bluuebunny/crossref_metadata_2025 huggingface dataset:
Caries Patterns in Primary Dentition in 3-, 5- and 7-Year-Old Children: Spatial Correlation and Preventive Consequences
Authors: Vanobbergen J. , Lesaffre E. , García-Zattera M.J. , Jara A. , Martens L. , Declerck D.
Published: December 2006

This study aimed to contribute to the descriptive information of oral health status in the primary dentition, especially concerning the distribution and spatial correlation of lesions. Data were obtained from two surveys. In the Signal-Tandmobiel® project 4,468 7-year-old children in Flanders (Belgium) were selected by a stratified clustered random sample. In the Tandje de Voorste – Smile for Life (TDV) project, data were obtained from 1,291 3-year-old and 1,315 5-year-old children. The children were examined by trained dentists, using standardized and widely accepted criteria, based on the British Association for the Study of Community Dentistry criteria. At the population level, symmetry in the prevalence of caries experience across the midline was tested at the tooth and tooth surface levels using generalized estimating equations and alternating logistic regression (ALR) approaches. Individual symmetry was tested using an approach described by Hujoel et al. [J Dent Res 1994;73:1575–1580]. Descriptive observations suggested a symmetrical distribution of caries experience at the population level. The null hypothesis of symmetry could not be rejected at a 0.05 level, suggesting that caries experience might be symmetric in the deciduous dentition. Based on the ALR approach, 2 × 2 associations of caries experience at the tooth and surface levels, both in 5- and 7-year-olds, appeared to be strongest for the left-right pairs in the mandible, followed by the left-right pairs in the maxilla. At the individual level the hypothesis of random caries pattern was rejected (p < 0.0001). In conclusion, at the population level the null hypothesis of left-right symmetry could not be rejected, while at the individual level lesions tended to cluster on one side of the mouth.
Effects of Water Fluoride Exposure at Crown Completion and Maturation on Caries of Permanent First Molars
Authors: Singh K.A. , Spencer A.J. , Brennan D.S.
Published: December 2006

Pre-eruptive fluoride exposure has been shown to be important for caries prevention. This paper aimed to determine the relative effects of water fluoride exposure during crown completion (CC) and maturation on caries experience in first permanent molars. Parental questionnaires covering residential history were linked to oral examinations of 19,885 6- to 15-year-old Australian children conducted in 1992 by the School Dental Services of South Australia and Queensland. The percentage of lifetime exposed to optimally fluoridated water at CC, maturation (MAT) and post-eruption (POST) was calculated. Combined exposure variables describing different levels of CC, maturation and post-eruption were created using a threshold exposure of 50%. Compared to the reference of CC <50%/MAT <50%/POST <50%, the categories CC ≧50%/MAT <50%/POST ≧50% [rate ratio (RR) 0.52], CC ≧50%/MAT ≧50%/POST <50% (RR 0.61) and CC ≧50%/MAT ≧50%/POST ≧50% (RR 0.67) had the strongest caries-preventive effect, followed by CC ≧50%/MAT <50%/POST <50% (RR = 0.79) and CC <50%/MAT ≧50%/POST ≧50% (RR = 0.81) in negative binomial regression models (p < 0.05). The categories CC <50%/MAT ≧50%/POST <50% (RR = 0.85) and CC <50%/MAT <50%/POST ≧50% (RR = 0.84) had weaker, non-significant caries-preventive effects. In conclusion a high exposure at CC was important for caries prevention irrespective of the effect of exposure at maturation and post-eruption. The strongest caries-preventive effect was produced by a high exposure at CC supplemented by a high exposure at maturation and/or post-eruption, but the latter two phases could not produce a significant caries-preventive effect on their own. Since most of the caries occurred on pit and fissure surfaces, the findings relate to this class of lesion.
Effects of Dental Probing on Occlusal Surfaces – A Scanning Electron Microscopy Evaluation
Authors: Kühnisch Jan , Dietz Wolfram , Stösser Lutz , Hickel Reinhard , Heinrich-Weltzien Roswitha
Published: December 2006

The aim of this clinical-morphological study was to investigate the effects of dental probing on occlusal surfaces by scanning electron microscopy (SEM). Twenty sound occlusal surfaces of third molars and 20 teeth with initial carious lesions of 17- to 26-year-old patients (n = 18) were involved. Ten molars of each group were probed with a sharp dental probe (No. 23) before extraction; the other molars served as negative controls. After extraction of the teeth, the crowns were separated and prepared for the SEM study. Probing-related surface defects, enlargements and break-offs of occlusal pits and fissures were observed on all occlusal surfaces with initial carious lesions and on 2 sound surfaces, respectively. No traumatic defects whatsoever were visible on unprobed occlusal surfaces. This investigation confirms findings of light-microscopic studies that using a sharp dental probe for occlusal caries detection causes enamel defects. Therefore, dental probing should be considered as an inappropriate procedure and should be replaced by a meticulous visual inspection. Critical views of tactile caries detection methods with a sharp dental probe as a diagnostic tool seem to be inevitable in undergraduate and postgraduate dental education programmes.
A Comparison of Terahertz Pulsed Imaging with Transmission Microradiography for Depth Measurement of Enamel Demineralisation in vitro
Authors: Pickwell Emma , Wallace Vincent P. , Cole Bryan E. , Ali Sophia , Longbottom Christopher , Lynch Richard J.M. , Pepper Michael
Published: December 2006

Terahertz pulsed imaging (TPI) is a relatively new, non-ionising and non-destructive imaging technique for studying hard tissues which does not require tooth section preparation, unlike transmission microradiography (TMR). If TPI can measure the depths of caries/demineralisation lesions accurately the same tooth samples could be reused and remeasured during in vitro and in situ studies on de- and/or remineralisation. The aim of this study was to compare TPI and TMR for measuring the depths of a range of artificially induced bovine enamel demineralised lesions in vitro. Bovine slabs with artificial caries, induced to different levels of demineralisation by two different but standard demineralisation techniques (‘acid gel’ and ‘carbopol’) were measured by TPI and TMR and the readings compared. The set of TPI/TMR measurements obtained on the gel-demineralised slabs showed an extremely high coefficient of determination (r2 = 0.995). Detailed analysis of the results and theoretical considerations (involving the relationship between refractive index profiling and mineral loss profile) are used to explain the findings and show that for acid gel lesions TPI is measuring demineralisation in the range of 47% of that of TMR depth plus an intercept of 16 µm, with further calculations allowing the TMR depths to be determined to within 5% using TPI.
Susceptibility of Acid-Softened Enamel to Mechanical Wear – Ultrasonication versus Toothbrushing Abrasion
Authors: Wiegand A. , Wegehaupt F. , Werner C. , Attin T.
Published: December 2006

The study aimed to compare the amounts of softened enamel removable by ultrasonication and by toothbrushing abrasion of briefly eroded samples. Thirty bovine enamel samples were demineralized in hydrochloric acid (pH 2.1) for 60 s and were then either brushed with 350 brushing strokes in toothpaste slurry (group A) or distilled water (group B) or were ultrasonicated for 120 s (group C). Enamel loss was measured after 10, 20, 50 and then after every 50 brushing strokes or after 5, 30, 60 and 120 s ultrasonication. Samples were indented with a Knoop diamond after erosion, and enamel loss due to abrasion or wear was calculated from the change in indentation depth after mechanical treatment. Within- and between-group comparisons were performed by ANOVA or t test. Initially, enamel loss increased with increasing brushing treatment or ultrasonication time. Enamel loss did not increase after 300 brushing strokes in group A (534 ± 169 nm) or 250 brushing strokes in group B (423 ± 80 nm), or after 60 s ultrasonication (231 ± 72 nm). Enamel loss was significantly higher in groups A and B than in group C. The results confirm that ultrasonication removes only the outer, more highly demineralized part of the softened enamel layer. Results also indicate that toothbrushing abrasion removes more softened enamel from briefly eroded enamel than ultrasonication, and therefore probably removes partly demineralized enamel from the deeper part of the softened layer. In vivo, excessive toothbrushing might remove the softened enamel layer almost completely.
Inhibition of Erosive Wear by Fluoride Varnish
Authors: Vieira A. , Jager D.H.J. , Ruben J.L. , Huysmans M.C.D.N.J.M.
Published: December 2006

It has been suggested that fluoride products with a protective mechanical component are advantageous in the prevention of erosive wear. The aim of this study was to evaluate in situ the effect of fluoride varnish (FV) in the prevention of wear due to erosion and combined erosion and toothbrush abrasion. Eleven volunteers wore for 3 weeks, during working hours, appliances containing 2 control and 2 FV-treated human enamel samples. Erosion took place extraorally 3 times a day (5 min) in the soft drink Sprite. At the end of each experimental day one control and one FV sample (C-er+abr and FV-er+abr) were brushed (5 s) with fluoridated dentrifice. The remaining control and FV sample (C-er and FV-er) were left unbrushed. Enamel volume loss was quantified by optical profilometry at day 5, 10 and 15. A statistically significant progression in enamel loss was found for the C-er, C-er+abr and FV-er+abr groups (p < 0.001, p < 0.001 and p = 0.001, respectively) but not for the FV-er group (p = 0.053). The values of cumulative normalized volume loss (×108 µm) at day 15 were: C-er 5.53 ± 2.14, C-er+abr 5.70 ± 2.07, FV-er 0.79 ± 0.67 and FV-er+abr 2.76 ± 1.35. The FV-er and FV-er+abr groups showed significant lower volume loss than the C-er group (p < 0.001 and p = 0.005, respectively) and the C-er+abr group (p < 0.001 and p = 0.002, respectively). The results indicate that fluoride varnish is effective in the reduction of erosive wear.
Combined Effects of Carbon Dioxide Laser and Fluoride on Demineralized Primary Enamel: An in vitro Study
Authors: Tagliaferro E.P.S. , Rodrigues L.K.A. , Nobre dos Santos M. , Soares L.E.S. , Martin A.A.
Published: December 2006

This in vitro study aimed at evaluating the efficacy of a CO2 laser (10.6 µm) alone or combined with acidulated phosphate fluoride (APF) on the inhibition of lesion progression in primary enamel. The specimens were treated with/without CO2 laser and/or APF and submitted to pH cycling. Microhardness analysis was performed and the enamel mineral loss values were obtained. The groups treated with laser and/or APF presented lower mineral loss when compared to the control group (p < 0.05). Laser irradiation alone or combined with APF decreased lesion progression in primary enamel. However, the combined treatment did not show any significant additional effect.
Influence of Fluoride Dentifrice on Brushing Abrasion of Eroded Human Enamel: An in situ/ex vivo Study
Authors: Magalhães A.C. , Rios D. , Delbem A.C.B. , Buzalaf M.A.R. , Machado M.A.A.M.
Published: December 2006

This in situ/ex vivo study assessed the effect of fluoride dentifrice on eroded enamel subjected to brushing abrasion. In a crossover study performed in 2 phases, 10 volunteers wore acrylic palatal appliances, each containing 3 human enamel blocks. Dentifrice was used to brush the volunteers’ teeth and the specimens subjected to abrasion. In phases A and B the dentifrices used had the same formulation, except for the absence or presence of fluoride, respectively. The blocks were subjected to erosion by immersion of the appliances in a cola drink for 5 min, 4 times a day. Then the blocks were brushed, and the appliance was replaced into the mouth. Enamel alterations were determined using profilometry and percentage change in surface microhardness (%SMHC) tests. The data were tested using the paired t test. The mean wear values (±SD, µm) were: group A 6.84 ± 1.72 and group B 5.38 ± 1.21 (p = 0.04). The mean %SMHC values (±SD) were: group A 54.6 ± 16.2 and group B 45.7 ± 6.8 (p = 0.04). Fluoride dentifrice had a protective effect on eroded enamel subjected to brushing abrasion.
An in vitro Study on the Effect of TiF4 Treatment against Erosion by Hydrochloric Acid on Pellicle-Covered Enamel
Authors: Hove L.H. , Young A. , Tveit A.B.
Published: December 2006

The aim of this in vitro study was to examine the effect of fluoride treatment on pellicle-covered enamel exposed to an acidic challenge simulating gastric reflux. Sixteen bovine and 16 human teeth were sectioned into four pieces, divided into four groups: (1) control, (2) 2-hour pellicle, (3) TiF4, and (4) 2-hour pellicle + TiF4, and subsequently subjected to 3 ml 0.01 M HCl stepwise for 4 + 4 + 4 min. The acid was analysed for calcium by atomic absorption spectroscopy. TiF4 reduced Ca release from enamel by 76, 57 and 56% following the 4 + 4 + 4-min acid exposures, respectively, in bovine and 44, 54 and 54% in human enamel. These results suggest that treatment of enamel with a TiF4 solution, with or without pellicle removal, may provide protection for the enamel against acid attack.
Drug Discovery and Delivery in the 21st Century
Authors: Triggle David J.
Published: December 2006

Drug discovery in the late 20th century has increasingly focused on the definition and characterization of the macromolecular substrates that serve as targets for drug design. The advent of genomics and the molecular biology revolution has permitted both the definition of new targets and the characterization of the genetic basis of disease states. The introduction of powerful new technologies should greatly accelerate the pace of new drug discovery. Although genomics, both human and nonhuman, should in principle increase the number of potential drug targets and provide a greater understanding of cellular events contributing to the pathology of disease this has yet to occur in practice, primarily because of the underlying complexity of cellular signaling processes. The emerging discipline of systems biology is attempting to bring both order and understanding to these signaling processes. Genomics has, however, impacted on drug discovery in ways that are important beyond a mere increase in potential drug target numbers. Genomics has provided the tools of contemporary drug discovery, the pharmacogenomic pathways to personalized medicine, and has greatly influenced the nature of synthetic organic chemistry, a discipline that is still the cornerstone of contemporary drug discovery. In the future, genomics and the tools of molecular biology will have a corresponding impact on drug delivery processes and mechanisms through introduction of drug delivery machines capable of both synthesis and activation by disease-specific signals. Such machines will be based on a synthetic genome, using an expanded genetic code, and designed for specific drug synthesis and delivery and activation by a pathological signal. This essay is based upon a lecture of the same title presented at the Faculty of Medicine, Kuwait University during a visit in the spring of 2005. It is intended, as was the lecture, to be a broad, descriptive and speculative overview rather than a comprehensive and detailed review.
Self-Reported Oral Hygiene Habits and Oral Health Problems of Kuwaiti Adults
Authors: Al-Shammari Khalaf F. , Al-Ansari Jassem M. , Al-Khabbaz Areej K. , Dashti Asmahan , Honkala Eino J.
Published: December 2006

Objective: The aims of this study were to examine self-reported oral hygiene habits and oral health problems of a sample of adult Kuwaitis. Materials and Methods: A self-administered, anonymous, structured questionnaire was distributed to 2,400 adult Kuwaiti nationals from all 6 governates of Kuwait assessing socio-demographic variables, oral hygiene habits, and oral health problems. Results: Of the 2,400 questionnaires, 1,925 (80.25%) responded. Of these, 62% reported brushing their teeth at least twice daily, while daily use of dental floss was uncommon (11.8%). Adequate toothbrushing habits were significantly associated with female gender, educational level, non-smoking status, and history of recent preventive dental visits (p = 0.001). The majority of subjects reported multiple oral health problems (64.7% with 2 or more and 41.8% with 3 or more). Factors associated with multiple oral health complaints included younger age, smoking, not having a recent preventive dental visit, and brushing the teeth less than twice daily. Conclusions: Less than two-thirds of the sampled adult Kuwaitis followed the recommended toothbrushing frequency of twice daily or more, and the majority of subjects have not had a preventive dental visit in the previous 6 months. Furthermore, most subjects reported multiple oral health problems that are mostly preventable through adequate oral hygiene habits and regular preventive dental visits.
Baseline Staging of Newly Diagnosed Breast Cancer – Kuwait Cancer Control Center Experience
Authors: Abuzallouf Sadeq , Motawy Mohammad , Thotathil Ziad
Published: December 2006

Objective: To determine the value of staging investigations in detecting metastases in newly diagnosed asymptomatic patients with breast cancer. Materials and Methods: A retrospective review of patients’ files with newly diagnosed breast cancer in the period from 1993 to 1998 was performed. Due to inadequate information, thirty-eight files were excluded leaving 785 files for analysis. Results: Of the total 785 patients, we found distant metastases at the time of primary diagnosis in 36 (4.6%) patients, bone metastases in 29 (3.7%) patients, pulmonary metastases in 6 (0.8%) patients and liver metastases in 5 (0.6%) patients. Overall, 0.7% of patients with clinical stage I and II disease had metastases compared with 16.2% of patients with clinical stage III disease (statistically significant p = 0.0001). Conclusion: The results confirm the low yield of routine bone scans, liver ultrasound and chest X-ray among patients with asymptomatic early-stage breast cancer. These tests are therefore not recommended for such patients, although intensive investigations are appropriate for more advanced tumors.
Incidence of Down Syndrome in Dubai, UAE
Authors: Murthy Sabita K. , Malhotra Ashok K. , Mani Sara , Shara Maryam Essa A. , Al-Rowaished Eman Essa Mohd , Naveed Sehba , AlKhayat Abdulla Ibrahim , AlAli Mahmoud Taleb
Published: December 2006

Objective: To describe incidence of Down syndrome in Dubai, United Arab Emirates (UAE). Subjects and Methods: A total of 63,398 newborn babies in Dubai (24,250 UAE nationals and 39,148 non-UAE) during a 5-year period of 1999–2003 were routinely examined by experienced nurses, neonatologists, pediatricians and/or general practitioners for symptoms of Down syndrome. Those suspected with Down syndrome were referred to the cytogenetic laboratory for karyotyping. Results: A total of 141 cases were confirmed cytogenetically as Down syndrome. Of these, 139 were trisomy 21 and of the remaining 2, 1 was a translocation and the other a mosaic. Theoverall incidence of Down syndrome in Dubai was 1/449 live births (2.2 per 1,000); 1/319 live births (3.13 per 1,000) among UAE nationals and 1/602 live births (1.66 per 1,000) among non-UAE nationals. The mean maternal age of UAE national mothers was 33.48 ± 8.08, with 41.66% of the mothers being in the advanced maternal age group (>35 years). The higher incidence of Down syndrome among UAE nationals is comparable to incidences reported for other Arab populations in the Middle Eastern region. Advanced maternal age, with mothers bearing children until their 50s and higher parity, appear to be the major contributing factors for the increased incidence. Conclusion: The study indicates the need to provide efficient genetic counseling and to introduce an effective antenatal screening program and prenatal diagnostic services to reduce the psychological and genetic burden on the families and community.
Penicillin-Resistant Streptococcus pneumoniae in Iran
Authors: Kohanteb Jamshid , Sadeghi Esmaeel
Published: December 2006

Objective: To determine the prevalence of penicillin-resistant Streptococcus pneumoniae isolated from patients with community-acquired pneumococcal infections. Materials and Methods: A broth dilution method was used to determine the minimum inhibitory concentration (MIC) of penicillin and other commonly used antibiotics. 115 heavy growth or pure culture of S. pneumoniae strains were isolated from: blood 10, cerebrospinal fluid (CSF) 15, ear 5, eye 12, purulent rhinosinusitis 48, sputum 22, and pleural fluid 3. Results: Of the 115 pneumococcoal isolates, 76 (66.1%) were sensitive to penicillin while the remaining 39 (33.9%) were nonsusceptible (15.6% resistant and 18.3% intermediately resistant). Among the 25 pneumococcal isolates from sterile sites (blood 15, CSF 10), 15 (60%) were penicillin-resistant whereas among the 90 isolates from nonsterile sites, 24 (26.7%) were resistant to penicillin (<0.004). The MIC values of antibiotics tested for S. pneumoniae were: penicillin 0.008–4 µg/ml, chloramphenicol 0.25–32 µg/ml, erythromycin 0.008–128 µg/ml, tetracycline 0.06–64 µg/ml, vancomycin 0.03–0.5 µg/ml, azithromycin 0.016–128 µg/ml, ciprofloxacin 0.006–8 µg/ml, cefotaxime 0.007–2 µg/ml, and ceftriaxone 0.016–12 µg/ml. Conclusion: Approximately one third of S. pneumoniae isolated from the clinical specimens were nonsusceptible to penicillin in this region.
Predictive Accuracy of Tissue Doppler Imaging for Assessment of Noninfarct Myocardial Region in Patients with Acute Myocardial Infarction
Authors: Hegazy Aly Mohamad , Akbar Mousa A.J. , Al-Sayegh Ali , Abdulkader Bader A.
Published: December 2006

Objectives: To investigate the value of pulsed tissue Doppler imaging (TDI) in order to predict significant coronary artery stenosis supplying the noninfarct region in patients after acute anterior myocardial infarction. Subjects and Methods: Transthoracic echocardiography and coronary angiography were performed on 220 patients with acute anterior myocardial infarction. The TDI-derived variables of the mitral valve annulus in the noninfarct region, systolic velocity (Sm), early diastolic velocity (Em) and late diastolic velocity (Am), were estimated in centimeters per second, and the Em/Am ratio was calculated. Results: Predictive indices revealed that the impaired TDI-derived variables, Sm, Em, Am and the Em/Am ratio, were an indicator for predicting significant coronary stenosis in the noninfarct region. Multivariate analysis revealed that the impaired Sm and Em velocities were significantly associated with age of the patients, coronary collaterals and infarct-related artery stenosis (p < 0.05). Receiver-operating characteristic curve data of TDI-derived variables for prediction of significant coronary stenosis revealed that the cut-off values of Sm, Em, Am and Em/Am ratio were 7.2 cm/s, 6.4 cm/s, 12.1 cm/s and 0.56, respectively. The ĸ coefficient value indicated that there was an agreement between coronary angiography and the TDI-derived variables Sm, Em, Am and Em/Am ratio in noninfarct regions (ĸ = 0.770, 0.731, 0.693 and 0.679, respectively). There was a significant correlation between the severity of coronary artery stenosis (independent variable) and impaired Sm and Em/Am ratio (dependent variables), y = 11.5 – 0.05x, r = –0.902, (p < 0.05), and y = – 0.14x + 1.87, r = –0.754, (p < 0.05), respectively. Conclusion: TDI can be used to identify patients with significant stenosis of the coronary arteries supplying the noninfarct region and consequently may be helpful in considering patients for coronary angiography in the early postinfarction period.
Quantitative Analysis of Barakol Content in Senna siamea Leaves and Flowers by TLC-Densitometry
Authors: Padumanonda Tanit , Suntornsuk Leena , Gritsanapan Wandee
Published: December 2006

Objective: To develop a TLC-densitometric method for the determination of barakol content in Senna siamea leaf and flower extracts, and to compare the barakol content in mature leaves, young leaves and young flowers of the plant which are consumed as a vegetable in curry. Materials and Methods: The extraction of pure barakol was performed by boiling the fresh young leaves of S. siamea with 0.5% sulfuric acid followed by chloroform extraction. The extract was further purified and recrystallized from absolute ethanol. Authentic sample of barakol was used for the validation of the TLC-densitometric method. Chromatography was performed on a TLC aluminium plate precoated with silica gel 60 F254as a stationary phase and chloroform-methanol (85:15 v/v) as a solvent system. Fifteen percent ethanolic extracts of mature leaves, young leaves and flowers of S. siamea were analyzed and compared for barakol content using the validated TLC-densitometric method. Both the validation and analysis of barakol by TLC-densitometry were carried out at the absorbance mode of 366 nm. Results: Barakol was extracted as pure lemon-yellow crystals from young S. siamea leaves with 0.1% yield. Linearity was found over the range of 200–900 ng/spot (r2 = 0.997). The developed method gave high precision (%RSD < 0.50) and accuracy (average 101.12%). The limit of detection and limit of quantitation were 8 and 50 ng, respectively. Barakol content in young leaves, mature leaves and young flowers were 1.67, 0.78 and 1.43% dry weight, respectively. Rf value of the barakol in young leaves, young flowers and authentic sample was the same: 0.45 ± 0.03. Conclusion: The TLC-densitometric method was simple, precise and convenient; hence it is an effective procedure for the simultaneous determination of barakol in plant extracts.
Spontaneous Reduction of a Traumatic L2-L3 Subluxation without Fracture in a 14-Year-Old Boy
Authors: Mouhsine E. , Theumann N. , Wettstein M. , Leyvraz P.-F. , Borens O. , Garofalo R.
Published: December 2006

Objective: To report a rare case of lumbar vertebral subluxation associated with spontaneous reduction in an adolescent treated conservatively. Clinical Presentation and Intervention: A 14-year-old male victim of a snowboard accident, which caused a lumbar spinal injury, was referred to the emergency room with significant lumbar pain. Neurologic examination was normal. Radiographic assessment at admission showed a unilateral left lateral subluxation of the L2-L3 vertebrae without associated fractures. These findings were confirmed by CT scan and a surgical management was decided. The preoperative MRI performed 24 h after the accident, however, revealed the spontaneous reduction of the subluxation, and an associated tear of the quadratus lumborum and the psoas muscles on the right side at the level of L2, L3 and L4. Following these findings conservative treatment with a plaster brace for 2 months was carried out. The brace was removed after 2 months. The patient had no pain and the range of motion of his lumbar spine was normal. Three months after injury, sports activities were resumed. At follow-up of 24 months, the patient was free of pain and radiographs showed a right positional bending without rotational or translation anomaly. Conclusion: To date, this is the first case of subluxation without fracture in a child, presenting without neurological deficit and where spontaneous reduction occurred. In this case, conservative treatment was effective and the outcome at 2-year follow-up was excellent.
Homozygous Familial Hypercholesterolemia with Generalized Arterial Disease
Authors: Selvan J.P. , Uthaman B. , Abushaban L. , Jebaraj R.
Published: December 2006

Objective: This report describes the clinical features and management of an 11-year-old boy with end-stage homozygous familial hypercholesterolemia (hoFH) and generalized arterial disease. Clinical Presentation and Intervention: The patient presented with recurrent anginal episodes. On examination, he was found to have multiple planar and tendinous xanthomas, an (LDL) cholesterol level of 24.6 mmol/l and family history of hypercholesterolemia. Resting electrocardiogram showed ST depression in the anterior and inferior leads. Coronary angiogram outlined 70% stenosis of the left main coronary, ostial stenosis of the right coronary artery and extensive atherosclerotic disease of the aorta and all its major branches. The lipid profile was grossly abnormal, but the other biochemical and hematological parameters were normal. The patient was managed with metoprolol 12.5 mg twice daily, nitroglycerin infusion, antithrombotics (aspirin 75 mg once daily and heparin infusion 150 units per hour), cholesterol-lowering drugs (simvastatin 10 mg once a day, cholestyramine 4 g twice a day) and analgesics. Conclusion: This case report emphasizes the need to diagnose early familial hypercholesterolemia in families with heart disease and the need to test the partners of affected persons so that the risk of conceiving children with hoFH can be counseled.
Low Prevalence of Anti-Hepatitis C Virus Antibodies in Mexico: A Systematic Review
Authors: Chiquete Erwin , Panduro Arturo
Published: December 2006

Background: The prevalence of reactive tests to anti-hepatitis C virus (HCV) antibodies in Mexico is unknown, though estimated to be 1%. There is no single nation-wide study or comprehensive literature review addressing the epidemiology of HCV infection in Mexico. Methods: We did a systematic review of English- and Spanish-language literature reporting on the frequency of anti-HCV antibodies in asymptomatic persons at low risk, of studies performed in Mexico. An exhaustive search in MEDLINE, IMBIOMED, MedicLatina, ARTEMISA and MEDIGRAPHIC databases was undertaken. Weighted mean prevalence (WMP) was calculated after combining the results of each study. Results: 22 studies involving 825,377 persons at low risk, mainly blood donors, were identified. Crude seroprevalence reported in each study ranged from 0.1 to 2%, with 16 (73%) studies reporting below 1%. Overall, WMP of anti-HCV antibodies (tested by enzyme immunoassay) was 0.37% (95% CI, 0.36–0.38%), differing by country region and immunoassay generation (p< 0.01). The most frequent risk factor reported was blood transfusion. Confirmation of specific anti-HCV antibodies by recombinant immunoblot assay ranged from 30 to 100%, whereas confirmation of viremia by PCR ranged from 16 to 80%. In 3 studies on HCV genotype frequency, genotype 1 had crude prevalence ranging from 63 to 70%, subtype 1b being the most prevalent (21–47%). Conclusions: The prevalence of anti-HCV antibodies in Mexico might be lower than previously estimated. Transfusion of blood products is the main risk factor. HCV subtype 1b is the most prevalent among persons with confirmed viremia. Information of a nation-wide survey is mandatory.
Intrahepatic mRNA Levels of Type I Interferon Receptor and Interferon-Stimulated Genes in Genotype 1b Chronic Hepatitis C
Authors: Taniguchi Hideaki , Iwasaki Yoshiaki , Takahashi Akira , Shimomura Hiroyuki , Moriya Akio , Yu Piao Cheng , Umeoka Fumi , Fujioka Shin-ichi , Koide Norio , Shiratori Yasushi
Published: December 2006

Objective: The aim of this study was to determine the association between pretreatment intrahepatic mRNA levels of interferon receptor and interferon-stimulated genes and response to interferon therapy for genotype 1b chronic hepatitis C. Methods: Forty-four patients with genotype 1b chronic hepatitis C who underwent liver biopsy and then received interferon therapy participated in this study. Pretreatment intrahepatic mRNA levels of interferon receptor genes (IFNAR1, IFNAR2b, and IFNAR2c) and interferon-stimulated genes (OAS1 and PKR) were quantified by competitive polymerase chain reaction. Results: In the genes examined, only IFNAR1 mRNA level was significantly higher in patients with sustained virological and biochemical response to interferon therapy versus those with nonsustained response (p < 0.01). Moreover, mRNA expression ratios of IFNAR1 to IFNAR2 were also significantly higher in patients with sustained virological and biochemical response to IFN therapy (p < 0.01 and p < 0.05, respectively). On the other hand, mRNA levels of IFNAR2b, IFNAR2c, and PKR were significantly higher in patients with histologically active or advanced liver rather than patients with mild or less advanced liver. Conclusions: High intrahepatic mRNA levels of IFNAR1 and mRNA ratio of IFNAR1 to IFNAR2 before treatment may be associated with a favorable response to interferon therapy.
A New Algorithm for Deduction of Hepatitis B Surface Antigen Subtype Determinants from the Amino Acid Sequence
Authors: Purdy Michael A. , Talekar Ganesh , Swenson Paul , Araujo Aufra , Fields Howard
Published: December 2006

Objective: We have reexamined hepatitis B virus subtypes to determine the role of specific HBsAg amino acids in serologic reactivity because of problematic genotype/subtype associations seen in a set of geographically diverse serum specimens. Methods: We obtained DNA sequences for 491 HBsAg-positive specimens from geographically distinct locations, determined their genotypes through phylogenetic analysis, and subtyped the specimens using an algorithm derived from published data on the molecular basis of HBsAg subtype reactivity. Problematic samples were subtyped serologically to resolve conflicts based on the amino acid sequence alone. Results: Three isolates were found to have unusual genotype/subtype associations. Examination of the isolates’ amino acid sequences suggested amino acid positions 122, 127, 140, 159 and 160 can be used to determine subtype reactivity from HBsAg amino acid sequences, while position 134, previously thought to play a role, is no longer important. Conclusions: This re-examination of hepatitis B virus subtypes shows the involvement of amino acid positions 122, 127, 140, 159 and 160 in HBsAg reactivity. While d, y, and r reactivities are controlled by single amino acid changes, w reactivity is determined by positions 122, 127, 140, and 159.
Dreaming in Posttraumatic Stress Disorder: A Critical Review of Phenomenology, Psychophysiology and Treatment
Authors: Wittmann Lutz , Schredl Michael , Kramer Milton
Published: December 2006

This review summarizes the available knowledge on the phenomenology of posttraumatic dreams. Posttraumatic nightmares are reported by up to 70% of individuals suffering from posttraumatic stress disorder (PTSD). An extensive review of polysomnographic studies suggests that neither this high incidence nor the occurrence of posttraumatic nightmares throughout the sleep cycle can be explained by altered REM sleep parameters. The assumption that a reduction of dream recall may serve as a coping mechanism in PTSD patients is questionable. About 50% of posttraumatic dreams comprise exact replications of the traumatic events. Therefore dreams in PTSD do not have stereotypical content. Data characterizing non-replicative posttraumatic dreams and indicating a change in dream content over time must be considered preliminary. Occurrence of posttraumatic dreams is associated with psychopathological developments. Imagery Rehearsal Therapy has repeatedly been proven to be a valuable tool in treating patients suffering from posttraumatic dream disturbance. A deeper knowledge of posttraumatic dreams is essential for any theory of PTSD as well as for a better understanding of the overall function of dreaming.
Childhood Separation Anxiety and the Risk of Subsequent Psychopathology: Results from a Community Study
Authors: Brückl Tanja M. , Wittchen Hans-Ulrich , Höfler Michael , Pfister Hildegard , Schneider Silvia , Lieb Roselind
Published: December 2006

Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.
Expression of Nuclear and Mitochondrial Thyroid Hormone Receptors in Postnatal Rat Tongue Muscle
Authors: Sato Iwao , Miyado Mami , Miwa Yoko , Sunohara Masataka
Published: December 2006

In this quantitative study, a competitive RT-PCR analysis was used to measure the level of the thyroid hormone receptors (TRs) in rat tongue muscle during the development of male Wistar rats aged 0, 5, 10, 15 and 21 postnatal days. There were differences between the expression of TR-α1 mRNA and the mRNAs for TR-β1 and TR-β2 in rat tongue muscle. Using Western blot analysis, a difference in expression between TR-α1 protein (c-ErbAα1 protein) and 43-kD c-ErbAα1 protein (T3-binding 43-kD mitochondrial protein) was detected during the development of the rat tongue muscle. Immunohistochemical examination using electron microscopy showed that TR-α1 was found in the mitochondria and nuclei in contrast to TR-β1 detected in rat tongue muscle. In mitochondrial fractions from rat tongue muscle, the expression of 43-kD c-ErbAα1 protein was increased dramatically at 15 and 21 days, and a similar tendency was seen in cytochrome c proteins using Western blot analysis. We presume that the 43-kD c-ErbAα1 protein plays a role in regulating mitochondrial RNA synthesis during the postnatal development of rat tongue. The mRNA and protein myosin heavy chain isoforms of muscle also had a different expression during development. The slow myosin isoform protein was not found from day 10 in contrast to fast myosin isoforms. It is likely that the expression of TR-α1 mRNA from the rat tongue muscle may be related to a specific phase in muscle phenotype during the development.
Allelochemical Communication in Vertebrates: Kairomones, Allomones and Synomones
Authors: Sbarbati A. , Osculati F.
Published: December 2006

Communication between different species by means of chemicals (allelomones) is widespread among prokaryotes, plants and invertebrates. This study reviews data suggesting that allelochemically mediated communication also exists among vertebrates. The work aims to provide a concise, interdisciplinary review of communication mediated by infochemicals, with a focus on interspecies and interkingdom signaling. A definition of infochemicals is given, with a brief review of the general principles of chemical communication in different kingdoms in nature. Findings are reported which suggest that interspecies chemical signaling is important for vertebrates also. It is proposed that the general laws of chemical ecology are valid for mammals too, and that the terms indicating the different types of allelomones (i.e. kairomone, allomone and synomone) might also be used in medicine. In particular, the microchemical environment at the airway and digestive interfaces are discussed from an infochemical point of view.
Dopaminergic Mechanisms Involved in Prolactin Release after Mifepristone and Naloxone Treatment during Late Pregnancy in the Rat
Authors: Soaje Marta , Valdez Susana , Bregonzio Claudia , Penissi Alicia , Deis Ricardo P.
Published: December 2006

Background/Aims: During late pregnancy, the antiprogesterone mifepristone facilitates prolactin release. This effect is enhanced by administration of the opioid antagonist naloxone, suggesting an inhibitory-neuromodulatory role of the opioid system. Since hypothalamic dopamine (DA) is the main regulator of prolactin release, in this study we explored the role of DA on prolactin release induced by mifepristone and naloxone treatment. Methods/Results: Rats on day 19 of pregnancy were used. Naloxone treatment did not modify the 3,4-dihydroxyphenylacetic acid/DA (DOPAC/DA) ratio or serum prolactin concentration in control rats. After mifepristone treatment, DA activity diminished significantly without modifying serum prolactin levels. Naloxone administration to antiprogesterone-treated rats did not change the DOPAC/DA ratio but increased serum prolactin. Tyrosine hydroxylase (TH) expression in medial basal hypothalamus (MBH) protein extracts was lowered by pretreatment with mifepristone, with no additional effect of naloxone. While mifepristone decreased the intensity of TH immunoreactivity in the arcuate and periventricular nuclei and in fibers of the median eminence, naloxone treatment had no further effect. Conclusions: (1) A reduction of tuberoinfundibular dopaminergic (TIDA) neuron activity is suggested by the fall of the DOPAC/DA ratio and the low expression of MBH TH; (2) this reduction facilitates prolactin secretion by naloxone, indicating that progesterone stimulates DA neurons to maintain low serum prolactin; (3) naloxone action seems to depend on a previous decrease of DA tone induced by mifepristone, without involve a direct effect on neuronal DA activity, and (4) endogenous opioids may inhibit prolactin secretion through a non-dopaminergic neuronal system that regulates prolactin secretion in which as yet undetermined prolactin-releasing factors may participate.
Regulation of 5′-Promoter Activity of the Rat Growth Hormone and Growth Hormone-Releasing Hormone Receptor Genes in the MtT/S and MtT/E Cells
Authors: Nogami Haruo , Hiraoka Yoshiki , Inoue Kinji , Aiso Sadakazu , Hisano Setsuji
Published: December 2006

The MtT/E and MtT/S cells have been established from a mammotrophic pituitary tumor, and postulated to be progenitor and premature growth hormone (GH) cells, respectively. The difference in the regulation of GH and GH-releasing hormone (GHRH) receptor gene transcription in relation to the developmental stage of GH cells were examined in these two cell lines. In MtT/S cells, triiodothyronine (T3), all-trans retinoic acid (RA) and 9-cis retinoic acid (9cRA) stimulated GH promoter activity but dexamethasone (DEX) did not. On the other hand, DEX stimulated GHRH-receptor promoter alone. T3, RA and 9cRA showed little effect alone but each of them augmented the effect of DEX when used together with DEX. In MtT/E cells, DEX, RA and 9cRA showed similar effect as observed in MtT/S cells on both GH and GHRH-receptor promoter activity. However, T3 neither stimulated GH promoter activity nor augmented the DEX-induced GHRH-receptor gene transcription in MtT/E cells. RT-PCR analyses revealed that both cell types expressed TRα1, TRβ1 and TRα2, but expression of TRβ2, a pituitary specific isoform of TR, was only detected in MtT/S cells. However, the deficiency of TRβ2 for its own sake does not appear to be a reason why T3 action was not observed in MtT/E cells, because co-transfection of expression plasmids for TRβ2 and RXRα failed in conferring on the cells an ability to respond to T3 by increased GH or GHRH-receptor promoter activity. These results suggest that the acquisition of mechanisms responsible for the regulation of GH or GHRH-receptor transcription by T3 may be involved in the process of functional development of GH cells.
Neuropeptide Urocortin and Its Receptors Are Expressed in Rat Kupffer Cells
Authors: Charalampopoulos Ioannis , Androulidaki Ariadne , Minas Vassilis , Chatzaki Ekaterini , Tsatsanis Chistos , Notas George , Xidakis Costas , Kolios George , Kouroumalis Elias , Margioris Andrew N. , Gravanis Achille
Published: December 2006

The stress neuropeptides, corticotropin-releasing hormone (CRH) and urocortin (UCN), modulate the inflammatory response via the hypothalamus-pituitary-adrenal axis and locally, in a paracrine manner, act on mast and macrophage cells. Kupffer cells (KCs) are the resident macrophages of the liver. They represent the bulk of tissue macrophages in the body and they are the first to face invading noxious agents reaching the body via the portal circulation. The aim of the present report was to study the expression of the CRH system in rat KC and test its functionality. Our findings are as follows: (1) In highly purified KCs the transcripts of UCN, of its receptors CRHR1, CRHR2 and that of the pseudoreceptor CRH-binding protein (CRHBP) were present while that of CRH was not detectable. (2) Similarly, immunoreactive UCN, CRHR1, CRHR2 and CRHBP were easily detectable by immunohistochemistry and immunofluorescence in sections of whole rat liver (localized in KC) as well as in purified KC while CRH was again not detectable. (3) Exposure of purified KC to CRH or UCN suppressed lipopolysaccharide-induced tumor necrosis factor alpha production, an effect completely prevented by the CRHR1 and CRHR2 receptor antagonist astressin. Our data demonstrate the presence of UCN and its receptors in rat KC, the absence of CRH, and the functionality of these receptors. We propose that a UCN-based system may affect local inflammatory phenomena in the liver acting in a paracrine manner.
Congenital Prothrombotic Disorders in Children with Peripheral Venous and Arterial Thromboses
Authors: Albisetti Manuela , Moeller Alexander , Waldvogel Katharina , Bernet-Buettiker Vera , Cannizzaro Vincenzo , Anagnostopoulos Alexia , Balmer Christian , Schmugge Markus
Published: December 2006

Aims: To evaluate the prevalence of congenital prothrombotic disorders in children with peripheral venous and arterial thromboses. Methods: Deficiencies in antithrombin (AT), proteins C (PC) and S (PS), and increased lipoprotein (a), and the presence of factor V (FV) G1691A, prothrombin G20210A and methylenetetrahydrofolate reductase (MTHFR) mutations were investigated. Results: Forty-eight patients (mean age, 3.4 years) were investigated. Of these patients, 23 had venous thrombosis, 22 had arterial thrombosis, and 3 had both. No patients had AT, PC or PS deficiency. FV G1691A mutation was present in 2 (7.6%) and 3 (12%) patients with venous and arterial thromboses, respectively. The prothrombin G20210A mutation was present in 1 (4%) patient with arterial thrombosis. Homozygous MTHFR C677T mutation was detected in 4 (18%) and 2 (9%) patients with venous and arterial thromboses, respectively. Increased lipoprotein (a) was present in 2 (10%) and 1 (4.5%) patients with venous and arterial thromboses, respectively. Regarding acquired risk factors, 79% of all thrombotic events were related to catheter usage. An underlying disease was present in 96% of the patients. Conclusions: Compared to acquired risk factors, congenital prothrombotic disorders are rarely present in children with peripheral venous and arterial thromboses. These results do not support general screening of children with venous and arterial thromboses for congenital prothrombotic disorders.