Database: EMBASE <: international biomedical and pharmaceutical literature, 1988 - May 2000. [Trial access until 3/2001. Feedback welcome to medical.library@umich.edu] Search Strategy (You Saved Citations 1-300 From Set 71): ----------------------------------------------------------------------------- 1 exp Decision support techniques/ 6442 2 exp Decision making/ 10302 3 exp Decision making, computer-assisted/ 93815 4 ((decision: or consensus) adj (making or make$1 or support 25188 or theory or trees or technique:)).mp. 5 exp "Sensitivity and specificity"/ 173587 6 Computer simulation/ 7229 7 Computer systems/ 4991 8 Computers/ 6568 9 (computer: adj5 (simulation: or system: or decision: or 29290 predict: or forecast:)).mp. 10 Forecasting/ 840 11 Models, biological/ 10332 12 Likelihood functions/ 3445 13 exp Risk/ 142555 14 Treatment outcome/ 68214 15 Treatment failure/ 5325 16 or/1-15 498158 17 exp Tooth demineralization/ 7492 18 demineralization.mp. 879 19 caries.mp. 1798 20 caires.mp. 0 21 craies.mp. 0 22 careis.mp. 1 23 carise.mp. 0 24 (teeth adj3 cavit:).mp. 32 25 (tooth adj3 cavit:).mp. 97 26 (dental adj3 cavit:).mp. 85 27 (dentin adj3 cavit:).mp. 19 28 (enamel adj3 cavit:).mp. 10 29 (teeth adj3 decay:).mp. 58 30 (tooth adj3 decay:).mp. 58 31 (dental adj3 decay:).mp. 47 32 (dentin adj3 decay:).mp. 0 33 (enamel adj3 decay:).mp. 1 34 (active adj decay).mp. 5 35 (rampant adj3 decay:).mp. 4 36 (recurrent adj3 decay:).mp. 5 37 (white adj spot:).mp. 231 38 carious.mp. 109 39 cariology.ti,ab. 2 40 (non-cavitated adj3 lesion:).mp. 0 41 (noncavitated adj3 lesion:).mp. 1 42 Tooth remineralization/ 788 43 (dental adj3 fissure:).mp. 14 44 (tooth adj3 fissure:).mp. 8 45 (teeth adj3 fissure:).mp. 1 46 caries-free.mp. 29 47 cariesfree.mp. 0 48 Cariogenic agents/ 3 49 precavit:.mp. 2 50 (filled adj3 teeth).mp. 45 51 (filled adj3 tooth).mp. 9 52 (oral adj fissure:).mp. 17 53 (tooth adj3 remineraliz:).mp. 1 54 (teeth adj3 remineraliz:).mp. 5 55 dft.mp. 542 56 dfs.mp. 980 57 dmf:.mp. 1235 58 cariogeni:.mp. 164 59 or/17-58 12313 60 16 and 59 1470 61 (disease adj free adj (survival or patient:)).mp. 5451 62 60 not 61 1170 63 "Root caries"/ 1483 64 exp Tooth root/ 302 65 62 not (63 or 64) 979 66 limit 65 to (human and english language) 777 67 limit 66 to (embryo < first trimester > or infant < to one 150 year > or child < unspecified age > or preschool child < 1 to 6 years > or school child < 7 to 12 years >) 68 limit 67 to (adolescent < 13 to 17 years > or adult < 18 to 98 64 years > or aged < 65+ years >) 69 67 and 68 98 70 66 not 67 627 71 70 or 69 725 72 from 71 keep 1-300 300 73 from 71 keep 301-600 300 74 from 71 keep 1-300 300 *************************** <1> UI - 2000171557 AU - Abrahams JJ AU - Hayt MW AU - Rock R IN - J.J. Abrahams, Dept. of Diagn. Radiology SP2-123, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06520-8042; United States. TI - Sinus lift procedure of the maxilla in patients with inadequate for dental implants: Radiographic appearance. SO - American Journal of Roentgenology Vol 174(5) (pp 1289-1292), 2000. AB - OBJECTIVE. Dental implants have gained popularity for treating edentulism, but some patients develop jaw atrophy, which leaves insufficient bone for implants. To treat these patients, the sinus lift procedure, which augments bone, was developed. Altered anatomy from this procedure has an unusual radiographic appearance, confusing those unfamiliar with it. We describe the sinus lift procedure and its radiographic appearance. CONCLUSION. With knowledge of this surgery and some of its pitfalls, radiographs can be more easily and accurately interpreted. [References: 7] <2> UI - 2000171490 AU - Lopez NJ AU - Gamonal JA AU - Martinez B IN - Dr. N.J. Lopez, Casilla Postal 89, Santiago 35; Chile. E-Mail: nlopez@interactiva.cl. TI - Repeated metronidazole and amoxicillin treatment of periodontitis. A follow-up study. SO - Journal of Periodontology Vol 71(1) (pp 79-89), 2000. AB - Background: The prevailing concept is that little or no clear benefit is derived from antibiotic therapy in chronic periodontitis. Studies to determine the effect of metronidazole plus amoxicillin (M+A) on adult periodontitis are questionable because standard design for clinical trials was usually not used. In addition, there is no information about the effect of M+A as the sole therapy for periodontitis. Methods: A randomized, triple- blind, controlled clinical trial was used to determine the effect of systemic administration of M+A, as the sole therapy, in progressive adult periodontitis. Forty-six subjects with moderate to advanced adult periodontitis who showed >=2 mm attachment loss in at least 2 sites in the previous 2 months were entered in the study. Subjects were randomly distributed to a group who received 21 tablets of metronidazole 250 mg plus amoxicillin 500 mg, or to a group receiving a placebo (1 tablet every 8 hours for 1 week). Patients were examined every 2 months for 12 months. The M+A or placebo regimen was repeated at 4 and 8 months. No effort was made to change the oral habits of patients and they received no additional therapy. Differences between groups were assessed using the Mann-Whitney U test. The differences at every 2-month interval within each group were assessed using the ANOVA test. Results: Seven subjects abandoned the study; at 12 months the M+A group had 20 subjects and the placebo group 19. There were no significant differences in the clinical parameters at baseline between the 2 groups. After 2 months and thereafter, the M+A group showed significant clinical improvement while the placebo group showed a progressive deterioration of periodontal status. At 12 months compared to baseline, subjects of the M+A group showed: 1) a significant overall mean attachment gain of 0.43 mm (P = 0.005); 2) a significant decrease of active sites (P <=0.03); 3) a significant increase of sites gaining attachment level (P <= 0.01); 4) a significant reduction of pocket depth (P <= 0.00006); and 5) a significant decrease in percentage of bleeding on probing sites (BOP) (P <= 0.0005). Significant differences between both groups at all 2-month evaluations were found in overall mean attachment level (P <= 0.000004), in percent of active sites (P <= 0.03), and in percent of BOP sites (P <= 0.02). Sites exhibiting >=2 mm of attachment loss in 2 successive or alternate evaluations, and periodontal abscess were noticed only in the placebo group. Conclusions: A 1- week course of systemic M+A every 4 months, as the only therapy, arrests the progression of adult periodontitis and significantly improves the clinical parameters of the disease. [References: 80] <3> UI - 2000171487 AU - Garrett S AU - Adams DF AU - Bogle G AU - Donly K AU - Drisko CH AU - Hallmon WW AU - Hancock EB AU - Hanes P AU - Hawley CE AU - Johnson L AU - Kiger R AU - Killoy W AU - Mellonig JT AU - Raab FJ AU - Ryder M AU - Stoller N AU - Polson A AU - Wang H-L AU - Wolinsky LE AU - Yukna RA AU - Harrold CQ AU - Hill M AU - Johnson VB AU - Southard GL IN - Dr. S. Garrett, Atrix Laboratories, Inc., 2579 Midpoint Dr., Fort Collins, CO 80525-4417; United States. TI - The effect of locally delivered controlled-release doxycycline or scaling and root planing on periodontal maintenance patients over 9 months. SO - Journal of Periodontology Vol 71(1) (pp 22-30), 2000. AB - Background: This research report evaluates clinical changes resulting from local delivery of doxycycline hyclate (DH) or traditional scaling and root planing (SRP) in a group of patients undergoing supportive periodontal therapy (SPT). Methods: In all, 141 patients received either DH (67) or SRP (74) treatment in sites >=5 mm on one-half of their dentition at baseline and month 4. Results: Clinical results were determined at month 9. Baseline mean probing depth recordings were similar between the two groups (DH = 5.9 mm; SRP = 5.9 mm). Mean month 9 results showed similar clinical results for attachment level gain (DH 0.7 mm; SRP 0.8 mm) and probing depth reduction (DH 1.3 mm; SRP 1.1 mm). Percentage of sites showing >=2 mm attachment level gain at month 9 was 24.7% in the DH group and 21.2% in the SRP group. Thirty-nine percent (39%) of DH sites and 38% of SRP sites showed >=2 mm probing depth reduction. When treated sides of the dentition were compared to untreated sides, DH showed a difference in disease activity (>=2 mm attachment loss) from 19.3% (untreated) to 7.2% (treated); and SRP from 14.3% (untreated) to 8.1% (treated). Conclusions: Results show that both DH without concomitant mechanical instrumentation and SRP were equally effective as SPT in this patient group over the 9-month study period. [References: 32] <4> UI - 2000169962 AU - Valantine H IN - Dr. H. Valantine, Stanford University Hospital, CVRC, Heart/Lung Transplantation Division, Palo Alto, CA 94305; United States. TI - Neoral use in the cardiac transplant recipient. SO - Transplantation Proceedings Vol 32(3 SUPPL. 1) (pp 27S-44S), 2000. AB - Special Considerations in the Cardiac Transplant Patient: CyA is the core immunosuppressant of choice for the majority of transplant patients. The introduction of Neoral, a new microemulsion formulation of CyA, and more recently a range of adjunctive immunosuppressants have further enhanced the efficacy and tolerability of CyA-based immunosuppression. In the first year following transplantation the major causes of morbidity and death are graft failure, acute rejection, and systemic infection. Patients with deteriorated pulmonary circulation before transplantation are at increased risk of early postoperative death. Risk factors for early acute rejection include female donor sex, young donor age, and multiple HLA-DR mismatches. The principal cause of death in the long term is graft vasculopathy which accounted for 40% of all deaths. Risk factors that have been hypothesized to play a role in the pathogenesis of graft vasculopathy 4 include hyperlipidemia, recipient age and gender, donor age, the number of HLA AB and DR mismatches, and CMV infection. Strategies proposed to reduce the risk of graft vasculopathy include aggressive use of lipid-lowering agents, avoidance of low CyA doses, and the use of adjunctive rapamycin or RAD therapy. Rejection surveillance therefore relies on routine serial endomyocardial biopsy. Recent research suggests that a more accurate assessment of the state of the graft can be obtained by considering the results across a number of biopsy samples obtained from different parts of the heart, rather than basing clinical judgment on the worst single result obtained. New molecular markers such as granzyme A mRNA are likely to improve the power of histology to diagnose and predict rejection. Neoral Immunosuppression in De Novo Patients: Neoral pharmacokinetics give greater bioavailability and less intrapatient variability than Sandimmune. In the keynote OLN 351 study comparing Neoral with Sandimmune in de novo heart transplant recipients, fewer Neoral patients needed antilymphocyte therapy to treat rejection, fewer female patients had rejection episodes in the Neoral group, the tolerability of the two formulations was equivalent, and there was a lower incidence of infections in the Neoral group. The clinical impact of Neoral in comparison with Sandimmune in de novo heart transplant patients has been investigated in a number of additional trials, including long-term studies, which have confirmed that Neoral is associated with: Lower CyA doses than Sandimmune. Equal or greater antirejection efficacy than Sandimmune. Comparable tolerability to Sandimmune. During the administration of intravenous CyA as an induction therapy in the days immediately following transplantation, there is evidence to suggest that a 6-hour infusion given twice daily, which mimics the pharmacokinetic profile of oral dosing, may be clinically more effective than a continuous 24-hour infusion. Neoral Immunosuppression in the Maintenance Patient: Milligram-for-milligram dose conversion from Sandimmune to Neoral is feasible. Following conversion, a reduction in the CyA dose may be required in the majority of patients to maintain target levels. In pediatric patients, the rate of elimination of CyA is greater and bioavailability increases with increasing age. Younger patients (less than 8 years of age) may be managed more effectively with a 3-times-daily, rather than a twice-daily dosing schedule. A number of studies have compared the clinical effects of Sandimmune and Neoral in maintenance therapy for cardiac transplant patients. As with de novo patients, these studies have found the new formulation of CyA to be associated with lower rates of acute rejection, lower therapeutic doses, and comparable tolerability. Milligram-to-milligram conversion from the old to the new CyA formulation is generally well tolerated, although in a minority of patients there is a significant increase in CyA levels. These may be associated with a transient increase in side effects which resolve on dose reduction. There is a dose-sparing effect with Neoral. Routine monitoring of both CyA and serum creatinine levels are advisable to optimize the tolerability and safety of therapy. Recent research indicates that drug monitoring 2 hours after CyA dosing provides a more accurate indication of AUC than trough level measurements. Patients with persistently low CyA levels are likely to be at increased risk of graft loss due to both acute rejection and chronic graft vasculopathy. New evidence suggests the use of C-2 CyA level monitoring to determine whether adequate drug is being absorbed. This TDM approach is not only recommended as a diagnostic tool but as a method for optimising Neoral immunosuppression. Long-term Side Effects of CyA Therapy: The major long-term safety problems directly associated with CyA-based immunosuppression include nephrotoxicity, hypertension, diabetes mellitus, and PTLD. CyA nephrotoxicity No clear risk factors for CyA nephrotoxicity have been identified and no correlation has been observed between CyA levels and serum creatinine levels. Overactivation of the renin-angiotensin system may play a role in the development of CyA nephrotoxicity, in which case early introduction of an ACE inhibitor would be expected to be of benefit. This possibility has yet to be investigated in a clinical trial. Reducing the CyA dose to treat renal dysfunction should be carried out with care, because this increases the risk of acute rejection. The introduction of additional, non- nephrotoxic adjunctive therapies such as MMF should be considered when substantially reducing the CyA dose. Hypertension: Management of hypertension requires careful attention to dietary sodium intake. Reducing the dose of CyA - as well as steroids, which also contribute to the problem - is important although care must be taken to avoid increasing the risk of rejection. The use of nonsteroidal anti-inflammatory agents should be avoided in hypertensive patients receiving CyA, because this may lead to further impairment of renal function. Because hypertension is often at its greatest in the early morning in cardiac transplant patients and the normal diurnal variation in blood pressure is absent, optimal management is often achieved by giving larger doses of antihypertensive agents at bedtime. PTLD: The optimal treatment for PTLD has not yet been determined, but strategies involving a reduction of immunosuppression in combination with aggressive chemotherapy have reported significant success. Prophylactic use of antiviral therapy is also recommended. Diabetes and Steroid Withdrawal: Steroid-sparing protocols are an important strategy for reducing posttransplant diabetes and should especially be considered in patients judged on the basis of preoperative metabolic parameters to be at a high risk of developing diabetes. Although steroid-sparing protocols are undoubtedly beneficial to many patients receiving immunosuppression with CyA or other agents, there is continuing debate over the clinical benefits of complete steroid withdrawal. Adjunct Immunosuppression Agents: Although CyA remains the cornerstone of maintenance immunosuppression therapy, the use of new adjunctive agents can reduce the risk of rejection; enable lower, better-tolerated doses of CyA and steroids to be administered; and enable therapy to be better tailored to clinical needs. Simulect (basiliximab) and daclizumab induction therapy within a CyA-based protocol has been shown to be highly effective in reducing the incidence of early acute rejection episodes in two major trials in renal transplantation, and similar results are anticipated in heart transplantation. Substitution of MMF for azathioprine reduces the frequency and severity of acute rejection episodes, may delay the development of chronic graft vasculopathy, and may improve patient survival in CyA-treated heart transplant patients. Sirolimus (rapamycin) and RAD have complementary mode of action to CyA. Early indications are that they offer significant clinical benefits in heart transplantation, including reduced rejection rates, lower CyA toxicity through reduced doses, and possibly a reduced incidence of chronic graft vasculopathy. Tacrolimus has a similar mode of action to CyA and the two agents should not be used in combination. In terms of clinical outcomes, no clear advantage has been demonstrated for either agent in comparison with the other. However, in some circumstances it may be appropriate to switch patients from CyA to tacrolimus-based therapy or vice versa, either to treat refractory rejection in CyA patients, or to treat severe tacrolimus toxicity. A range of options is available for the treatment of acute rejection; these options vary according to rejection severity and persistence. Many of these use adjunctive immunosuppressants including MMF, rapamycin, or RAD. [References: 80] <5> UI - 2000169346 AU - Langeron O AU - Masso E AU - Huraux C AU - Guggiari M AU - Bianchi A AU - Coriat P AU - Riou B IN - Dr. O. Langeron, Departement d'Anesthesie-Reanimation, Groupe Hospitalier Pitie-Salpetriere, 47 Boulevard de l'Hopital, 75651 Paris Cedex 13; France. E-Mail: olivier.langeron@psl.ap-hop-paris.fr. TI - Prediction of difficult mask ventilation. SO - Anesthesiology Vol 92(5) (pp 1229-1236), 2000. AB - Background: Maintenance of airway patency and oxygenation are the main objectives of face-mask ventilation. Because the incidence of difficult mask ventilation (DMV) and the factors associated with it are not well known, we undertook this prospective study. Methods: Difficult mask ventilation was defined as the inability of an unassisted anesthesiologist to maintain the measured oxygen saturation as measured by pulse oximetry > 92% or to prevent or reverse signs of inadequate ventilation during positive-pressure mask ventilation under general anesthesia. A univariate analysis was performed to identify potential factors predicting DMV, followed by a multivariate analysis, and odds ratio and 95% confidence interval were calculated. Results: A total of 1,502 patients were prospectively included. DMV was reported in 75 patients (5%; 95% confidence interval, 3.9-6.1%), with one case of impossible ventilation. DMV was anticipated by the anesthesiologist in only 13 patients (17% of the DMV cases). Body mass index, age, macroglossia, beard, lack of teeth, history of snoring, increased Mallampati grade, and lower thyromental distance were identified in the univariate analysis as potential DMV risk factors. Using a multivariate analysis, five criteria were recognized as independent factors for a DMV (age older than 55 yr, body mass index > 26 kg/m2, beard, lack of teeth, history of snoring), the presence of two indicating high likelihood of DMV (sensitivity, 0.72; specificity, 0.73). Conclusion: In a general adult population, DMV was reported in 5% of the patients. A simple DMV risk score was established. Being able to more accurately predict DMV may improve the safety of airway management. [References: 26] <6> UI - 2000160414 AU - Iida H AU - Naito T AU - Sakai N AU - Aoki S IN - H. Iida, Department of Medicine, Toyama Prefectural Central Hospital, 2-278 Nishinagae, Toyama-shi 930-8550; Japan. TI - Effect of cyclosporine therapy on idiopathic membranous nephropathy presented with refractory nephrotic syndrome. SO - CLIN EXP NEPHROL, Vol 4(1) (pp 81-85), 2000. AB - Background. Recent studies suggested the possible benefits of cyclosporine (CsA) therapy in patients with membranous nephropathy, although most of these studies were short-term. An uncontrolled retrospective study was undertaken to evaluate the long-term effect of CsA therapy on idiopathic membranous nephropathy presented with refractory nephrotic syndrome. Methods. The subjects were eight patients with idiopathic membranous nephropathy presenting with refractory nephrotic syndrome. All patients had received a course of corticosteroid therapy before CsA therapy, and had not responded to the corticosteroid, including one or two administrations of intravenous methylprednisolone pulse therapy. The CsA doses were adjusted to maintain trough blood level at 100 ng/ml during the first 3 months and then reduced to maintain the level at 50 ng/ml in patients who had responded to partial remission. Results. CsA therapy induced a marked decrease in proteinuria from the first month, and a significant decrease from month 3 and thereafter. The mean serum total protein and albumin levels rose, and total cholesterol fell significantly with CsA therapy. The serum creatinine level was unchanged during CsA therapy. Three patients showed complete remission and two were in partial remission, while three were nephrotic at 12 months of CsA therapy. From 18 to 24 months of CsA therapy, three patients were in complete remission, four were in partial remission, and one patient was nephrotic. There were no side effects of CsA, except for gum hyperplasia and hypertrichosis in one patient. Conclusion. These results suggest that long- term CsA therapy at a low or moderate dose is potentially effective and safe in most nephrotic patients with idiopathic membranous nephropathy refractory to corticosteroid therapy. [References: 15] <7> UI - 2000153847 AU - Mohite U AU - Das M AU - Parikh PM AU - Saikia TK AU - Gopal R AU - Mohite M AU - Paul A AU - Todankar H AU - Advani SH IN - Dr. P.M. Parikh, Dept. of Hematol. and Med. Oncology, Tata Memorial Hospital, Parel, Mumbai 400 012; India. TI - Cyclosporine associated fever in a patient undergoing allogeneic bone marrow transplantation. SO - INDIAN J HEMATOL BLOOD TRANSFUS, Vol 18(1) (pp 11+10), 2000. AB - Cyclosporine (CSA) is the mainstay of both prevention and treatment of graft versus host disease (GVHD) in the allogeneic bone marrow transplant (BMT) setting. Its use is associated with side effects like nephrotoxicity, hypertension, hirsutism, tremors, seizures and gum hypertrophy. We report here a case of cyclosporine induced fever in a patient undergoing allogeneic Bone Marrow Transplant - a rare case of drug induced pyrexia. [References: 8] <8> UI - 2000150506 AU - Sakamoto H AU - Suzuki Y AU - Watanabe D AU - Yanagimachi N AU - Sasaki J IN - Dr. H. Sakamoto, Department of Oral Surgery, Tokai University School of Medicine, Boseidai, Isehara, Kanagawa 259-1193; Japan. E-Mail: sakamoto@is.icc.u-tokai.ac.jp. TI - Ga-67 scintigram in the diagnosis of infection of masticator muscles due to an odontogenic infection. SO - Clinical Nuclear Medicine Vol 25(5) (pp 383-384), 2000. AB - A 36-year-old man had a mandibular swelling and severe difficulty opening his mouth. His left lower wisdom tooth had been extracted 2 days before. He had a high fever (39 [degree] C), leukocytosis (9,300/ml), and an elevated C-reactive protein level (9.66 mg/ml). Ga-67 scintigraphy showed intense uptake in the mandible and masticator muscles. SPECT images displayed in maximum intensity projection format clearly defined the inflamed internal and external pterygoid muscles and masseter and temporalis muscles. Although each masticator muscle was severely swollen by the infection, the fascial structure was well preserved. Repeated antibiotic therapy ultimately controlled the infection. [References: 2] <9> UI - 2000143005 AU - Trope C AU - Kaern J AU - Hogberg T AU - Abeler V AU - Hagen B AU - Kristensen G AU - Onsrud M AU - Pettersen E AU - Rosenberg P AU - Sandvei R AU - Sundfor K AU - Vergote I IN - C. Trope, Department of Gynecologic Oncology, Norwegian Radium Hospital, Montebello, N-0310 Oslo; Norway. E-Mail: claes.trope@klinmed.uio.no. TI - Randomized study on adjuvant chemotherapy in stage I high-risk ovarian cancer with evaluation of DNA-ploidy as prognostic instrument. SO - Annals of Oncology Vol 11(3) (pp 281-288), 2000. AB - Purpose: Adjuvant chemotherapy versus observation and chemotherapy at progression was evaluated in 162 patients in a prospective randomized multicenter study. We also evaluated DNA-measurements as an additional prognostic factor. Patients and methods: Patients received adjuvant carboplatin AUC 7 every 28 days for six courses (n = 81) or no adjuvant treatment (n = 81). Eligibility included surgically staged and treated patients with FIGO stage I disease, grade 1 aneuploid or grade 2 or 3 non- clear cell carcinomas or clear cell carcinomas. Disease-free (DFS) and disease-specific (DSS) survival were end-points. Results: Median follow-up time was 46 months and progression was observed in 20 patients in the treatment group and 19 in the control group. Estimated five-year DFS and DSS were 70% and 86% in the treatment group and 71% and 85% in the control group. The hazard ratio was 0.98 (95% confidence interval (95% CI): 0.52-1.83) regarding DFS and 0.94 (95% CI: 0.37-2.36) regarding DSS. No significant differences in DFS or DSS could be seen when the log-rank test was stratified for prognostic variables. Therefore, data from both groups were pooled for the analysis of prognostic factors. DNA-ploidy (P = 0.003), extracapsular growth (P = 0.005), tumor rupture (P = 0.04), and WHO histologic grade (P = 0.04) were significant independent prognostic factors for DFS with P < 0.0001 for the model in the multivariate Cox analysis. FIGO substage (P = 0.01), DNA ploidy (P < 0.05), and histologic grade (P = 0.05) were prognostic for DSS with a P-value for the model < 0.0001. Conclusions: Due to the small number of patients the study was inconclusive as regards the question of adjuvant chemotherapy. The survival curves were superimposable, but with wide confidence intervals. DNA-ploidy adds objective independent prognostic information regarding both DFS and DSS in early ovarian cancer. [References: 53] <10> UI - 2000139512 AU - Alexandrakis G AU - Hubbell RN AU - Aitken PA IN - Dr. G. Alexandrakis, Bascom Palmer Eye Institute, Univ. of Miami School of Medicine, Miami, FL; United States. TI - Nasolacrimal duct obstruction secondary to ectopic teeth. SO - Ophthalmology Vol 107(1) (pp 189-192), 2000. AB - Objective: To describe two patients with nasolacrimal duct obstruction (NLDO) caused by ectopic eruption of teeth. The literature concerning nasal and other unusual ectopic sites of tooth eruption is reviewed. Design: Two interventional case reports and literature review. Participants: A 3-year-old girl with epiphora and recurrent dacryocystitis of the right eye. Previous medical and surgical management was unsuccessful. A 32-year-old female with a long history of right eye discomfort and epiphora. Previous examinations and workup were negative. Intervention: A computed tomographic (CT) scan of the orbits and sinuses was performed in both patients. The ectopic teeth were surgically removed. Main Outcome Measures: Nasolacrimal system function and response to treatment at the last follow-up were recorded. Results: In the first patient, CT imaging disclosed two teeth within the right inferior meatus compressing the nasolacrimal duct. In the second patient, CT revealed a large dental structure in the maxillary sinus compressing the nasolacrimal duct. Endoscopic tooth extraction and nasolacrimal duct probing in the first patient and surgical removal of the dental structure in the second patient effected complete resolution of symptoms. Both patients were symptom free at last follow-up. Conclusions: These cases suggest that ectopic eruption of teeth should be added to the differential diagnosis of NLDO. Surgical removal of the ectopic teeth compressing the nasolacrimal duct results in resolution of the lacrimal drainage obstruction. (C) 2000 by the American Academy of Ophthalmology. [References: 30] <11> UI - 2000136980 AU - Jeremic B AU - Shibamoto Y AU - Milicic B AU - Nikolic N AU - Dagovic A AU - Aleksandrovic J AU - Vaskovic Z AU - Tadic L IN - Dr. B. Jeremic, Department of Radiotherapy, University Hospital, Hoppe-Seyler-Strasse 3, D-72076 Tuebingen; Germany. E-Mail: bjeremic@med.uni-tuebingen.de. TI - Hyperfractionated radiation therapy with or without concurrent low-dose daily cisplatin in locally advanced squamous cell carcinoma of the head and neck: A prospective randomized trial. SO - Journal of Clinical Oncology Vol 18(7) (pp 1458-1464), 2000. AB - Purpose: To investigate whether the addition of cisplatin (CDDP) to hyperfractionation (Hfx) radiation therapy (RT) offers an advantage over the same Hfx RT given alone in locally advanced (stages III and IV) squamous cell carcinoma of the head and neck. Patients and Methods: One hundred thirty patients were randomized to receive either Hfx RT alone to a tumor dose of 77 Gy in 70 fractions in 35 treatment days over 7 weeks (group 1, n = 65) or the same Hfx RT and concurrent low-dose (6 mg/m2) daily CDDP (group II, n = 65). Results: Hfx RT/chemotherapy offered significantly higher survival rates than Hfx RT alone (68% v 49% at 2 years and 46% v 25% at 5 years; P = .0075). It also offered higher progression-free survival (46% v 25% at 5 years; P = .0068), higher locoregional progression-free survival (LRPFS) (50% v 36% at 5 years; P = .041), and higher distant metastasis-free survival (DMFS) (86% v 57% at 5 years; P = .0013). However, there was no difference between the two treatment groups in the incidence of either acute or late high-grade RT- induced toxicity. Hematologic high-grade toxicity was more frequent in group II patients. Conclusion: As compared with Hfx RT alone, Hfx RT and concurrent low-dose daily CDDP offered a survival advantage, as well as improved LRPFS and DMFS. (C) 2000 by American Society of Clinical Oncology. [References: 44] <12> UI - 2000133909 AU - Owen H AU - Waddell-Smith I IN - Dr. H. Owen, Department of Anaesthesia, Flinders Medical Centre, Bedford Park, SA 5042; Australia. TI - Dental trauma associated with anaesthesia. SO - Anaesthesia & Intensive Care Vol 28(2) (pp 133-145), 2000. AB - Damage to teeth is the most common complaint against anaesthetists. A dental history and oral examination are important before anaesthesia. Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected. The maxillary central incisors are most at risk. Certain diseases and drugs should alert anaesthetists to increased likelihood of dental pathology. The flange of the Macintosh blade appears responsible for much damage and alternative equipment or techniques of endotracheal intubation should be considered, particularly when risk factors are present. Manoeuvres to protect teeth must not impact adversely on airway management. Custom mouthguards can be useful. A management plan can help control losses if damage does occur. Patients should be warned about the possibility of dental trauma. [References: 108] <13> UI - 2000132925 AU - Newacheck PW AU - Hughes DC AU - Hung Y-Y AU - Wong S AU - Stoddard JJ IN - Dr. P.W. Newacheck, Institute for Health Policy Studies, Department of Pediatrics, University of California, San Francisco, CA 94143; United States. TI - The unmet health needs of America's children. SO - Pediatrics Vol 105(4 II) (pp 989-997), 2000. AB - Objective. Unmet need for health care is a critical indicator of access problems. Among children, unmet need for care has special significance inasmuch as the failure to obtain treatment can affect health status and functioning in the near- and long-term. The purpose of this study was to present current prevalence estimates and descriptive characteristics of children with unmet health needs using nationally representative household survey data. Methods. We analyzed 4 years of National Health Interview Survey data spanning 1993 through 1996. Our analysis included 97 206 children <18 years old. Measures of unmet need for medical care, dental care, prescription medications, and vision care were obtained from an adult household member (usually the mother) responding for the child. Bivariate and multivariate analyses were used to assess the degree to which unmet need was related to the demographic and socioeconomic characteristics of the child and family. Results. Overall, 7.3% (4.7 million) of US children experienced at least 1 unmet health care need. Dental care was the most prevalent unmet need. After adjustment for confounding factors, near-poor and poor children were both about 3 times more likely to have an unmet need as nonpoor children (adjusted odds ratio [95% confidence interval] = 2.89 [2.52, 3.32], 3.0 [2.53, 3.56], respectively). Uninsured children were also about 3 times more likely to have an unmet need as privately insured children (adjusted odds ratio [95% confidence interval] = 2.92 [2.58, 3.32]). Conclusions. Despite the nation's great wealth, unmet health needs remain prevalent among US children. A combined public policy that addresses financial and nonfinancial barriers to care is required to reduce the prevalence of unmet need for health care. [References: 18] <14> UI - 2000131290 AU - Meechan JG IN - Dr. J.G. Meechan, Dept. of Oral and Maxifacial Surgery, University of Newcastle upon Tyne, Newcastle upon Tyne; United Kingdom. E-Mail: J.G. Meechan@ncl.ac.uk. TI - The effect of mandibular third molar presence and position on the risk of an angle fracture. SO - Journal of Oral & Maxillofacial Surgery Vol 58(4) (pp 399), 2000. <15> UI - 2000131285 AU - Stellingsma C AU - Meijer HJA AU - Raghoebar GM IN - Dr. C. Stellingsma, Department of Oral/Maxfac. Surg., University Hospital Groningen, PO Box 30.001, 9700 RB Groningen; Netherlands. E-Mail: c.stellingsma@kchir.azg.nl. TI - Use of short endosseous implants and an overdenture in the extremely resorbed mandible: A five-year retrospective study. SO - Journal of Oral & Maxillofacial Surgery Vol 58(4) (pp 382-387), 2000. AB - Purpose: A retrospective study was performed to assess the success of short endosseous implants in combination with an implant-retained overdenture in the extremely resorbed mandible. Patients and Methods: Patients included had a mandible not exceeding a median height of 12 mm measured on a standardized lateral cephalometric radiograph. Seventeen patients (14 women, 3 men; mean age, 65 years) with 68 endosseous implants were clinically and radiographically evaluated. Results: During the follow-up period (mean, 77 months; range, 60 to 97 months), 8 implants were lost, bringing the cumulative survival rate to 88%. The peri-implant tissues were in good condition, and the bone loss around the implants was minimal. Conclusion: Because of the relative simplicity and low morbidity of this treatment strategy, it is a justified treatment option. [References: 35] <16> UI - 2000129177 AU - Adamolekun B AU - Mielke J AU - Ball D AU - Mundanda T IN - B. Adamolekun, 2255 S. Koke Mill Road, Springfield, IL 62707; United States. TI - An evaluation of the management of epilepsy by primary health care nurses in Chitungwiza, Zimbabwe. SO - Epilepsy Research Vol 39(3) (pp 177-181), 2000. AB - In order to design an effective training program for nurses on the management of epilepsy in Zimbabwe, the drug management of epilepsy by community health nurses without prior training in epilepsy management was evaluated. Epilepsy patients in Chitungwiza, a high-density suburb of Harare, were routinely managed at four health clinics run by nurses. The patients also attended a monthly epilepsy support group (ESG) program, which provided them with vocational and social rehabilitative support. Neurologists evaluated the drug therapy of all patients attending this support group program over a 2-year period. The specialist interventions required to drug therapy in patients with inadequate seizure control or drug side effects were noted. A total of 114 epilepsy patients (age range 8-56 years, M:F=1:1.2) were seen, of these 84.2% had generalized seizures, 40.3% of patients had been seizure-free for at least 6 months, 71.9% of patients were on phenobarbitone, while 59.6% were on monotherapy. No drug intervention was required to on-going drug therapy in 43% of patient consultations. The most important intervention in patients with inadequate seizure control was an increase in drug dose, required in 29% of consultations. Of serum drug level estimations in clinically indicated cases, 58% were below the therapeutic ranges. This tendency to sub-therapeutic dosing with AED amongst nurses implied that a written AED drug therapy protocol specifying optimal maintenance doses and dose increment schedules may be beneficial to the community-based nursing management of epilepsy. Copyright (C) 2000 Elsevier Science B.V. [References: 8] <17> UI - 2000126244 AU - Drosos AA AU - Voulgari PV AU - Katsaraki A AU - Zikou AK IN - A.A. Drosos, Department of Internal Medicine, Medical School, University of Ioannina, 451 10 Iounnina; Greece. TI - Influence of cyclosporin A on radiological progression in early rheumatoid arthritis patients: A 42-month prospective study. SO - Rheumatology International Vol 19(3) (pp 113-118), 2000. AB - The aim of this study was to evaluate whether cyclosporin A (CsA) influences the radiological disease progression in early rheumatoid arthritis (RA) patients in comparison with other disease-modifying drugs (DMARDs). A total of 103 early RA patients, without prior use of DMARDs, were randomized to receive CsA (3 mg/kg per day) or methotrexate (MTX) (0.15 mg/kg per week). In addition, all patients received prednisone (7.5 mg/day). After 42 months of treatment, pairs of hand and wrist radiographs of 41 patients treated with CsA and 42 treated with MTX were evaluated blindly and separately by two investigators, using reference radiographs for scoring. A scale scoring similar to Larsen's standard radiographs with minor modifications was used. The studied radiographs were obtained at the beginning and 42 months after therapy in both groups. Patients in both groups responded beneficially to the above treatment regimens. In the CsA group, 37 patients (71 %) remained radiographically stable and 4 worsened, while in the MTX group 39 patients (76%) remained stable and 3 deteriorated. No significant radiological worsening was found in the CsA-treated patients as compared to those treated with MTX. Early immunointervention in RA patients appears to be crucial for the future development of joint damage. CsA can delay radiological disease progression and may inhibit joint damage deterioration in early RA patients. [References: 39] <18> UI - 2000125870 AU - Song Q AU - Lange T AU - Spahr A AU - Adler G AU - Bode G IN - Dr. G. Bode, Department of Internal Medicine I, University of Ulm, Ulm; Germany. TI - Characteristic distribution pattern of Helicobacter pylori in dental plaque and saliva detected with nested PCR. SO - Journal of Medical Microbiology Vol 49(4) (pp 349-353), 2000. AB - The precise mode of transmission and the natural reservoir for Helicobacter pylori are unknown. PCR assays have proved to be highly sensitive and specific and are regarded as the method of choice for detecting H. pylori DNA in the oral cavity. The aim of this study was to investigate the prevalence and distribution of H. pylori in the oral cavity. Forty-two patients undergoing gastroscopy were investigated for the presence of H. pylori in dental plaque and saliva by nested PCR, and in the stomach by the 13C-urea breath test. Samples tested comprised dental plaque from molars, premolars and incisors and saliva. Two sets of primers homologous to the 860-bp fragment of H. pylori DNA, which have been shown previously to be highly sensitive and specific, were used for nested PCR. Eleven patients (26.2%) were infected with H. pylori in the stomach. H. pylori DNA was identified in dental plaque samples from 41 patients (97%) and in 23 saliva samples (55%), The prevalence in dental plaque from molars, premolars and incisors was 82%, 64% and 59%, with an odds ratio of 3.18, 1.24 and 1 (reference), respectively. In conclusion, H. pylori was present in the oral cavity of 97% of tested patients, with a characteristic distribution that was independent of the infection status of the stomach. Thus H. pylori may belong to the normal oral microflora. [References: 38] <19> UI - 2000122244 AU - Oeffinger KC AU - Eshelman DA AU - Tomlinson GE AU - Buchanan GR AU - Foster BM IN - Dr. K.C. Oeffinger, Dept. of Family Pract./Commun. Med., Texas Univ. Southwestern Med. Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9067; United States. TI - Grading of late effects in young adult survivors of childhood cancer followed in an ambulatory adult setting. SO - Cancer Vol 88(7) (pp 1687-1695), 2000. AB - BACKGROUND. The objective of the current study was to describe a multidisciplinary transition program for following young adult survivors of childhood cancer in an adult-based ambulatory medical setting and to report the late effects with grades of toxicity diagnosed in all adult survivors followed in the program. METHODS. The study population was comprised of all young adult survivors (n = 96) of childhood cancer who were seen in the After the Cancer Experience (ACE) Young Adult Program prior to January 31, 1999. The median age of the survivors was 22.8 years (range, 17-34 years) and the median interval from the time of cancer diagnosis was 15.2 years (range, 6-25 years). Primary cancer groups included: leukemia, 33%; sarcoma, 24%; Hodgkin disease, 15%; non-Hodgkin lymphoma, 12%; Wilms' tumor, 9%; and other, 7%. Late effects were graded using the Common Toxicity Criteria, Version 2 (CTCv2), developed by the National Cancer Institute. RESULTS. Approximately 69% of the patients (66 of 96) had at least 1 late effect. Thirty-three percent of patients had a single late effect whereas 36% had >= 2 late effects. Thirty percent of patients had a CTCv2 Grade 3 or 4 late effect. CONCLUSIONS. The current study represents an example of a successful multidisciplinary transition program in an ambulatory, adult setting for young adult survivors of childhood cancer. Late effects of cancer treatment are common in young adult survivors, with approximately 33% being moderate to severe. Further studies are needed to modify CTCv2-with the aim of developing a reliable and valid tool to assess late effects in long term survivors of childhood cancer. (C) 2000 American Cancer Society. [References: 25] <20> UI - 2000118364 AU - Kaye D IN - Dr. D. Kaye, MCP Hahnemann School of Medicine, Philadephia, PA; United States. TI - Infective endocarditis: Keeping a killer at bay. SO - Consultant Vol 40(3) (pp 622-626), 2000. <21> UI - 2000119643 AU - King A AU - Upadhyaya M AU - Penney C AU - Doshi R IN - A. King, Department of Neuropathology, Institute of Psychiatry, De Crespigny Park, London SE5 8AF; United Kingdom. TI - A case of Miller-Dieker syndrome in a family with neurofibromatosis type I. SO - Acta Neuropathologica Vol 99(4) (pp 425-427), 2000. AB - The Miller-Dieker syndrome (type I lissencephaly) is a neuronal migration disorder which is associated with microdeletions in the short arm of chromosome 17. Neurofibromatosis type I (NF1) is an autosomal dominant condition associated with mutations in the long arm of chromosome 17, and characterised by neurofibromas, cafe-au-lait spots and axillary freckling. The neonatal period for a female infant born at 39 weeks gestation by emergency Caesarean section was complicated by frequent epileptic seizures as well as hypotonia. A computed tomography scan revealed evidence of lissencephaly, and chromosomal analysis showed a microdeletion on the short arm of chromosome 17 (17p13.3), confirming the diagnosis as Miller-Dieker syndrome. The child died at the age of 4 years and examination of the brain confirmed lissencephaly with a thickened cortex, deficient white matter, and grey matter heteropias. The mother had cafe-au-lait spots, and axillary freckling. In addition, the mother's and maternal grandmother's genetic analysis showed identical mutations in the neurofibromatosis I gene on the long arm of chromosome 17, confirming the diagnosis of NF1. The child did not possess the mutation. This case illustrates a rare neuronal migration disorder appearing in a child from a family with a history of NF1. [References: 11] <22> UI - 2000118164 AU - Sy M AU - Zalcman M AU - Struyven J IN - M. Sy, Department of Radiology, Free University of Brussels, Brussels; Belgium. TI - Intraabdominal desmoid tumor. SO - Journal Belge de Radiologie Vol 83(1) (pp 24), 2000. <23> UI - 2000117356 AU - Ashcroft DM AU - Po ALW AU - Griffiths CEM IN - Prof. A.L.W. Po, Ctr. Evidence-Based Pharmacotherapy, School of Life and Health Sciences, Aston University, Birmingham B4 7ET; United Kingdom. E-Mail: a.liwanpo@aston.ac.uk. TI - Therapeutic strategies for psoriasis. SO - Journal of Clinical Pharmacy & Therapeutics Vol 25(1) (pp 1-10), 2000. AB - Psoriasis is a chronic, inflammatory, hyperproliferative skin disease that affects approximately 1-2% of the general population in the U.K. and U.S.A. It is rarely life-threatening, but causes considerable patient morbidity. The disease waxes and wanes, with substantial variability both between and within individual patients. There is no cure for psoriasis; therefore, the aim of treatment is to minimize the extent and severity of the disease to the point at which it no longer disrupts substantially the patient's quality of life. We review the current treatment options, which include topical therapies, phototherapy and systemic agents. Lack of efficacy, adverse effects and aesthetic problems limit the use of many topical therapies. Likewise, the risk of toxicity is a major problem with currently available phototherapies and systemic treatments. Advances in understanding the aetiology and pathogenesis of psoriasis allude to the possibility of innovative, targeted therapies in the future. [References: 38] <24> UI - 2000106072 AU - Canavan TP AU - Radosh L IN - Dr. L. Radosh, Dept. of Family and Community Med., Lancaster General Hospital, 555 N Duke St, Lancaster, PA 17604-3555; United States. E-Mail: radosh@pol.net. TI - Managing endometriosis: Strategies to minimize pain and damage. SO - Postgraduate Medicine Vol 107(3) (pp 213-224), 2000. AB - Endometriosis is a common condition affecting a significant number of women of childbearing age. The diagnosis is clinical and thus can be difficult to make. History taking is generally most helpful, and diagnostic tests have a limited role. Diagnostic laparoscopy remains the 'gold standard' for diagnosis of endometriosis. Treatment is geared toward improving fertility and controlling pain and is often not curative. However, both medical and surgical therapies are of value in controlling the disease. Attention to the psychosocial needs of the patient are also critical. Future therapies will be based on a further understanding of the pathogenesis of endometriosis and the effect of hormones on the disease. For the primary care physician who may not be comfortable prescribing GnRH analogs or other medical therapies, referral to a gynecologist or endocrinologist should be considered. [References: 34] <25> UI - 2000101613 AU - Aurouze C AU - Moller ET AU - Bevis RR AU - Rehm K AU - Rudney J IN - Dr. C. Aurouze, Le mont d'or, 83110 Sanary Sur Mer; France. E-Mail: cath005@yahoo.com. TI - The presurgical status of the alveolar cleft and success of secondary bone grafting. SO - Cleft Palate-Craniofacial Journal Vol 37(2) (pp 179-184), 2000. AB - Objective: The primary purpose of this study was to evaluate presurgical status of the alveolar cleft site and success of secondary alveolar bone grafting. Design: Thirty patient records were retrospectively reviewed. Patients selected for inclusion had isolated cleft of at least the primary palate. Patients with additional anomalies were not selected. The study population consisted of 15 female sites and 16 male cleft sites. There were two bilateral cleft lip and palate (CLP) patients and 28 unilateral CLP patients. The age at the time of the secondary alveolar bone grafting ranged from 7 years to 14 years, 4 months. Setting: The study was conducted at the Cleft Palate Clinic at the University of Minnesota, School of Dentistry. Method: Presurgical radiographs taken at least 1 month prior to the secondary bone grafting and postsurgical radiographs taken at least 6 months after bone surgery were measured. Measurements included size of the cleft defect and bone support for distal and mesial teeth adjacent to the cleft. Evaluation of success was determined on the basis of postsurgical measurements of satisfactory, intermediate, and unsatisfactory outcomes. Results and Conclusion: The size of the cleft defect was not correlated with the success rate of the secondary alveolar bone grafting. If the amount of distal bone support for the mesial tooth was the same as those in a periodontally healthy individual, a satisfactory outcome was 5.8 times more likely. If the amount of mesial bone support for the distal tooth was the same as those in a periodontally healthy individual, the satisfactory outcome was 3.8 times more likely. Although not a primary purpose of the study, it was found that in this study population, if the patient was female, a satisfactory outcome was 3.8 times more likely. [References: 18] <26> UI - 2000099877 AU - Magliulo G AU - Varacalli S AU - Ciofalo A IN - Dr. G. Magliulo, via Gregorio VII 80, 00165 Rome; Italy. TI - Osteomyelitis of the skull base with atypical onset and evolution. SO - Annals of Otology, Rhinology & Laryngology Vol 109(3) (pp 326-330), 2000. AB - Skull base osteomyelitis arises as a complication of malignant external otitis, but it can be also due to middle ear and/or mastoid infection. Other causes can be infections of the paranasal sinuses or of the mandible or maxilla due to odontic caries. Generally, osteomyelitis involves elderly patients affected by diabetic immunodeficiency or microvascular disease. In this paper, we present 3 new cases of skull base osteomyelitis with atypical onset and evolution. The difficulties of diagnosis and details of the management are discussed. [References: 18] <27> UI - 2000098196 AU - Mishory A AU - Yaroslavsky Y AU - Bersudsky Y AU - Belmaker RH IN - Dr. R.H. Belmaker, Beersheva Mental Health Center, P.O. Box 4600, Beersheva; Israel. E-Mail: belmaker@bgumail.bgu.ac.il. TI - Phenytoin as an antimanic anticonvulsant: A controlled study. SO - American Journal of Psychiatry Vol 157(3) (pp 463-465), 2000. AB - Objective: Phenytoin, a classical anticonvulsant, shares with antimanic anticonvulsants the property of blockade of voltage-activated sodium channels. The authors therefore planned a trial of phenytoin for mania. Method: Patients with either bipolar I disorder, manic type, or schizoaffective disorder, manic type, entered a 5-week, double-blind controlled trial of haloperidol plus phenytoin versus haloperidol plus placebo. Of 39 patients, 30 completed at least 3 weeks and 25 completed 5 weeks. Results: Significantly more improvement was observed in the patients receiving phenytoin. Added improvement with phenytoin in scores on the Brief Psychiatric Rating Scale and Clinical Global Impression was seen in the patients with bipolar mania but not those with schizoaffective mania. Conclusions: Blockade of voltage-activated sodium channels may be a common therapeutic mechanism of many anticonvulsants given for mania, and phenytoin may be a therapeutic option for some manic patients. [References: 6] <28> UI - 2000096276 AU - Taylor DO IN - Dr. D.O. Taylor, Department of Medicine, Division of Cardiology 4A-100, University Utah Health Sciences Ctr., 50 N. Medical Drive, Salt Lake City, UT 84132; United States. TI - Immunosuppressive therapies after heart transplantation: Best, better, and beyond. SO - Current Opinion in Cardiology Vol 15(2) (pp 108-114), 2000. AB - Despite the significant advances in transplantation immunology and immunosuppressive therapies over the past 30 years, current immunosuppressive regimens are still inadequate in the majority of cardiac transplant recipients. Although short- and long-term survival rates have improved significantly, only 50% will survive 10 years and very few will survive 20 years. Complications of overimmunosuppression and underimmunosuppression account for the majority of these deaths. Only true 'immunologic' tolerance can provide the outcome we pursue, namely, prolonged allograft function and otherwise normal immune function without chronic immunosuppressive therapy and its risks. Until a successful tolerance-inducing protocol is developed, we must use the current and upcoming immunosuppressive agents and techniques. (C) 2000 Lippincott Williams and Wilkins, Inc. [References: 35] <29> UI - 2000090405 AU - Cantarovich M AU - Quantz M AU - Elstein E AU - Ergina P AU - Magnan C AU - De Varennes B IN - Dr. M. Cantarovich, Division of Transplantation, Department of Medicine, McGill University Health Ctr., 687 Pine Ave. West, Montreal, Que.; Canada. TI - Neoral dose monitoring with cyclosporine 2-hour postdose levels in heart transplant patients receiving anti-thymocyte globulin induction. SO - Transplantation Proceedings Vol 32(2) (pp 446-448), 2000. <30> UI - 2000094636 AU - Lamell CW AU - Griffen AL AU - McClellan DL AU - Leys EJ IN - A.L. Griffen, Department of Pediatric Dentistry, Ohio State University, 305 W. 12th Ave., Columbus, OH 43210; United States. E-Mail: griffen.1@osu.edu. TI - Acquisition and colonization stability of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in children. SO - Journal of Clinical Microbiology Vol 38(3) (pp 1196-1199), 2000. AB - The presence of Porphyromonas gingivalis has been shown to be a risk factor for periodontitis in adults, and Actinobacillus actinomycetemcomitans has been implicated as a pathogen in early-onset periodontitis. Both species have been shown to establish stable colonization in adults. In cross- sectional studies, both A. actinomycetemcomitans and P. gingivalis have been detected in over one-third of apparently healthy children. Information on the stability of colonization with these organisms in children could help to elucidate the natural history of the development of periodontitis. For this purpose, samples previously collected from a cohort of 222 children between the ages of 0 and 18 years and previously examined for the presence of P. gingivalis with a PCR-based assay were examined for the presence of A. actinomycetemcomitans. It was detected in 48% of subjects and, like P. gingivalis, was found at similar frequencies among children of all ages (P = 0.53), suggesting very early initial acquisition. One hundred one of the original subjects were recalled after 1 to 3 years to determine the continuing presence of both A. actinomycetemcomitans and P. gingivalis. The prevalence of both species remained unchanged at resampling. However, in most children both species appeared to colonize only transiently, with random concordance between the results of the first and second sampling. Stability of colonization was unrelated to age for A. actinomycetemcomitans, but P. gingivalis was more stable in the late teenage years. [References: 34] <31> UI - 2000093970 AU - Mele A AU - Tosti ME AU - Marzolini A AU - Moiraghi A AU - Ragni P AU - Gallo G AU - Balocchini E AU - Santonastasi F AU - Stroffolini T AU - Mauri F AU - Negrone FS AU - Colasurdo A AU - De Lisa M AU - Polani E AU - Lionetti E AU - Capozzi G AU - Nilo S AU - Dell'aquila G AU - Selva V AU - Messina V AU - D'aniello P AU - Riccio C AU - Frola A AU - Sangiuolo A AU - Ciao V AU - Iapicco S AU - Ligrone E AU - Totaro A AU - Parisi E AU - Spinazzola G AU - Ferrara MA AU - Visconti L AU - D'argenio PD AU - Rapuano G AU - Sperandeo C AU - Marra A AU - Di Cunto M AU - Trabucco ML AU - Simonetti A AU - Adamo B AU - Parlato A AU - De Crescenzo C AU - Peluso F AU - Ronga C AU - Morra G AU - Panico MG AU - Leonardi L AU - Coluccio R AU - Capone MR AU - Caiazzo AL AU - Parrella R AU - D'alessandro A AU - La Manna G AU - Castiello R AU - Pieralice E AU - Ruta A AU - Viafora S AU - Faina M AU - Pozzuoli A AU - Varrenti D AU - Fantini F AU - Miglierina I AU - Curcio LM AU - Ruiu M AU - Cigno DS AU - Mathis M AU - Angelotti G AU - Giordani E AU - Aquilani S AU - Quintiliani S AU - Ruffini P AU - Borrini BM AU - Lanciotti P AU - Palmieri M AU - Murgo G AU - Cappelletti L AU - Marchionni E AU - Alessandrini A AU - Ziglioli F AU - Verti L AU - Zatelli M AU - Gardenghi L AU - Camerlengo P AU - Greci M AU - Marcotti ML AU - Davoli A AU - Bignardi M AU - Poli A AU - Cagarelli R AU - Lambertini A AU - Errani F AU - Bulgarelli A AU - Vaccina D AU - Casolari E AU - Pezzi AM AU - Beltrami P AU - Todeschini R AU - Picciolli P AU - Rangoni R AU - et al IN - Dr. A. Mele, Reparto di Epidemiologia Clinica, Istituto Superiore di Sanita, Viale Regina Elena, 299, 00161 Roma; Italy. TI - Prevention of hepatitis C in Italy: Lessons from surveillance of type- specific acute viral hepatitis. SO - J VIRAL HEPATITIS, Vol 7(1) (pp 30-35), 2000. AB - Using data from the surveillance system for type-specific acute viral hepatitis, the temporal incidence trend of non-A, non-B acute hepatitis and risk factors for acute hepatitis C have been evaluated in Italy. The association between hepatitis C and the potential risk factors (odds ratios, OR) was estimated using hepatitis A patients as controls. The independent roles of the different risk factors were estimated by multiple logistic regression analysis. The incidence of non-A, non-B acute hepatitis declined from 5 per 100 000 to 1 per 100 000 between 1985 and 1996. Anti-HCV data collected by SEIEVA since 1991 showed that 60% of patients with non-A, non-B acute hepatitis were positive for antibodies to the hepatitis C virus (anti- HCV) at the time of hospitalization. During the 6 months prior to the disease onset, the most frequently reported risk factors were multiple sexual partners, other parenteral exposure and intravenous drug use; transmission by blood transfusion declined from 20% in 1985 to 2% in 1996. On multivariate analysis, intravenous drug use (OR = 35.5; 95% CI = 23.1-54.4), surgical intervention (OR = 4.6; 95% CI = 3.3-6.5), dental treatment (OR = 1.5; 95% CI = 1.1-1.9) and two or more sexual partners (OR = 2.2; 95% CI = 1.6-3.0) were all independent predictors of hepatitis C. These findings indicate that HCV infection is decreasing in Italy. Intravenous drug use, multiple sexual partners, surgical intervention and dental therapy are the main modes of transmission. [References: 14] <32> UI - 2000087806 AU - Thomas DW AU - Newcombe RG AU - Osborne GR IN - Dr. D.W. Thomas, Dept. of Oral Surg. Med./Pathology, Univ. of Wales College of Medicine, Heath Park, Cardiff CF14 4XY; United Kingdom. E-Mail: woadwt@cf.ac.uk. TI - Risk factors in the development of cyclosporine-induced gingival overgrowth. SO - Transplantation Vol 69(4) (pp 522-526), 2000. AB - Background. Severe gingival hyperplasia (GH) is one of the most frequent side-effects associated with the prescription of cyclosporine-A (CsA). Using the largest group of renal allograft recipients assembled for this purpose, in this study, we statistically modeled the genetic (HLA), medical, and dental risk factors for the development of GH subsequent to administration of CsA. Methods. Two hundred thirty-six renal transplant patients underwent full dental examination to quantify the extent and distribution of hyperplasia and dental disease (gingivitis, plaque, and calculus). Computerized data from all patients included pre-transplant medical history and dosage of nifedipine and azathioprine, as well as dose and serum levels of CsA and CsA microemulsion. Donor and host HLA haplotype were studied to investigate potential association of haplotype and donor-host mismatching with the development of GH. We evaluated the data by multivariate regression analysis, using Statistical Package for Social Sciences (SPSS). Results. There was no association with age, sex, duration of renal replacement therapy, or interval since transplantation or pre-transplant disease (P>0.05). There also was no association of disease with host HLA haplotype, but degree of HLA-A mismatching was protective for GH development (P<0.002). GH was associated with the dose and serum levels of CsA (P<0.001) and the last dose of CsA microemulsion (P=0.009) but not nifedipine (P=0.10). Gingival inflammation and plaque were also strongly associated with GH (P<0.0003). In multivariate analysis, however, the last recorded dose of CsA (P< 0.0001), presence of local gingival inflammation (P<0.0001), and gingivitis (P<0.003) were the independent predictors of the extent and severity of GH. Conclusions. Inter- patient variation in the extent and severity of GH is related to CsA dose and serum levels. Differences in host HLA phenotype do not explain individual susceptibility to GH, but donor-host HLA-A mismatching may be important. Inter-site variation in the extent and severity of the disease is related to local gingival inflammation. [References: 34] <33> UI - 2000084087 AU - Kleinfelder JW AU - Mueller RF AU - Lange DE IN - Dr. J.W. Kleinfelder, Section of Periodontology, Faculty of Medical Sciences, Department of Dentistry, A. Deusinglaan 1, NL-9713 AV Groningen; Netherlands. TI - Fluoroquinolones in the treatment of Actinobacillus actinomycetemcomitans-associated periodontitis. SO - Journal of Periodontology Vol 71(2) (pp 202-208), 2000. AB - Background: Periodontitis patients harboring Actinobacillus actinomycetemcomitans (Aa) are prime candidates for systemic antibiotic therapy. Besides tetracycline and the combination of metronidazole and amoxicillin the fluoroquinolones are also believed to have antibacterial activity against Aa. The aim of the present study was to evaluate systemic ofloxacin therapy as adjunct to flap surgery. Methods: Twenty-five adult periodontitis patients with subgingival detection of Aa were treated with 2 x 200 mg/d ofloxacin for 5 days as adjunct to open flap surgery (test). Another 10 patients received only flap surgery (control). Probing depth (PD) and clinical attachment level (CAL) was recorded and subgingival plaque samples were cultivated on TSBV agar for detection of Aa at baseline as well as 3 and 12 months following therapy. Results: At 3 and 12 months following therapy mean PD at monitored sites in the test group changes from 6.8 mm (+/-1.3) to 3.6 mm (+/-1.0), 3.8 mm (+/-1.1) and CAL from 7.5 mm (+/-1.4) to 5.4 mm (+/-1.4), 5.5 mm (+/-1.3). In the control group PD changed from 6.5 mm (+/-0.7) to 4.0 mm (+/-1.7), 4.1 mm (+/-1.6) and CAL from 7.5 mm (+/-0.1) to 6.3 mm (+/-1.7), 6.4 mm (+/-1.8). P was <0.05 for CAL between groups. Three and 12 months following adjunctive systemic ofloxacin therapy, Aa was suppressed below levels in 22 of 22, test patients, whereas Aa could not be recovered in only 2 of the 10 controls. (P <0.0001). Conclusions: Systemic ofloxacin as adjunct to open flap surgery is able to suppress A. actinomycetemcomitans below detectable level in patients harboring this organism at baseline. [References: 62] <34> UI - 2000082331 AU - Peng NJ AU - Liu RS AU - Li JY AU - Tsay DG AU - Kong KW AU - Kwok CG AU - Strauss HW IN - R.S. Liu, Department of Nuclear Medicine, Taipei Veterans General Hospital, National Yang-Ming University, 201 Sec.2, Shih-Pai Road, Taipei, 11217; Taiwan. E-Mail: rsliu@npcc.gov.tw. TI - Increased cerebral blood flow in MELAS shown by Tc-99m HMPAO brain SPECT. SO - Neuroradiology Vol 42(1) (pp 26-29), 2000. AB - We report cerebral SPECT studies on two siblings with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Tc-99m HMPAO brain SPECT was performed 8, 19 and 30 days after a stroke-like episode in one case and 10 days after a strokelike episode, 6 h after a partial seizure and as a follow-up study in the other. Increased blood flow was seen in both these patients with stroke-like episodes due to MELAS. The cause of the increased blood flow is uncertain, but it may be related to the decreased pH created by local increase in lactic acid. [References: 11] <35> UI - 2000074953 AU - Vargas CM AU - Macek MD AU - Marcus SE IN - C.M. Vargas, Analys., Epidemiol./Hlth. Prom. Off., National Ctr. for Health Statistics, Centers for Dis. Control/Prevention, 6525 Belcrest Road, Hyattsville, MD 20782; United States. E-Mail: cav5@cdc.gov. TI - Sociodemographic correlates of tooth pain among adults: United States, 1989. SO - Pain Vol 85(1-2) (pp 87-92), 2000. AB - This study presents the sociodemographic distribution of tooth pain and the dental care utilization of affected individuals. Data for adults 20 years of age and over were derived from the 1989 National Health Interview Survey's supplements on dental health, orofacial pain, and health insurance (n=33 073). Prevalence of tooth pain by socioeconomic status (SES) and adjusted odds ratios of reporting tooth pain in the past 6 months and of having no dental visits in the past year among persons reporting pain in the previous 6 months were computed taking into account the survey's complex sample design. Tooth pain in the past 6 months was reported by 14.5% (95% CI 14.0, 15.0) of adults aged 20-64 years and by 7.0% (95% CI 6.1, 7.9) of those 65 years and over. In the younger age group, tooth pain was more likely to be reported by those with low SES than it was by those with high SES; in the older age group, tooth pain was more likely reported by non-Hispanic blacks than it was by non-Hispanic whites or Hispanics. Of those reporting pain, younger and older non-Hispanic blacks and persons with lower educational attainment were more likely not to have a dental visit in the previous 12 months. Persons with low SES characteristics were more likely to report tooth pain and to endure their pain without the benefit of dental care while the pain was present. [References: 24] <36> UI - 2000075610 AU - Lah TT AU - Cercek M AU - Blejec A AU - Kos J AU - Gorodetsky E AU - Somers R AU - Daskal I IN - T.T. Lah, National Institute of Biology, Vecna pot 111, 1000 Ljubljana; Slovenia. E-Mail: tamara.lah@uni.lj.si. TI - Cathepsin B, a prognostic indicator in lymph node-negative breast carcinoma patients: Comparison with cathepsin D, cathepsin L, and other clinical indicators. SO - Clinical Cancer Research Vol 6(2) (pp 578-584), 2000. AB - New prognosticators are needed for breast cancer patients after the initial surgical treatment to make therapeutic decisions that ultimately will affect their DFS. These consist of specific proteolytic enzymes including lysosomal endopeptidases. In this study, the activity and protein concentrations of cathepsins (Cats) D, B, and L were measured in 282 invasive breast tumor cytosols. These potential biological prognostic indicators were compared with other histopathological parameters, such as tumor size, lymph node involvement, tumor-node-metastasis stage, histological grade, DNA analysis, and steroid receptors. CatD protein concentration correlated with lymph node involvement. CatB and CatL levels correlated significantly with Scarf-Bloom-Richardson histological grade and were also higher in estrogen- negative tumors, and CatB was higher in larger tumors. As prognostic markers, CatB concentration was significant for increased risk for recurrence in the entire patient population and specifically also in lymph node-negative patients as follows: high CatB concentration (above 371 mug/g) in tumor cytosols was significant (P < 0.00) for high risk of recurrence but was of only borderline prognostic significance (P < 0.06) for overall survival of all patients. In lymph node-negative patients, CatB (above 240 mug/g, P < 0.003) was highly significant for recurrence-free survival, followed by CatL (above 20 mug/g, P < 0.049) and CatD (above 45 nmol/g, P < 0.044) concentrations. For overall survival of node-negative patients, only CatB was a significant (P < 0.014) prognosticator. We conclude that CatB is useful as a prognostic indicator in lymph node-negative patients. This suggests that selective adjuvant therapy should be applied in this lower risk group of patients when high levels of CatB are determined. [References: 30] <37> UI - 2000069728 AU - Ardekian L AU - Rachmiel A AU - Rosen D AU - Abu-El-Naaj I AU - Peled M AU - Laufer D IN - Dr. L. Ardekian, Dept. of Oral Maxillofacial Surgery, Rambam Medical Center, Haifa 35245; Israel. E-Mail: l.ardekian@rambam.health.gov.il. TI - Burkitt's lymphoma of the oral cavity in Israel. SO - J CRANIO-MAXILLOFAC SURG, Vol 27(5) (pp 294-297), 1999. AB - The clinical presentation of Burkitt's lymphoma in the maxillofacial area is variable. The objective of this study is to review and analyse all cases of Burkitt's lymphoma with oral or maxillofacial involvement diagnosed in our department. A retrospective review of patients with Burkitt's lymphoma in the facial area between the years 1978 and 1997 was undertaken. The patients, 8 male and 5 female, were from 7 to 50 years old (mean 15.3 years). Six patients were Stage I and 7 were Stage II. Five had abdominal involvement and 2 lymph node involvement besides the maxillofacial presentation. Three tumours were in the mandible, 3 in both mandible and maxilla, 2 in the palate, and 5 in the maxilla alone. In 5 patients the tumour presented as a facial swelling, in 3 as an exophytic mass, in 2 as an ulcer, 1 case presented as a hyperplastic lesion, and 2 were periapical lesions. Complaints included pain (7), swelling (5), and sensory disturbance (2). EBV titres were positive in 4 patients. Abdominal involvement was only seen in patients under 12 years old. All patients were treated with chemotherapy, while adjuvant radiotherapy was indicated in 3 cases. Follow-up of 1-20 years revealed a 2-year survival rate of 61.5%. It seems that the Israeli disease is between that of the African and American types, when considering age distribution. (C) 1999 European Association for Cranio-Maxillofacial Surgery. [References: 23] <38> UI - 2000061397 AU - Bielanski W IN - W. Bielanski, Department of Physiology, Univ. Med. School, 31-531 Krakow; Poland. E-Mail: mpbielan.@cyf-kr.edu.pl. TI - Epidemiological study on Helicobacter pylori infection and extragastroduodenal disorders in Polish population. SO - Journal of Physiology & Pharmacology Vol 50(5) (pp 723-733), 1999. AB - An association between Helicobacter pylori (H. pylori) infection and extragastroduodenal disorders (EGDD) is still not clear. The aim of the study was to investigate the relationship between H. pylori infection and the symptoms of coronary artery disease (CAD), facial dermatological changes (FDC), gastroesophageal reflux diseases (GERD), and periodontal diseases (PD) in Polish population. The study was performed between 1996-1999 year on 7060 adult inhabitants of municipal area of Krakow (aged 18-76, mean 46.3 year; 55.8% female, 44.2% male): 2204 subjects with EGDD and 4856 without symptoms of EGDD. Each patient responded to a detailed questionnaire under supervision of medical staff. The H. pylori status was assessed non-invasively using urea breath test (UBT) with capsulated low-dose 13C-UBT (38 mg). Exclusion criteria were: recent H. pylori eradication, treatment with PPI, bismuth and/or antibiotics in the last 4 weeks. Four groups of cases with EGDD symptoms were selected. Within each group exclusively only one of studied symptoms was recorded. The study included 328, 138, 688, and 1050 patients with CAD, FDC, GERD and PD, respectively. For each studied group an age and sex-matched asymptomatic controls were selected (897, 387, 1083, and 2489 control patients). Results: Overall H. pylori infection rate was 69.9% (in 71.4% of 2204 cases and in 69.31% of 4856 controls). In CAD group: 68% of 328 cases were H. pylori (+ve) vs. 70% H. pylori (+ve) of 897 controls. An association was not significant: OR = 0.93 (95% CI, 0.72-1.20). In 138 of FDC cases, 59% were H. pylori (+ve) vs. 71% H. pylori (+ve) in 387 controls showing the lack of positive association; OR = 0.60 (95% CI, 0.42-0.87). In GERD, 69% of 688 cases were H. pylori (+ve) vs. 73% of 1083 H. pylori (+ve) controls and negative association was observed; OR = 0.80 (95% CI, 0.65- 1.00). In 1050 of PD cases 75% were H. pylori (+ve) vs. 68% H. pylori (+ve) of 2489 controls; positive association was significant; OR = 1.4 (95% CI, 1.16-1.68). We conclude that in the studied Polish population, no positive association exists between H. pylori positivity and CAD, FDC or GERD possibly due very high overall H. pylori infection rate. The only positive link observed between H. pylori infection and periodontal disease may reflect direct 'in situ' H. pylori pathological action of H. pylori in oral cavity. It is not excluded that periodontal diseases may facilitate the H. pylori oro-gastric transmission and colonization of the bacteria in the digestive tract. [References: 21] <39> UI - 2000059328 AU - Tsai T-L AU - Kuo C-H AU - Changchien C-S IN - Dr. C.-H. Kuo, Division of Gastroenterology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien; Taiwan. TI - Sonographic appearance of a gastric bezoar on gastric water loading: Report of a case. SO - Journal of Medical Ultrasound Vol 7(4) (pp 226-228), 1999. AB - Gastric bezoar may occur in patients with prolonged gastric emptying time, diabetes mellitus and following surgery for peptic ulcer. Sonography may show a mass with a typical broad band of high-amplitude echoes with complete sonic shadowing. We describe the sonographic features of a gastric phytobezoar in a 67-year-old woman and emphasize that the use of gastric water loading made the sonographic diagnosis of this bezoar possible. [References: 18] <40> UI - 2000055294 AU - Tsunoda R AU - Suda S AU - Fukaya T AU - Saito K IN - Dr. S. Suda, Department of Oral Surgery, Kanto Teishin Hospital, Higashigotanda 5-9-22, Shinagawa-ku, Tokyo 141-0022; Japan. TI - Descending necrotizing mediastinitis caused by an odontogenic infection: A case report. SO - Journal of Oral & Maxillofacial Surgery Vol 58(2) (pp 240-242), 2000. <41> UI - 2000055273 AU - Whitesides L AU - Cotto-Cumba C AU - Myers RAM IN - Dr. R.A.M. Myers, Hyperbaric Medicine, R. Adams Cowley Shock Trauma Center, Univ. of Maryland Medical System, 22 S Greene St, Baltimore, MD 21201; United States. TI - Cervical necrotizing fasciitis of odontogenic origin: A case report and review of 12 cases. SO - Journal of Oral & Maxillofacial Surgery Vol 58(2) (pp 144-151), 2000. AB - Purpose: This article reviews the demographics, presentation, cause, clinical findings, and treatment of 12 cases of cervical necrotizing fasciitis of odontogenic origin. Patients and Methods: A retrospective chart review of 12 cases treated between 1987 and 1997 was done. Results: Most cases resulted from an abscessed mandibular molar. The most common significant medical conditions in the patient's history were diabetes, hypertension, obesity, and substance abuse. All patients were treated surgically within 24 hours of admission. Hyperbaric oxygen (HBO) was used as adjunctive treatment in all cases. The average length of hospital stay was 31 days. All patients recovered. Conclusion: Early surgical intervention and the use of HBO decreases morbidity and improves the clinical outcome. [References: 42] <42> UI - 2000054678 AU - Becker M IN - Dr. M. Becker, Div. of Diagn./Intervent. Radiology, Department of Radiology, Geneva University Hospital, Rue Micheli-du-Crest 24, 1211 Geneva; Switzerland. TI - Oral cavity, oropharynx, and hypopharynx. SO - Seminars in Roentgenology Vol 35(1) (pp 21-30), 2000. <43> UI - 2000051429 AU - Sharma S AU - Dasroy SK IN - Dr. S. Sharma, Modern Medical Institute, Raipur; India. TI - Gingival hyperplasia induced by phenytoin. SO - New England Journal of Medicine Vol 342(5) (pp 325), 2000. <44> UI - 2000047801 AU - Kanerva L AU - Alanko K AU - Estlander T IN - L. Kanerva, Section of Dermatology, Finnish Inst. of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki; Finland. TI - Allergic contact gingivostomatitis from a temporary crown made of methacrylates and epoxy diacrylates. SO - Allergy Vol 54(12) (pp 1316-1321), 1999. AB - Occupational allergic contact dermatitis caused by (meth)acrylates is common in dental personnel, whereas dental acrylic fillings and crowns have rarely been reported to cause problems in dental patients. Here we report on a 48-year-old woman who developed gingivitis, stomatitis, and perioral dermatitis after a temporary crown made of restorative, two-component material had been inserted. The manufacturer stated that the temporary crown base paste and catalyst contained three (meth)acrylates, namely, a proacrylate, which is a modification of 2,2-bis[4-(2-hydroxy-3- methacryloxypropoxy)phenyl]propane (BIS-GMA); a tricyclate, which is a saturated, aliphatic, tricyclic methacrylate; and urethane methacrylate. The manufacturer refused to give more exact information on the (meth)acrylates. Patch testing revealed that the patient was highly allergic to BIS-GMA, other epoxy diacrylates, and (meth)acrylates, as well as to the base paste and catalyst of the temporary crown. Accordingly, it was concluded that the allergic reaction was caused by BIS-GMA, or a cross-reacting (meth)acrylate, or other (meth)acrylates in the temporary crown. [References: 28] <45> UI - 2000046938 AU - Dubrey SW AU - Melikian C AU - Banner NR IN - Dr. S.W. Dubrey, Department of Cardiology, Hillingdon Hospital, Pield Heath Road, Uxbridge, Middlesex UB8 3NN; United Kingdom. TI - Multiple-choice questions in thoracic transplantation medicine. SO - Postgraduate Medical Journal Vol 76(892) (pp 120-124), 2000. <46> UI - 2000039280 AU - Merte K AU - Frohlich M AU - Hafer M AU - Hirsch E AU - Schneider H AU - Winkler M IN - Dr. K. Merte, Dept. of Conserv. Dent./Periodontol., Dental School, University of Leipzig, 04103 Leipzig; Germany. TI - Two-year clinical performance of two primer adhesives on class V restorations. SO - Journal of Biomedical Materials Research Vol 53(1) (pp 93-99), 2000. AB - The prime purpose of this clinical trial was to examine the clinical quality and retention rate of resin composite in connection with two recently developed acetone-based primer adhesives in Class V lesions according to ADA Clinical Protocol Guidelines for Dentin and Enamel Adhesive Materials. All cavities were nonretentive and predominantly in dentin (mixed Class V lesions). Total bonding was not limited either by sub-base or by base materials. All the trial restorations were placed under rubber dam. Group 1 (Version 16-135-1) and group 2 (Version 17.17-1) consisted of 42 patients with 46 trials and 38 patients with 43 fillings, respectively. The mean follow-up period and the recall response at the end of the study of group 1 were 22.8 months and 92.9% and of group 2 were 22.4 months and 94.7%. The trial restorations of both groups maintained their predominantly rated USPHS- Code Alpha level within the follow-up period. The cumulative failure rate of two trials in group 1 and four in group 2 determined a failure percentage of 4.4% and 9.3%, respectively, which is within the ADA-18 month limit of <10% Charlie. The Version KL 16-135-1 came into the market as Prime and Bond(TM) 2.1, and the other one turned out to be Dyract Adhesive(TM) PSA, which was primarily introduced as a single-component adhesive for compomer restorative Dyract(TM) (Dentsply DeTrey, Germany). [References: 33] <47> UI - 2000027231 AU - Shashikala M AU - Surendra VHH TI - Pharmaceutical Industries : Medical screening report. SO - INDIAN J OCCUP ENVIRON MED, Vol 3(3) (pp 143-145), 1999. AB - This programme involves screening of employees for morbidity and further recommendations to improve the Occupational Health Services within the industrial sector. Methodology includes preliminary walkthrough survey of entire factory and Interview (Oral questionnaire) and Medical Examination of the employees (788) of Pharmaceutical Industries in Bangalore (pooled data of different Pharmaceutical Sections - Pharmaceutical Formulations, Bulk drugs, Laboratory, Administration and Canteen). Analysis revealed refractory error 112 (14.2%), acid peptic disease 110 (14%), psychosocial stress 96 (12.2%), irritation of eyes 77 (9.8%), hypertension 62 (7.9%), anaemia 57 (7.2%), vitamin B complex deficiency 52 (6.6%), nasal allergy 51 (6.5%), muscle and joint pain 48 (6.1%), dental caries 44 (5.6%), nasobronchial allergy 23 (2.9%), diabetes 19 (2.4%), respiratory tract infection 18 (2.3%), dermatitis 18 (2.3%), impaired hearing 8 (1%) etc. [References: 3] <48> UI - 2000018753 AU - Lurtz B AU - Richards AM AU - Cole RP IN - Dr. B. Lurtz, Odstock Centre for Burns, Plastic and Maxillo-Facial Surgery, Salisbury District Hospital, Salisbury; United Kingdom. TI - Is there a familial predisposition to tight labial maxillary frenula? [9]. SO - Plastic & Reconstructive Surgery Vol 105(1) (pp 475-476), 2000. <49> UI - 2000017433 AU - Donaldson D AU - Tremble J TI - Diabetes mellitus - Oral manifestations and dental disease. SO - J R SOC PROMOT HEALTH, Vol 119(4) (pp 211-212), 1999. <50> UI - 2000015488 AU - Reijneveld SA AU - Stronks K IN - S.A. Reijneveld, TNO Prevention and Health, Department of Public Health, PO Box 2215, 2301 CE Leiden; Netherlands. E-Mail: SA.Reijneveld@pg.tno.nl. TI - The impact of response bias on estimates of health care utilization in a metropolitan area: The use of administrative data. SO - International Journal of Epidemiology Vol 28(6) (pp 1134-1140), 1999. AB - Background. Surveys among the general population are an important method for collecting epidemiological data on health and utilization of health care in that population. Selective non-response may affect the validity of these data. This study examines the impact of response bias on estimates of health care utilization and on risk estimates for utilization in relation to demographic and socioeconomic characteristics, using administrative data on use of health care. Methods. Data on registered health care utilization were extracted from health insurance register and linked to respondents (2934; 62.7%) and non-respondents (1744) in a personal health interview survey among adult residents from the lower two-thirds income bracket in Amsterdam, the Netherlands. Results. Estimates of registered healthcare utilization are higher if based on respondents only, than if they are based on the entire target sample. This goes for prescription drugs, specialist medical care, paramedical care, dental care and medical aids, but not for hospital care. Most risk estimates of registered utilization for background characterisitcs (gender, family composition, marital status, year of settlement, affluence of neighbourhood and ethnicity) differ only slightly and without statistical significance. If different, most estimates based on respondents only are somewhat higher. The largest differences are found for age (average overestimation of risks for age groups 35-64 and 65+ years compared to that of 16-34 years: 16% and 17%, respectively). Conclusions. In this study, response bias affects estimates of registered health care utilization but hardly affects risk estimates of utilization by background characteristics. [References: 33] <51> UI - 2000014468 AU - Palangie T AU - Pierga JY AU - Pouillart P IN - P. Pouillart, Institut Curie, 26, rue d'Ulm, F-75005 Paris; France. TI - Dose-intense salvage therapy after neoadjuvant chemotherapy: Feasibility and preliminary results. SO - Cancer Chemotherapy & Pharmacology Vol 44(SUPPL.) (pp S24-S25), 1999. AB - Breast cancer patients who, following treatment with primary chemotherapy (FAC 50) present an axillary node involvement of more than 4 nodes together with clinically palpable residual disease (minor response to chemotherapy) and the presence of tumour cell emboli in lymphatics have a very poor outcome. DFS rates of 50 patients treated between 1990 and 1994 were 31% at 5 years. Our aim was therefore to evaluate an entirely different therapeutic regime in these very high risk patients. 32 patients selected for these criteria entered a pilot study consisting in treatment with 3 four weekly cycles of vinorelbine, ifosfamide, cisplatinum followed by a high dose chemotherapy (HDCT) course and rescue by peripheral hematopoietic stem cells which had been collected by cytapheresis after the second course of chemotherapy. HDCT consisted of thiotepa, L-Pam, CBDCA (800 mg/m2 dl), ifosfamide and mesna. Following primary chemotherapy, 14 patients had breast conservation and 18 had a modified mastectomy. Median number of involved lymph nodes was 11 (range 4-26). 29 patients received the complete HDCT course. Median age was 40 (range 24-59). Engraftment was prompt with a median of 10 days to leucocyte recovery to 1000/mul and 9 days to platelet recovery. One patient developed reversible renal failure, and subsequently died of Gram-septicemia. To date, with a median follow up of 20 months (range 14-36), 6 patients have relapsed and 2 patients have died. It is too early to make any firm conclusions, but we feel that this alternative regime is feasible and may prove superior to the classical optimal dose anthracycline-containing regimes in patients who have a tendency to rapidly develop resistance to anthracyclines. [References: 2] <52> UI - 2000009261 AU - Benson BW AU - Mohtadi NGH AU - Rose MS AU - Meeuwisse WH IN - Dr. W.H. Meeuwisse, Univ. of Calgary Sport Medicine Ctr., 2500 University Dr NW, Calgary, Alta. T2N 1N4; Canada. E-Mail: meeuwiss@ucalgary.ca. TI - Head and neck injuries among ice hockey players wearing full face shields vs half face shields. SO - JAMA Vol 282(24) (pp 2328-2332), 1999. AB - Context. Speculation exists that use of a full face shield by ice hockey players may increase their risk of concussions and neck injuries, offsetting the benefits of protection from dental, facial, and ocular injuries, but, to our knowledge, no data exist regarding this possibility. Objective. To determine the risk of sustaining a head or neck injury among intercollegiate ice hockey players wearing full face shields compared with those wearing half shields. Design, Setting, and Participants. Prospective cohort study conducted during the 1997-1998 Canadian Inter-University Athletics Union hockey season of 642 male hockey players (mean age, 22 years) from 22 teams. Athletes from 11 teams wore full face shields and athletes from 11 teams wore half face shields during play. Main Outcome Measure. Reportable injury, defined as any event requiring assessment or treatment by a team therapist or physician or any mild traumatic brain injury or brachial plexus stretch, categorized by time lost from subsequent participation and compared by type of face shield. Results. Of 319 athletes who wore full face shields, 195 (61.6%) had at least 1 injury during the study season, whereas of 323 who wore half face shields, 204 (63.2%) were injured. The risk of sustaining a facial laceration and dental injury was 2.31 (95% confidence interval [CI], 1.53-3.48; P<.001) and 9.90 (95% CI, 1.88-52.1; P=.007) times greater, respectively, for players wearing half vs full face shields. No statistically significant risk differences were found for neck injuries, concussion, or other injuries, although time lost from participation because of concussion was significantly greater in the half shield group (P<.001), than in the group wearing full shields. Conclusions. These data provide evidence that the use of full face shields is associated with significantly reduced risk of sustaining facial and dental injuries without an increase in the risk of neck injuries, concussions, or other injuries. [References: 27] <53> UI - 2000003156 AU - Bachanek T AU - Chalas R AU - Pawlowicz A AU - Tarczydlo B IN - Dr. T. Bachanek, Dept. of Conservative Stomatology, Medical Academy, Karmelicka 7, 20-081 Lublin; Poland. TI - Exposure to flour dust and the level of abrasion of hard tooth tissues among the workers of flour mills. SO - Annals of Agricultural & Environmental Medicine Vol 6(2) (pp 147-149), 1999. AB - A study of the oral health of workers in flour mills was carried out. The examined group consisted of 40 males and 8 females currently employed at flour mills. As much as 93.75% of the workers showed evidence of dental abrasion, particularly of the front teeth. The authors concluded that the dental abrasions in the group are closely related to the work environment. [References: 7] <54> UI - 2000002763 AU - Windisch P AU - Sculean A AU - Gera I IN - P. Windisch, Department of Periodontology, Semmelweis University of Medicine, Budapest; Hungary. TI - GTR with three different types of membranes in the treatment of intrabony periodontal defects: Three-year results in sixty consecutive cases. SO - Journal of Long-Term Effects of Medical Implants Vol 9(3) (pp 235-246), 1999. AB - The aim of the present study was to evaluate the clinical results at 3 years following treating intrabony periodontal defects with different nonresorbable and bioabsorbable membrane barriers. Sixty intrabony periodontal defects were treated according to the principles of guided tissue regeneration (GTR). Twenty pockets were treated with Gore Resolut(TM), a bioabsorbable membrane; 20 were treated with Gore-Tex(TM), a titanium- reinforced membrane; and 20 with nonresorbable Gore-Tex membrane (all manufactured by Gore Regenerative Technologies, Flagstaff, AZ). The therapeutic results were evaluated by assessing probing pocket depth (PPD), recession of the gingival margin (GR), and clinical attachment level (CAL) at baseline, at 1 and at 3 years after therapy. The postoperative phase was uneventful in all cases. At 1 year after surgery, the results showed a mean PPD reduction from 9.42 mm to 3.35 mm (p < 0.0001) with Resolut; from 10.30 mm to 4.00 with titanium-reinforced Gore-Tex (p < 0.0001); and from 8.40 mm to 3.73 mm (p< 0.0001) with Gore-Tex membranes. The mean GR increased from 1.92 mm to 3.70 mm (p < 0.001) with Resolut; from 0.47 mm to 2.85 mm (p < 0.0001) with titanium-reinforced Gore-Tex; and from 0.73 mm to 2.15 mm (p < 0.0001) with Gore-Tex membranes. The mean CAL changed from 11.35 mm to 6.92 mm (p < 0.001) with Resolut; from 10.78 mm to 6.85 mm (p < 0.0001) with titanium-reinforced Gore-Tex; and from 9.13 mm to 5.87 mm (p < 0.0001) with Gore-Tex membranes. The clinical results at 3 years were not significantly different when compared with the 1-year results (p > 0.05). No significant differences existed between the mean changes in PPD, GR, and CAL in the three different test groups. Furthermore, one tooth scheduled for extraction for periodontal and prosthodontic reasons was treated with Resolut. Histological analysis 6 months after treatment demonstrated the neoformation of a connective tissue attachment and of new alveolar bone. This additional evidence thus proved that treatment with bioabsorbable membranes according to GTR principles delivers not only clinical improvement, but also histological periodontal regeneration. [References: 30] <55> UI - 1999435281 AU - Nusbaum AO AU - Som PM AU - Rothschild MA AU - Shugar JMA IN - Dr. P.M. Som, Department of Radiology, Mount Sinai Hospital, Box 1234, One Gustave L. Levy Place, New York, NY 10029; United States. TI - Recurrence of a deep neck infection: A clinical indication of an underlying congenital lesion. SO - Archives of Otolaryngology -- Head & Neck Surgery Vol 125(12) (pp 1379-1382), 1999. AB - Objective: To discuss the computed tomographic (CT) and clinical findings of those entities that may present as recurrent deep neck infections. Patients and Methods: Twelve patients with recurrent deep neck infections and CT scans were retrospectively identified since 1990. Their CT scans and medical histories were reviewed. The diagnosis was pathologically confirmed in all cases. Results: The CT scans revealed an abscess or a localized infected cyst in the deep soft tissues of the neck, with varying degrees of associated inflammatory change in the adjacent soft tissues. The diagnoses in these cases included 1 first branchial cleft cyst, 3 second branchial cleft cysts, 1 third branchial cleft cyst, 2 fourth branchial cleft cysts, 2 infected lymphangiomas, 2 thyroglossal duct cysts, and 1 cervical thymic cyst. Conclusions: Most deep neck infections are the result of suppurative adenitis. The location of the primary focus is usually from the mucosa of the upper aerodigestive tract or from an odontogenic source. Less common causes are perforations due to a foreign body, thrombophlebitis of the internal jugular vein, or osteomyelitis of the spine. Recurrences in these situations are unusual. Less commonly, congenital lesions can present as deep neck infections, and recurrences are common. Our cases suggest that the recurrence of a deep neck infection should alert the physician to the possibility of an underlying congenital lesion and that CT is helpful in the early recognition of these lesions. [References: 24] <56> UI - 1999430751 AU - Varma S AU - Varma N AU - Malhotra P AU - Singh S AU - Sharma DR IN - Prof. S. Varma, Department of Medicine, Postgrad. Inst. of Med. Educ./Res., Chandigarh; India. TI - Cyclosporin A monotherapy in young Indian aplastic anaemia patients. SO - Journal of the Indian Medical Association Vol 97(12) (pp 505-506), 1999. <57> UI - 1999427264 AU - Litt MD AU - Kalinowski L AU - Shafer D IN - M.D. Litt, Beha. Sciences/Community Hlth. Dept., Univ. of Connecticut Health Center, Farmington, CT 06030; United States. E-Mail: litt@nso.uchc.edu. TI - A dental fears typology of oral surgery patients: Matching patients to anxiety interventions. SO - Health Psychology Vol 18(6) (pp 614-624), 1999. AB - Two studies are described in which dental patients were administered the Dental Fear Survey (DFS) and then received 1 of 5 anxiety reduction interventions to prepare them for extraction of 3rd-molar teeth. Interventions included standard clinic treatment, oral premedication, and several relaxation-based procedures. Dependent variables were self-reported and observer-rated distress. In the 1st study (N = 231), cluster analyses of the DFS subscales revealed that patients could be subtyped as low-fear, high- fear, or cue-anxious patients who admitted fear only in response to specific stimuli. Dental fear subtypes were distinguishable by situational cognitions reported, and fear subtype interacted with anxiety intervention to predict distress. These results were replicated in the 2nd study (N = 150). The results are seen as supportive of a multidimensional view of dental anxiety. [References: 28] <58> UI - 1999426493 AU - Kewitt GF AU - Van Sickels JE IN - Dr. J.E. Van Sickels, Div. of Oral and Maxillofacial Surg., University of Kentucky, Chandler Medical Center, Lexington, KY 40536-0297; United States. E-Mail: vansick@pop.uky.edu. TI - Long-term effect of mandibular midline distraction osteogenesis on the status of the temporomandibular joint, teeth, periodontal structures, and neurosensory function. SO - Journal of Oral & Maxillofacial Surgery Vol 57(12) (pp 1419-1425), 1999. AB - Purpose: This study retrospectively evaluated the long-term effects of transverse symphyseal distraction osteogenesis (DO) on the temporomandibular joint (TMJ) symptoms, periodontal health, tooth vitality, and nerve injury after surgery. Patients and Methods: Twenty-three patients were treated with symphyseal DO during a 4-year period. Fifteen patients were available for follow-up from 7 to 45 months postoperatively (ave, 24.5 months). The patients were clinically evaluated for TMJ symptoms, periodontal pocket formation, tooth vitality and mobility, crestal bone loss, and attached gingival tissue changes. Radiographs of the mandibular anterior teeth were used to evaluate for periodontal bone loss, periapical lesions, or widening of the periodontal ligament (PDL). Results: Preoperatively, 47% of the patients had TMJ symptoms. No patient had symptom worsening or developed new symptoms postoperatively. Five patients' TMJ symptoms improved, and 3 experienced complete resolution of symptoms. No periodontal bone loss or soft tissue recession were evident. Tooth vitality was maintained in 13 patients. Two patients developed Class II mobility of 1 mandibular central incisor, 1 patient had tooth pain and a widened PDL adjacent to the osteotomy/corticotomy site, and 1 patient experienced mental nerve paresthesia. Conclusions: DO can be used to treat transverse discrepancies of the mandible with limited morbidity. [References: 31] <59> UI - 1999419382 AU - Edwards JE AU - McQuay HJ AU - Moore RA AU - Collins SL IN - J.E. Edwards, Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, Oxford OX3 7LJ; United Kingdom. TI - Reporting of adverse effects in clinical trials should be improved: Lessons from acute postoperative pain. SO - Journal of Pain & Symptom Management Vol 18(6) (pp 427-437), 1999. AB - We assessed the quality of assessment and reporting of adverse effects in randomized, double-blind clinical trials of single-dose acetaminophen or ibuprofen compared with placebo in moderate to severe postoperative pain. Reports were identified by systematic searching of a number of bibliographic databases (e.g., MEDLINE). Information on adverse effect assessment, severity and reporting, patient withdrawals, and anesthetic used was extracted. Compliance with former guidelines for adverse effect reporting was noted. Fifty-two studies were included; two made no mention of adverse effects. No method of assessment was given in 19 studies. Twenty trials failed to report the type of anesthetic used, eight made no mention of patient withdrawals, and nine did not state the severity of reported adverse effects. Only two studies described the method of assessment of adverse effect severity. When all adverse effect data were pooled, significantly more adverse effects were reported with active treatment than with placebo. For individual adverse effects, there was no difference between active (acetaminophen 1000 mg or ibuprofen 400 mg) and placebo; the exception was significantly more somnolence/drowsiness with ibuprofen 400 mg. Ninety percent of trials reporting somnolence/drowsiness with ibuprofen 400 mg were in dental pain. All studies published after 1994 complied with former guidelines for adverse effect reporting. Different methods of assessing adverse effects produce different reported incidence: patient diaries yielded significantly more adverse effects than other forms of assessment. We recommend guidelines for reporting adverse effect information in clinical trials. Copyright (C) 1999 U.S. Cancer Pain Relief Committee. [References: 27] <60> UI - 1999416725 AU - Mitchell D IN - Dr. D. Mitchell, Royal Brompton/Harefield NHS Trust, Sydney St, London SW3 6NP; United Kingdom. TI - New approaches to the therapy of sarcoidosis. SO - Clinical Pulmonary Medicine Vol 6(6) (pp 339-346), 1999. AB - Indications for the treatment of sarcoidosis include some 10% of patients with critical extrathoracic involvement and some 15% with progressive pulmonary involvement. Corticosteroids provide the mainstay of treatment; there is no doubt as to their efficacy in the short or medium term, but their long-term efficacy remains uncertain. Relapse rates severe enough to require further treatment are significant, the rate depending on ethnic group, extent and severity of disease, and patient compliance. Osteopenia is frequent among patients receiving long-term corticosteroid therapy and can be detected in >50% of these patients. Intermittent etidronate therapy prevents loss of vertebral and trochanteric bone and significantly reduces the rate of new vertebral fractures. In long-term corticosteroid treatment, deflazacort may have fewer overall side effects and be significantly more sparing in bone demineralization. Hydroxychloroquine, methotrexate, and azathioprine are steroid sparing and may be particularly helpful in the management of refractory forms of sarcoidosis. Inhaled corticosteroids yield no easily recognizable measured therapeutic benefit in pulmonary sarcoidosis but are helpful in the management of troublesome cough. Chloroquine and ketoconazole inhibit production of excess 1,25- dihydroxyvitamin D and are helpful in the management of hypercalcemia. Organ transplantation (lung, kidney, heart, and liver) provides excellent medium- term results comparable to those resulting from these procedures in other disorders. Recurrence may occur in the allograft; it is usually asymptomatic and does not compromise patient survival. Cardiac conduction disturbances, arrhythmias, and cardiomyopathy attributable to sarcoidosis may present without obvious cause; sudden death remains likely among those with unrecognized or untreated cardiac lesions. Despite the use of intravenous or oral corticosteroids and other drugs including methotrexate, azathioprine, hydroxychloroquine, cyclosporine, and cyclophosphamide, with occasional recourse to cranial irradiation, the prognosis of CNS involvement by sarcoidosis remains poor with significant mortality and morbidity. Future prospects for therapy are discussed and await a more precise elucidation of the pathogenesis. [References: 50] <61> UI - 1999405692 AU - White JE TI - Loss of dental support increases risk for ischemic stroke [1]. SO - Journal of the American Osteopathic Association Vol 99(10) (pp 502), 1999. <62> UI - 1999402929 AU - Patton LL AU - Van der Horst C IN - L.L. Patton, Department of Dental Ecology, 388 Dental Office Building, University of North Carolina, Chapel Hill, NC 27599-7450; United States. TI - Oral infections and other manifestations of HIV disease. SO - Infectious Disease Clinics of North America Vol 13(4) (pp 879-900), 1999. AB - Oral lesions are important in the clinical spectrum of HIV/AIDS, arousing suspicion of acute seroconversion illness (aphthous ulceration and candidiasis), suggesting HIV infection in the undiagnosed individual (candidiasis, hairy leukoplakia, Kaposi's sarcoma, necrotizing ulcerative gingivitis), indicating clinical disease progression and predicting development of AIDS (candidiasis, hairy leukoplakia), and marking immune suppression in HIV-infected individuals (candidiasis, hairy leukoplakia, necrotizing periodontal disease, Kaposi's sarcoma, long-standing herpes infection, major aphthous ulcers). In addition, oral lesions are included in staging systems for HIV disease progressions and as entry criteria or endpoints in clinical trials of antiretroviral drugs. Recognition and management of these oral conditions is important for the health and quality of life of the individual with HIV/AIDS. In keeping with this, the U.S. Department of Health Services Clinical Practice Guideline for Evaluation and Management of Early HIV Infection includes recommendations that an oral examination, emphasizing oral mucosal surfaces, be conducted by the primary care provider at each visit, a dental examination by a dentist should be done at least two times a year, and patients should be informed of the importance of oral care and educated about common HIV-related oral lesions and associated symptoms. [References: 138] <63> UI - 1999384987 AU - Major J AU - Jakab MG AU - Tompa A IN - J. Major, Natl. Institute of Chemical Safety, Department of Human Genotoxicology, P.O. Box 36, H-1450 Budapest; Hungary. E-Mail: okkokbi@mail.inext.hu. TI - The frequency of induced premature centromere division in human populations occupationally exposed to genotoxic chemicals. SO - MUTAT RES GENET TOXICOL ENVIRON MUTAGEN, Vol 445(2) (pp 241-249), 1999. AB - Premature (early) centromere division (PCD, i.e., the separation of centromeres during the prometaphase/metaphase of the mitotic cycle) seems to be a possible manifestation of chromosome instability in human chromosome- breakage syndromes. Chromosome instability also frequently occurs in the peripheral blood lymphocytes (PBL) of humans occupationally exposed to clastogenic agents, and is considered an etiologic factor of neoplastic diseases. In order to investigate the importance of PCD in cancer risk assessment, we studied the frequency of PCDs in PBL of 400 Hungarian subjects. The various groups comprised 188 control donors and 212 subjects occupationally exposed to different genotoxic chemicals, such as acrylonitrile (ACN) and/or dimethylformamide (DMF), benzene, cytostatic drugs, ethylene oxide (ETO), mixed exposure in the rubber industry, mixed organic solvents including CCl4, hot oil-mist, bitumen, and polychlorinated biphenyls (PCB). Data were compared with chromosomal aberration frequencies determined in the same samples. PCD yields are significantly higher in populations exposed to mixed chemicals, crude oil and cytostatic drugs, compared with controls. PCDs involving more than three chromosomes are also more frequent in ETO- and oil mist-exposed groups than in the others. The results indicate that the induction of PCDs is neither incidental nor artificial. As a consequence, we suggest that PCD can be developed into a new, exposure-related cytogenetic biomarker for a more adequate occupational cancer risk assessment. A further, follow-up epidemiological and cytogenetic investigation of PCD is in progress. [References: 26] <64> UI - 1999394384 AU - Chim CS AU - Lie AKW AU - Liang R AU - Todd D AU - Kwong YL AU - Chan TK IN - Dr. C.S. Chim, Department of Medicine, Queen Mary Hospital, Hong Kong; Hong Kong. E-Mail: jcschim@hkucc.hku.hk. TI - Treatment of de novo acute myeloid leukaemia in Hong Kong: A twenty-year experience (1975 to 1996). SO - AUST NEW ZEALAND J MED, Vol 29(5) (pp 726-730), 1999. AB - Background: Small patient numbers and short follow-up are common in some acute myeloid leukaemia (AML) studies and data on secondary malignancies after treatment of AML are rare. Aims: To determine the prognostic factors and long-term treatment results. Methods: A retrospective study of patients with de novo AML under the age of 60 over a 20-year period in which two induction therapy regimens: 7:3 (1975-1983) and 7:3:7 (1984-1996) and three consolidation chemotherapy regimens: 5:2 (1975-1983), 5:2:5 (1984-1990) and Ara-C/mitoxantrone (1991-1996) were used. Disease-free (DFS), overall survivals (OS) and prognostic factors were analysed. Results: Two-hundred and two of 276 (73%) patients attained complete remission (CR). The CR rates of 7:3 and 7:3:7 regimens were 70.5% and 74.5% respectively (p=0.92). The median DFS was 12 months and the projected DFS at 10- and 20-years were 23% and 21% respectively. For patients consolidated with 5:2, 5:2:5 and Ara- C/mitoxantrone, the median DFS was 15 m, 12 m and 11 m respectively and the projected ten-year DFS were 27%, 21% and 18% respectively (p=0.2). Ninety per cent of relapses occurred within two years from remission but there were two late relapses at 109 m and 120 m respectively. Young age and FAB M3 subtype were favourable prognostic factors to OS (p=0.04) and DFS (p=0.006) respectively. There was no secondary solid tumour in the long-term survivors. Conclusion: Our experience confirmed the efficacy of standard-dose Ara- C/daunorubicin and the prognostic value of age and FAB subtype. Median and projected DFS were similar to western studies. [References: 31] <65> UI - 1999389363 AU - Beck JD AU - Pankow J AU - Tyroler HA AU - Offenbacher S IN - Dr. J.D. Beck, Department of Dental Ecology, University of North Carolina, Chapel Hill, NC 27599; United States. TI - Dental infections and atherosclerosis. SO - American Heart Journal Vol 138(5 II) (pp S528-S533), 1999. AB - In most countries, coronary heart disease is one of the leading causes of morbidity and death. This report reviews the current evidence indicating that oral conditions (specifically periodontitis) may be a risk factor for atherosclerosis and its clinical manifestations and provides new preliminary data. This review is done in the context of the research indicating that inflammation plays a central role in atherogenesis and that there is a substantial systemic microbial and inflammatory burden associated with periodontal disease. Our review concentrates on 5 longitudinal studies that show oral conditions being associated with the onset of coronary heart disease while controlling for a variety of established coronary heart disease risk factors. In addition to published evidence, preliminary findings from our Dental Atherosclerosis Risk in Communities study also indicate that periodontal disease is associated with carotid intimal-medial wall thickness, a measure of subclinical atherosclerosis, adjusting for factors known to be associated with both conditions. [References: 25] <66> UI - 1999389340 AU - Danesh J IN - J. Danesh, CTSU, Radcliffe Infirmary, Oxford OX2 6HE; United Kingdom. E-Mail: john.danesh@balliol.ox.ac.uk. TI - Coronary heart disease, Helicobacter pylori, dental disease, Chlamydia pneumoniae, and cytomegalovirus: Meta-analyses of prospective studies. SO - American Heart Journal Vol 138(5 II) (pp S434-S437), 1999. <67> UI - 1999386656 AU - Graham RM AU - Burrell MG AU - Bainton R AU - Carson L AU - Needham G IN - R.M. Graham, Dept. Oral Facial Dental Specialties, Aberdeen Royal Infirmary, Aberdeen AB9 2ZB; United Kingdom. TI - Aspergillosis with calcification of the maxillary sinus [9]. SO - British Journal of Oral & Maxillofacial Surgery Vol 37(5) (pp 425-426), 1999. <68> UI - 1999375466 AU - Berer A AU - Ohler L AU - Simonitsch I AU - Thalhammer R AU - Lechner K AU - Geissler K IN - Dr. A. Berer, Klinik fur Innere Medizin I, Abteilung fur Hamatologie, Wahringer Gurtel 18-20, A-1090 Wien; Austria. TI - Long term improvement of hematopoiesis following cyclosporine treatment in a patient with myelodysplastic syndrome. SO - Wiener Klinische Wochenschrift Vol 111(19) (pp 815-818), 1999. AB - Current treatment of patients with myelodysplastic syndrome (MDS) is unsatisfactory. Very recently, immunosuppressive treatment strategies have been gaining interest. We report a patient with transfusion-dependent MDS achieved significant hematopoietic improvement following cyclosporine (CsA) therapy and who is now transfusion independent for more than 5 years. This single observation supports the view that CsA, among other immunosuppressive agents, could play an important role in future treatment concepts in MDS and may lead to clinically relevant and sustained improvement of hematopoiesis in a subset of patients. [References: 25] <69> UI - 1999371369 AU - Campanello M AU - Herlitz H AU - Lindstedt G AU - Mellstrom D AU - Wilske J AU - Akerlund S AU - Jonsson O IN - O. Jonsson, Department of Urology, Sahlgrenska University Hospital, S-413 45 Goteborg; Sweden. TI - Determinants of bone loss in patients with Kock ileal urinary reservoir. SO - Scandinavian Journal of Urology & Nephrology Vol 33(5) (pp 312-316), 1999. AB - The purpose of the present study was to determine the change in bone mineral density (BMD) measured with dual energy X-ray absorptiometry (DXA) in patients with Kock reservoirs for urinary diversion who were examined with the same technique 3 years earlier, and relate the changes to kidney function and variables reflecting bone metabolism. A total of 28 patients with Kock ileal reservoirs to the skin (23) or urethra (5) were reinvestigated 3 years after the first measurement. BMD was measured in the lumbar spine, femur and whole body with DXA. Bone specific alkaline phosphatase, osteocalcin, parathyroid hormone (PTH), calcitonin and chloride were also determined in serum. GFR was determined from the plasma clearance of 51Cr-EDTA. The mean values for BMD expressed in percentage of corresponding mean values for age- matched controls (BMD%) were almost identical after 3 years. Only osteocalcin levels correlated with the BMD% values. However, significant positive correlations were found between GFR and the observed individual changes in BMD% over the 3 years in spite of the fact that most GFR values were fairly normal. Enhanced bone loss was associated with high concentrations of osteocalcin and bone specific alkaline phosphatase. Comparisons with blood gas analyses and determination of 1,25 dihydroxyvitamin D performed in the previous study indicate to us that the relation between reduced GFR and low mineral content might, in part, be related to a low-grade metabolic acidosis and reduced availability of the biologically active vitamin D hormone. The conclusion to be drawn is that urinary diversion with a Kock reservoir does not regularly cause bone demineralization. However, patients with even moderately reduced GFR appear to be at risk for developing osteoporosis in the long-time run. [References: 18] <70> UI - 1999365753 AU - Hennessy BJ AU - Kerns DG AU - Davies WG IN - B.J. Hennessy, U.S. Army Dental Activity, Billy Johnson Dental Clinic, Fort Hood, TX 76544-5063; United States. TI - The incidence of active duty dental patients taking antihypertensive medications. SO - Military Medicine Vol 164(10) (pp 740-745), 1999. AB - Hypertension affects 58 million Americans. Dentists frequently encounter patients who are using one or more antihypertensive medications. This study evaluates the incidence of active duty soldiers dispensed antihypertensive medications at a large military installation. Lisinopril was the most frequently prescribed antihypertensive medication during a 2-month period in 1997 and was followed by hydrochlorothiazide, amlodipine, propranolol, felodipine, verapamil, atenolol, diltiazem, terazosin, clonidine, nifedipine, and metoprolol. These 12 drugs accounted for 93.46% of all antihypertensive medications dispensed. In this study, the percentage of active duty soldiers dispensed any antihypertensive medication was 1.51% (30 different medications were dispensed); 0.16% of all soldiers younger than age 30 and 1.25% of all soldiers older than age 30 were prescribed 1 of the 12 most commonly prescribed antihypertensive agents. Considering the same top-12 antihypertensive agents, the percentage of male soldiers younger than 30 who received a prescription was 0.24% and the percentage of male soldiers older than 30 who received a prescription was 4.3%. The percentage for males older than 40 receiving 1 of the 12 medications listed above was 12.05%. Similarly, the percentages for females were 0.27% for younger than 30, 1.87% for older than 30, and 3.51% for older than 40. Active duty males older than age 30 were more than twice as likely to be prescribed an antihypertensive agent than females in the same age group. Male active duty soldiers older than age 40 were more than 50 times more likely to be prescribed an antihypertensive agent than active duty males younger than 30. [References: 19] <71> UI - 1999361197 AU - Defazio G AU - Berardelli A AU - Abbruzzese G AU - Coviello V AU - Carella F AU - De Berardinis MT AU - Galardi G AU - Girlanda P AU - Maurri S AU - Mucchiut M AU - Albanese A AU - Basciani M AU - Bertolasi L AU - Liguori R AU - Tambasco N AU - Santoro L AU - Assennato G AU - Livrea P IN - Dr. G. Defazio, Dept. Neurological Psychiatric Sci., Piazza Giulio Cesare 11, I-70124 Bari; Italy. TI - Risk factors for spread of primary adult onset blepharospas