indicated that genes from all 3 TCRBV families studied (TCRBV‐2, ‐6, ‐8) were expressed in the PBL samples at all time points and in healthy gingival tissues at day 0. A restriction in the expression pattern of TCRBV genes similar to those which have previously been reported in chronic periodontitis was noted at gingivitis sites. It is possible that such an event may identify susceptibility to periodontal disease independently of other positive predictive markers such as GCF‐PGE2.
Interleukin‐1β+3953 allele 2: association with disease status in adult periodontitis
Authors: Gore E. A. , Sanders J. J. , Pandey J. P. , Palesch Y. , Galbraith G. M. P.
Published: December 2005

Abstract. Adult periodontitis is a complex multifactorial disease whose etiology is not well defined. The pro‐inflammatory and bone resorptive properties of interleukin‐1 beta (IL‐1β) strongly suggest a role for this cytokine in the pathogenesis of periodontal disease. In the study reported here, the frequency of IL‐1β+3953 genotypes including allele 2 of the IL‐1β+3953 restriction fragment length bi‐allelic polymorphism was significantly increased in patients with advanced adult periodontitis compared to those with early and moderate disease. Furthermore, allele 2 was associated with increased production of IL‐1β by activated peripheral blood polymorphonuclear cells of patients with advanced disease, although this increase failed to reach statistical significance. Finally, the data obtained revealed significant linkage disequilibrium between allele 2 of the IL‐1β+3953 polymorphism and allele 2 of the bi‐allelic IL‐1α−889 polymorphism in both patients and orally healthy controls. These findings provide new insight into the possible role of IL‐1α and β gene polymorphisms in the susceptibility to adult periodontitis.
Subgingival temperature and microbiota in initial periodontitis
Authors: Maiden M. F. J. , Tanner A. C. R. , Macuch P. J. , Murray L. , Kent R. L.
Published: December 2005

Abstract. The association between subgingival temperature, other clinical characteristics, and the subgingival microbiota was examined in adult subjects with initial periodontitis and differing levels of gingival inflammation, 43 subjects were measured at 6 sites per tooth for pocket depth, attachment level, presence of plaque, gingival redness, bleeding on probing and subgingival temperature at 3‐month intervals for 1 year. Subgingival plaque was sampled from 15 initial active periodontitis sites (10 subjects), 121 gingivitis, sites (20 subjects) and 202 healthy sites (13 subjects), and included the 5 hottest and 5 coldest sites in each subject. Plaque samples were analyzed for 13 subgingival species using whole‐genomic DNA probes. The major influences on the subgingival microbiota were the clinical status of sites, pocket depth, and the presence of supragingival plaque. No significant association between species and site temperature was observed. Initial active sites were associated with Bacteroides forsythus and Campylobacter rectus. and had a higher mean subgingival temperature and deeper mean pocket depth than inactive sites, A weak association between pocket depth and site temperature was noted. The major influence on subgingival temperature of sites was the anterior to posterior anatomical temperature gradient in the mandible and maxilla.
Effect of allogeneic freeze‐dried demineralized bone matrix on regeneration of alveolar bone and periodontal attachment in dogs
Authors: Caplanis Nicholas , Lee Michael B. , Zimmerman Grenith J. , Selvig Knut A. , Wikesjö Ulf M.E.
Published: December 2005

Abstract. This split‐mouth study was designed to evaluate regeneration of alveolar bone and periodontal attachment following implantation of allogeneic. freeze‐dried, demineralized bone matrix (DBM). Buccal fenestration defects (6×4 mm) were created on the maxillary canine teeth in 6 beagle dogs. DBM was implanted into one randomly selected defect in each animal. The contralateral defect served as surgical control. Tissue blocks were harvested following a 4‐week healing interval and prepared for histometric analysis. DBM was discernible in all implanted defects with limited evidence of bone metabolic activity. The DBM particles appeared invested within a dense connective tissue, often in close contact to the instrumented root. Fenestration defect height averaged 3.8±0.1 and 3.7±0.3mm, total bone regeneration 0.9±0.9 and 0.4±1.2 mm, and total cementum regeneration 2.3±1.5 and 0.6±0.7 mm for DBM and control defects, respectively. Differences with regards to cementum regeneration were statistically significant (p=0.03). In summary, the results of this study suggest that DBM implants may enhance cementum regeneration in this defect model, and that they have no apparent effect on alveolar bone regeneration. Enhanced cementum regeneration may be possibly be explained by provisions for guided tissue regeneration from the implant suppressing a significant influence of the gingival connective tissue on the healing process. Moreover, a 4‐week healing interval appears insufficient for turnover of DBM.
Comparison of 2 toothbrushing methods for efficacy in supragingival plaque removal The Toothpick method and the Bass method
Authors: Morita M. , Nishi K. , Watanabe T.
Published: December 2005

Abstract. Plaque removing efficacy was compared between a new toothbrushing method named the Toothpick method and the Bass method, 20 male university dental students participated in the study, which consisted of 2 experiments. Prior to each experiment, all subjects were asked to abstain from all oral hygiene procedures for 48 h. In Exp. I, plaque‐removing efficacy was assessed after each participant's mouth had been professionally brushed by a dentist. In this experiment, 2 quadrants were brushed professionally using the Toothpick method, and the remaining 2 quadrants were brushed using the Bass method. The brushing time amounted to a total of 2 min per mouth. In Exp. II, the subjects brushed their own teeth after receiving toothbrushing instruction. A blind examiner assessed dental plaque using a modification of the Quigley and Hein index at 6 sites around each tooth, Toothbrushing using the Toothpick method was found to remove significantly more plaque from proximal tooth surfaces than brushing using the Bass method.
The description of a unique population with a very high prevelance of localized juvenile periodontitis
Authors: Stabholz A. , Mann J. , Agmon S. , Soskolne W. A.
Published: December 2005

Abstract. The reported prevalence of localized juvenile periodontitis (LJP) amongst teenagers and young adults varies greatly. The etiology of LJP has been related to Actnobacillus actinomy cetemcomitans Aa$ and it has also been suggested that there may be a transmission of Aa within families resulting in the familial distribution of the disease. This study describes the high prevalence of LJP in adolescents, 12–20 years of age, from a group of nuclear families living and functioning in a closed, closely knit community. The survey was carried out on a population of teenagers that had attended the same school and their siblings. All students attending that school and their siblings were examined. They were given a periodontal examination and a questionnaire relating to their demographic details and their personal oral hygiene habits. The periodontal examination was limited to the incisors and first molar teeth. Plaque index (PII), gingival index (GI), the presence or absence of bleeding on probing (BOP), probing pocket depth (PPD) and recession ere measured. All patients having at least two of the examined sites with probing pocket depth ≥5 mm or one site ≥6 mm were considered as possible sufferers from LJP and had a full mouth periapieal radiographic survey carried out using a paralleling technique to confirm the diagnosis. At the sites with probing pocket depth ≥5 mm, a Shei ruler was used to measure the $$ of the root coronal to the alveolar bone. A cut off point of ≥20mm was used as a measure of true bone loss confirming the clinical diagnosis of LJP 86 individuals from 30 families comprised the population of interest There were 44 males and 42 females with a mean age of 14.7±2.3. Of the 86 individuals examined, 33 individuals from 15 families were diagnosed as having LJP (38.4%). None of the individuals examined showed any evidence of the generalized form of juvenile periodontitis. The mean age of the LJP patients was 15±23 yrs. with a 1:1.75 male to female ratio. Except for 2 pairs of families with genetic tics, no familial connections could be traced between the different nuclear families affected by LJP despite repeated and intensive questioning. There were no significant differences in the PII and the GI between the groups while the LJP group had significantly higher BOP. PPD and PAL than the non‐LJP group. These finding strongly suggest an environmental influence in the etiologu of the disease.