bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical examinations to validate self‐completion questionnaires: dermatitis in the UK printing industry
Authors: Livesley E. J. , Rushton L. , English J. S. C , Williams H. C.
Published: March 2003

A self‐completion questionnaire sent to 2600 Nottinghamshire members of the Graphical Paper and Media Union elicited a 62% response. Forty one per cent of respondents reported suffering a skin complaint at some time and 11% had a current skin problem on the hand. This paper reports the validation stage of the study. Samples of 45 ‘cases’ of self‐reported dermatitis and 60 ‘controls’, who reported they had never suffered a skin complaint, were clinically examined. All 45 self‐reported cases were clinically confirmed as dermatitis. Occupationally related irritant contact dermatitis (ICD) was diagnosed in 20 (44%); 26 (58%) complaints were thought to be induced or exacerbated by occupation. Of the controls, 21 (35%) were also diagnosed with a skin complaint, the majority being mild, with an occupational association in 17, the majority (15) being ICD. Sixteen ICD cases were patch tested resulting in positive reactions to colophony, neomycin, nickel and potassium dichromate (2 of each). Two cases of basal cell carcinoma on the face were also identified, of which the participants were unaware. Although there was no false positive self‐reporting there was a considerable number of false negatives, demonstrating the importance of clinical validation of questionnaires relating to industrial skin disease. This study has highlighted the need for improvement in skin care provision in the printing industry.
Cross‐reactivity patterns to budesonide
Authors: Ferguson A. D. , Emerson R. M. , English J. S. C.
Published: March 2003

Allergic contact dermatitis from topical corticosteroids is not uncommon. Budesonide has been included in the European standard series as a marker for corticosteroid allergy, though little is known of its cross‐reactivity with other corticosteroids. Twelve patients previously positive to budesonide on patch testing were given further patch and intradermal tests to a range of corticosteroids. Six patients previously negative to budesonide on patch testing were used as a control group. Budesonide cross‐reacts with hydrocortisone‐21‐sodium phosphate and triamcinolone acetonide. Patients positive to budesonide should therefore avoid hydrocortisone and triamcinolone acetonide. Patch testing, unfortunately, is an inaccurate method of determining cross‐reactivity patterns among corticosteroids.
Titanium‐niobium, a new finishing wire alloy
Authors: Dalstra Michel , Denes Gabriella , Melsen Birte
Published: March 2003

The mechanical properties of the newly introduced titanium‐niobium finishing wires were investigated. Both in bending and torsional loading mode, the stiffness, yield point, post‐yield behavior, and springback of titanium‐niobium wires were experimentally determined and compared to those of equally sized stainless steel wires. The experimentally obtained values were also validated with theoretical values from engineering formulas of cantilever deformations. The ratios for these parameters for the two materials proved to be different in bending and torsion. The stiffness of titanium‐niobium in bending is roughly half of that of stainless steel, whereas in torsion it is roughly one‐third. These characteristics enable the clinician to use titanium‐niobium for creative bends without the excessive force levels of steel wires. The springback of titanium‐niobium in bending is 14% lower than that of steel, whereas in torsion it is about the same or even slightly higher than that of steel, thus making it possible to utilize the wire for even major third‐order corrections. Finally, the weldability of titanium‐niobium wires was found to be good, so it is possible to weld wires of different dimensions together for the generation of differentiated force systems.
Effect of landmark identification on cephalometric measurements: guidelines for cephalometric analyses
Authors: Perillo M.A. , Beideman R.W. , Shofer F.S. , Jacobsson‐Hunt U. , Higgins‐Barber K. , Laster L.L. , Ghafari J.G.
Published: March 2003

Identification of craniofacial landmarks, particularly condylar anatomy, on the lateral cephalometric radiograph is erratic. The accuracy of recognition is critical for proper diagnosis of malocclusion and for assessing growth and orthodontic treatment. The aim of this study was to evaluate the identification of condylion and other cephalometric landmarks commonly used, or thought to be easily identifiable. A lateral cephalograph was taken on each of 34 adult subjects. Five examiners, three orthodontists, a dental radiologist and a second‐year orthodontic resident rated the condyle, along with sella (S), nasion (Na), point A (A), infradentale (I), pogonion (Pog) and menton (Me) as identifiable, non‐identifiable and interpreted. In addition, distances between several of these landmarks were measured. The left condyle, subject to less magnification than the right condyle because it is closer to the film, was more identifiable than the right condyle, which had the highest rating as non‐identifiable. Among other landmarks, nasion and point A were the least identifiable, Pog and Me the most. Correlation coefficients for measurements between identifiable landmarks (I‐Me) were greater than coefficients for distances involving less identifiable landmarks (S‐A). Interestingly, linear measurements were less variable than the identification of corresponding landmarks. These findings corroborate the previous conclusions that clearly identifiable (and the least amount of interpreted) landmarks should be used for proper evaluation of dentofacial relationships. They also suggest, on average, precision in landmark identification is more critical for research purposes than in routine clinical cephalomteric measurements, which serve only as a guide to diagnosis.
The effects of torque control spurs in twin‐block appliances
Authors: Harradine N.W.T. , Gale D.
Published: March 2003

The study compared the effects of torque control spurs on upper incisor retroclination and extrusion with two designs of a twin‐block functional appliance in Class II/1 cases. The two designs were also compared with respect to anchorage loss in the lower arch and for patient compliance rates. Consecutively started cases were chosen – 90 patients with a design incorporating a labial bow (CTB group) and 110 with upper incisor ‘torquing’ spurs (STB group) and used to calculate failure rates. Thirty consecutive patients with satisfactory records from each group were analysed cephalometrically. The STB group experienced substantially less upper incisor retroclination, reduced upper incisor extrusion and slightly more favourable mandibular growth. The labial movement of lower incisors and the patient compliance were not significantly different in the two groups. Overall, 82.5% of patients fully reduced their overjet with 9% failing to reduce the overjet below 6 mm.Fig. 1f

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The expression of osteopontin with condylar remodeling in growing rats
Authors: Sugiyama Hiroki , Imada Masae , Sasaki Akiko , Ishino Yoshihiro , Kawata Toshitugu , Tanne Kazuo
Published: March 2003

It is suggested that osteopontin may promote osteoclast binding to resorptive sites by interacting with the αvβ3 receptor on osteoclasts. However, the role of osteopontin in functional remodeling of bony structures remains unclear. The present study was conducted to examine the distribution of osteopontin on the condyle and explore the role in condylar remodeling in growing rats using an immunohistochemical method. Twenty Wistar strain male rats aged 7, 14, 28 and 56 days were used. In 7‐ and 14‐day‐old rats, no immunoreaction to osteopontin was detected in the cartilage cells. In 28‐day‐old rats initiating mastication, the thickness of condylar cartilage was decreased abruptly as compared to the younger rats. High immunoreaction to osteopontin was found in the cytoplasm of hypertrophic chondrocytes and on the trabecular bone surfaces of primary spongiosa adjacent to the osteoclasts or chondroclasts. The immunoreactions to osteopontin in the cytoplasm of hypertrophic chondrocytes were less in 56‐day‐old rats than in 28‐day‐old rats. It is shown that the alteration in mechanical loading on the mandibular condyle due to functional changes from weaning to mastication correlates with the localization of osteopontin in growing rats. Furthermore, it is suggested that osteopontin may stimulate osteoclastic resorption of calcified matrix by mediating the attachment of osteoclasts and/or chondroclasts during growth‐related functional remodeling of the condyle.
Lectin‐binding pattern of primary malignant melanomas and melanocytic nevi
Authors: Monastirli A. , Pasmatzi E. , Georgiou S. , Kapranos N. , Frangia K. , Braun H. , Ioannovich J. , Varakis J. , Tsambaos D.
Published: March 2003

A panel of six biotinylated lectins was applied in order to study the composition and distribution of plasma membrane carbohydrate residues in 83 primary cutaneous melanomas (MMs) and in 85 melanocytic nevi (MN) with the avidin‐biotin peroxidase technique. No clear‐cut differences between MN and MMs were observed with regard to the staining with lectins. In MN and MMs derived from different patients, the lectin‐binding pattern was variable and heterogeneous even within the individual nevi or melanomas. It seems reasonable, therefore, to assume that the lectin‐binding pattern cannot be regarded as a reliable histochemical marker for the differentiation of MN from MMs. Moreover, because the pattern reveals no statistically significant correlation with the thickness or the depth of invasion of MM, it seems to lack prognostic significance.
Giant cell lichenoid dermatitis within herpes zoster scars in a bone marrow recipient
Authors: Córdoba Susana , Fraga Javier , Bartolomé Beatriz , García‐Díez Amaro , Fernández‐Herrera Jesús
Published: March 2003

Cutaneous lesions arising in herpes zoster (HZ) scars are rare. We report a 34‐year‐old woman with acute lymphoblastic leukemia underwent allogenic bone marrow transplant (BMT). Ten days after the BMT, she developed clusters of vesicles over the right neck, scapula, shoulder and chest. She was treated with intravenous acyclovir and foscarnet. One month after the vesiculous episode of HZ she showed 5 mm to 2 cm clustered flat violaceous lichenoid papules and confluent plaques within the HZ scars. Histopathologic examination revealed a inflammatory infiltrate present in the papillary dermis with granulomatous agregated formed by histiocytes, multinucleated giant cells and lymphocytes. She was treated with topic steroids with significant improvement. Pathologic findings are similar to those of an unusual lichenoid reaction named “giant cell lichenoid dermatitis”. We present the first reported case of giant cell lichenoid dermatitis at the sites of HZ scars.
Lipid and giant cell poor necrobiotic xanthogranuloma
Authors: Kossard Steven , Chow Elizabeth , Wilkinson Barbara , Killingsworth Murray
Published: March 2003

An 88‐year‐old man over a 7‐month period developed multiple yellow firm focally ulcerative papules and nodules over his face, neck and forearms. Seven skin biopsies showed a diffuse infiltrate of epithelioid histiocytes associated with areas of necrosis with neutrophilia. Two biopsies showed xanthogranulomatous foci, but cholesterol clefts, prominent giant cells or lymphoid aggregates were not evident. Necrosis with leukocytoclastic debris overshadowed the presence of hyaline necrobiosis. Ultrastructural examination and oil red‐o stains on frozen sections revealed focal lipid vacuoles within histiocytes. A paraprotein was detected in the patient's serum. This presentation may represent a lipid and giant cell poor variant of necrobiotic xanthogranuloma (NXG) and may potentially lead to a delay in diagnosis.
Expression of VCAM‐1, ICAM‐1, E‐selectin, and P‐selectin on endothelium in situ in patients with erythroderma, mycosis fungoides and atopic dermatitis
Authors: Sigurdsson Vigfús , De Vries I. Jolanda M. , Toonstra Johan , Bihari Ilse C. , Thepen Theo , Bruijnzeel‐Koomen Carla A.F.M. , Van Vloten Willem A.
Published: March 2003

Background: Erythroderma may result from different causes. At present it is unclear whether the patho‐mechanisms that lead to these different types of erythroderma are identical or different. Adhesion molecules and their ligands play a major role in endothelial‐leukocyte interactions, which affect the binding, transmigration and infiltration of lymphocytes and mononuclear cells during inflammation, injury, or immunological stimulation. The aim of this study was to investigate the adhesion molecule expression on endothelial cells in erythroderma in situ.

Methods: Snap‐frozen skin biopsy specimens from 23 patients with erythroderma were studied. Eight had idiopathic erythroderma, 5 erythrodermic atopic dermatitis, 4 Sézary syndrome and 6 had erythroderma from miscellaneous causes. As a control we studied skin specimens from 10 patients with mycosis fungoides, 5 patients with atopic dermatitis and 5 healthy non‐atopic volunteers. To determine adhesion molecule expression on endothelial cells in situ, sections were immuno‐histochemically double stained with biotinylated Ulex Europaeus agglutinin 1 as a pan‐endothelial cell marker, and for the adhesion molecules VCAM‐1, ICAM‐1, E‐, and P‐selectin. All double‐ and single‐stained blood vessels in the dermis were counted.

Results: Mean endothelial expression in erythroderma was as follows: VCAM‐1 51.4%, ICAM‐1 70.1%, E‐selectin 43.5%, and P‐selectin 52.6%. There was no statistical difference between different groups of erythroderma. Mean expression of all adhesion molecules tested, was in Sézary syndrome higher than in mycosis fungoides albeit not significant. In erythrodermic atopic dermatitis only VCAM‐1 expression was significantly higher than in lesional skin of atopic dermatitis. No differences were observed in expression of the other three adhesion molecules.

Conclusions: There is no difference regarding adhesion molecule expression on endothelial cells between different types of erythroderma.
Non‐hematopoietic cutaneous metastases in children and adolescents: thirty years experience at St. Jude Children's Research Hospital
Authors: Wesche W. A. , Khare V. K. , Chesney T. M. , Jenkins J. J.
Published: March 2003

Background: The spectrum of cutaneous metastasis of non‐hematopoietic neoplasms in the pediatric population is not well documented. We report the histologic diversity of this unusual process over a 30‐year period at a tertiary care center for pediatric malignancy (St. Jude Children's Research Hospital, Memphis, TN, USA).

Methods: Of 1,971 pathology accessions which included histologic material on skin (1,604 surgical cases and 367 autopsy cases) we found 40 cases (2% of total skin accessions) coded for metastatic non‐hematopoietic malignancy.

Results: The patients (n=34) ranged in age from 1 month to 20 years (mean=9.8 years) and had a male:female ratio of 1:1. The histologic diagnoses were as follows: rhabdomyosarcoma NOS (6 cases), embryonal rhabdomyosarcoma (4 cases), alveolar rhabdomyosarcoma (4 cases), neuroblastoma (8 cases), osteosarcoma (2 cases), choriocarcinoma (2 cases), peripheral neuroepithelioma or Ewing's sarcoma (2 cases), malignant rhabdoid tumor (1 case), paraganglioma (1 case), nasopharyngeal carcinoma (1 case), sarcoma NOS (1 case), colon adenocarcinoma (1 case), and malignant melanoma (1 case).

Conclusions: Cutaneous or subcutaneous metastasis of non‐hematopoietic malignancies in children and adolescents is a rare occurrence but in a high percentage of cases may be the first manifestation of disease. The tumors most likely to metastasize to the skin in children are rhabdomyosarcoma and neuroblastoma and they are more likely than adult malignancies to disseminate to multiple distant sites.
The combined utilization of clinical and histological findings in the diagnosis of trichotillomania
Authors: Bergfeld Wilma , Mulinari‐Brenner Fabiane , McCarron Karen , Embi Colleen
Published: March 2003

Background: Trichotillomania (TM) is a chronic disorder in which patients traumatically remove their own hair in a bizarre pattern. TM histopathological findings are not well defined.

Methods: Twenty‐eight scalp biopsies of TM were reviewed. Multiple vertical sections and special stains were used to evaluate the specimens. Twenty‐six patients (24 female, 2 male) were in the cohort, 2 patients had 2 sets of biopsies.

Results:  Age range was 13^78 years (mean 41 years), most of them presented with chronic TM. Specific histological findings included trichomalacia (57%) and pigmented casts (46%). Non‐specific histological findings included: follicular plugging (96%), decreased number of follicles (96%), reversed anagen:telogen ratio (86%), decreased number of sebaceous glands (68%), melanoderma (68%), increased number of fibrous tracts (64%) and vellus hairs (57%), superficial dermal inflammation (57%), evidence of hemorrhage (18%) and presence of hair granulomas (18%).

Conclusions:  Even though TM is often a disease of the young people, middle aged and elderly patients with TM have more often a biopsy to confirm the diagnosis. This paper suggests diagnostic criteria for TM. Specific histological findings and clinical suspicion of TM were considered major criteria, while the non‐specific histological findings were considered minor diagnostic criteria for TM.
Expression of CD44 and CD44v6 in primary cutaneous CD30 positive T‐cell lymphoproliferative disorders
Authors: Liang Xiayuan , Smoller Bruce R. , Golitz Loren E.
Published: March 2003

Background:  Expression of the lymphocyte homing receptor CD44 and its variant form, CD44v6, have been linked to unfavorable prognosis and tumor dissemination in non‐Hodgkin's lymphoma. The role of CD44 and CD44v6 in primary cutaneous lymphomas may not necessarily correlate with that observed in nodal lymphomas. Our study attempts to evaluate the expression pattern of CD44 and CD44v6 in primary cutaneous CD30 positive T‐cell lymphoproliferative disorders including primary cutaneous anaplastic large cell lymphoma (cALCL) and lymphomatoid papulosis (LyP) and compared the expression between these two subgroups.

Methods:  Immunohistochemical staining of CD44 and CD44v6 was performed on 10 cALCL and 18 LyP cases.

Results:  CD44 consistently expressed in all cases of primary cutaneous CD30 positive T‐cell lymphoproliferative disorders. In contrast with previous studies, our results showed that CD44v6 expressed in 46% of all cases, including 50% cALCL and 44% LyP. There was no statistic difference in expression of CD44 or CD44v6 between cALCL and LyP subgroups.

Conclusions:  These results provide a new evidence that CD44v6 is expressed in a subset cases of primary cutaneous CD30 positiveT‐cell lymphoproliferative disorders and suggest that other factors or molecules rather than CD44 or CD44v6 are responsible for the difference between cALCL and LyP.
Diagnostic Cost Groups (DCGs) and Concurrent Utilization among Patients with Substance Abuse Disorders
Authors: Rosen Amy K. , Loveland Susan A. , Anderson Jennifer J. , Hankin Cheryl S. , Breckenridge James N. , Berlowitz Dan R.
Published: March 2003

Objective. To assess the performance of Diagnostic Cost Groups (DCGs) in explaining variation in concurrent utilization for a defined subgroup, patients with substance abuse (SA) disorders, within the Department of Veterans Affairs (VA).

Data Sources. A 60 percent random sample of veterans who used health care services during Fiscal Year (FY) 1997 was obtained from VA administrative databases. Patients with SA disorders (13.3 percent) were identified from primary and secondary ICD‐9‐CM diagnosis codes.

Study Design. Concurrent risk adjustment models were fitted and tested using the DCG/HCC model. Three outcome measures were defined: (1) „service days” (the sum of a patient's inpatient and outpatient visit days), (2) mental health/substance abuse (MH/SA) service days, and (3) ambulatory provider encounters. To improve model performance, we ran three DCG/HCC models with additional indicators for patients with SA disorders.

Data Collection. To create a single file of veterans who used health care services in FY 1997, we merged records from all VA inpatient and outpatient files.

Principal Findings. Adding indicators for patients with mild/moderate SA disorders did not appreciably improve the R‐squares for any of the outcome measures. When indicators were added for patients with severe SA who were in the most costly category, the explanatory ability of the models was modestly improved for all three outcomes.

Conclusions. Modifying the DCG/HCC model with additional markers for SA modestly improved homogeneity and model prediction. Because considerable variation still remained after modeling, we conclude that health care systems should evaluate „off‐the‐shelf” risk adjustment systems before applying them to their own populations.
Multiple follicular cysts, infundibular type with vellus hairs and solar elastosis of the ears: a new dermatoheliosis?
Authors: Morgan Michael B. , Stevens G. Lex , Somach Stephen
Published: March 2003

Background:  Vellus hair cyst is an uncommon developmental abnormality of the vellus follicle histologically defined as a stratified squamous epithelial‐lined cyst containing one or more vellus hairs.

Methods:  Herein, we report three patients with a heretofore described clinicopathologic condition consisting of multiple contiguous cysts of the ear helices showing solar elastosis and multiple cysts containing vellus hairs, microscopically.

Conclusion:  Given the anatomic location, history of excessive ultraviolet exposure and pathologic alterations, we surmise that this is a condition related to Favre–Racouchot syndrome, which is predisposed by excessive ultraviolet light exposure.
Description and evaluation of an education and communication skills training course in HIV and AIDS for dental consultants
Authors: Lewis D. A. , Brain G. , Cushing A. M. , Hall A. , Zakrzewska J. M.
Published: March 2003

A 2‐day course was organised for dental hospital consultants as part of a project on raising awareness of dental staff about HIV and AIDS. The course comprised an information update, practical experience in the diagnosis of oral conditions and a ‘hands‐on’ exercise in infection control. The 2nd day of the course consisted of experiential communication skills training using rôle‐play with actors and video feedback. Evaluation of the course showed that the consultants perceived the course to be valuable. There was a general improvement in dentists’ confidence in their knowledge, ability to communicate with HIV‐positive patients and in talking to staff who are unwilling to provide treatment. These changes are statistically significant and these skills are still being utilized and maintained 2 years later. Information and training packs prepared by multidisciplinary groups using a variety of teaching methods should be made available to those involved in training dental staff.
Local CD‐ROM in interaction with HTML documents over the Internet
Authors: Mattheos Nikos , Nattestad Anders , Attström Rolf
Published: March 2003

The internet and computer assisted learning have enhanced the possibilities of providing quality distance learning in dentistry. The use of multimedia material is an essential part of such distance learning courses. However the Internet technology available has limitations regarding transmission of large multimedia files. Therefore especially when addressing undergraduate students or geographically isolated professionals, large download times make distance learning unattractive. This problem was technically solved in a distance learning course for undergraduate students from all over Europe. The present communication describes a method to bypass the problem of transmitting large multimedia files by the use of a specially designed CD‐ROM. This CD‐ROM was run locally on the students’ PC interacting with HTML documents sent over the Internet.
The concept of disease: ethical challenges and relevance to dentistry and dental education
Authors: Hofmann Bjørn M. , Eriksen Harald M.
Published: March 2003

Modern medicine and dentistry face fundamental ethical challenges. To treat or not to treat, that is the question! Can these challenges be met with a rigorous and consistent concept of disease? This is the key question of this article and the ensuing debate is of fundamental importance in the teaching of ethics to medical and dental students. The investigation of traditional concepts of disease reveals that they are flawed and do not withstand ethical challenges. An alternative concept of human ailment is elaborated on, based on the triad disease, illness and sickness. This model is applied to representative cases in medicine in general and dentistry in particular. It is argued that the concepts of disease, illness and sickness represent a framework for analysing and coping with inherent ethical challenges. This reveals that medicine and dentistry are concerned both with biological explanations and with questions of the virtuous life, i.e., both with science and with ethics. These considerations pose challenges for the health professions as a whole, but particularly for those concerned with educating the practitioners of the future.
Basic science knowledge of dental students on conventional and problem‐based learning (PBL) courses at Liverpool
Authors: Last K. S. , Appleton J. , Stevenson H.
Published: March 2003

This cross‐sectional study investigated performances of two consecutive cohorts of second year dental students on completion of a conventional didactic course and two succeeding cohorts of second year dental students on a recently introduced problem‐based learning (PBL) course at The University of Liverpool School of Dentistry. A 40 part true/false questionnaire tested recall of factual knowledge in anatomy, biochemistry, oral biology and physiology. The results showed no significant difference in the total scores when negatively marked between the conventional and PBL course groups but higher total scores in the PBL groups when positively marked. Performances in anatomy, oral biology and physiology did not differ between the groups when negatively marked but the scores of the conventional course groups in biochemistry were significantly lower than the others. With positive marking biochemistry scores were not significantly different but all other subjects were significantly higher in the PBL course groups. The PBL course groups offered fewer blank responses than the conventional course groups but the ratio of correct to incorrect responses, for both definite and intelligent guess responses, were similar in these groups. The compositional profile of the study groups was similar with respect to educational background but the PBL course groups included more females and more older students. The results of this study show that the overall knowledge recall in the basic sciences by dental students on PBL or conventional didactic courses does not differ and may be helpful to those considering the introduction of PBL into the curriculum.
Learning root debridement with curettes and power‐driven instruments in vitro: the role of operator motivation and self‐assessment
Authors: König J. , Rühling A. , Schlemme H. , Kocher T. , Schwahn C. , Plagmann H. C.
Published: March 2003

The influence of systematic dummy‐head training with Periopolisher® (PP, group A) and Gracey instruments (GRA, group B) on the effectiveness of root debridement was evaluated by Rühling et al., 2002 (9). Their results indicate that independent of the instrument used, untrained operators were only able to debride root surfaces at low levels of effectiveness. It was possible to increase effectiveness to a high level through systematic training in both groups. The aim of the present study was to assess the role of operator motivation and self‐assessment on scaling effectiveness. Before baseline, operators were asked to answer a questionnaire rating the expectation of the instrument performance. Four groups of inexperienced operators (n = 11 each) received 10 weeks dummy‐head training. In groups A (GRA) and B (PP), training was combined with a motivational programme. Groups C (GRA) and D (PP) received the same training, but no additional motivational programme. In a dummy‐head, 10 test teeth were debrided and operators were asked to estimate their effectiveness of debridement at each test day. Effectiveness was calculated as percentage of debrided root area on 10 test teeth at different time points with an image analysis programme (NIH Image) and ANOVA. Two groups were compared using the Mann–Whitney U‐test (unpaired) and the Wilcoxon signed ranks test (paired). Motivated groups (A and B) reached about 25% higher debridement results (p < 0.001) and were able to estimate their effectiveness more precisely compared to groups C and D. In the low motivation groups (C and D), overestimation of more than 20% was evident (p < 0.001). The questionnaires revealed underestimation of the GRA instruments and overestimation of PP instruments. Operator motivation and self‐assessment greatly influence learning of effective root debridement.
4.4 Electronic management systems
Authors: Eplee Harvey , Murray Brian , Revere James H. , Bollmann Friedhelm , Haddad George , Klimek Joachim , Barna Sergiu , Rhodes George , Looki Tuomas , Malone Aiden , Molvar Michael , Pienkowski Bob , Schoonheim Meta , Teravainen Jari‐Pekka
Published: March 2003

The international development and deployment of an electronic modularized dental curriculum is central to the development of an electronic engine to be used for the effective management of dental education. This will ensure continuity in high quality of care across all boundaries, through the continuous updating of its content and linkages to contemporary resources and databases. An electronic engine to be used for the effective management of dental education in a comprehensive dental school/hospital setting is at the core of an international ‘virtual’ dental education institution. The issue of policy development necessary to ensure consistency, quality and management for an electronic engine is at the very centre of: a) systems management and system databases; b) records of students, patients and personnel; and c) financial records.
5.1 The demography of oral diseases, future challenges and the implications for dental education
Authors: Zarkowski Pamela , Gyenes Monika , Last Keith , Leous Peter , Clarkson John , McLoughlin Jacinta , Murtomaa Heikki , Gibson John , Gugushe T. , Edelstein Burton , Matthews Robin , Vervoorn Marjoke , Van Den Heuvel J. L. M.
Published: March 2003

This Section considered the immense challenges presented by the changing demography of populations (in particular, cross‐boundary flow), changing oral and dental disease trends. It also considered the difficulties of gathering data on such information. It then considered how these challenges may affect the education of the dental team in the future. The Section considered the concept of the ‘global village’ as a representation of the changing world demography. We were at pains to recognize that our role was in considering both emerging and established market economies. In fact, a major part of the Section's activities concentrated on the development of the professional ethic of social responsibility – represented at the local, regional, national and international levels. We considered a finite group of oral and dental diseases, namely dental caries, periodontal diseases, oral cancer and cranio‐facial disorders. In addition, we chose to comment on systemic diseases influenced by oral diseases, oral diseases influenced by systemic diseases and iatrogenic diseases (including prion disorders and cross‐infection control issues). The Section recognized the profound difference between needs and demands in the provision of oral and dental health care. We considered the concept of best practices within our working remit and named these as:

•  the gathering of valid data on health trends;

•  uniformity in the measurement of disease and diagnostic parameters;

•  the identification of a core curriculum which best addresses an increased awareness of changing demography; and

•  a multidisciplinary approach to education and research in the context of global collaboration.

The Section recognized the enormous potential for global networking with the explosion of information and communication technology. We investigated the requirements in converging towards higher global standards, while accepting and appreciating important regional and continental differences. To this end, the Section has put forward a number of important recommendations and realistic goals.
Canopy arthropod assemblages along a precipitation and latitudinal gradient among Douglas‐fir Pseudotsuga menziesii forests in the Pacific Northwest of the United States
Authors: Progar R. A. , Schowalter T. D.
Published: March 2003

Insects are particularly sensitive to environmental conditions and can serve as responsive indicators of changing climatic patterns and habitat conditions. However, changes in patterns of abundance over environmental gradients in forest ecosystems are poorly known. To examine landscape patterns of invertebrate assemblages, arboreal arthropods were collected during two seasons (spring and summer) by bagging branches from the lower, middle and upper canopy levels from six stands in nine second‐growth (100–150 yr old) forests and old‐growth (500 yr old) forests in Washington and Oregon. Detrended correspondence analysis and multi‐response permutation procedure showed that the composition of the canopy assemblages varied significantly with latitude, precipitation and tree age. Indicator analysis was used to assess each taxon's importance in response to the environmental variables. Individual taxa showed associations with latitudinal and precipitation gradients, and between old‐growth and mature Douglas‐fir. These effects may be used to anticipate the impacts of climate change or land use scenarios on the spatial patterns of forest invertebrate assemblages.
Starling foraging success in relation to agricultural land‐use
Authors: Olsson Ola , Bruun Måns , Smith Henrik G.
Published: March 2003

Changes in agricultural land‐use have been suggested to contribute to the decline of several bird species through negative effects on their food supply during breeding. One important change in land‐use has been loss of pastures, especially permanent pastures. In this study we investigated how different forms of agricultural land‐use affected foraging success of a declining bird species, the European starling Sturnus vulgaris. We let caged starlings forage in different forms of agricultural fields and determined time spent foraging and foraging success. The starlings’ activity level (time spent actively foraging) as well as the number of prey caught per time unit was strongly related to the abundance of prey in soil samples. Also the body mass change during the experiment was positively related to activity level and prey capture rate. We found consistent differences in foraging variables between habitats. In spring sown grain starlings were least active and found fewer prey items at a lower rate than in any other habitat. The other three habitats differed less, but in general mowed hay fields appeared slightly more valuable than the cultivated and natural pastures. We did not find any differences between natural and cultivated pastures in foraging variables. Thus, starling foraging success is higher in grass‐covered fields than in cultivated fields, but the management of the grass‐covered fields mattered less. The results are consistent with starlings having higher population densities and breeding success in areas with higher availability of pasture. We suggest that the physical structure of the habitat (sward height) and moisture may be additional variables that need to be taken into account to explain starling breeding density and success in the agricultural landscape.
Implications of long‐distance movements of frugivorous rain forest hornbills
Authors: Holbrook Kimberly M. , Smith Thomas B. , Hardesty Britta D.
Published: March 2003

Long‐distance seed dispersal influences many critical ecological processes by improving chances of gene flow and maintaining genetic diversity among plant populations. Accordingly, large‐scale movements by frugivores may have important conservation implications as they provide an opportunity for long‐distance seed dispersal. We studied movement patterns, resource tracking, and potential long‐distance seed dispersal by two species of Ceratogymna hornbills, the black‐casqued hornbill C. atrata, and the white‐thighed hornbill C. cylindricus, in lowland tropical forests of Cameroon. We determined fruiting phenology of 24 tree species important in hornbill diet at monthly intervals and compared these patterns to monthly hornbill census data. After capture and radio‐tagging of 16 hornbills, we used radio telemetry by vehicle and fixed wing aircraft to determine the extent of long‐distance movements. Hornbills exhibited up to 20‐fold changes in numbers in response to fruit availability in our 25 km2 study area. Also, hornbills made large‐scale movements up to 290 km, which are larger than any movement previously reported for large avian frugivores. Together, these observations provide direct evidence that hornbills are not resident and that hornbills track available fruit resources. Our results suggest that Ceratogymna hornbills embark on long‐distance movements, potentially dispersing seeds and contributing to rain forest regeneration and diversity.
Characterization of lymphocyte subsets in rhesus macaques during the first year of life
Authors: DeMaria MaryAnn , Casto Michael , O'Connell Michael , Johnson R. Paul , Rosenzweig Michael
Published: March 2003

Abstract: Establishing reliable phenotypic data sets from the analysis of peripheral blood lymphocytes of normal animals is required to assess disease states. The rhesus macaque animal model is well established with respect to adult animals, but limited data are available that characterizes lymphocyte subsets in normal neonates. To address this, we used four‐color flow cytometric analysis to follow phenotypic changes in 29 normal rhesus animals through their first ten months of life. From birth to 44 wk of age, the white cell count and absolute lymphocyte count were both elevated compared to adults. CD4+ cells constituted over 80% of all T cells at birth, a percentage that declined gradually over the first 12 wk of life, coincidental with increases in the percentages of CD8+ T cells, CD3–8+ natural killer cells and CD20+ B cells. This difference in relative frequency of CD4 and CD8 results in a significant skewing of CD4:CD8 ratio from 0.7:1 in adults to 3.5:1 in neonates. In addition, the predominant population of T lymphocytes consisted of CD45RA+CD62L+ naïve cells. This subset continues to be the predominant phenotype for at least the first year of age. After birth the expression of activation markers (CD25) increased particularly on CD4+ T cells, although these levels generally reached a frequency similar to that observed in adults between 12 and 20 weeks after birth. These results are similar to those seen in humans and further confirm the reliability of the rhesus macaque animal model to study human diseases.
Defective platelet aggregation in polycythaemia vera is not caused by impaired calcium signaling, phospholipase D activation or decreased amounts of focal adhesion proteins
Authors: Le Blanc Katarina , Berg Anders , Palmblad Jan , Samuelsson Jan
Published: March 2003

Abstract: We have previously demonstrated that platelets in polycythaemia vera (PV) exhibit decreased aggregation after stimulation with platelet activating factor (PAF) and reduced expression of GPIIIa on both resting and stimulated platelets. In the present study, we investigated if these results were related to changes in the mobilization of intracellular calcium, activation of phospholipase D (PLD) or amounts of GPIIIa and the intracellular tyrosine kinases Fak, Syk, Grb2, Shc and rhoA. Intracellular calcium levels were not different in resting platelets from 14 PV patients and 15 healthy controls (median 43 nmol/L, range 10–114, vs. 36 nmol/L, range 10–119). After stimulation with PAF (1 µmol/L) an equal increase was seen (125 nmol/L for PV platelets, range 67–257, vs. 113 nmol/L for controls, range 60–250). Also formation of phosphatidyl ethanol (PEt) was similar after exposure to 0.5 U/ml thrombin (0.28% PEt of total phospholipid, range 0.16–1.10, vs. 0.24 for controls, range 0.11–2.3) and 1 µmol/L PMA (0.25, range 0.16–0.32, vs. 0.14, range 0.09–0.6). In contrast to the reduced amount of GPIIIa on the surface of PV platelets, immunoblotting on whole cell lysates showed no reduction in PV patients compared to controls, indicating the possibility of an impaired incorporation of GPIIIa to the cell membrane. Levels of Fak, Syk, Shc, Grb2 and rhoA appeared equal in patients and controls. Similar intracellular proteins were tyrosine phosphorylated after stimulation with thrombin, PAF and PMA. In summary, defective platelet aggregation after stimulation with PAF is caused by neither defective mobilization of intracellular calcium nor, in contrast to the situation in PV granulocytes, an impaired activation of PLD. Moreover, no apparent differences in the intracellular amounts of Fak, Syk Shc, Grb2 and rhoA could be detected between PV and control platelets.
All‐trans retinoic acid significantly reduces the incidence of early hemorrhagic death during induction therapy of acute promyelocytic leukemia
Authors: Visani Giuseppe , Gugliotta Luigi , Tosi Patrizia , Catani Lucia , Vianelli Nicola , Martinelli Giovanni , Ottaviani Emanuela , Testoni Nicoletta , Nocentini Franco , Pastano Rocco , Piccaluga Pierpaolo , Isidori Alessandro , Grafone Tiziana , Tura Sante
Published: March 2003

Abstract: Early hemorrhagic death (within the first 10 d of treatment [EHD]) is reported as the main cause of death during induction therapy for acute promyelocytic leukemia (APL). In order to evaluate possible differences in the incidence of EHD during induction regimens based on all‐trans retinoic acid (ATRA), we retrospectively analyzed a consecutive series of 86 APL patients, diagnosed and treated at our Institution from 1982. Forty‐three patients received combination chemotherapy with anthracyclines and cytosine arabinoside (January 1982 to December 1991), while induction of the remaining 43 was based on ATRA alone or on a combination of ATRA and anthracyclines (January 1992 to October 1996). There were significantly less induction deaths in the ATRA group [9 (chemotherapy group‐CT) vs. 2 (ATRA group‐RA) overall and 8(CT) vs. 1(RA) of EHD; p=0.01]. Hemostatic evaluations showed an earlier reduction of
d‐dimer in the ATRA group. No cases of morphological resistance were observed in the ATRA group after induction. In addition, the number of relapses occurring in the first 24 months from the achievement of complete remission (CR) was significantly lower in the ATRA group (15 vs. 7; p=0.01), with a disease free survival at 2 yr of 67% vs. 31%. In conclusion, ATRA appears to be able to significantly reduce the incidence of EHD, increasing the number of possible long‐term remissions.
Neonatal and maternal thrombocytopenia: incidence and immune background
Authors: Uhrynowska M. , Niznikowska‐Marks M. , Żupańska B.
Published: March 2003

Abstract: We performed a prospective study on the incidence of thrombocytopenia (t‐penia) and its immunological origin in unselected 26 275 mothers and 24 101 newborns. Platelet antibodies were examined by the platelet immunofluorescence test (PIFT) and the monoclonal antibody immobilisation of platelet antigens assay (MAIPA). T‐penia (platelet count <100×109/l) was found in 124 (0.5%) mothers (in 0.04% severe, <50×109/l) and in 116 (0.5%) newborns (in 0.15% severe); 90 (72.6%) and 112 (96.6%), respectively, were available for further studies. In both groups non‐immune t‐penia was diagnosed about 4.5 times more often than the immune t‐penia. Among 90 mothers, t‐penia was severe in 11.1%, antibodies were detected in 17.8%; both factors were not prognostic for delivering thrombocytopenic newborns. Among 112 babies, 21 were delivered by thrombocytopenic mothers and 91 by mothers with normal platelet count; among newborns with immune t‐penia the proportion of alloimmune (NAIT) to autoimmune was equal (10 with NAIT, 10 with autoimmune, 4 of them born by mothers with hidden autoimmune t‐penia). In 33% of the neonates t‐penia was severe, most often among NAIT. In conclusion, although t‐penia in mothers as well as in infants is not frequent and severe, and an immune origin not often found, the search for antibodies, in particular alloantibodies, should be done. Even if the serological results are not helpful at the moment, they can be of importance in subsequent pregnancy and for related pregnant women.
Association of the α‐spectrin R28H mutation with allele αLELY and with αI/αII domain haplotypes in three Brazilian families
Authors: Bassères Daniela S. , Bordin Silvana , Costa Fernando F. , Saad Sara T. O.
Published: March 2003

Abstract: We have studied three Brazilian kindreds presenting spectrin αI/74 hereditary elliptocytosis (HE) due to a G→A substitution, responsible for the R28H mutation. The mutant allele was associated with αI domain haplotype 1 (XbaI−/MspI−/PvuII+) in all three families and with two different αII domain haplotypes (1/RIT, 4/RVR). This result may reflect that this mutation occurs in a “hot spot” and may have arisen more than once or that a crossing over event may have occurred between the two domains studied. We detected one new haplotype in the αI domain (haplotype 3 – XbaI+/MspI−/PvuII+). The mutant allele was associated with the lack of the αII domain Alu insertion in all three cases. Allele αLELY, detected by PCR and restriction enzyme digestion, was present in the heterozygous form in patient 1 (αHE/αLELY) and in the homozygous form in patients 2 and 3 (αHE‐LELY/αLELY). It was found to be associated with αII domain haplotypes 1 (RIT) and 4 (RVR) and with the presence and absence of the Alu insertion. This may have arisen through recombination events, since this polymorphism is located in the αIV–αV domain junction, which is far distant from the αII domain.
A novel gene STORP (STOmatin‐Related Protein) is localized 2 kb upstream of the promyelocytic gene on chromosome 15q22
Authors: Gilles Frédéric , Glenn Martha , Goy André , Remache Yvonne , Zelenetz Andrew D.
Published: March 2003

Abstract: We generated a 100‐kb map of the region 5′ of the PML (promyelocytic leukemia) gene on human chromosome 15q22 and identified a new gene provisionally named STORP for stomatin‐related protein. The STORP gene is positioned 2 kb upstream of the PML gene in a head‐to‐head configuration, and contains 7 exons spanning a genomic region of about 11 kb. There is an open reading frame of 398 amino acids, which would encode a protein of 45 kD. Northern blot analysis demonstrated that the STORP gene has a ubiquitous pattern of expression similar to that of the PML gene. Hybridization of STORP cDNA probe to genomic DNA from other species demonstrated that the STORP gene is conserved among mammalian vertebrates and that the physical linkage with PML is conserved in mice. Unlike PML, the STORP gene is not induced by interferon alpha (IFNα), and thus can be distinctly regulated from the PML gene. STORP is homologous to the EPB72 gene coding for the erythrocyte band 7 integral membrane protein or stomatin, which is deficient in a certain form of hereditary stomatocytosis. The function of STORP is unknown. Further study will focus on studying its potential role in red cell function and disorders.