bluuebunny/crossref_metadata_2025 huggingface dataset:
Computer‐assisted detection as a second reader in symptomatic asian women with palpable breast cancer
Authors: Chu W. C. W. , Lam W. W. M. , Pang A. L. M. , So N. M. C. , Tang A. P. Y. , Tse G. M. K. , Ahuja A. T.
Published: April 2004

Purpose: To determine the potential role of a computer‐assisted detection (CAD) algorithm as a second reader for experienced and inexperienced radiologists in mammography reading in Asian women.

Material and Methods: Two‐view mammograms performed in 124 consecutive patients who presented with palpable breast cancer masses were retrospectively evaluated by two experienced breast radiologists (7 and 10 years' experience). The original reports of the session radiologists with variable experience of reading mammograms (2 to more than 10 years) were also evaluated. The number of suspicious masses and microcalcification clusters detected in each patient by both groups of radiologists were recorded. The radiologists then re‐evaluated the films with the CAD system as a second reader. Any improvement in the detectability of breast pathology by either the experienced radiologists and/or by the session radiologists was then assessed. A total of 127 breasts had biopsy‐proven carcinoma; 74 breasts had mastectomy performed. All the imaging results were correlated with tru‐cut biopsy or mastectomy histology.

Results: With CAD‐aided interpretation, there were altogether 95 visible masses and 77 suspicious microcalcification clusters in 109 mammographically detectable cancers correlated with histology results. There was a 7.4% (7/95) and 10.4% (8/77) increase in the number of masses and microcalcification clusters detected, respectively, by the experienced radiologists after application of CAD, whereas the increase was 13.7% (13/95) and 27.3% (21/77) for detection of masses and microcalcifications by the session radiologists, respectively. In 9 patients, a secondary focus detected by CAD was confirmed by histology. Three patients had contralateral breast tumors, 1 had a satellite invasive tumor while 5 had ductal carcinoma in situ on the same breast. Based on the biopsies and 74 mastectomies, the true‐positive and false‐positive detection rate of CAD was 92.6% and 31.8% for detection of carcinomas. The true‐positive and false‐positive detection rates were 100% and 58.8% for microcalcification clusters.

Conclusion: The current generation CAD algorithm helped to improve the detection rate of carcinomas, calcifications and multifocality in Asian breasts.
Sclerosing stromal tumor of the ovary in pregnancy: clinical, ultrasonography, and magnetic resonance imaging findings
Authors: Calabrese M. , Zandrino F. , Giasotto V. , Rissone R. , Fulcheri E.
Published: April 2004

We report a case of sclerosing stromal tumor of the ovary in a 30‐year‐old pregnant patient presenting with pelvic pain, dysuria, and metrorrhagia. Very few reports of sclerosing stromal tumor of the ovary during pregnancy have been presented. The purpose of our work is to present the findings at physical examination, ultrasonography, magnetic resonance imaging, and histopathology, to review the literature regarding this uncommon neoplasm, and to show the usefulness of magnetic resonance imaging in the assessment of pelvic masses during pregnancy.
Postnatal nicotine exposure does not further compromise hypoxia defense mechanisms in prenatally nicotine‐exposed lambs
Authors: Hafström O , Milerad J , Sundell HW
Published: April 2004

Aims: To determine whether combined pre‐ and postnatal nicotine exposure compared with prenatal exposure alone results in more compromised postnatal hypoxia defense mechanisms and further alteration of the postnatal breathing pattern (reduced tidal volume and increased respiratory rate). Methods: Seven lambs exposed to nicotine prenatally (pN) (approximate maternal dose: 0.5 mg/kg/d) and seven lambs exposed to nicotine pre‐ and postnatally (ppN) (postnatal dose: 1.6–2 mg/kg/d) were studied without sedation at an average age of 5 d and 21 d during resting (room air) conditions, during exposure to 10% O2 and during a brief exposure to 100% O2. Results: Resting minute ventilation, occlusion pressure, effective impedance, heart rate and mean arterial blood pressure were similar in the two groups during wakefulness and quiet sleep. Resting tidal volume was significantly higher in ppN than in pN lambs during wakefulness (9.4 ±; 0.7 vs 7.7 ±; 1.4 ml/kg, p > 0.05) and quiet sleep (9.8 ±; 0.6 vs 7.6 ±; 1.5 ml/kg, p > 0.01) at 5 d and also at 21 d during wakefulness (7.7 ±; 1.0 vs 6.2 ±; 1.1 ml/kg, p > 0.05). The ventilatory, heart rate and blood pressure responses to hypoxia were comparable in the two groups during both activity states. Time to arousal from quiet sleep in response to hypoxia was equivalent in the two groups. The ventilatory response to hyperoxia was not significantly different in the two groups during either activity state.

Conclusion: Continued postnatal nicotine exposure after prenatal exposure did not further compromise hypoxia defense mechanisms after birth.
Mayer‐Rokitansky‐Küster‐Hauser syndrome associated with pulmonary stenosis
Authors: Kula S , Saygili A , Tunaoǧlu FS , Olguntürk R
Published: April 2004

Two siblings with Mayer‐Rokitansky‐Küster‐Hauser (MRKH) syndrome associated with pulmonary valvular stenosis are reported. Although the syndrome is well documented, the genetic background and familial occurrence is not known and the association with cardiac anomalies has not previously been reported. This report is the first report which describes the combination of cardiac anomaly with MRKH syndrome.
Burst suppression on amplitude‐integrated electroencephalogram may be induced by midazolam: a report on three cases
Authors: ter Horst HJ , Brouwer OF , Bos AF
Published: April 2004

Continuous amplitude‐integrated electroencephalogram (aEEG) recording with a cerebral function monitor is a useful tool to evaluate prognoses following perinatal asphyxia in term infants. Drugs may change the pattern of the conventional EEG. This report presents three infants treated with midazolam for status epilepticus and repetitive seizures who proved resistant to other anticonvulsants (phenobarbitone, lidocaine). The infants developed burst suppression patterns on aEEG concurrent with high serum levels of midazolam (900‐7093 μg l‐1). Following discontinuation of midazolam treatment, serum levels normalized and background patterns returned to normal voltage traces.

Conclusion: These findings indicated that midazolam can cause burst suppression on aEEG. Therefore, the prognostic value of aEEG is limited in case of high serum levels of midazolam. Serum levels of midazolam should be measured in infants who have burst suppression patterns on aEEG during midazolam treatment.
Preterm male infants need more initial respiratory and circulatory support than female infants
Authors: Elsmén E , Pupp I Hansen , Hellström‐Westas L
Published: April 2004

Aim: The aim of this study was to investigate possible gender‐related differences in clinical parameters during the first week of life that could explain the higher morbidity and mortality of preterm male infants. Methods: In total, 130 clinical variables were collected from 236 inborn infants (130 male and 106 female infants) with gestational age (GA) >29wk. A subgroup of 175 extremely low birthweight infants (ELBW) >1000 g (n= 86 males; n= 89 females) was analysed separately. Results: At 6 postnatal h, 60.8% of the male infants needed mechanical ventilation versus 46.2% of the females (p= 0.026). Chronic lung disease (CLD) developed in 36.2% of males versus 9.8% of female infants (p= 0.004). Inotrope support with dopamine was used in more than 50% of the infants; additional inotrope support to dopamine was needed by 19.4% of male and 9.7% of female infants (p= 0.041). The gender‐related difference in need for inotrope support was more evident among the ELBW infants; 67.1% of male infants needed inotrope support versus 50.6% of females (p= 0.028). At 12–24 h, male ELBW infants had lower minimum mean arterial blood pressure (mean (SD) 25(4) mmHg vs 28(6) mmHg, p= 0.004)) and lower minimum PaCO2 than females infants (4.3 (1.1) kPa vs 4.7 (0.9) kPa, p= 0.043).

Conclusions: There are early gender‐related differences in need for ventilatory and circulatory support that may contribute to the worse long‐term outcome in prematurely born male infants.
Immediate and short‐term effects of pulmonary artery banding on left ventricular performance in foetal sheep
Authors: Sonesson S‐E , Fouron J‐C , Teyssier G , Skoll A , Chartrand C
Published: April 2004

Aim: To evaluate foetal left ventricular performance when its preload was increased by banding the pulmonary artery, a study design where a simultaneous change in left ventricular afterload is unlikely. Methods: Nine ovine foetuses were studied with real‐time images and Doppler echocardiography before, 3–4 and 6–8 d after surgery. Seven of these foetuses were also studied during the surgical intervention, immediately before and within 2 min after banding. Results: The immediate effects of a 90‐95% reduction of the pulmonary artery cross‐sectional area were: a 53 ±; 20% (mean ±; SD) decrease and a 38 ±; 10% increase of right (RvQ) and left ventricular output (LvQ), respectively. Comparing measurements before and 3–4 d after operation, there was a 64 ±; 16% decrease of RvQ and a 64 ±; 25% increase of LvQ. The increase in LvQ was due to an increase in both heart rate (19 ±; 10%) and stroke volume (38 ±; 18%). After an additional 3–4 postoperative days, heart rate remained increased to the same extent, but there was a more pronounced increase of LvQ (93 ±; 19%) and stroke volume (59 ±; 22%).

Conclusion: The parallel foetal circulation has a capacity to handle a severely increased afterload for the right ventricle by immediately improving and maintaining an increased left ventricular performance. This improvement was in part accomplished by an increase in stroke volume.
The Rhetoric of a Juggernaut: AOLTimeWarner's Internet Policy Statement
Authors: AMERNIC JOEL H. , CRAIG RUSSELL J.
Published: April 2004

This paper addresses an issue of public policy regarding the Internet. It is motivated by the belief that the Internet is in danger of being controlled by a few megacorporations. We seek to understand the nature of such control by performing a textual analysis of the ‘Internet Policy Statement’ released by AOLTimeWarner in 2001. Our analysis reveals hidden assumptions, ideology and metaphor; highlights how rhetoric influences social expectations; and generally helps us make sense of the words of a mega‐corporate managerial elite and how this elite views the Internet. We reveal a self‐serving and persuasive public policy statement made by a corporate Juggernaut.
Innovation and Clustering among Information Technology Firms in Melbourne1
Authors: MOHANNAK KAVOOS
Published: April 2004

This paper investigates innovative activities, clustering and regional interaction of a group of Information and Communication Technology (ICT) firms in the metropolitan area of Melbourne. In order to make an evaluation of the regional innovation potential among the firms, a written questionnaire was sent to the selected firms. The focal point of the analysis lay in determining innovative activities within individual firms and degree of linkages between different firms. The results indicate that innovative relationships with customers and suppliers are stronger within the region and they tend to co‐operate more on a vertical basis. However, the findings suggest that firms rely only partly on innovation partners within the region and to a considerable extent they are integrated in national and international networks.
Tissue‐specific down‐regulation of RIPK 2 in Mycobacterium leprae‐infected nu/nu mice
Authors: Kim Byoung Chul , Kang Tae-Jin , Jin Song Hou , Kim Se-Kon , Lee Seong-Boem , Chae Gue-Tae
Published: April 2004

RIPK 2 is adapter molecule in the signal pathway involved in Toll‐like receptors. However, there has been no reported association between receptor‐interacting serine/threonine kinase 2 (RIPK 2) expression and the infectious diseases involving mycobacterial infection. This study found that its expression was down‐regulated in the footpads and skin but was up‐regulated in the liver of Mycobacterium leprae‐infected nu/nu mice compared with those of the M. leprae non‐infected nu/nu mice. It was observed that the interlukin‐12p40 and interferon‐γ genes involved in the susceptibility of M. leprae were down‐regulated in the skin but were up‐regulated in the liver. Overall, this suggests that regulation of RIPK 2 expression is tissue‐specifically associated with M. leprae infection.
Subpopulations of mononuclear leukocytes associated with inhibition of Ehrlich ascites tumor growth by treatment with Bothrops jararaca venom
Authors: Santos Mariana Morena de Vieira , da Silva Reinaldo José , da Silva Márcia Guimarães , Fecchio Denise
Published: April 2004

Snake venoms have been used as antineoplastic substances in several experimental models. We demonstrated in previous studies that Bothrops jararaca venom (BjV) induces inhibition of Ehrlich ascites tumor (EAT) growth accompanied by an increase of mononuclear (MN) leukocytes in all groups inoculated with EAT and/or venom. The objective of the present study was to characterize the subpopulations of MN leukocytes involved in the inhibition of EAT growth by treatment with BjV. Swiss mice were inoculated with 1.0×103 EAT cells by the intraperitoneal route and treated with 0.4 mg/kg of BjV by the same route (Group TV). Treatment was started 24 h after tumor cell inoculation and consisted of five intraperitoneal injections performed at 72 h intervals. After 2, 8 and 14 days, groups of animals were sacrificed and the number of B, TCD4 and TCD8 lymphocytes, macrophages and natural killer cells present in the peritoneal cavity was determined by flow cytometry. The control group consisted of animals inoculated with EAT and treated with 0.1 ml of saline under the same conditions as the experimental group (Group T). Two additional control groups consisted of animals not inoculated with EAT and treated with saline or venom. Data were analyzed statistically by the Kruskal‐Wallis non‐parametric test for independent samples. On the 2nd and 8th day we observed a difference between groups T and TV (group T > group TV) for all cell types, except natural killer cells, that only differed on the 2nd day. However, on the 14th day there was no difference in MN cells among groups. These data suggest that the inhibition of EAT is related to the toxic action of BjV on tumor cells and/or to the proteolytic effect of the venom on the mediators produced by the cells for growth modulation.
Elevated plasma phospholipase A2 and platelet‐activating factor acetylhydrolase activity in colorectal cancer
Authors: Denizot Yves , Truffinet Véronique , Bouvier Stéphane , Gainant Alain , Cubertafond Pierre , Mathonnet Muriel
Published: April 2004

This clinical study reports that blood levels of the pro‐inflammatory mediator platelet‐activating factor (PAF) did not change in colorectal cancer patients. In contrast, plasma levels of two enzymatic activities, one implicated in PAF production (i.e. phospholipase A2) and one in PAF degradation (i.e. PAF acetylhydrolase activity) were significantly elevated.
Ozone as Janus: this controversial gas can be either toxic or medically useful
Authors: Bocci Velio
Published: April 2004

Ozone is an intrinsically toxic gas and its hazardous employment has led to a poor consideration of ozone therapy. The aim of this review is to indicate that a wrong dogma and several misconceptions thwart progress: in reality, properly performed ozone therapy, carried out by expert physicians, can be very useful when orthodox medicine appears inadequate. The unbelievable versatility of ozone therapy is due to the cascade of ozone‐derived compounds able to act on several targets leading to a multifactorial correction of a pathological state. During the past decade, contrary to all expectations, it has been demonstrated that the judicious application of ozone in chronic infectious diseases, vasculopathies, orthopedics and even dentistry has yielded such striking results that it is deplorable that the medical establishment continues to ignore ozone therapy.
Education, Criticism and the Creative Imagination: the legacy of William Hazlitt
Authors: Halpin David
Published: April 2004

William Hazlitt (1778–1830), one of the most important critics of the English Romantic Period, held and published highly developed views about the nature of the creative imagination, the function of criticism and what it means to be truly learned [1]. Although he never advanced
an explicit theory of education, least of all one about the purposes of schooling, his principles of thought and action and his thesis about style and structure in writing are highly relevant to contemporary discussions of what counts as genuine learning and teaching and the intellectual vocation
of members of the educational academy.
The Inescapability of Significant Contextual Learning in Work Performance
Authors: Hager Paul , Smith Erica
Published: April 2004

Many countries have implemented versions of competency-based training in which competency standards or statements serve to provide standardized learning and skill development outcomes for vocational education and training. It seems that a main attraction that motivated the introduction
of such competency-based systems was the assumption by some that they would be 'failsafe', in that achievement of the learning and skill development outcomes would guarantee that the learner was workplace competent. However there were always convincing conceptual reasons for denying that the
achievement of standards-based learning and skill development outcomes would be equivalent to being workplace competent. This paper aims to explain these reasons, to provide empirical evidence of the scope of the gap between formal standardized training and workplace competence, and to address
the implications of this gap for the improvement of vocational education and training. The assumption that the gap could be avoided overlooks the crucial importance of context and culture in workplace performance. It is argued that sound vocational education and training needs to take account
of these features.
Neo-Piagetian Theory and Research: enhancing pedagogical practice for educators of adults
Authors: Knight Catharine C. , Sutton Rosemary E.
Published: April 2004

Educators are continuously challenged to increase their pedagogical effectiveness when teaching adult learners. Neo-Piagetian theory and research, based on Piaget's classic work, provides promising concepts and tools to help educators enhance their pedagogical knowledge and competence
when teaching adults. Consequently, through research findings and examples we explore the pedagogical utility of neo-Piagetian theory. Specifically, we examine: (1) the influence of cognitive development into adulthood on teaching, (2) the roles of functional and optimal levels of learner
cognition, and (3) the pedagogical implications of employing neo-Piagetian concepts and research to support the teaching and learning endeavours of adult learners.
Electron Tomographic Analysis of Somatic Cell Plate Formation in Meristematic Cells of Arabidopsis Preserved by High-Pressure Freezing[W]
Authors: Seguié-Simarro Joseé M. , Austin Jotham R. , White Erin A. , Staehelin L. Andrew
Published: April 2004

We have investigated the process of somatic-type cytokinesis in Arabidopsis (Arabidopsis thaliana) meristem cells with a three-dimensional resolution of ∼7 nm by electron tomography of high-pressure frozen/freeze-substituted samples. Our data demonstrate that this process can be divided into four phases: phragmoplast initials, solid phragmoplast, transitional phragmoplast, and ring-shaped phragmoplast. Phragmoplast initials arise from clusters of polar microtubules (MTs) during late anaphase. At their equatorial planes, cell plate assembly sites are formed, consisting of a filamentous ribosome-excluding cell plate assembly matrix (CPAM) and Golgi-derived vesicles. The CPAM, which is found only around growing cell plate regions, is suggested to be responsible for regulating cell plate growth. Virtually all phragmoplast MTs terminate inside the CPAM. This association directs vesicles to the CPAM and thereby to the growing cell plate. Cell plate formation within the CPAM appears to be initiated by the tethering of vesicles by exocyst-like complexes. After vesicle fusion, hourglass-shaped vesicle intermediates are stretched to dumbbells by a mechanism that appears to involve the expansion of dynamin-like springs. This stretching process reduces vesicle volume by ∼50%. At the same time, the lateral expansion of the phragmoplast initials and their CPAMs gives rise to the solid phragmoplast. Later arriving vesicles begin to fuse to the bulbous ends of the dumbbells, giving rise to the tubulo-vesicular membrane network (TVN). During the transitional phragmoplast stage, the CPAM and MTs disassemble and then reform in a peripheral ring phragmoplast configuration. This creates the centrifugally expanding peripheral cell plate growth zone, which leads to cell plate fusion with the cell wall. Simultaneously, the central TVN begins to mature into a tubular network, and ultimately into a planar fenestrated sheet (PFS), through the removal of membrane via clathrin-coated vesicles and by callose synthesis. Small secondary CPAMs with attached MTs arise de novo over remaining large fenestrae to focus local growth to these regions. When all of the fenestrae are closed, the new cell wall is complete. Few endoplasmic reticulum (ER) membranes are seen associated with the phragmoplast initials and with the TVN cell plate that is formed within the solid phragmoplast. ER progressively accumulates thereafter, reaching a maximum during the late PFS stage, when most cell plate growth is completed.
Composition and Structure of the Centromeric Region of Rice Chromosome 8[W]
Authors: Wu Jianzhong , Yamagata Harumi , Hayashi-Tsugane Mika , Hijishita Saori , Fujisawa Masaki , Shibata Michie , Ito Yukiyo , Nakamura Mari , Sakaguchi Miyuki , Yoshihara Rie , Kobayashi Harumi , Ito Kazue , Karasawa Wataru , Yamamoto Mayu , Saji Shoko , Katagiri Satoshi , Kanamori Hiroyuki , Namiki Nobukazu , Katayose Yuichi , Matsumoto Takashi , Sasaki Takuji
Published: April 2004

Understanding the organization of eukaryotic centromeres has both fundamental and applied importance because of their roles in chromosome segregation, karyotypic stability, and artificial chromosome-based cloning and expression vectors. Using clone-by-clone sequencing methodology, we obtained the complete genomic sequence of the centromeric region of rice (Oryza sativa) chromosome 8. Analysis of 1.97 Mb of contiguous nucleotide sequence revealed three large clusters of CentO satellite repeats (68.5 kb of 155-bp repeats) and >220 transposable element (TE)–related sequences; together, these account for ∼60% of this centromeric region. The 155-bp repeats were tandemly arrayed head to tail within the clusters, which had different orientations and were interrupted by TE-related sequences. The individual 155-bp CentO satellite repeats showed frequent transitions and transversions at eight nucleotide positions. The 40 TE elements with highly conserved sequences were mostly gypsy-type retrotransposons. Furthermore, 48 genes, showing high BLAST homology to known proteins or to rice full-length cDNAs, were predicted within the region; some were close to the CentO clusters. We then performed a genome-wide survey of the sequences and organization of CentO and RIRE7 families. Our study provides the complete sequence of a centromeric region from either plants or animals and likely will provide insight into the evolutionary and functional analysis of plant centromeres.
Local Bargaining in the National Health Service: New Approaches to Employee Relations
Authors: Carr Frank
Published: April 2004

This research uses the establishment of local bargaining arrangements in the National Health Service (NHS) to examine managerial employee relations objectives. It finds a continued commitment to pluralism and a rejection of an HRM approach. Change is taking place, possibly involving a shift towards a consultative style, in a traditional industrial relations framework.
‘Doing the right thing’ Organisational structure and process for democratic governance in the firm
Authors: Viggiani Frances A.
Published: April 2004

Can businesses be viable, effective, and generally democratic organisations? Several literatures bearing on the democratic firm are reviewed, examining democratic governance, participative management, new forms of ownership and how these affect firm performance. A small, espousedly democratic grocery store in upstate New York illustrates characteristic behaviours, structures and processes consistent with financial viability and economic effectiveness.
Viscous Critical‐Layer Analysis of Vortex Normal Modes
Authors: Le Dizès Stéphane
Published: April 2004

The linear stability properties of an incompressible axisymmetrical vortex of axial velocity W0(r) and angular velocity Ω0(r) are considered in the limit of large Reynolds number. Inviscid approximations and viscous WKBJ approximations for three‐dimensional linear normal modes are first constructed. They are then shown to be singular at the critical points rc satisfying ω=mΩ0(rc) +kW0(rc), where ω is the frequency, k and m the axial and azimuthal wavenumbers. The goal of this paper is to resolve these singularities. We show that a viscous critical‐layer analysis is analytically tractable. It leads to a single sixth‐order equation for the perturbation pressure. This equation is identical to the one obtained in stratified shear flows for a Prandtl number equal to 1. Integral expressions for typical solutions of this equation are provided and matched to the outer inviscid and viscous approximations in the complex plane around rc. As for planar flows, it is proved that the critical layer solution with a balanced behavior matches a non‐viscous approximation in a 4π/3 sector of the complex‐plane. As a consequence, the Frobenius expansions of a non‐viscous mode on each side of a critical point rc differ by a π phase jump.
An oral cancer information leaflet for smokers in primary care: results from two randomised controlled trials
Authors: Humphris G. M. , Field E. A.
Published: April 2004

Abstract  – 

Objectives:  To investigate whether primary care patients who claim to smoke tobacco gain greater benefit of a patient information leaflet (PIL) on oral cancer than nonsmokers.

Methods:  Two studies were conducted. Study 1 examined the research question initially, and Study 2 acted as a replication and inclusion of additional secondary outcome measures. The leaflet was designed and tested in an earlier study. Knowledge of oral cancer was assessed by a previously validated 36‐dichotomous‐item scale. A single‐item question ascertained self‐reported smoking status (kappa = 0.94). Study 1 participants were drawn from 14 practices (6 medical, 8 dental). A randomised control group design was adopted. The experimental group received the leaflet on attendance to the practice and then completed the questionnaire. The control group received the questionnaire only. Complete data were collected from 739 respondents. The design of Study 2 was identical; 786 new respondents from 16 practices (7 medical, 9 dental) were collected.

Results:  Both studies confirmed that smokers knew less about oral cancer than nonsmokers (P < 0.05) when access to the leaflet had been denied. On receipt of the leaflet, there was no distinction in oral cancer knowledge between the smoking status categories of respondents. Evidence of reassurance about screening from leaflet exposure was supported by the second study.

Conclusion:  This programmed research has demonstrated an effect of a brief PIL to offset the decrement in oral cancer knowledge observed in primary care patients who use tobacco in comparison to their nonsmoking counterparts. The leaflet reduced anxiety about oral health screening in smokers.
Patient orientation and professional orientation of Dutch dentists
Authors: Bruers J. Josef M. , Felling Albert J. A. , Truin Gert Jan , Van't Hof Martin A. , Van Rossum Ger M. J. M.
Published: April 2004

Abstract  – By providing dental health care, dentists dedicate themselves to the preservation and/or improvement of oral health in their patients. By adequately carrying out this care providers' role, dentists will gain recognition, esteem and respect from both patients and colleagues. This analysis aims to assess the patient and professional orientation of dentists and investigate which of their personal and practice characteristics can be regarded determining for these two aspects of their role as care providers. In the year 2000, data was collected via a written questionnaire sent to a random, stratified sample of 790 dentists, of whom 607 (77%) responded. Multivariate regression analysis shows that the preventive treatment concept, professional satisfaction and the number of hours per week that household tasks are performed are positive determinants for dentists' patient orientation. Also, the longer dentists are active in their profession, the more patient oriented they will be, and with more hours per week support from oral hygienists they are less patient oriented. As for professional orientation, dentists' preventive treatment concept and their professional satisfaction can also be considered positive determinants. Furthermore, dentists are more profession oriented when their partner works in the practice, with more hours per week support from oral hygienist(s) and with more collaboration contacts with other care providers. Compared to men, women are on average less profession oriented. Among Dutch dentists, there exist clear differences in the way they take on their role as care providers with regard to patient orientation and professional orientation.
Demographic factors, denture status and oral health‐related quality of life
Authors: John Mike T. , Koepsell Thomas D. , Hujoel Philippe , Miglioretti Diana L. , LeResche Linda , Micheelis Wolfgang
Published: April 2004

Abstract  – 

Objectives:  This study investigated the association between denture status, demographic factors, and oral health‐related quality of life (OHRQoL).

Methods:  OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP‐G, 53 items), which was administered in a personal interview to 2050 subjects (60% of eligible subjects responded) 16–79 years of age in a national survey. Median regression was used to analyze the influence of denture status (no, removable, complete dentures), age, gender, education (less than 10 years of schooling, 10–12 years, more than 12 years), and residential area (rural, urban) on the OHIP‐G summary score.

Results:  In bivariable analyses, compared to the base category, the OHIP‐G median increased 8.0 U for subjects with removable dentures, 20.0 U for subjects with complete dentures, 1.7 U for each 10‐year age period, 2.0 U for men, 3.0 U for less than 10 years of schooling (compared to ≥10 years.), and 1.0 U for urban areas (P < 0.05 for all effects except for residential area). In the multivariable analysis, compared to subjects without dentures, subjects with removable dentures had a 7.5 (95% CI: 5.2–9.8) higher OHIP‐G median and subjects with complete dentures had a 18.5 (95% CI: 14.7–22.4) higher median when demographic variables were controlled. No demographic variables were statistically significant except for residential area (P = 0.04).

Conclusions:  Denture status was a stronger predictor for impaired OHRQoL than demographic variables and rendered age and education almost negligible in their influence on OHRQoL.
Four years of clinical experience with an adverse reaction unit for dental biomaterials
Authors: Vamnes Jan Sverre , Lygre Gunvor Bentung , Grönningsæter Arne Geir , Gjerdet Nils Roar
Published: April 2004

Abstract  – 

Objectives:  We describe the function of, and results from, the Norwegian National Dental Biomaterials Adverse Reaction Unit after 4 years of activity from 1993 to 1997.

Methods:  During this period of time, 296 patients were examined at the unit, which is located at the Dental School, University of Bergen. The most prevalent age group was 40–49 years, and 70% were women. Dental amalgam was the primary reason for referral to the unit for nearly 85% of the patients, followed by metals in crowns and bridges (11%). Materials in removable dentures, resin‐based filling materials and cements, endodontic materials, and others, including temporary materials, were also involved. Nearly all (96%) patients reported general subjective symptoms, such as muscle and joint pain, fatigue, and memory problems. Complaints involving the orofacial region (lips, face, temporomandibular joint) and intraoral subjective symptoms were also common.

Results:  Of the patients who were patch tested with substances in dental materials, 23% were positive to gold, 28% to nickel, 14% to cobalt, 9% to palladium, 6% to mercury, and 8% to one or more components of resin‐based materials. Mercury concentrations in blood and urine were statistically higher in the patients with amalgam fillings compared with those without.

Conclusions:  Generally, we could not establish a straightforward cause‐and‐effect relationship between the presence of dental biomaterials and general symptoms. Twenty patients were advised to replace restorative materials because of contact lesions. Another 20 patients were recommended replacement of materials because of allergy verified with positive patch tests. The complex nature of most of the reactions requires a multidisciplinary approach to the care taking of patients who are concerned about reactions from dental materials, particularly amalgam.
Survival, movement, and resource use of the butterfly Parnassius clodius
Authors: Auckland Julia N. , Debinski Diane M. , Clark William R.
Published: April 2004

Abstract.  1. A mark–recapture study was conducted on the American Apollo butterfly Parnassius clodius Menetries during three field seasons (1998–2000) to examine its movement patterns over the course of a season within a sagebrush meadow in Grand Teton National Park, Wyoming, U.S.A. The study examined how resources affected butterfly distribution patterns and used mark–recapture data to gain insight into movement differences between sexes and over time.

2. The average straight‐line movement of P. clodius was 202 m day−1, adjusted for sampling effort at different distances. Movement estimates in all 3 years were highly correlated with the average distance between plots sampled.

3. Butterfly abundance was correlated positively with per cent cover of its host plant Dicentra uniflora, but this relationship decreased in importance during the peak of the flight period when individuals may be more interested in finding mates. There was a weak, positive correlation between butterfly abundance and the abundance of its primary nectar source, Eriogonum umbellatum in 1999, but no relationship in 2000.

4. Survival, recapture, and transition probabilities were estimated using open population, capture–recapture models. Survival and recapture probability decreased over the course of each season, while the probability of moving between plots increased. Recapture probability was significantly lower for females than for males among all 3 years, but there was no difference between the sexes in survival rate.
Barley exposed to aerial allelopathy from thistles (Cirsium spp.) becomes less acceptable to aphids
Authors: Glinwood Robert , Ninkovic Velemir , Pettersson Jan , Ahmed Elham
Published: April 2004

Abstract.  1. Recent studies have shown that plant–plant interaction via chemicals (allelopathy) can affect insects. Here the effects on aphid acceptance of barley after exposure to volatiles and root exudates from two common weeds, the thistles Cirsium arvense and Cirsium vulgare, were investigated.

2. Settling by bird cherry‐oat aphid, Rhopalosiphum padi, was significantly reduced on barley plants that had been exposed to volatiles from Cirsium species for 5 days. Settling by Sitobion avenae was also reduced on Cirsium‐exposed plants, whereas settling by Metopolophium dirhodum was not.

3. In olfactometer tests, Cirsium‐exposed barley was significantly less attractive to R. padi than was unexposed barley, indicating that exposure causes a change in the volatile profile of barley.

4. Exposure of barley to root exudates from Cirsium species had no effect on R. padi settling.

5. The results lend weight to the theory that the effects of plant–plant allelopathy can extend to higher trophic levels.
Behaviour and growth of dragonfly larvae along a permanent to temporary water habitat gradient
Authors: Johansson Frank , Suhling Frank
Published: April 2004

Abstract. 1. Freshwaters form a gradient from small temporary waters to large permanent waters. Identifying and examining traits that restrict the distribution of species along this gradient are crucial to the understanding of community structure in these habitats.

2. Using dragonfly larvae species, differences in traits important for growth and survival were studied.

3. The traits were studied in a series of laboratory experiments using two pairs of dragonfly species that coexist in the Namibian semi‐desert. One species pair was from the most temporary part of the water permanence gradient and the other species pair from an intermediate part of the gradient.

4. As predicted, activity, capture rate, and growth rate were significantly greater in the two temporary water species. Contrary to the prediction made in the work reported here, species differences in microhabitat selection were not related to the species' habitat origin. Cannibalism did not differ between species.

5. The results lend support to the hypothesis that selection has favoured certain combinations of trait values and that these traits are important for a successful life in temporary and permanent waters.
Discrimination of Normal Gastric Mucosa from Helicobacter pylori Gastritis using Standard Endoscopes and a Single Observation Site: Studies in Children and Young Adults
Authors: Nakayama Yoshiko , Horiuchi Akira , Kumagai Toshiko , Kubota Seiko , Kobayashi Motohiro , Sano Kenji , Ota Hiroyoshi
Published: April 2004

Background.  In the Helicobacter pylori‐negative normal stomach, collecting venules are visible in the gastric corpus as numerous minute points. This finding has been termed ‘regular arrangement of collecting venules’ (RAC). The aim of the present study was to investigate the reliability of the presence of the RAC pattern for discrimination of normal gastric mucosa from H. pylori gastritis in pediatric patients.

Methods.  Fifty‐two consecutive children, adolescents and young adults (male:female 24 : 28; median age 15 years, range 8–29 years) referred for endoscopy and assessed for H. pylori infection were prospectively studied. The lower lesser curvature of the corpus near the incisura was evaluated for the RAC pattern using a standard endoscope with the tip close to, but not in contact with, the gastric surface. Gastric biopsies were taken after the endoscopic observation.

Results.  In all the 29 RAC‐positive patients, active H. pylori gastritis was absent, whereas H. pylori gastritis was found in 20 of 23 RAC‐negative patients (86.9%).

Conclusions.  Identification of the RAC pattern at the lower lesser curvature of the corpus using close observation with a standard endoscope proved to be an effective and practical marker to discriminate normal histology from H. pylori gastritis among both children and young adults. Absence of the RAC pattern should prompt gastric mucosal biopsies despite otherwise normal‐appearing gastric mucosa.
Effect of Helicobacter pylori Infection on Gastric Acid Secretion and Meal‐Stimulated Serum Gastrin in Children
Authors: Kato Seiichi , Ozawa Kyoko , Koike Tomoyuki , Sekine Hitoshi , Ohara Shuichi , Minoura Takanori , Iinuma Kazuie
Published: April 2004

Background.  Comparative studies of gastric acid secretion in children related to Helicobacter pylori infection are lacking. The purpose of this study was to compare acid secretion and meal‐stimulated gastrin in relation to H. pylori infection among pediatric patients.

Materials and Methods.  Thirty‐six children aged 10–17 years (17 with H. pylori infection) undergoing diagnostic endoscopy participated in the study. Diagnoses included gastritis only (n = 23), duodenal ulcer (n = 5) and normal histology (n = 8). Gastric acid output was studied using the endoscopic gastric secretion test before and 2–3 months after H. pylori eradication. Meal‐stimulated serum gastrin response was assessed before and 12 months after eradication.

Results.  H. pylori gastritis was typically antrum‐predominant. Acid secretion was greater in H. pylori‐positive patients with duodenal ulcer than in gastritis‐only patients or controls [mean ± standard error (SE): 6.56 ± 1.4, 3.11 ± 0.4 and 2.65 ± 0.2 mEq/10 minutes, respectively; p < .001]. Stimulated acid secretion was higher in H. pylori‐positive boys than girls (5.0 ± 0.8 vs. 2.51 ± 0.4 mEq/10 minutes, respectively; p < .05). Stimulated acid secretion pre‐ and post‐H. pylori eradication was similar (5.47 ± 0.8 vs. 4.67 ± 0.9 mEq/10 minutes, respectively; p = .21). Increased basal and meal‐stimulated gastrin release reversed following H. pylori eradication (e.g. basal from 134 to 46 pg/ml, p < .001 and peak from 544 to 133 pg/ml, p < .05).

Conclusions.  H. pylori infection in children is associated with a marked but reversible increase in meal‐stimulated serum gastrin release. Gastric acid hypersecretion in duodenal ulcer remains after H. pylori eradication, suggesting that the host factor plays a critical role in outcome of the infection.
Determinants of Helicobacter pylori Seroprevalence in Mexican Adolescents
Authors: Constanza Camargo M. , Eduardo Lazcano‐Ponce , Javier Torres , Eduardo Velasco‐Mondragón , Manuel Quiterio , Pelayo Correa
Published: April 2004

Background.  Helicobacter pylori infection is one of the most common human infections and is considered to play an etiologic role in several gastroduodenal diseases. In this study we determined the H. pylori seroprevalence among adolescents in Morelos, Mexico, and explored the association between seroprevalence and socioeconomic, dietary and lifestyle variables.

Materials and Methods.  A cross‐sectional study was conducted in 5861 Mexican subjects aged 11–21 years. H. pylori infection was determined by an enzyme‐linked immunosorbent assay previously validated in Mexico. A self‐administered questionnaire was used to collect information on sociodemographic factors, housing, living conditions and food consumption. Multivariate logistic regression methods were used to obtain odds ratios and 95% confidence intervals.

Results.  The overall H. pylori seroprevalence was 47.6%; 40.6% in preadolescents (11–14 years), 48.6% in adolescents (15–17 years), and 59.8% in young adults (18–24 years). A positive association was found between age and H. pylori seroprevalence. Inverse associations were found for availability of drinking water, sewerage, and home appliances at the time of the subject's birth, a proxy variable of socioeconomic status. Intake of milk products and total fats was positively associated with infection.

Conclusions.  This large seroprevalence study showed that H. pylori infection is frequent among adolescents in Mexico. An early acquisition of infection is indirectly suggested. Some variables denoting low socioeconomic status were inversely associated with H. pylori seroprevalence. Associations with intake of milk products and total fats suggest new hypotheses in this field of research.
Detection of Helicobacter pylori DNA in Feces and Saliva by Polymerase Chain Reaction: a Review
Authors: Kabir Shahjahan
Published: April 2004

The polymerase chain reaction (PCR), known for its high sensitivity and specificity, has been used for the detection of Helicobacter pylori DNA in bodily materials such as feces and saliva. Since fecal specimens contain PCR inhibitors, DNA before PCR amplification has been purified using various biochemical, immunological and physical pre‐PCR steps. Several PCR protocols, differing from each other in the selection of genomic targets and primers, have produced varying degrees of specificity and sensitivity in detecting H. pylori DNA. PCR identified antimicrobial resistance of H. pylori in feces. It also detected virulence factor genes such as the cytotoxin‐associated gene (cagA) and vacuolating cytotoxin gene (vacA) in feces and saliva. While the cagA gene was detected in 50–60% of fecal specimens, it was found in 25% of salivary specimens from patients. There was considerable variation in the detection rate of H. pylori DNA in salivary samples. The detection rate in saliva with the most effective primer pair was lower than that observed in feces, making saliva a less suitable specimen for the diagnosis of H. pylori infection. There is controversy regarding the permanent presence of H. pylori in saliva. Whether the salivary and gastric specimens of an individual harbor identical or different strains has not been resolved. PCR cannot distinguish between living and dead organisms. However, it can offer quick results on fecal and salivary specimens, which may contain fastidious and slow‐growing H. pylori in low numbers.
Rapid Combined Characterization of Microorganism and Host Genotypes using a Single Technology
Authors: Hjalmarsson Sandra , Alderborn Anders , Fock Caroline , Muldin Ingrid , Kling Helene , Uhlén Mathias , Engstrand Lars
Published: April 2004

Background.  Genetic information is becoming increasingly important in diagnosis and prognosis of infectious diseases. In this study we investigated the possibility of using a single technology, the Pyrosequencing™ technology (Biotage AB, Uppsala, Sweden), to gather several kinds of important genetic information from the human pathogen Helicobacter pylori, as well as from the carrier of the H. pylori infection.

Materials and Methods.  DNA from 87 clinical isolates of H. pylori, 50 isolates from H. pylori‐infected transgenic mice and nine gastric biopsies from H. pylori‐infected patients was analyzed for targets in the 16S rRNA, 23S rRNA and cytotoxin associated gene A (cagA) genes to determine species identity, clarithromycin susceptibility and virulence level, respectively. In addition, three single nucleotide polymorphisms in the human interleukin‐1B (IL‐1B) gene, reported to affect the risk of developing gastric cancer, were analyzed in the gastric biopsy samples.

Results.  All DNA targets were processed and analyzed in parallel, enabling convenient genetic characterization of both pathogen and host. All genotypes were easily and accurately assigned. In the 16S rRNA analysis, 99.83% of the bases were correctly called.

Conclusions.  We conclude that genetic analysis using Pyrosequencing™ technology was nonlaborious, and gave highly accurate data for different kinds of target. We therefore believe that this technology has the potential to complement or in the future substitute the time‐consuming traditional microbial identification and typing methods, as well as enabling rapid typing of relevant host genetic markers.