bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between occlusal plane determinants and craniofacial structures
Authors: . Nissan J , Barnea E. , Zeltzer C. , Cardash H. S.
Published: May 2003

summary  A cephalometric study was conducted on 34 complete denture wearers to investigate the relationship between the anatomical structures commonly used to determine the occlusal plane and the facial skeletal shape. The results showed no correlation between the shape of the skeletal face, the gonial angle and the length of the mandible versus the location of the retromolar pad, the occlusal plane and Camper's plane. However, a statistically significant linear correlation (P < 0·0001) was found between the facial skeletal shape designated SN POG and the location of Camper's plane. Cephalometric analysis alone cannot determine the location of the occlusal plane in edentulous patients. Intra‐oral structures should also be considered.
Functional magnetic resonance imaging of human jaw movements
Authors: Tamura T. , Kanayama T. , Yoshida S. , Kawasaki T.
Published: May 2003

summary  This study used functional magnetic resonance images (fMRI) to examine brain activity during clenching, gum chewing, and tapping tasks. It has been considered difficult to obtain sufficient fMRI data during jaw movement because the head motion associated with the jaw movements creates artifacts on the images. To avoid these artifacts, larger pixels were used, thus allowing some head motion of the subjects, and data from subjects where the heads were evaluated to have moved more than 0·5 mm were discarded. Further, all pixels obtained by fMRI were evaluated and pixels positively synchronized with the task, which were considered to show brain activity, were selected. Sufficient fMRI data was obtained from 30 experiments, 10 sets for each task. During the clenching and tapping tasks, the activated pixels were in the sensory, motor and pre‐motor cortexes, and in the sensory and motor cortexes but not in the pre‐motor cortex during the gum chewing task. There appears to be no significant differences between right‐ and left‐hemispheres. It is conceivable that there are differences between voluntary jaw movements (clenching and tapping tasks) and mastication (gum chewing task) concerning the control of jaw movements.
Visual observation of the dynamic flow of elastomer rubber impression material between the impression tray and oral mucosa while seating the impression tray
Authors: Nishigawa G. , Natsuaki N. , Maruo Y. , Okamoto M. , Minagi S.
Published: May 2003

summary  The purpose of this study was to inspect visually, the dynamics of the impression flow at seating of the impression tray. The effects of the relief and the escape hole of the impression tray on the impression flow were also examined. Three types of the transparent impression tray (flat tray, relief tray and escape hole tray) were prepared. Transparent silicone polymer was put on the impression tray surface. Four drops of the dark blue silicone impression material was injected into the transparent silicone polymer on the impression tray. The impression tray was seated on the model of the denture‐supporting mucosa. The movement of the four drops caused by the impression flow was visually recorded with the video camera and examined. The result for the flat tray showed that the impression material moved from inside to the outside. It was also shown that the speed of the moved impression material increased as the seating of the impression tray advanced. The results for the relief tray and the escape hole tray showed the effect of the relief and the escape hole prepared to the impression tray on the speed and the direction of the flow of the impression material.
Influence of dentinal regions on bond strengths of different adhesive systems
Authors: Özer F. , Ünlü N. , Sengun A.
Published: May 2003

summary  This in vitro study assessed comparatively the shear bond strengths of three composite resins, 3M Valux Plus (3MVP), Herculite (H), Clearfil AP‐X (CAP‐X), a polyacid modified composite resin Dyract (D), and a resin modified glass–ionomer materials Vitremer (V), to cervical and buccal dentine regions of extracted human molar teeth. Four different bonding systems, 3M ScotchBond Multipurpose (SB), Clearfil Liner Bond 2 (LB2), Opti Bond (OB), and Prime & Bond 2·1 (PB 2·1) were used with the manufacturer's respective composite and compomer materials. One hundred freshly extracted mandibular molar teeth were selected for this study. Flat buccal dentine surfaces were created on 50 teeth and cylindrical rods of the five materials were bonded to the dentine surfaces. For assessment of cervical bond strengths, the materials were bonded to mesial and distal enamel bordered occlusal dentinal surfaces of the remaining 50 teeth. The five groups of restorative procedures were applied as follows; Group 1: SB + 3MVP, Group 2: LB2 + CAP‐X, Group 3: OB + H, Group 4: PB2·1 + D, Group 5: Vitremer primer (VP) VP + V. Each restorative procedure thus had 20 specimens (10 buccal + 10 cervical). After 24 h of water storage (37 °C), the specimens were tested on a Universal Testing machine in shear with a cross head speed of 0·5 mm min−1. The bond strength values were calculated in MPa and the results were evaluated statistically using Kruskal–Wallis one‐way/anova and Mann–Whitney U‐tests. It was found that the bond strengths of SB + 3MVP, LB2 + CAP‐X and VP + V to buccal dentine surfaces were significantly stronger (P < 0·05) than those to the occluso‐cervical dentine floors. When the bond strengths to the occluso‐cervical dentine and buccal dentine surface were compared, there was no significant difference between the materials (P > 0·05). Vitremer was found the least successful adhesive material in terms of shear bond strength on both buccal and occluso‐cervical dentine surfaces.
Masticatory performance with a prosthesis following maxillectomy: an analysis of 43 cases
Authors: Umino S. , Masuda G. , Fujita K.
Published: May 2003

summary  To statistically evaluate the factors that influenced masticatory performance following Maxillectomy, masticatory performance was measured in 43 patients with a post‐operative prosthesis by means of a spectrophotometer using adenosine triphosphate (ATP) granules. Our statistical analysis revealed that the number of occluding post‐canine teeth and the patient's sex were factors that influenced masticatory performance and demonstrated that it was most important to improve occlusion in the pre‐molar/molar region.
Finite element analysis of the effect of the bucco‐lingual position of artificial posterior teeth under occlusal force on the denture supporting bone of the edentulous patient
Authors: Nishigawa G. , Matsunaga T. , Maruo Y. , Okamoto M. , Natsuaki N. , Minagi S.
Published: May 2003

summary  To improve the quality of the complete denture prosthesis, the bucco‐lingual position of the artificial posterior teeth must be determined with consideration of the shape of the maxillary and mandibular residual ridge and the relationship between them. The arrangement of posterior artificial teeth should be considered not only for the denture stability but also for the avoidance of high pressure on the supporting structures. A two‐dimensional finite element method program to investigate the statics for the contour of the complete denture and the residual ridge was developed. With this program, the effect of the bucco‐lingual position of the artificial posterior teeth under occlusal force on the denture supporting bone could be investigated.
Adhesive bonding of super‐elastic titanium–nickel alloy castings with a phosphate metal conditioner and an acrylic adhesive
Authors: Matsumura H. , Tanoue N. , Yanagida H. , Atsuta M. , Koike M. , Yoneyama T.
Published: May 2003

summary  The purpose of the current study was to evaluate the bonding characteristics of super‐elastic titanium–nickel (Ti–Ni) alloy castings. Disk specimens were cast from a Ti–Ni alloy (Ti‐50·85Ni mol%) using an arc centrifugal casting machine. High‐purity titanium and nickel specimens were also prepared as experimental references. The specimens were air‐abraded with alumina, and bonded with an adhesive resin (Super‐Bond C & B). A metal conditioner containing a phosphate monomer (Cesead II Opaque Primer) was also used for priming the specimens. Post‐thermocycling average bond strengths (MPa) of the primed groups were 41·5 for Ti–Ni, 30·4 for Ti and 19·5 for Ni, whereas those of the unprimed groups were 21·6 for Ti, 19·3 for Ti–Ni and 9·3 for Ni. Application of the phosphate conditioner elevated the bond strengths of all alloy/metals (P < 0·05). X‐ray fluorescence analysis revealed that nickel was attached to the debonded resin surface of the resin‐to‐nickel bonded specimen, indicating that corrosion of high‐purity nickel occurred at the resin–nickel interface. Durable bonding to super‐elastic Ti–Ni alloy castings can be achieved with a combination of a phosphate metal conditioner and a tri‐n‐butylborane‐initiated adhesive resin.
Effects of interocclusal appliances on EMG activity during parafunctional tooth contact
Authors: Roark A. L. , Glaros A. G. , O'Mahony A. M.
Published: May 2003

summary  To test the hypothesis that a flat plane interocclusal appliance affects the electromyographic (EMG) activity of the temporalis and masseter muscles in pain‐free individuals, maxillary splints were fabricated for 20 individuals who reported no history, signs or symptoms of myofascial pain or arthralgia as determined by two trained, independent examiners. Subjects were instructed to establish light tooth contact, maximum clenching, and moderate clenching with/without the splint in place (as determined by random assignment) while EMG data from the left and right temporalis and masseter muscles were recorded. A 5‐min biofeedback training session to relax the masticatory muscles was followed by a repetition of the tooth contact/clenching tasks with/without the splint in place. With the splint in place, the activity of the temporalis muscles decreased for all tasks, significantly for the left and right temporalis under maximal clenching and for the right temporalis under moderate clenching. In contrast, the activity of the masseter muscles increased under light and moderate clenching (significantly for the left masseter under moderate clenching) and decreased slightly under maximal clenching. The effectiveness of interocclusal appliances may be due to mechanisms other than redistribution of adverse loading.
Investigation of the factors related to the formation of the buccal mucosa ridging
Authors: Takagi I. , Sakurai K.
Published: May 2003

summary  The aim of this study was to clarify the factors related to the formation of the buccal mucosa ridging, which has been mentioned to be a clinical sign of clenching. Twenty‐one individuals were investigated and divided into three groups: (i) those without buccal mucosa ridging, (ii) the buccal mucosa ridging located in all the posterior teeth region, and (iii) the buccal mucosa ridging corresponding only to the molar teeth region. A pressure sensor was used and placed at two points: first upper premolar and second upper molar. The recording tasks were: (i) silent reading at rest, (ii) light voluntary clenching, (iii) maximum voluntary clenching, (iv) holding the cheeks tightly against the teeth while light voluntary clenching, (v) holding the cheeks tightly against the teeth without tooth contact, (vi) pulling angle of mouth laterally while light voluntary clenching, (vii) pulling angle of mouth laterally without tooth contact and (viii) swallowing. No significant differences were found between groups in all the recording tasks except for the swallowing, at which significant difference (P < 0·05) was found between the groups of individuals having buccal mucosa ridging and without it. Based on these results it became clear that the buccal mucosa pressure exerted on the buccal aspect of teeth during swallowing plays an important role in the formation of buccal mucosa ridging.
The intermembrane space of plant mitochondria contains a DNase activity that may be involved in programmed cell death
Authors: Balk Janneke , Chew Su Kit , Leaver Christopher J. , McCabe Paul F.
Published: May 2003

The key role for mitochondria in mammalian apoptosis, a form of programmed cell death (PCD), is well established, but a similar role for plant mitochondria is just emerging. In order to unravel the molecular mechanisms linking plant mitochondria to the downstream events of PCD, we have developed an Arabidopsis cell‐free system that can be used to monitor biochemical and morphological changes in isolated nuclei that are associated with PCD. Using this system, two activities that resulted in nuclear DNA degradation could be distinguished, both of which were facilitated by the addition of mitochondria. One activity mediated the generation of 30 kb DNA fragments within 3 h and chromatin condensation within 6 h, when nuclei were incubated with mitochondria alone. The second activity required cytosolic extract in addition to mitochondria and resulted in oligonucleosome‐sized DNA cleavage after >12 h. Submitochondrial fractionation and pharmacological studies suggested the presence of an Mg2+‐dependent nuclease activity in the intermembrane space, which is responsible for the former in vitro activity. The evolutionary conservation of the role of mitochondria in PCD in animals and plants is discussed.
Leucine‐rich repeat‐mediated intramolecular interactions in nematode recognition and cell death signaling by the tomato resistance protein Mi
Authors: Hwang Chin‐Feng , Williamson Valerie M.
Published: May 2003

The root‐knot nematode resistance gene Mi from tomato encodes a nucleotide‐binding/leucine‐rich repeat (NB/LRR) protein with a novel amino‐terminal domain compared to related disease‐resistance genes. The closely linked paralog Mi‐1.1, which does not confer nematode resistance, encodes a protein 91% identical to the functional copy, Mi‐1.2. The chimeric construct Mi‐DS3, which encodes the 161 amino‐terminal residues from Mi‐1.1 fused to the remainder of Mi‐1.2, induces localized necrosis when transiently expressed in Nicotiana benthamiana leaves. We produced mutant constructs that exchanged sequences encoding each of the 40 amino acid differences from the Mi‐1.1 LRR region into Mi‐DS3 and into Mi‐1.2. For 23 of the substitutions, necrosis was lost upon transient expression of the mutated Mi‐DS3 in N. benthamiana, and nematode resistance was lost when the altered Mi‐1.2 was expressed in the tomato roots. One substitution, R961D, failed to give Mi‐DS3‐induced necrosis, but produced a dominant lethal phenotype when introduced into Mi‐1.2. This gain‐of‐function phenotype was suppressed by co‐expression with the amino‐terminal region of Mi‐1.1, suggesting that residue 961 is critical for negative regulation by the corresponding N‐terminal region. Substitutions of Mi‐1.1 residues 984–986 retained the ability to cause necrosis in Mi‐DS3, but resulted in loss‐of‐nematode resistance in Mi‐1.2, suggesting that these residues are essential for nematode recognition. None of the loss‐of‐function mutations in Mi‐1.2 had a dominant negative phenotype. These results indicate that the Mi‐1.2 LRR is involved in regulation of the transmission of the resistance response as well as in recognition of the nematode.
Two cis‐acting elements necessary and sufficient for gibberellin‐upregulated proteinase expression in rice seeds
Authors: Sutoh Keita , Yamauchi Daisuke
Published: May 2003

In germinating rice seeds, a cysteine proteinase (REP‐1), synthesized in aleurone‐layer cells, is a key enzyme in the degradation of the major storage protein, glutelin. The expression of the gene for REP‐1 (Rep1) is induced by gibberellins (GAs) and repressed by abscisic acid (ABA). To identify GA‐responsive elements in the Rep1 promoter, we developed a transient expression system in rice aleurone cells. Deletion and point‐mutation analyses indicated that the GA‐response complex was composed of TAACAGA, TAACGTA, and two copies of CAACTC. The two former sequences were identical to GAREs conserved in the promoter of genes for α‐amylase and proteinases in cereals. The latter, termed as CAACTC regulatory elements (CAREs), were novel GAREs. Gain‐of‐function experiments revealed that two pairs of GARE and CARE were necessary and sufficient to confer GA inducibility. The sequences were also required for effective transactivation by the transcription factor OsGAMyb. Four copies of either GARE or CARE showed transactivation neither by OsGAMyb nor by GA induction. CARE and GARE were also found in the promoters of a rice α‐amylase gene, RAmy1A, and a barley proteinase gene, EPB1, which are expressed in germinating seeds. Mutations of CARE in their promoters caused a loss of GA inducibility and GAMyb transactivation, suggesting that CARE is the regulatory element for GA‐inducible expression of hydrolase genes in the germinating seeds.
Characterization of Arabidopsis thaliana methyl‐CpG‐binding domain (MBD) proteins
Authors: Zemach Assaf , Grafi Gideon
Published: May 2003

Cytosine methylation at symmetrical CpG and CpNpG sequences plays a key role in the epigenetic control of plant growth and development; yet, the way by which the methylation signal is interpreted into a functional state has not been elucidated. In animals, the methylation signal is recognized by methyl‐CpG‐binding domain (MBD) proteins that specifically bind methylated CpG dinucleotides. In Arabidopsis thaliana, 12 putative MBD proteins were identified and classified into seven subclasses. Here, we characterized six MBD proteins representing four subclasses (II, III, IV, and VI) of the Arabidopsis MBD family. We found that AtMBD7 (subclass VI), a unique protein containing a double MBD motif, as well as AtMBD5 and AtMBD6 (subclass IV), bind specifically symmetrically methylated CpG sites. The MBD motif derived from AtMBD6, but not from AtMBD2, was sufficient for binding methylated CpG dinucleotides. AtMBD6 precipitated histone deacetylase (HDAC) activity from the leaf nuclear extract. The examined AtMBD proteins neither bound methylated CpNpG sequences nor did they display DNA demethylase activity. Our results suggest that AtMBD5, AtMBD6, and AtMBD7 are likely to function in Arabidopsis plants as mediators of the CpG methylation, linking DNA methylation‐induced gene silencing with histone deacetylation.
Fungal responsive fatty acid acetylenases occur widely in evolutionarily distant plant families
Authors: Cahoon Edgar B. , Schnurr Judy A. , Huffman Errol A. , Minto Robert E.
Published: May 2003

The fungal elicitor‐induced ELI12 gene from parsley has been previously shown to encode a divergent form of the Δ12‐oleic acid desaturase. In this report, we show that the ELI12 gene product is a fatty acid acetylenase or a triple‐bond‐forming enzyme. Expression of this enzyme in transgenic soybean seeds was accompanied by the accumulation of the Δ12‐acetylenic fatty acids, crepenynic and dehydrocrepenynic acids. Using PCR with degenerate oligonucleotides, we also show that homologs of the ELI12 gene are present in other members of the Apiaceae family. In addition, cDNAs for divergent forms of the Δ12‐oleic acid desaturase were detected among the expressed sequence tags (ESTs) from English ivy, an Araliaceae species, and sunflower, an Asteraceae species. As with the ELI12 gene, expression of these cDNAs in transgenic soybean embryos was accompanied by the accumulation of crepenynic and dehydrocrepenynic acids. Homologs of the sunflower acetylenase gene were also detected in other Asteraceae species, as revealed by PCR analysis of isolated genomic DNA. Results from Northern blot and EST analyses indicated that the expression of the sunflower gene, like ELI12, was induced by fungal elicitation. Overall, these results demonstrate that expressed genes for Δ12‐fatty acid acetylenases occur in at least three plant families, and are responsive to fungal pathogenesis. Natural products derived from crepenynic and dehydrocrepenynic acids that display antifungal, insecticidal, and nematicidal properties are distributed through at least 15 plant families. The acetylenases described here provide probes for chemotaxonomists, and facilitate functional genomic and molecular investigations of these defensive mechanisms.
Dominant repression of target genes by chimeric repressors that include the EAR motif, a repression domain, in Arabidopsis
Authors: Hiratsu Keiichiro , Matsui Kyoko , Koyama Tomotsugu , Ohme‐Takagi Masaru
Published: May 2003

The redundancy of genes for plant transcription factors often interferes with efforts to identify the biologic functions of such factors. We show here that four different transcription factors fused to the EAR motif, a repression domain of only 12 amino acids, act as dominant repressors in transgenic Arabidopsis and suppress the expression of specific target genes, even in the presence of the redundant transcription factors, with resultant dominant loss‐of‐function phenotypes. Chimeric EIN3, CUC1, PAP1, and AtMYB23 repressors that included the EAR motif dominantly suppressed the expression of their target genes and caused insensitivity to ethylene, cup‐shaped cotyledons, reduction in the accumulation of anthocyanin, and absence of trichomes, respectively. This chimeric repressor silencing technology (CRES‐T), exploiting the EAR‐motif repression domain, is simple and effective and can overcome genetic redundancy. Thus, it should be useful not only for the rapid analysis of the functions of redundant plant transcription factors but also for the manipulation of plant traits via the suppression of gene expression that is regulated by specific transcription factors.
AtNRAMP3, a multispecific vacuolar metal transporter involved in plant responses to iron deficiency
Authors: Thomine Sébastien , Lelièvre Françoise , Debarbieux Elise , Schroeder Julian I. , Barbier‐Brygoo Hélène
Published: May 2003

Metal homeostasis is critical for the survival of living organisms, and metal transporters play central roles in maintaining metal homeostasis in the living cells. We have investigated the function of a metal transporter of the NRAMP family, AtNRAMP3, in Arabidopsis thaliana. A previous study showed that AtNRAMP3 expression is upregulated by iron (Fe) starvation and that AtNRAMP3 protein can transport Fe. In the present study, we used AtNRAMP3 promoter β‐glucoronidase (GUS) fusions to show that AtNRAMP3 is expressed in the vascular bundles of roots, stems, and leaves under Fe‐sufficient conditions. This suggests a function in long‐distance metal transport within the plant. Under Fe‐starvation conditions, the GUS activity driven by the AtNRAMP3 promoter is upregulated without any change in the expression pattern. We analyze the impact of AtNRAMP3 disruption and overexpression on metal accumulation in plants. Under Fe‐sufficient conditions, AtNRAMP3 overexpression or disruption does not lead to any change in the plant metal content. Upon Fe starvation, AtNRAMP3 disruption leads to increased accumulation of manganese (Mn) and zinc (Zn) in the roots, whereas AtNRAMP3 overexpression downregulates Mn accumulation. In addition, overexpression of AtNRAMP3 downregulates the expression of the primary Fe uptake transporter IRT1 and of the root ferric chelate reductase FRO2. Expression of AtNRAMP3::GFP fusion protein in onion cells or Arabidopsis protoplasts shows that AtNRAMP3 protein localizes to the vacuolar membrane. To account for the results presented, we propose that AtNRAMP3 influences metal accumulation and IRT1 and FRO2 gene expression by mobilizing vacuolar metal pools to the cytosol.
Enhanced ethylene responsiveness in the Arabidopsis eer1 mutant results from a loss‐of‐function mutation in the protein phosphatase 2A A regulatory subunit, RCN1
Authors: Larsen Paul Brian , Cancel Jesse Daniel
Published: May 2003

Ethylene signaling in Arabidopsis begins with a family of five ethylene receptors that regulate the activity of the Raf‐like kinase, CTR1. Recent work to identify novel factors required for modulating ethylene signaling resulted in the isolation of enhanced ethylene response 1 (eer1), a mutant that displays both increased sensitivity and increased amplitude of response to ethylene. Molecular cloning of eer1 reveals that its mutant phenotype results from a loss‐of‐function mutation in the previously characterized RCN1, one of three PP2A A regulatory subunits in Arabidopsis. Our analysis shows that neither RCN1 expression nor PP2A activity is regulated by ethylene. Instead, we found that Arabidopsis PP2A‐1C, a PP2A catalytic subunit previously characterized as interacting with RCN1, associates strongly with the kinase domain of CTR1 in vitro. This likely represents a role for PP2A in modulation of CTR1 activity because an in vitro kinase assay did not reveal phosphorylation of either RCN1 or PP2A‐1C by CTR1, indicating that neither of them is a substrate for CTR1. PP2A activity is required for Ras‐dependent activation of mammalian Raf, with reductions in PP2A activity significantly compromising the effectiveness of this mechanism. Our genetic and biochemical results suggest that a similar requirement for PP2A activity exists for ethylene signaling, with loss‐of‐function mutations affecting PP2A activity possibly reducing the effectiveness of CTR1 activation, thus lowering the threshold required for manifestation of ethylene response.
Functional analysis of the 37 kDa inner envelope membrane polypeptide in chloroplast biogenesis using a Ds‐tagged Arabidopsis pale‐green mutant
Authors: Motohashi Reiko , Ito Takuya , Kobayashi Masatomo , Taji Teruaki , Nagata Noriko , Asami Tadao , Yoshida Shigeo , Yamaguchi‐Shinozaki Kazuko , Shinozaki Kazuo
Published: May 2003

To study the functions of the nuclear genes involved in chloroplast development, we systematically analyzed albino and pale‐green Arabidopsis thaliana mutants by using a two‐component transposon system based on the Ac/Ds element of maize as a mutagen. One of the pale‐green mutants, albino or pale green mutant 1 (designated as apg1), did not survive beyond the seedling stage, when germinated on soil. The chloroplasts of the apg1 plants contained decreased numbers of lamellae with reduced levels of chlorophyll. A gene encoding a 37 kDa polypeptide precursor of the chloroplast inner envelope membrane was disrupted by insertion of the Ds transposon in apg1. The 37 kDa protein had partial sequence similarity to the S‐adenosylmethionine‐dependent methyltransferase. The apg1 plants lacked plastoquinone (PQ), suggesting that the APG1 protein is involved in the methylation step of PQ biosynthesis, which is localized at the envelope membrane. Our results demonstrate the importance of the 37 kDa protein of the chloroplast inner envelope membrane for chloroplast development in Arabidopsis.
Survey of the implementation of the recommendations in the Health Services Circular 1998/224 ‘Better Blood Transfusion’
Authors: Murphy M. F. , Edbury C. , Wickenden C.
Published: May 2003

Summary.  This report describes a questionnaire survey on the implementation of the recommendations of the Health Services Circular (HSC) ‘Better Blood Transfusion’ 1998/224 for improving transfusion practice. The survey was carried out to inform a second UK Chief Medical Officers' symposium on ‘Better Blood Transfusion’ in October 2001. Sixty‐nine percent of hospitals where blood is transfused in England participated. The results show that, by 2001, most hospitals had established Hospital Transfusion Committees (HTCs), developed protocols for the process of transfusion and were participating in the Serious Hazards of Transfusion (SHOT) scheme. However, there was limited compliance with other recommendations, including the provision of training for staff involved in transfusion and information to patients, the development of protocols for the appropriate use of blood, the performance of audits of transfusion practice and the introduction of peri‐operative cell salvage. The survey did not determine the reasons for this limited compliance. New initiatives including the issue of a further HSC on ‘Better Blood Transfusion’ are aimed at enabling hospitals to improve their transfusion practice in a more systematic way than that was found in the results of this survey.
Tracing blood units to their recipients: results of a two‐centre study
Authors: Ballard S. , Buck J. , Llewelyn C. , Murphy M. , Williamson L.
Published: May 2003

summary. An important principle of the use of blood components is the ability to trace them from the donor to the recipient. This study set out to establish whether there was sufficient documentation in patient case notes to confirm the transfusion of blood components in a sample of computer blood bank records at two large teaching hospitals in UK. The criteria for verification of transfusion were taken from guidelines from the British Committee for Standards in Haematology (Transfusion Medicine 1999, 9, 227–238). The blood bank computer records indicated that 486 units of blood components were issued and not returned to the blood bank for 80 patients during a 2‐month period. Of the 486 units, transfusion of 409 units (84%) was verified against patient notes, but 77 units (16%) could not be verified as received by the patient. The study showed that documentation of transfusions was variable. For example, written prescriptions were only found for 204 units (42%). These results have implications for ‘lookback studies’ involving blood transfusion. Further efforts are required to educate those involved in transfusing blood about the need for accurate documentation.
Human neutrophil antigen‐4a gene frequencies in an Australian population, determined by a new polymerase chain reaction method using sequence‐specific primers
Authors: Clague H. D. , Fung Y. L. , Minchinton R. M.
Published: May 2003

Summary. Human neutrophil antigen‐4a (HNA‐4a) is a high‐frequency (99% in the USA) neutrophil antigen, which has recently been linked to a case of alloimmune neonatal neutropenia. We have devised a new polymerase chain reaction sequence‐specific primer (PCR‐SSP) method to assess HNA‐4a genotype, and used it to determine the HNA‐4a gene frequencies in an Australian population. The gene frequency was found to be 0·906, which is the same as in the American population. The PCR‐SSP genotyping method perfectly correlates with serological phenotyping and is efficient for screening large numbers of samples.
Competitive enzyme‐linked immunoassay of monoclonal immunoglobulin G anti‐D preparations
Authors: Thorpe S. J. , Fox B. , Turner C. , Scott M.
Published: May 2003

Summary. The development of monoclonal immunoglobulin G (IgG) anti‐D for prophylaxis necessitates estimation of their potency in terms of their red cell‐binding ability, but it is unclear which quantification methodology is most suitable for this. The aim of this study was to assess 50 monoclonal anti‐D from the 4th International Workshop for quantitative and qualitative binding to red cells in a competitive enzyme‐linked immunoassay (EIA) in which varying amounts of monoclonal antibodies (MoAbs) and a constant amount of biotinylated monoclonal anti‐D (BRAD‐5) compete for red cell binding. The potencies of the MoAb were estimated against the International Reference Preparation (IRP) for anti‐D Ig. Two MoAbs as supplied were insufficiently inhibitory of biotinylated BRAD‐5 binding to be quantified; the potencies of the remainder ranged from 4 to 343 IU mL−1 and included 11 MoAbs showing dose–responses that were nonparallel to those of other MoAb and the IRP. Estimation of the concentration of antibody in the supernatants by radial immunodiffusion ranged from 0·5 to 61 µg mL−1, giving specific activities of <1–24 IU µg−1. The results show that competitive EIA is suitable for quantitating most monoclonal anti‐D for development and quality control purposes, regardless of their D epitope reactivity.
The first example of anti‐Diegob found in a Polish woman with the Di(a+b–) phenotype and haemolytic disease of the newborn not requiring treatment
Authors: Lenkiewicz B. , Żupańska B.
Published: May 2003

Summary.  All pregnant women with anti‐Diegob (anti‐Dib) described so far were non‐Caucasians. We present the case of a Polish Di(a+b–) woman with anti‐Dib, which did not bind complement, was immunoglobulin G3 (IgG3) alone and had very low functional activity. She delivered a Di(a+b+) infant with a positive direct antiglobulin test and the antibody in his serum but very mild haemolytic disease.

Both parents of the pregnant woman were Di(a+b+), so were all her three children. The whole family have been living in a small village in southeastern Poland for a long time. The rare Diego phenotypes, found now and previously in Poland, suggest gene admixture introduced as a result of Poland being invaded by Mongolian‐background Tatars during the past centuries.
Myocardial ischaemia precipitated by acute normovolaemic haemodilution
Authors: Carvalho B. , Ridler B. M. F. , Thompson J. F. , Telford R. J.
Published: May 2003

Summary. Acute normovolaemic haemodilution (ANH) is widely used as part of a blood conservation strategy to minimize the use of allogenic blood in the peri‐operative period. Its role has not been proven in a prospective randomized trial. The potential benefits must not blind clinicians to the possible hazards. We report a life‐threatening complication of ANH prior to induction of anaesthesia for aortic aneurysm repair.
Incidence of Phytophthora species in oak forests in Austria and their possible involvement in oak decline
Authors: Balci Y. , Halmschlager E.
Published: May 2003

A survey on the occurrence of Phytophthora species in oak ecosystems in Austria was conducted from April to May 1999 and in June 2000. The investigations were carried out at 35 study sites distributed throughout the zone of oak forests in eastern Austria. Four oak species, including Quercus robur, Q. petraea, Q. cerris and Q. pubescens were considered in the survey. Rhizosphere soil samples were taken from sample trees, which consisted of healthy and declining trees as indicated by their crown transparency. Young oak leaflets were used as baits to recover Phytophthora species. The assemblage of Phytophthora spp. detected in Austrian oak forests consisted of five species, including Phytophthora quercina, P. citricola, P. gonapodyides, P. europaea and P. syringae. P. quercina and P. citricola were isolated from 11 and seven sites, respectively, and were thus the most common and most widely distributed species. The three other species were recovered only sporadically. P. citricola could be separated into two morphologically and genetically well‐characterized types (A and B). Phytophthora species, in particular the common P. quercina and P. citricola occurred on sites showing a wide variety of soil types, soil textures and moisture classes. There was mild evidence for connection between deteriorating crown status and the presence of Phytophthora spp. Furthermore, significant differences in contents of magnesium, as well as calcium, aluminium, nitrogen and carbon at different soil depths (0–10, 10–20 and 20–40 cm) were detected between Phytophthora‐infested and Phytophthora‐free sites. The results of the present study provide circumstantial evidence that Phytophthora species are involved in oak decline at certain sites in Austria.
Swiss stone pine trees and spruce stumps represent an important habitat for Heterobasidion spp. in subalpine forests
Authors: Gonthier P. , Garbelotto M. , Nicolotti G.
Published: May 2003

In the Western Italian Alps (WIA), the three European species of the forest pathogen Heterobasidion spp. can coexist in the same area. Heterobasidion parviporum Niemelä & Korhonen and Heterobasidion abietinum Niemelä & Korhonen are normally found in areas with a significant presence of their respective primary hosts, spruce (Picea spp.) and fir (Abies spp.). The host/niche occupied by Heterobasidion annosum (Fr.) Bref. in the region still remains unclear. Although Scots pine (Pinus sylvestris), a major host for this fungal species in other parts of Europe, is abundant in the region, little or no evidence of disease caused by H. annosum is visible in this tree species. Two different, but not mutually exclusive, hypotheses can explain the presence of H. annosum: (1) Scots pines are infected but largely asymptomatic and (2) H. annosum has adapted to different hosts. An analysis of Heterobasidion species was performed in two natural, mixed‐conifer forests using traditional isolation techniques and novel direct molecular diagnosis from wood. In a subalpine stand of mixed spruce (Picea abies), larch (Larix spp.), and Swiss stone pine (Pinus cembra), 18 naturally infected spruces and larches only yielded H. parviporum. A Swiss stone pine in the same stand was extensively colonized by both H. parviporum and H. annosum. In a second subalpine stand, an analysis of 18 spruce stumps and nine Swiss stone pine stumps yielded both H. parviporum and H. annosum isolates. Pine stumps had been mostly colonized by H. parviporum prior to tree felling, suggesting that this species may be secondarily infected by the locally predominant Heterobasidion species (i.e. H. parviporum). Results of our analysis also indicated that primary colonization of spruce stumps (e.g. through basidiospores) was caused by both H. parviporum and H. annosum, while secondary infection of such stumps was mostly because of H. parviporum.
A Memory Clinic at a Geriatric Hospital: A Report on 577 Patients Assessed with the CAMDEX Over 9 Years
Authors: Stratford Joe A. , Logiudice Dina , Flicker Leon , Cook Roslyn , Waltrowicz Wendy , Ames David
Published: May 2003

Objective: To report 9 years’ experience of an Australian memory clinic using the Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four instruments used in distinguishing patients with and without dementia.

Methods: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10).

Results: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were ‘normal’. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = −0.57 to 0.93).

Conclusion: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders.
Randomized Controlled Trials in Psychiatry. Part II: Their Relationship to Clinical Practice
Authors: Mulder Roger T. , Frampton Chris , Joyce Peter R. , Porter Richard
Published: May 2003

Objective: To discuss the extent to which the results of randomized controlled trials (RCTs) in psychiatry can be generalized to clinical practice.

Method: Threats to internal and external validity in psychiatric RCTs are reviewed.

Results: Threats to internal validity increase the possibility of bias. Psychiatric RCTs have problems with small samples, arbitrary definitions of caseness, disparate definitions of outcome and high spontaneous recovery rates. Particular issues arise in psychotherapy RCTs. Threats to external validity reduce the extent to which the results of a RCT produce a correct basis for generalization to other circumstances. These include high rates of comorbidity and sub syndromal pathology in normal clinical practice, manual-based treatment protocols and varying definitions of successful treatment.

Conclusions: Randomized controlled trials remain the most robust design to investigate the effectiveness of treatments. They should be applied to important clinical questions; and carried out, as far as possible, with typical patients in the clinical conditions in which the treatment is likely to be used.
Psychiatry, Religion and Cognitive Science
Authors: Bathgate David
Published: May 2003

Objective: To see whether certain findings in cognitive science can serve to bridge the conceptual gap between psychiatry, particularly in its psychotherapeutic aspects, and religious/spiritual understanding.

Method: A brief review is given of certain basic differences between psychiatric understanding in its psychotherapeutic aspects, and much of Western religious/spiritual understanding. Reference is then made to certain findings in contemporary cognitive science which might challenge the implicit mind–body split of Western religious tradition and its parallel in psychotherapeutic practice. Attention is also drawn to elements in religious/spiritual tradition that run counter to this dualistic point of view.

Results and Conclusions: Much of contemporary religious/spiritual understanding, and of modern psychiatric understanding, especially in terms of psychotherapy, appear to exist in quite separate domains. Psychotherapy and the greater part of Western religious thinking, however, share a belief in the existence of a transcendent mind. Recent developments in cognitive science and certain spiritual traditions, challenge this implicit mind–body split, providing an opportunity for a renewed dialogue between psychiatry and religion and the possibility of collaborative research.
Correlates of Youth Suicide Attempters in Australian Community and Clinical Samples
Authors: Carter Gregory L. , Issakidis Cathy , Clover Kerrie
Published: May 2003

Objective: This study (i) explores differences between a clinical sample of deliberate selfpoisoning (DSP) patients and a community sample who reported previous attempted suicide (AS); and (ii) examines correlates of suicidal behaviour in these groups compared with a community control group (CC) with no suicidal behaviour.

Method: The study design was: case–case, case–control and cross-sectional population studies. A clinical sample of DSP (n = 51), a community sample of AS (n = 31) and a community sample with no suicidal behaviour (n = 842) were used, all aged 18–24 years. The DSP and AS groups were compared on several variables and two logistic regression models were developed for risk of (i) DSP and (ii) AS compared to community controls.

Results: The adjusted odds ratios for DSP were: female gender (OR = 5.7, CI = 1.7–19.4), anxiety (OR = 7.4, CI = 2.2–25.1), affective (OR = 23.0, CI = 6.9–76.5), or substance-use disorder (OR = 19.2, CI = 5.6–65.4) and greater mental health related disability (OR = 0.5, CI = 0.3–0.7 for 1 SD decrease). For AS the results were: anxiety (OR = 9.4, CI = 1.7–52.8) or substance-use disorder (OR = 3.0, CI = 1.1–8.7) and greater mental health disability (OR = 0.5, CI = 0.4–0.7). Affective disorder was close to significant for the AS group (OR = 4.0, CI = 0.9–17.1).

Conclusions: Correlates of DSP/AS were usually more powerful in the clinical group, but showed a similar pattern of psychiatric disorder and disability factors in both groups, supporting a continuum of risk factors across these groups. Interventions based on modifiable risk factors could target the same factors for public health, primary care or hospital populations: anxiety, depression and substance use disorders and mental health related disability.
Epidemiological Analysis of Electroconvulsive Therapy in Victoria, Australia
Authors: Wood Debra A. , Wood Debra A. , Burgess Philip M.
Published: May 2003

Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998–1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment.

Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age–sex specific utilization rates were calculated using this statutory data for the 1998–1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population.

Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age–sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex.

Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.
A Naturalistic Study of the Measurement of Seizure Adequacy in Electroconvulsive Therapy
Authors: Edwards Mark , Koopowitz Leslie F. , Harvey Eileen J.
Published: May 2003

Objective: The aim of this study was to assess an electroconvulsive therapy (ECT) rating scale by studying the intraictal electroencephalograph parameters induced by the seizure, and determine the clinical utility of such a scale in terms of time, application and ease of use.

Method: This naturalistic study of 55 depressed patients over a 2-year period examined specific parameters of the intraictal electroencephalograph seizure morphology and computer printout, and their association with overall clinical outcome. The rating scale was developed and evaluated in terms of clinical reliability and ease of use.

Results: Overall, 1076 individual ECT treatments were given. Using multiple regression analysis, overall seizure adequacy correlated most closely with abrupt seizure endpoint, a high amplitude rhythmic spike and wave phase of >13 s, a seizure energy index of >1000 u, and an electroencephalograph seizure length of > 24 s. ‘Adequate’ overall ratings as determined by the rating scale were shown to correlate significantly with overall clinical improvement. The rating scale had extremely high interrater and test–retest reliability; and was relatively easy to use and time efficient.

Conclusions: The use of the rating scale has the potential to help clinicians optimize ECT. While not perfect in any sense, it still gives clinicians good predictive qualities when used as a clinical guide. It is important that larger studies look at all the potential variables that may interact with seizure adequacy and clinical outcome.