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 1-125 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 75 from 71 keep 301-600 300 76 from 71 keep 601-725 125 *************************** <1> UI - 93175245 AU - Wilson M AU - Lopatin D AU - Osborne G AU - Kieser JB IN - Microbiology Laboratory, Institute of Dental Surgery, University of London, 256 Grays Inn Road,London WC1X 8LD; United Kingdom. TI - Prevalence of Treponema denticola and Porphyromonas gingivalis in plaque from periodontally-healthy and periodontally-diseased sites. SO - Journal of Medical Microbiology Vol 38(6) (pp 406-410), 1993. AB - Intracrevicular plaque from periodontally-healthy individuals who had refrained from oral hygiene measures for 24 h prior to sampling, and subgingival plaque from diseased sites of patients with chronic periodontitis were screened by ELISA for the presence of Porphyromonas gingivalis and Treponema denticola. The samples were also subjected to the PerioScan test to detect the presence of enzymes capable of degrading N-benzoyl-DL-arginine-2-naphthylamide (BANA). Of the 141 samples from periodontally-healthy sites, 73% contained T. denticola antigens and 78% P. gingivalis antigens, compared to 43% and 59%, respectively, in plaque samples from the 159 diseased sites. A positive reaction in the PerioScan test was obtained in 89% of plaque samples from diseased sites and in 60% of those from healthy sites. The correlation between the results of the two assays was poor in the case of intracrevicular plaque from healthy sites. However, with plaque samples from diseased sites, the results of the PerioScan test showed very strong correlation with those obtained with the ELISA, suggesting that the former may be a useful, rapid means of indicating the presence of T. denticola and P. gingivalis in such plaque samples. <2> UI - 93162516 AU - Labar B AU - Mrsic M AU - Pavletic Z AU - Bogdanic V AU - Nemet D AU - Aurer I AU - Radman I AU - Filipovic-Groic N AU - Sertic D AU - Kalenic S AU - Presecki V IN - Department of Medicine, University Zagreb School of Medicine, Clinical Hospital Centre, Rebro,Kispaticeva 12, 41000 Zagreb; Croatia. TI - Prostaglandin E2 for prophylaxis of oral mucositis following BMT. SO - Bone Marrow Transplantation Vol 11(5) (pp 379-382), 1993. AB - Between October 1988 and December 1990, 60 patients with leukaemia (25 with AML, 19 ALL and 16 CML) undergoing BMT were randomised in a double-blind clinical trial to receive prostaglandin E2 (PGE) (Prostin E2, 0.5 mg per tablet) or placebo for prophylaxis of oral mucositis. Patients had to dissolve tablets in the mouth three times daily starting 7 days before BMT and continuing until 21 days after BMT. The incidence of severe oral mucositis was similar for both groups, 55% in patients receiving PGE and 52% in patients receiving placebo. The duration of severe mucositis did not differ between PGE and placebo groups (chi-square 0.95, p = NS). The incidence of HSV infection was significantly higher in patients receiving PGE. Patients with HSV infection receiving PGE also had a higher incidence of severe oral mucositis. The results presented indicate that PGE is not effective for prophylaxis of oral mucositis in BMT recipients. <3> UI - 93160645 AU - Drury I AU - Beydoun A IN - EEG and Epilepsy Laboratories, Department of Neurology, Univ of Michigan School of Medicine,Ann Arbor, MI; United States of America. TI - Seizure disorders of aging: Differential diagnosis and patient management. SO - Geriatrics Vol 48(5) (pp 52-54+57-58), 1993. AB - The incidence of seizures increases significantly after age 60, mainly because of an associated rise in the prevalence of such etiologies as stoke, brain tumors, and toxic metabolic disturbances, including alcohol or drug misuse and diabetes. The differential diagnosis must rule out transient ischemic attacks, syncope, and psychiatric disorders, among other conditions. Treatment is based on the underlying cause. Seizures caused by toxic metabolic disturbances are treated by correcting the underlying condition. Those with other etiologies require single drug therapy with an anticonvulsant, such as phenytoin, valproic acid or carbamazepine. <4> UI - 93157949 AU - Slots J AU - Chen C IN - School of Dentistry, University of Southern California, 925 West 34th Street,Los Angeles, CA 90089-0641; United States of America. TI - Detection of Porphyromonas gingivalis associated with human periodontitis by DNA methods. SO - Clinical Infectious Diseases Vol 16(SUPPL. 4) (pp S317-S318), 1993. <5> UI - 93149798 AU - Coplans MP AU - Curson I IN - 32 The Hamlet,Champion Hill, London SE5 8AW; United Kingdom. TI - Deaths associated with dentistry and dental disease 1980-1989. SO - Anaesthesia Vol 48(5) (pp 435-438), 1993. AB - A study of deaths associated with dentistry and dental disease in England and Wales between 1980 and 1989 has been undertaken. There were fewer deaths associated with dentistry than in the previous decade. Whilst most of the deaths are still associated with general anaesthesia, the total number has decreased, as has the percentage of deaths in which general anaesthesia was thought to play a significant part. There were only four deaths involving an operator/anaesthetist compared with 13 in the previous decade and all four took place between 1980 and 1983. However, there were two deaths associated with sedation techniques, both of which occurred after 1984, whereas there had been none in the previous decade. On the information available, it is still not possible to establish the role of the patient's posture in these deaths. <6> UI - 93143865 AU - Donoff RB AU - Rosenberg AE AU - Weber AR AU - Scully RE AU - Colin WB IN - Dept. of Oral/Maxillofacial Surgery, Harvard School of Dental Medicine, Massachusetts General Hospital,Boston, MA; United States of America. TI - A 23-year-old woman with a rapidly enlarging intraoral mass after a tooth extraction. SO - New England Journal of Medicine Vol 328(20) (pp 1478-1483), 1993. <7> UI - 93121201 AU - Lowe GDO IN - Department of Medicine, Royal Infirmary,Glasgow G31 2ER; United Kingdom. TI - Roles of white cells and fibrinogen [6]. SO - British Medical Journal Vol 306(6886) (pp 1196), 1993. <8> UI - 93121200 AU - Fuchs D AU - Reibnegger G AU - Wachter H IN - Inst. Med. Chemistry/Biochemistry, University of Innsbruck,A-6020 Innsbruck; Austria. TI - Biological mechanisms for link [5]. SO - British Medical Journal Vol 306(6886) (pp 1196), 1993. <9> UI - 93102972 AU - Newton JR AU - Freeman CP AU - Hannan WJ AU - Cowen S IN - Department of Psychiatry, Royal Park Hospital, Private Bag No 3,Parkville, 3052 Melbourne, Vic; Australia. TI - Osteoporosis and normal weight bulimia nervosa - Which patients are at risk?. SO - Journal of Psychosomatic Research Vol 37(3) (pp 239-247), 1993. AB - This study assesses the degree of bone mineral loss in women with active DSM IIIR bulimia nervosa. The subjects in this study were 20 GP-referred female patients of normal weight who met criteria for bulimia nervosa and 16 healthy age, sex and weight matched controls. Dual energy X-ray densitometry of lumbar L1-L4 vertebrae was performed on all subjects. The patients with bulimia nervosa had a significantly lower mean lumbar bone mineral density (0.964 g/cm2) than the control group (1.043 g/cm2, p < 0.01). Within the patient group only subjects with a past history of anorexia nervosa had a significantly lower mean bone mineral density (BMD) than the controls. Small sample sizes limit the power of the study, however significant correlations were found between duration of amenorrhoea, low BMI and lumbar BMD. Bulimic patients do suffer from osteoporosis. Risk factors for this may be; a past history of anorexia nervosa, prolonged secondary amenorrhoea, and a persistently low body mass index. <10> UI - 93101638 AU - Bessette PR AU - Hanson MJ AU - Czarnecki DJ AU - Yuille DL AU - Rankin JJ IN - St Luke's Medical Center, 2900 West Oklahoma Avenue,Milwaukee, WI 53215; United States of America. TI - Evaluation of postoperative osteomyelitis of the sternum comparing CT and dual Tc-99m MDP bone and In-111 WBC SPECT. SO - Clinical Nuclear Medicine Vol 18(3) (pp 197-202), 1993. AB - This article reports on a retrospective study of 32 patients who underwent CT and combined Tc-99m MDP and In-111 WBC SPECT between 1988 and 1991 for postoperative sternal osteomyelitis. Of these 32 patients, 7 patients (Group 1) underwent evaluation for possible sternal osteomyelitis due to persistent fevers, leukocytosis, or changes in the sternal incision; 12 patients (Group 2) had surgically proven osteomyelitis, and in 13 patients (Group 3) there was definite clinical evidence of sternal wound infection (however, surgical specimens of the sternum were not submitted). There was considerable overlap between the CT findings in the soft tissues adjacent to the sternum in Group 1 and Group 2 patients. Severe demineralization was seen in two patients, and erosion of the sternum was seen in five patients with proven osteomyelitis. Combined Tc-99m MDP bone and In-111 WBC SPECT was positive for osteomyelitis in 11 of 12 patients in Group 2. One patient with osteomyelitis had negative scintigraphy; however, this patient had a four-week course of IV antibiotic therapy prior to the study. All seven patients in Group 1 had negative SPECT scans and were treated successfully with oral antibiotics and minimal soft tissue debridement. Three patients in Group 3 had negative SPECT scans and were treated successfully with antibiotics and limited debridement. Ten patients with positive SPECT scans were treated with a combination of antibiotics and aggressive surgical intervention. In conclusion, CT findings in the soft tissues offer little specificity in distinguishing soft tissue inflammation from osteomyelitis of the sternum. Furthermore, bone demineralization and erosion, except in the most severe cases, are often difficult to interpret because of surgical changes. Although the sample is small, combined Tc-99m MDP bone and In-111 WBC SPECT seems to be a superior imaging modality in identifying postoperative osteomyelitis of the sternum. <11> UI - 93097660 AU - Tolman DE AU - Laney WR IN - Department of Dentistry, Mayo Clinic,Rochester, MN 55905; United States of America. TI - Tissue-integrated dental prostheses: The first 78 months of experience at the Mayo Clinic. SO - Mayo Clinic Proceedings Vol 68(4) (pp 323-331), 1993. AB - During a 78-month period at the Mayo Clinic, 1,778 Branemark endosseous dental implants were placed in the edentulous or partially edentulous jaws of 353 consecutive patients who ranged in age from 8 to 82 years. The largest treatment category involved edentulous mandibles, which accounted for 53% of the total restorations. Approximately 76% of the threaded cylindrical implants supported 312 oral prostheses at the end of the study period. The implant survival rate was 97.8% in the mandible and 88.8% in the maxilla. Complications associated with this treatment included loss of implant anchorage in bone, soft tissue problems, and mechanical difficulties related to design and function of the prostheses. All complications were managed without loss of continuous function of the prostheses, except in four patients who resumed wearing a conventional removable maxillary complete denture. This experience demonstrates that Branemark endosseous dental implants are predictable and can provide lasting integration under function when placed and loaded in accordance with the recommended protocol. <12> UI - 93091454 AU - De Marco JK AU - Hesselink JR IN - Department of Radiology, Naval Hospital,San Diego, CA 92134; United States of America. TI - Trigeminal neuropathy. SO - Neuroimaging Clinics of North America Vol 3(1) (pp 105-128+B), 1993. AB - Imaging of the trigeminal nerve is useful in a variety of clinical settings. Magnetic resonance imaging signal characteristics of segments of the trigeminal nerve as well as common clinical syndromes are reviewed. Trigeminal nerve imaging with computed tomography and magnetic resonance is compared, and a protocol is offered for magnetic resonance imaging. <13> UI - 93084430 AU - Franco EL AU - Dib LL AU - Pinto DS AU - Lombardo V AU - Contesini H IN - Institut Armand-Frappier, 531 Des Prairies Blvd,Laval, QC. H7V 1B7; Canada. TI - Race and gender influences on the survival of patients with mouth cancer. SO - Journal of Clinical Epidemiology Vol 46(1) (pp 37-46), 1993. AB - Previous studies have shown that race and gender are important correlates of survival among patients with cancer of certain sites. Since race and gender influence the stage of disease at diagnosis and the choice of therapy it has been argued that survival differentials may not be real but instead, they represent secondary associations with clinical variables. Therefore, verification of the true prognostic effects of race and gender requires proper controlling for potential confounders, such as stage and treatment. We have studied the 15-year survival experience of a hospital-based cohort of 4527 patients diagnosed with cancer of the mouth over a 28-year period in Brazil. Race and gender were strong predictors of stage and treatment. The odds ratios for no treatment were 1.35 (95% confidence limits [CL]: 1.09, 1.66) for females and 1.63 (CL: 1.29, 2.06) for non-white patients even after adjustment by stage, presumably a key criterion to define treatment. Survival differentials were found for lip-cancer, with respect to race, and for cancers of the gum, floor of mouth, and other oral subsites, with respect to gender. Non-whites experienced 2.1 times the risk of lip cancer recurrence (CL: 1.20, 3.61) and 2.3 times the risk of dying from it (CL: 1.29, 4.09) as compared to whites. However, controlling for stage and treatment modality variables by proportional hazards regression reduced the same risk ratios to 1.01 (CL: 0.57, 1.78) and 1.17 (CL: 0.65, 2.13), respectively. The survival advantage experienced by females (17% lower risk of recurrences and 29% lower risk of cancer deaths) regarding other oral sites was independent from the effect of clinical factors. <14> UI - 93063115 AU - Marbach JJ IN - School of Public Health, Columbia University, 600 West 168th Street,New York, NY 10032; United States of America. TI - Is phantom tooth pain a deafferentation (neuropathic) syndrome? Part II: Psychosocial considerations. SO - Oral Surgery, Oral Medicine, Oral Pathology Vol 75(2) (pp 225-232), 1993. <15> UI - 93062030 AU - Saksena S AU - Bardy G AU - Benditt D AU - Childson D AU - Connolly S AU - Dorian P AU - Downar E AU - Dubuc M AU - Echt D AU - Fisher J AU - Furman S AU - Fogoros R AU - Gulamhusein S AU - Haffajee C AU - Hammill S AU - Irwin J AU - Josephson M AU - Klein G AU - Kron J AU - et al IN - Eastern Heart Institute, 350 Boulevard,Passaic, NJ 07055; United States of America. TI - Defibrillation thresholds and perioperative mortality associated with endocardial and epicardial defibrillation lead systems. SO - Pacing & Clinical Electrophysiology Vol 16(1 II) (pp 202-207), 1993. AB - Defibrillation thresholds (DFT) and perioperative mortality were evaluated in 123 patients who had endocardial defibrillation leads implanted in conjunction with the Medtronic model 7216A/7217 (Medtronic, Inc.) cardioverter-defibrillator (ICD). Clinical variables, implant DFTs, and 30-day perioperative mortality were compared with 266 patients who had the ICD implanted with epicardial defibrillation leads. The two groups were comparable in age, gender, and incidence of coronary artery disease. New York Heart Association Class I and II were more frequent in patients with endocardial leads (87.7%) as compared to those with epicardial leads (78.8%; P < 0.001). Mean left ventricular ejection fraction was significantly higher in patients with the endocardial lead system (37% vs 33%; P < 0.05). A significant proportion of patients with epicardial lead systems underwent another cardiac surgical procedure at the time of ICD implantation (13.9%) as compared to none in those who had endocardial leads implanted (P < 0.001). All patients with endocardial leads and implantation of triple lead systems as compared to 53.4% with epicardial leads (P < 0.001). The mean DFT at implant was lower in epicardial lead recipients (8.9 J) as compared to endocardial lead recipients (13.3 J; P < 0.001). Perioperative mortality had a significant trend to lower risk for endocardial lead systems (0.8%) as compared to epicardial systems (4.2%; P = 0.07). We conclude that this endocardial lead system has additional electrode and higher defibrillation energy requirements than the epicardial lead systems used with the Medtronic pacemaker ICD. However, the use of endocardial nonthoracotomy defibrillation leads is associated with a markedly reduced perioperative risk of ICD implantation. This could be due to patient characteristics, a less invasive implant procedure, and absence of concomitant cardiac surgery. <16> UI - 93056582 AU - Mohammadi-Araghi H AU - Haery C IN - Dept. of Oral/Maxillofacial Surgery, College of Dentistry, University of Illinois, 801 S. Paulina,Chicago, IL 60612; United States of America. TI - Fibro-osseous lesions of craniofacial bones: The role of imaging. SO - Radiologic Clinics of North America Vol 31(1) (pp 121-134), 1993. AB - Fibro-osseous lesions of the craniofacial structures are a group of pathologic conditions that are somewhat difficult to classify. Fibro-osseous lesions of the jaw may be divided into two categories: fibrous dysplasia, a developmental lesion characterized by the development of swelling, which consists of proliferating fibrous tissue that replaces normal bone; and those that have been postulated to originate from the periodontal ligament. This article describes the imaging characteristics of fibrous dysplasia and other fibro-osseous lesions of oral bones, including ossifying fibroma, periapical cemental dysplasia, cemento-ossifying fibroma, and florid osseous dysplasia. <17> UI - 93047422 AU - Rowland RW AU - Escobar MR AU - Friedman RB AU - Kaplowitz LG IN - Box 566 MCV Station,Richmond, VA 23298; United States of America. TI - Painful gingivitis may be an early sign of infection with the human immunodeficiency virus. SO - Clinical Infectious Diseases Vol 16(2) (pp 233-236), 1993. AB - Anecdotal reports have suggested that painful gingivitis may be associated with infection due to the human immunodeficiency virus (HIV). Twenty patients who presented to the emergency department with a chief complaint of gum pain were evaluated for HIV infection. CD4/CD8 T lymphocyte profiles, complete blood cell counts and differentials, and lymphocyte function (response to mitogenic stimulation). Seven of the 20 patients (35%) were seropositive for HIV. Three of the seven HIV-seropositive patients were unaware of their HIV infection until tested in this study (with use of an ELISA and western blotting). The HIV-seropositive patients were significantly older than the HIV-seronegative patients (31.4 +/- 3 years and 24 +/- 1 year, respectively). Two of the seven HIV-seropositive patients presented with severe CD4 lymphocyte depletion. The other five HIV-seropositive patients presented with CD4 lymphocyte counts of 473 +/- 155 (mean +/- SE). Regardless of HIV serological status, all patients demonstrated a severely depressed mitogenic response when compared with control subjects. There were no remarkable differences in complete blood cell counts and differentials within each serological group. Significant differences, however, were noted when CD4/CD8 lymphocyte counts and ratios were measured. Identification of clinical presentations, such as painful gingivitis, that reflect an early stage of HIV infection could aid in the timing of therapy and prevention of the spread of HIV infection. <18> UI - 93047084 AU - Childers NK AU - Stinnett EA AU - Wheeler P AU - Wright JT AU - Castleberry RP AU - Dasanayake AP IN - DCPHD, School of Dentistry, University of Alabama,Birmingham, AL 35294; United States of America. TI - Oral complications in children with cancer. SO - Oral Surgery, Oral Medicine, Oral Pathology Vol 75(1) (pp 41-47), 1993. <19> UI - 93046978 AU - Mizuno I AU - Mizutani H AU - Ueda M AU - Kaneda T IN - Department of Oral Surgery, Nagoya University School of Medicine, 65, Tsuruma-cho,Showa-Ku, Nagoya 466; Japan. TI - Temporal necrotizing infection of dental origin. SO - Journal of Oral & Maxillofacial Surgery Vol 51(1) (pp 79-81), 1993. <20> UI - 93044212 AU - Schwartz GG IN - Dept. Clin. Epidem./Prev. Medicine, Univ. of Pittsburgh Sch. of Medicine,Pittsburgh, PA 15261; United States of America. TI - Multiple sclerosis and prostate cancer: What do their similar geographies suggest?. SO - Neuroepidemiology Vol 11(4-6) (pp 244-254), 1992. AB - Mortality rates from multiple sclerosis show a well-known north-south gradient, both within the United States and internationally. Mortality rates from prostate cancer show a similar gradient and are significantly correlated with multiple sclerosis (MS) mortality and MS prevalence. This finding adds prostate cancer to the set of diseases whose geographic distributions are significantly correlated with MS and whose members include colon cancer, dental caries, and Parkinson's disease. Review of the literature indicates that these clinically dissimilar diseases may share an aberration in vitamin (hormone) D. Recent evidence demonstrating a multi-faceted role for vitamin D in immunoregulation suggests that a vitamin D aberration may also contribute to the etiology of MS. A vitamin D hypothesis can illuminate several unexplained features of the epidemiology of MS and suggests opportunities for epidemiologic, laboratory, and clinical investigation. <21> UI - 93034756 AU - Ciesielski C AU - Marianos D AU - Ou C-Y AU - Dumbaugh R AU - Witte J AU - Berkelman R AU - Gooch B AU - Myers G AU - Luo C-C AU - Schochetman G AU - Howell J AU - Lasch A AU - Bell K AU - Economou N AU - Scott B AU - Furman L AU - Curran J AU - Jaffe H IN - Division of HIV/AIDS, Centers for Disease Control, 1600 Clifton Road N.E.,Atlanta, GA 30333; United States of America. TI - Transmission of human immunodeficiency virus in a dental practice. SO - Annals of Internal Medicine Vol 116(10) (pp 798-805), 1992. AB - Objective: To determine if patients of a dentist with the acquired immunodeficiency syndrome (AIDS) became infected with human immunodeficiency virus (HIV) during their dental care and, if so, to identify possible mechanisms of transmission. Design: Retrospective epidemiologic follow-up of the dentist, his office practice, and his former patients. Setting: The practice of a dentist with AIDS in Florida. Participants: A dentist with AIDS, his health care providers and employees, and former patients of the dentist, including eight HIV-infected patients. Measurements: Identification of risks for HIV transmission (if present), degree of genetic relatedness of the viruses, and identification of infection control and other office practices. Results: Five of the eight HIV-infected patients had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P > 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified. Conclusion: Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route. <22> UI - 93013872 AU - Loe H IN - Natl. Institute of Dental Research, National Institutes of Health, Building 31,Bethesda, MD 20892; United States of America. TI - Periodontal disease: The sixth complication of diabetes mellitus. SO - Diabetes Care Vol 16(1) (pp 329-334), 1993. <23> UI - 93011663 AU - Rosman J AU - Steinhauslin F AU - David S AU - Genton A AU - Mosimann F AU - Wauters J-P IN - Division of Nephrology, Department of Internal Medicine, University Hospital of Lausanne,CH-1011 Lausanne; Switzerland. TI - Impact of recipient and donor age on the outcome of renal transplantation. SO - Transplantation Proceedings Vol 24(6) (pp 2723-2724), 1992. <24> UI - 93009993 AU - Loeliger A AU - Van Leeuwen M AU - Rozenberg-Arska M AU - Dekker AW IN - Dept of Internal Medicine, University Hospital Utrecht, PO Box 85500,NL-3508 GA Utrecht; Netherlands. TI - Hepatosplenic candidiasis, a fatal disease?. SO - Infection Vol 20(6) (pp 336-338), 1992. AB - We report on two patients with acute leukemia and prolonged granulocytopenia after cytotoxic therapy in whom the diagnosis hepatosplenic candidiasis was made. Both patients developed upper abdominal discomfort with elevated alkaline phosphatase after resolution of granulocytopenia. The diagnosis was established by demonstration of multiple abscesses in liver and spleen on ultrasound and computed tomography. Both patients were initially treated with amphotericin B i.v., one of them received liposomal amphotericin B (cumulative dose of 2,530mg and 570mg, respectively). Thereafter, therapy was continued for months with oral fluconazole. The treatment of hepatosplenic candidiasis was successful, however, the patients died from relapse and progression of leukemia. <25> UI - 92367328 AU - Gift HC AU - Reisine ST AU - Larach DC IN - NIH/NIDR, Westwood Bldg, 5333 Westbard Ave,Bethesda, MD 20892; United States of America. TI - The social impact of dental problems and visits. SO - American Journal of Public Health Vol 82(12) (pp 1663-1668), 1992. AB - Objectives. The purpose of this analysis was to assess selected social consequences of maintaining oral health and treating oral diseases. The associations among socioeconomic and demographic factors with time lost from work or school and reductions in normal activities are explored. Methods. Data were gathered as part of the 1989 National Health Interview Survey from 50 000 US households (117 000 individuals), representing 240 million persons. The oral health care supplement was analyzed using the software SUDAAN to produce standard errors for estimates based on complex multistage sample designs. Results. Because of dental visits or problems, 148 000 hours of work were lost per 100 000 workers, 117 000 hours of school were lost per 100 000 school-age children, and 17 000 activity days beyond work and school time were restricted per 100 000 individuals in 1989. Exploratory analyses suggest that sociodemographic groups have different patterns of such time loss and of reduced normal activities. Conclusions. Overall, there is low social impact individually from dental visits and oral conditions. At the societal level, however, such problems and treatments among disadvantaged groups appear to have a greater impact. <26> UI - 92359266 AU - Crippin JS AU - Wang KK IN - Baylor University Medical Center, 3 Truett, 3500 Gaston Avenue,Dallas, TX 75246; United States of America. TI - An unrecognized etiology for pyogenic hepatic abscesses in normal hosts: Dental disease. SO - American Journal of Gastroenterology Vol 87(12) (pp 1740-1743), 1992. AB - Cryptogenic pyogenic hepatic abscesses are a diagnosis of exclusion. We have identified two patients with severe dental disease at the time of the diagnosis of their liver abscess. In both cases, oral flora was cultured from the abscess. Unlike a previous report, both patients were immunocompetent. When compared with a group of patients with liver abscesses and diverticulitis, two differences were found. In contrast to the single abscesses seen in 10 of 10 patients with diverticulitis, the patients with dental disease had multiple abscesses (p < 0.02). In addition, Fusobacterium nucleatum was cultured from both dental disease associated abscesses but only one of the diverticulitis associated liver abscesses (p < 0.05). If a liver abscess is thought to be cryptogenic, a thorough dental exam is recommended. <27> UI - 92359263 AU - Malaty HM AU - Evans Jr DJ AU - Abramovitch K AU - Evans DG AU - Graham DY IN - Veterans Affairs Medical Center, 2002 Holcombe Boulevard,Houston, TX 77030; United States of America. TI - Helicobacter pylori infection in dental workers: A seroepidemiology study. SO - American Journal of Gastroenterology Vol 87(12) (pp 1728-1731), 1992. AB - The finding of Helicobacter pylori in dental plaque suggested that dental workers may be at increased risk of acquiring H. pylori infection from occupational exposure. A cross-sectional survey of 239 dental workers from 37 Texas cities (including 89 dentists, 44 dental hygienists, 98 dental assistants, and eight dental students) was conducted. H. pylori infection was determined by the presence of IgG antibodies to H. pylori, using a specific and sensitive ELISA. Participants ranged in age from 19 to 72 yr (mean 34 yr) and the duration of dental practice ranged from 1 to 48 yr (mean 12 yr). Type of dental occupation, duration of practice, type of practice (public or private), instrument used for cleaning teeth (ultrasonic scaler or curette), and prevalence of upper gastrointestinal symptoms were determined by self- administered questionnaires and interviews. Eighty-two percent had no symptoms referable to the upper gastrointestinal tract. The overall prevalence of H. pylori infection was 24%: 17% in dentists, 18% in dental hygienists, 34% in dental assistants, and 25% in dental students. The prevalence increased significantly with age (p < 0.05). The prevalence of H. pylori infection was significantly higher in non-whites, 29 of 63 (46%), than whites, 29 of 176 (16%) (p < 0.001). Logistic regression analysis (dependent variable H. pylori) revealed no significant association between H. pylori infection and the type, duration, or volume of practice, or the type of cleaning instrument used. We conclude that dental workers are not at increased risk to H. pylori infection. <28> UI - 92353264 AU - Anonymous TI - Risk of HIV transmission during dental treatment. SO - Lancet Vol 340(8830) (pp 1259-1260), 1992. <29> UI - 92350603 AU - Forred WA AU - Brunader REA AU - Mork TJ AU - Kugler JP IN - Department of Family Practice, Silas B. Hays Army Community Hosp.,Fort Ord, CA; United States of America. TI - An educational report: The mechanics of geriatric assessment in a military community-based family practice residency. SO - Military Medicine Vol 157(11) (pp 586-590), 1992. <30> UI - 92347029 AU - Teja Z AU - Persson R AU - Omnell L IN - Dental Department, Children's Hospital/Medical Center, 4800 Sandpoint Way NE,Seattle, WA 98105; United States of America. TI - Periodontal status of teeth adjacent to nongrafted unilateral alveolar clefts. SO - Cleft Palate-Craniofacial Journal Vol 29(4) (pp 357-362), 1992. AB - The purpose of this study was to compare the periodontal condition of teeth adjacent to the cleft with contralateral teeth in adult subjects with a nongrafted unilateral alveolar cleft. Periodontal parameters were evaluated in 18 subjects who had at least one tooth immediately adjacent to the cleft. For each tooth investigated, plaque index, gingival index, and probing depth were recorded and each tooth was assigned a mobility score. Width of attached gingiva and extent of recession was measured. Bone level was assessed using standardized magnified radiographs and a computerized digitizing system. The overall findings of this study support those of other studies and indicate that in individuals with a nongrafted alveolar cleft, teeth adjacent to the defect show signs of gingivitis but not of periodontal disease. The anatomic defect, eruption pattern, orthodontic tooth movements, and the presence of restorations appear to contribute to the reduced bone level on the central incisor adjacent to the cleft and to the presence of gingivitis. <31> UI - 92346626 AU - Shields JA AU - Shields CL AU - Shah PG AU - Pastore DJ AU - Imperiale Jr SM IN - Ocular Oncology Service, Wills Eye Hospital, 900 Walnut St,Philadelphia, PA 19107; United States of America. TI - Lack of association among typical congenital hypertrophy of the retinal pigment epithelium, adenomatous polyposis, and Gardner syndrome. SO - Ophthalmology Vol 99(11) (pp 1709-1713), 1992. AB - Background: It has been recently documented that multiple bilateral pigmented lesions at the level of the retinal pigment epithelium may be an indicator of patients with familial adenomatous polyposis who are prone to develop intestinal cancer, particularly if there is a positive family history of these intestinal disorders. Although atypical, such lesions have been called congenital hypertrophy of the retinal pigment epithelium (CHRPE). This study was undertaken to determine whether the typical lesions of CHRPE, seen frequently by ophthalmologists, also were indicators of familial adenomatous polyposis. Methods: Review of charts and follow-up studies were performed on all patients diagnosed and coded as having solitary CHRPE or its multifocal variant (congenital grouped pigmentation; bear tracks). Patients and their physicians were contacted by telephone to complete a detailed questionnaire designed to detect signs or symptoms of familial adenomatous polyposis or Gardner syndrome among these patients with CHRPE and their relatives. Results: Of the 132 patients with previously diagnosed CHRPE, there were none with familial adenomatous polyposis. Gardner syndrome, or intestinal cancer, and only one patient had a history of intestinal polyps. Among more than 2000 of their blood relatives, only 20 had intestinal polyposis or colonic cancer (1%). This is much lower than would be expected from a survey of patients with the typical fundus lesions seen with familial adenomatous polyposis. Conclusion: It appears that solitary CHRPE and congenital grouped pigmentation differ clinically from the multiple pigmented lesions seen with familial adenomatous polyposis and that patients with these conditions, as well as their relatives, are not at a greater risk of developing intestinal cancer. <32> UI - 92343680 AU - Reed JM AU - Anand VK IN - Division of Otolaryngology, 2500 North State St.,Jackson, MS 39216-4505; United States of America. TI - Odontogenic cervical necrotizing fasciitis with intrathoracic extension. SO - Otolaryngology & Head & Neck Surgery Vol 107(4) (pp 596-600), 1992. <33> UI - 92323934 AU - Grimstad IA AU - Hirschberg H AU - Rootwelt K IN - Department of Clinical Chemistry, Rikshospitalet,0027 Oslo; Norway. TI - 99mTc-hexamethylpropyleneamine oxime leukocyte scintigraphy and C- reactive protein levels in the differential diagnosis of brain abscesses. SO - Journal of Neurosurgery Vol 77(5) (pp 732-736), 1992. AB - The demonstration and accurate localization of intracerebral mass lesions are commonly performed with computerized tomography (CT), which often cannot determine the nature of the lesion. As an aid in the differential diagnosis between brain abscess and neoplasm, the authors have evaluated both 99mTc- hexamethylpropyleneamine oxime (99mTc-HMPAO) leukocyte scintigraphy and the serum C-reactive protein level. Of 23 patients with intracranial mass lesions, 22 individuals showed ring-like contrast enhancement on CT scans: the one exception was a patient treated for a meningioma who had a negative CT scan despite clinical suspicion of intra- or extracranial abscess. The final diagnosis was invariably established by microscopic examination of tissue specimens. In 10 patients the final diagnosis was brain abscess; the other 13 patients harbored a brain neoplasm (glioma in nine, astrocytoma in one, and metastasis in three). The 99mTc-HMPAO leukocyte scintigraphy detected all cases of abscess. There were no false-positive results. An elevated C-reactive protein level (> 13 mg/liter) was found in all but one patient with abscess and in three patients with neoplasm; two of these three patients had dental root infections which could account for the elevation of C-reactive protein. It is concluded that 99mTc-HMPAO leukocyte scintigraphy should be performed when there is a possibility that a brain abscess may exist. Any steroid treatment should be discontinued for 48 hours prior to leukocyte scintigraphy. Also, C-reactive protein determination should be performed and is useful even when steroids are given. <34> UI - 92288749 AU - Jacobi KP AU - Cook DC AU - Corruccini RS AU - Handler JS IN - Department of Anthropology, Indiana University,Bloomington, IN 47405; United States of America. TI - Congenital syphilis in the past: Slaves at Newton Plantation, Barbados, West Indies. SO - American Journal of Physical Anthropology Vol 89(2) (pp 145-158), 1992. AB - Hutchinson's incisors and Moon's molars are specific lesions of congenital syphilis. The extensive but fragmentary clinical literature on these conditions describes reduced dimensions and thin enamel in the permanent incisors and first molars, crowding and infolding of the first molar cusps, notching of the upper incisors, and apical hypoplasias of the permanent canines. A Barbados slave cemetery (ca. 1660-1820 AD) includes three individuals with these features, suggesting a frequency at birth of congenital syphilis in the population approaching 10%. These three cases show triple the frequency of all hypoplasias and more than seven times the frequency of pitting hypoplasia present in the remainder of the series. The recognizable congenital syphilis cases account for much of the remarkably high frequency of hypoplasias in the series as a whole. We infer that syphilis contributed substantially to morbidity, infant mortality, and infertility in this population. Presence or absence of congenital syphilis may account for much of the variability in health and mortality seen among nineteenth century African-American populations. <35> UI - 92287178 AU - Strumia R AU - Perini L AU - Tarroni G AU - Fiocchi O AU - Gilli P IN - Clinica Dermatologica, Universita degli Studi,I-44100 Ferrara; Italy. TI - Skin lesions in kidney transplant recipients. SO - Nephron Vol 62(2) (pp 137-141), 1992. AB - A complete examination of the skin was performed in 53 kidney transplant recipients. Cutaneous lesions were detected in almost all patients. Papillomavirus infections, premalignant and malignant lesions represent the greatest risk for these patients. Our study underlines the importance of a continuous observation to facilitate early diagnosis and treatment of these lesions. <36> UI - 92276362 AU - Galmarini D AU - Fassati LR AU - Caccamo L AU - Colledan M AU - Doglia M AU - Ferla G AU - Gatti S AU - Gridelli B AU - Lucianetti A AU - Maggi U AU - Paone G AU - Piazzini A AU - Reggiani P AU - Rossi G IN - Centro Trapianto Fegato, Ospedale Maggiore Policlinico, IRCCS, Via F. Sforza 35,20122 Milano; Italy. TI - The cyclosporin related toxicity in high risk liver transplant patients. SO - Pharmacological Research Vol 26(SUPPL. 2) (pp 18-19), 1992. <37> UI - 92255486 AU - Pan W-L AU - Chan C-P AU - Huang C-C AU - Lai M-K IN - Department of Periodontics, Chang-Gung Memorial Hospital, 199 Tung-Hwa North Rd,Taipei; Taiwan. TI - Cyclosporine-induced gingival overgrowth. SO - Transplantation Proceedings Vol 24(4) (pp 1393-1394), 1992. <38> UI - 92251046 AU - Ellen RP IN - Faculty of Dentistry, University of Toronto, 124 Edward Street,Toronto, Ont. M5G 1G6; Canada. TI - Considerations for physicians caring for older adults with periodontal disease. SO - Clinics in Geriatric Medicine Vol 8(3) (pp 599-616), 1992. AB - Periodontal disease is a generic term encompassing a variety of inflammatory conditions affecting the supporting tissues of the teeth. Periodontitis is inflammation associated with net resorption of supporting alveolar bone and periodontal ligament. Gingivitis is inflammation limited to the covering gingival tissues and does not directly lead to tooth mobility or loss. Periodontal diseases are very prevalent. Because the bone and ligament resorption are essentially irreversible, accumulated tissue damage of periodontitis is reflected in a prevalence and severity that increase with age. Periodontitis is not caused by aging per se but by a complex host- parasite relationship in which specific pathogens among the subgingival microbiota not only injure tissues directly but stimulate a cascade of inflammatory mediators to damage host tissues. Analytic epidemiology has identified several risk indicators for advanced periodontitis in older adults. These are microbiologic (prevalence of certain anaerobes in the microbiota), behavioral (tobacco smoking and infrequent professional dental care), medical (older age, preexisting and generalized periodontitis, gingival bleeding), and social (financial worries). Periodontitis in older adults is treated by reducing the impact of these risk indicators. The infections are controlled by combinations of debridement, antimicrobial agents, and surgical procedures as indicated. Medically well older adults can be treated similarly to younger adults. Management of periodontal conditions can be complicated for patients who are medically compromised. Communication between physicians and dental personnel is often required to ascertain the medical history and list of medications taken by older patients. Many of the medications prescribed for medical problems associated with aging impact on treatment choices for managing periodontitis. Moreover, periodontists frequently prescribe analgesics, antibiotics, and anti-inflammatory agents that might interact with others among the numerous drugs taken by older patients. Older adults with cognitive or physical disabilities have special needs for individualized hygiene instruction and implements. Periodontal health promotion and improving access to periodontal care for the elderly are challenges, because dental services are most often in the private sector and dental insurance does not often apply after retirement. Because they grew up in an era in which tooth loss due to 'gum' diseases was considered inevitable, their current motivation toward regular preventive care must be improved by removing barriers and impediments to care. In addition to life- threatening medical conditions, frail individuals institutionalized in collective living centers face compounded problems concerning the provision of adequate, not even optimal, dental care. Their periodontal health often deteriorates rapidly after institutionalization, and in some instances it can possibly predispose to aspiration pneumonia or other disseminated infections. Thus there are many reasons why physicians should educate themselves about the natural history, causes, and treatments for periodontal diseases and should become more sensitive to the challenges faced by the dental team trying to serve an aging population by preserving their periodontal health. <39> UI - 92250818 AU - Reginato AJ AU - Falasca GF AU - Gloth FM TI - Can vitamin D deficiency produce an unusual pain syndrome? [2]. SO - Archives of Internal Medicine Vol 152(8) (pp 1720-1721), 1992. <40> UI - 92238709 AU - Sandor T AU - Felsenberg D AU - Kalender WA AU - Clain A AU - Brown E IN - Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street,Boston, MA 02115; United States of America. TI - Compact and trabecular components of the spine using quantitative computed tomography. SO - Calcified Tissue International Vol 50(6) (pp 502-506), 1992. AB - A computer algorithm was employed to quantify separately cortical and trabecular bone mineral density (BMD) from single energy computed tomography (CT) scans of 139 vertebrae (L1-L3) of 50 normal female subjects. In addition, the trabecular-to-integral and cortical-to-integral mass ratios were determined using digital image segmentation techniques. They showed that for the central 8-mm vertebral slice, the mass of integral bone consists of about one-fifth trabecular and four-fifth cortical bone. The trabecular-to- integral volume ratios were 0.37 +/- 0.08 and 0.63 +/- 0.08, respectively. Based on cross-sectional data from this subject group, the average annual loss was -2.21 +/- 0.15 mg/cm3 or -1.84 +/- 0.12% for trabecular bone, -3.15 +/- 0.25 mg/cm3 or -1.01 +/- 0.08% for cortical bone, and -2.60 +/- 0.20 mg/cm3 or -1.09 +/- 0.09% for the integral bone. The proportions of the age- related loss of BMD from the integral bone which originated from trabecular and cortical bone were 29.5 and 70.5%, respectively. <41> UI - 92221948 AU - Scannapieco FA AU - Stewart EM AU - Mylotte JM IN - Department of Medicine, Buffalo General Hospital, 100 High Street,Buffalo, NY 14203; United States of America. TI - Colonization of dental plaque by respiratory pathogens in medical intensive care patients. SO - Critical Care Medicine Vol 20(6) (pp 740-745), 1992. AB - Objective: To assess the prevalence of oral colonization by respiratory pathogens in a group of ICU patients, with specific attention to dental plaque and the oral mucosa. Design: Prospective, nonrandomized study with age-matched controls. Settings: Medical ICU in a tertiary-care Veterans Affairs Medical Center and a dental school outpatient preventive dentistry clinic. Patients: Nonconsecutive, unselected patients admitted to the medical ICU during a 2-month period; controls were age-matched patients seen for the first time in the preventive dentistry clinic. Interventions: None. Measurements: Oral hygienic status was assessed in both groups using a semiquantitative system. Quantitative cultures of dental plaque and buccal mucosa were done within 12 hrs of medical ICU admission and every third day thereafter until discharge/death from the medical ICU. In controls, cultures of plaque and buccal mucosa were done on the initial visit only. Severity of illness of medical ICU patients was quantitated using the Acute Physiology and Chronic Health Evaluation (APACHE II) system and McCabe-Jackson criteria. Main Results: Oral hygiene of medical ICU patients was poor. These patients had a mean plaque score (1.9 +/- 0.2) that was significantly greater than that same score seen in outpatients of the preventive dentistry clinic (1.4 +/- 0.1; p < .005). Plaque and/or oral mucosa of 22 (65%) of 34 medical ICU patients were colonized by respiratory pathogens, in contrast to only four (16%) of 25 preventive dentistry clinic patients (p < .005). The potential respiratory pathogens cultured from medical ICU patients included methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and ten genera of Gram-negative bacilli. Colonization by respiratory pathogens was statistically associated with concomitant antibiotic therapy within the medical ICU group of patients, but not with severity of illness. Although medical ICU patients tended to have more dental plaque than preventive dentistry clinic patients, there was no statistically significant association noted between the presence of dental plaque and respiratory pathogen colonization. Conclusions: These findings suggest that bacteria commonly causing nosocomial pneumonia colonize the dental plaque and oral mucosa of intensive care patients. In many cases, this colonization occurs by large numbers of bacteria. Dental plaque may be an important reservoir of these pathogens in medical ICU patients. Efforts to improve oral hygiene in medical ICU patients could reduce plaque load and possibly reduce oropharyngeal colonization. <42> UI - 92201977 AU - Koscielniak E AU - Rodary C AU - Flamant F AU - Carli M AU - Treuner J AU - Pinkerton CR AU - Grotto P IN - Department of Oncology/Haematology, Olga Hospital Paediatric Centre, Bismarckstrasse 8,D-7000 Stuttgart 1; Germany. TI - Metastatic rhabdomyosarcoma and histologically similar tumors in childhood: A retrospective European multi-center analysis. SO - Medical & Pediatric Oncology Vol 20(3) (pp 209-214), 1992. AB - This is a retrospective analysis of children with metastatic soft tissue sarcoma (STS) registered in the major European STS studies: the SIOP MMT 75, the German CWS 1981 and 1986 studies, the Italian STS study, and the United Kingdom Children's Cancer Study Group centres in Britain. One hundred forty- six patients out of 164 were evaluable in this analysis. The median age was 7 years (1-18) and the male/female ratio was 1.3:1. The median follow-up was 80 months (7-171). The most common site of the primary tumor was the extremity (28%), which correlated well with the high preponderance (39%) of the alveolar type of RMS (aRMS). There was no dominant combination of metastatic sites and the most common single organ with metastasis was the lung (41%). Since the therapy depended on the country and period in which the patient was treated, we did not analyse the outcome and therapy together. Complete remission was achieved in 50% of the cases. Those with aRMS had a good chance of achieving CR (61%) but the majority of these patients relapsed (78%). The median time needed to relapse was 243 days (53 days to 47 months) for all patients. Analysis of the site of the primary tumor showed that the CR rate was best in the GU non-BP site (62%) and worst in PM cases (35%). The overall survival and DFS rate were 18% and 15%, respectively. The GU non-BP patients had a DFS rate of 50%, while the rate for all other sites varied between 12% and 18%. A total of 24 patients remained in CCR. The majority of them had embryonal type of RMS and metastases in only one anatomic site. Our analysis indicates that the best chance of prolonged survival was in metastatic GU non-BP cases, patients with embryonal type RMS, and those with metastases in only one organ. To try to improve the treatment of metastatic STS, a prospective European cooperative study was started in 1989. <43> UI - 92188601 AU - Miller CS AU - Damm DD IN - Oral Medicine Section, Department of Oral Health Science, Univ. of Kentucky Col. of Dentistry,Lexington, KY 40536-0084; United States of America. TI - Incidence of verapamil-induced gingival hyperplasia in a dental population. SO - Journal of Periodontology Vol 63(5) (pp 453-456), 1992. <44> UI - 92176373 AU - Herman LL AU - Kurtz RC AU - Brennan MF AU - Shike M IN - Gastroenterology Service, Memorial Sloan-Kettering Cancer Ctr., 1275 York Avenue,New York, NY 10021; United States of America. TI - Acute pancreatitis from intussusception of a gastric polyp in a patient with Gardner's syndrome. SO - Digestive Diseases & Sciences Vol 37(6) (pp 955-960), 1992. AB - Gastric polyps in Gardner's syndrome are usually benign small fundic gland neoplasms with little clinical significance. We report a case of gastroduodenal intussusception secondary to a large benign gastric polyp in a 44-year-old woman with Gardner's syndrome who presented with acute pancreatitis. The intussuscepted polyp caused obstruction of the ampulla of Vater with subsequent acute pancreatitis. <45> UI - 92174594 AU - Bernasconi C AU - Lazzarino M AU - Morra E AU - Alessandrino EP AU - Pagnucco G AU - Resegotti L AU - Locatelli F AU - Ficarra F AU - Bacigalupo A AU - Carella AM AU - Van Lint MT IN - Divisione di Ematologia, Ospedale S. Giovanni Battista,Torino; Italy. TI - Early intensification followed by allo-BMT or auto-BMT or a second intensification in adult ALL: A randomized multicenter study. SO - Leukemia Vol 6(SUPPL. 2) (pp 204-208), 1992. AB - In January 1987 we started a multicenter study in order to evaluate in adult ALL patients the results of an intensive chemotherapy effected early after CR, and to compare the efficacy of allogeneic BMT vs autologous BMT vs prolonged intensive chemotherapy in the attempt to eradicate minimal residual leukemia. To September 1990 ninety-six patients entered this study; of the 87 evaluable for induction 25 were at low risk and 62 at high risk; 67 (77%) achieved CR by an induction chemotherapy including vincristine, adriamycin, cyclophosphamide, dexamethasone. Fifty-six out of 67 remitters were enrolled for the early intensification, which consisted of HDAra-C + amsacrine (or IDAra-C + mitoxantrone) followed by vincristine + adriamycin + cyclophosphamide and etoposide + Ara-C. During the early intensification an unexpectedly high number of relapses (10/56) was observed, showing that very intensive treatment with myelosuppressive agents is not useful at this point of the post-remission therapy. One patient suffered toxic death. Out of 45 patients who completed the early intensification 16 had a related well-matched donor and were selected for allogeneic BMT (performed in 11); of the remaining 29 patients, 14 were randomized for autologous BMT (performed in 9) and 15 for a second intensification. The overall DFS at 3 years is 35%. The high number of early relapses makes it difficult to draw conclusions from the comparison of the three eradication modalities. The best results, although without statistical significance, were obtained after allogeneic BMT; in high-risk patients this procedure should be effected as soon as possible after attainment of CR. Autologous BMT and prolonged intensive chemotherapy gave results similar to each other; both were sometimes followed by delayed relapses. <46> UI - 92171046 AU - Hamilton M IN - M.P.H., P.O. Box 796,Pinetop, AZ 85935; United States of America. TI - Water fluoridation: A risk assessment perspective. SO - Journal of Environmental Health Vol 54(6) (pp 27-32), 1992. AB - In trace quantities, fluoride occurs naturally in the environment and is considered essential for the proper development of bones and teeth. Water fluoridation is the controlled addition of fluoride to the water supply to maintain a concentration which is optimal for the prevention of dental caries. Although fluoride has received extensive study, water fluoridation continues to be a highly controversial issue. A recent study conducted by the National Toxicology Program concluded that there was 'equivocal evidence of carcinogenic activity' associated with sodium fluoride. This paper will review the toxicological data and assess the fluoride exposure for the general population, using a risk assessment approach. The emphasis here is on the practice of water fluoridation and to place this practice in perspective by reviewing the current data. <47> UI - 92147354 AU - Barclay S AU - Thomason JM AU - Idle JR AU - Seymour RA IN - Department of Operative Dentistry, University of Newcastle upon Tyne, Dental School,Newcastle upon Tyne; United Kingdom. TI - The incidence and severity of nifedipine-induced gingival overgrowth. SO - Journal of Clinical Periodontology Vol 19(5) (pp 311-314), 1992. <48> UI - 92127012 AU - Halverson BA AU - Anderson III WH TI - The mandibular third molar position as a predictive criteria for risk for pericoronitis: A retrospective study. SO - Military Medicine Vol 157(3) (pp 142-145), 1992. <49> UI - 92118663 AU - Cawson RA TI - Antibiotic prophylaxis for dental treatment. SO - British Medical Journal Vol 304(6832) (pp 933-934), 1992. <50> UI - 92113880 AU - Hollinger FB AU - Hsiang Ju Lin IN - Division of Molecular Virology, Texas Medical Center, One Baylor Plaza,Houston, TX 77030-3498; United States of America. TI - Community-acquired hepatitis C virus infection. SO - Gastroenterology Vol 102(4) (pp 1426-1429), 1992. <51> UI - 92094360 AU - Felder RS AU - Nardone D AU - Palac R IN - Geriatric Dental Service, 3710 S.W. U.S. Veterans Hospital Rd., Portland, OR 97207; United States of America. TI - Prevalence of predisposing factors for endocarditis among an elderly institutionalized population. SO - Oral Surgery, Oral Medicine, Oral Pathology Vol 73(1) (pp 30-34), 1992. <52> UI - 92088928 AU - Baum D AU - Bernstein D AU - Starnes VA AU - Oyer P AU - Pitlick P AU - Stinson E AU - Shumway N IN - Dept of Pediatrics, Stanford University, School of Medicine,Stanford, CA 94305; United States of America. TI - Pediatric heart transplantation at Stanford: Results of a 15-year experience. SO - Pediatrics Vol 88(2) (pp 203-214), 1991. AB - The long-term results of pediatric heart transplantation were evaluated in 53 patients, aged 0.25 to 18.94 years, who received transplants at Stanford University Medical Center between 1974 and 1989. Indications for transplantation were idiopathic cardiomyopathy (68%), congenital heart disease (21%), endocardial fibroelastosis (8%), and doxorubicin cardiomyopathy (3%). Immunosuppression was achieved with combinations of cyclosporine, prednisone, and azathioprine. Thirty-seven of 42 recipients leaving the hospital after transplantation were alive and in New York Heart Association class I at study's end. Cumulative survival was 79% at 1 year, 76% at 3 years, and 69% at 5 years. Fourteen recipients have survived more than 5 years (5.1 to 12.4 years). Hospital readmission for illness has been infrequent, decreasing from 6.8 days to 0.9 days per year over 5 years. Eleven patients have required no rehospitalization. Posttransplant deaths were due to infection (19%), rejection (4%), pulmonary hypertension (4%), coronary artery disease (2%), and lymphoproliferative disease (2%). Retransplantation was required for intractable rejection in 4 patients and advanced coronary artery disease in 2. Hypertension and elevated blood urea nitrogen and creatinine levels were common in individuals receiving cyclosporine. Growth was often impaired in prepubertal children receiving daily prednisone. Based on this 15-year experience, it is concluded that heart transplantation represents a reasonable alternative for selected young patients with end-stage cardiac disease. <53> UI - 92080418 AU - Wong JD AU - Janda JM IN - Microbial Diseases Laboratory, California Dept./Health Svcs.,Berkeley, CA 94704-1011; United States of America. TI - Association of an important Neisseria species, Neisseria elongata subsp. nitroreducens, with bacteremia, endocarditis, and osteomyelitis. SO - Journal of Clinical Microbiology Vol 30(3) (pp 719-720), 1992. AB - We retrospectively analyzed epidemiologic information associated with 22 cultures of Neisseria elongata subsp. nitroreducens (formerly CDC group M-6) submitted to the Microbial Diseases Laboratory, California Department of Health Services, Berkeley, over a 16-year period. The most common illnesses noted with this bacterium were endocarditis, bacteremia, and osteomyelitis. Risk factors associated with N. elongata subsp. nitroreducens infections included dental manipulations and/or a previous history of endocarditis, valve damage, or rheumatic heart disease. <54> UI - 92075618 AU - Loesche WJ AU - Lopatin DE AU - Stoll J AU - Van Poperin N AU - Hujoel PP IN - Dept. Biological/Material Sci., The University of Michigan, School of Dentistry,Ann Arbor, MI 48109-1078; United States of America. TI - Comparison of various detection methods for periodontopathic bacteria: Can culture be considered the primary reference standard?. SO - Journal of Clinical Microbiology Vol 30(2) (pp 418-426), 1992. AB - The development of diagnostic tests for a periodontal infection raises the issue as to what the appropriate reference standard, or ''gold standard,'' should be for the evaluation of a new test. The present research was initiated to compare the ability of several detection methods, i.e., a serial dilution anaerobic culture and/or microscopic procedure, a DNA probe procedure, and immunological reagents using both an enzyme-linked immunosorbent assay and an indirect immunofluorescence assay to detect Treponema denticola, Porphyromonas gingivalis, Bacteroides forsythus, and Actinobacillus actinomycetemcomitans in subgingival plaque samples taken from 204 periodontally diseased tooth sites. The prevalence of the four monitored species varied as a function of both the species and the detection method. Spirochetes were present in 99% of the plaques, whereas A. actinomycetemcomitans was detected at the lowest frequency. The culture method yielded the lowest prevalence values for the three cultivable species. This raised the question as to which results, those obtained by culture or those obtained by the DNA probes and the immunological reagents, were the most reliable. This issue was addressed by looking at the prevalence profile of the monitored organisms, as determined by all the detection methods. If the species was detected by three or four of the detection methods, then it was considered present, whereas if it was absent by three or four of the detection methods, then it was considered absent. This approach showed the DNA probes and immunological reagents to be significantly superior (P < 0.05) to the culture approach for the detection of P. gingivalis, A. actinomycetemcomitans, and B. forsythus and to be comparable to the microscopic approach in the detection of T. denticola. <55> UI - 92075615 AU - Lewis DL AU - Boe RK IN - Faculty of Ecology, University of Georgia,Athens, GA 30602; United States of America. TI - Cross-infection risks associated with current procedures for using high-speed dental handpieces. SO - Journal of Clinical Microbiology Vol 30(2) (pp 401-406), 1992. AB - When a dye solution used to simulate patient material was either injected into high-speed dental handpiece (drill) waterlines or applied to the equipment externally, internal air turbine chambers became contaminated. These chambers served as a reservoir of the material, which was slowly dislodged by air expelled during subsequent handpiece operation and which was diluted by water spray used for cooling the drilling surface. Considering the fact that patient materials could reside in internal parts of the equipment that are not usually disinfected and that the material may be subsequently sprayed into cuts and abrasions in the oral cavity, the common approach to reprocessing handpieces (external wiping in combination with flushing) may pose unacceptably high risks to those individuals treated soon after infected patients. Therefore, unless reliable data on cross-infection frequencies are obtained and prove it unnecessary, heat-treating high-speed handpieces between each patient should be considered an essential component of standard procedures whenever universal precautions are practiced in dentistry. <56> UI - 92070110 AU - Sarajlic M AU - Nikolic V AU - Durst-Zivkovic B AU - Sarajlic N AU - Catovic A AU - Pisl Z IN - Department of Radiology, Military Hospital, Zagreb; Yugoslavia. TI - Follow-up of the intracranial supernumerary tooth. SO - Radiologe Vol 32(1) (pp 43-43), 1992. AB - A rare case of an intracranially located supernumerary tooth was described, observed over a period of 14 years, where movement was established laterally in relation to the referent Carthesian coordinate system, down and forward with rotation around the anteroposterior axis. During skull growth, the skull base angle changed by 20 [degree] , but this movement only affected the change in tooth position slightly. During the observation period, no further changes in the neurological findings were ob <57> UI - 92046644 AU - Johansson C AU - Mellstrom D AU - Lerner U AU - Osterberg T IN - Dept of Geriatric Medicine, Clinic V, Vasa Hospital,411 33 Gothenburg; Sweden. TI - Coffee drinking: A minor risk factor for bone loss and fractures. SO - Age & Ageing Vol 21(1) (pp 20-26), 1992. AB - The influence of coffee drinking as a possible risk factor for loss of bone mass was assessed in a cohort of 619 70-year-old men and women who were examined with dual photon absorptiometry of the right calcaneum. A high consumption of coffee was significantly associated with a lower bone mass, deteriorated dental state, lower socio-economic level and a higher consumption of tobacco. In non-smoking women a bivariate relationship was found between the daily consumption of three or more cups of coffee and a low bone mass (p < 0.01). However, in a stepwise logistic regression model, only tobacco smoking, body mass index, body height, physical activity and a deteriorated dental state were found to be significant predictive factors for a low bone mineral content. Bone mass and tobacco smoking were the only significant predictive factors for fractures before the ages of 70 and 76 years. Coffee drinking was not a contributory independent risk factor for loss of bone mass and fractures in this population study. <58> UI - 92024470 AU - Fung JJ AU - Abu-Elmagd K AU - Todo S AU - Shapiro R AU - Tzakis A AU - Jordan M AU - Armitage J AU - Jain A AU - Martin M AU - Bronster O AU - Stieber A AU - Kormos R AU - Selby R AU - Gordon R AU - Starzi TE IN - Department of Surgery, Division of Transplant Surgery, University of Pittsburgh, 3601 Fifth Avenue,Pittsburgh PA 15213; United States of America. TI - FK506 in clinical organ transplantation. SO - Clinical Transplantation Vol 5(6 II) (pp 517-522), 1991. <59> UI - 91346255 AU - Egger G IN - Centre for Health Promotion and Research, Sydney; Australia. TI - Prevention may be better than cure - but has it worked?. SO - Medical Journal of Australia Vol 155(7) (pp 431-432), 1991. <60> UI - 91317270 AU - Haug RH AU - Hoffman MJ AU - Indresano AT IN - Div. Oral/Maxillofacial Surg., Metrohealth Medical Center, 3395 Scranton Road,Cleveland, OH 44109; United States of America. TI - An epidemiologic and anatomic survey of odontogenic infections. SO - Journal of Oral & Maxillofacial Surgery Vol 49(9) (pp 976-980), 1991. AB - An 81-month review of patients with infections of odontogenic origin admitted to the oral and maxillofacial surgery service at a county hospital and teaching facility in northeast Ohio is presented. Age, sex, race, etiology, pathogens isolated, admission temperature, and admission white blood cell count were identified and related to the anatomic space(s) encountered. Multispace and single-space infections occurred with equal distribution. In both the multispace and single-space infections, the submandibular and buccal spaces were most frequently involved. Males were affected with single-space infections twice as often as females. An equal distribution among sexes was found in multispace infections. The most common age range for all infections was 25 to 30 years. alpha-Hemolytic streptococci, Bacteroides melaninogenicus, and beta-hemolytic streptococci were the most frequently isolated pathogens. Third molars were the prevalent cause in both multispace and single-space infections that required hospital admissi <61> UI - 91316627 AU - Yun MW-D AU - Hwung CF AU - Lui CC IN - Department of Otolaryngology, Chang-Gung Memorial Hospital,Kaohsiung; Taiwan. TI - Cavernous sinus thrombosis following odontogenic and cervicofacial infection. SO - European Archives of Oto-Rhino-Laryngology Vol 248(7) (pp 422-424), 1991. AB - Cavernous sinus thrombosis (CST) is rarely seen clinically as a complication of infectious processes since the discovery of penicillin. At the present time, dental abscess is an uncommon cause of CST. We now report our experiences with a 60-year-old diabetic male, who developed CST 38 days after extraction of an infected upper third molar tooth. The importance of eradicating regional cervicofacial foci of infection is stressed. <62> UI - 91312938 AU - Welsh LW AU - Welsh JJ AU - Kelly JJ IN - 179 Washington Lane,Jenkintown, PA 19046; United States of America. TI - Massive orofacial abscesses of dental origin. SO - Annals of Otology, Rhinology & Laryngology Vol 100(9 I) (pp 768-773), 1991. AB - Massive cervicofacial abscesses of dental origin are relatively rare, and may be associated with serious and grave morbidity. In extreme cases, an occasional fatality may result from regional complications. Three cases are presented that describe the clinical and radiographic evaluation and the surgical approaches for abscess drainage. Specific attention is directed toward 1) the management of imminent airway obstruction, 2) the application of computed tomographic technology for localization and surgical planning, and 3) current antibiotic therapy. <63> UI - 91287485 AU - Prokhonchukov AA AU - Ainbinder NE AU - Ul'yanov SV AU - Milokhov KV AU - Bugai EP AU - Trukhina ME AU - Vasil'ev VG AU - Sychugova LI IN - Central Scientific-Research Institute of Stomatology, Moscow; USSR. TI - Software and hardware for the differential diagnosis of parodontal disease using discriminant analysis. SO - Bio-Medical Engineering Vol 25(2) (pp 70-76), 1991. <64> UI - 91282437 AU - Einstein DM AU - Tagliabue JR AU - Desai RK IN - Dept. of Diag. Radiology (A21), Cleveland Clinic Foundation, 9500 Euclid Ave.,Cleveland, OH 44195; United States of America. TI - Abdominal desmoids: CT findings in 25 patients. SO - American Journal of Roentgenology Vol 157(2) (pp 275-279), 1991. AB - Desmoids are histologically benign but locally aggressive fibrous tumors. Although overall they are rare lesions, they are a common manifestation of Gardner syndrome. We retrospectively reviewed clinical records and CT scans of 25 patients with abdominal desmoids. The number, location, and CT characteristics of the lesions were recorded for each patient. Tumors were solitary in 72% of patients and multiple in 28%. Fifty percent were located in the abdominal wall, 41% in the mesentery, and 9% in the retroperitoneum. More than two thirds of the lesions had well-defined borders, with the remainder displaying an infiltrative outer margin. The majority of tumors had attenuation values equal to (47%) or greater than (41%) the attenuation of muscle on contrast-enhanced CT scans. Complications attributable to the desmoid were commonly detectable on CT (hydronephrosis occurred in 36% and small-bowel obstruction in 20%). Our results detail the spectrum of CT findings and complications caused by abdominal desmoids. <65> UI - 91274941 AU - Zhang L-Q AU - Shavi R AU - Hunt MA AU - Chen J-JJ IN - Department of Electrical and Biomedical Engineering, Vanderbilt University, Nashville, TN 37235; United States of America. TI - Clustering analysis and pattern discrimination of EMG linear envelopes. SO - IEEE Transactions on Biomedical Engineering Vol 38(8) (pp 777-784), 1991. AB - A technique has been developed for performing pattern analysis of EMG activities generated during locomotion. In this development it was found that the shapes of the EMG linear envelopes (LE) are mainly determined by their phase spectra; their magnitude spectra are much less important. Autoregressive (AR) parametric models and discrete Fourier transform (DFT) approaches were tested and compared. The latter was proved to be a better way to describe the EMG LE's. Feature extraction and clustering were performed by doing DFT of EMG LE's, extracting part of the phase and magnitude spectra (in less important degree) as features, and using the percent powers to weigh the corresponding harmonics. The approach was applied to the clustering analysis of EMG LE's of normal and anterior cruciate ligament (ACL) injured subjects during walking. <66> UI - 91271774 AU - Resegotti L AU - Vitolo U AU - Bertini M AU - Brusamolino E AU - Comotti B AU - Tarella Todeschini CG AU - Aglietta M AU - Barbui T AU - Bernasconi G AU - Ghio R AU - Perona G AU - Pileri A IN - Division of Hematology, Molinette Hospital,Torino; Italy. TI - MACOP-B for advanced stage large cell lymphoma (DLCL). More is better?. SO - Leukemia Vol 5(SUPPL. 1) (pp 86-89), 1991. AB - A study of the predictive value for CR, DFS and OS of the presenting features was carried out on 180 patients with advanced stage DLCL treated with MACOP-B between June 1986 and March 1989. A multivariate regression analysis identified LDH level, bone marrow involvement and tumor burden as indipendent risk factors with a 4 year survival rate of 79%, 58% and 28% respectively. Therefore MACOP-B proved to be an adeguate treatment for the first two groups of patients but not for the third which requires a more aggressive treatment. A sequentil single drug high dose chemotherapy with collection of peripheral blood stem cell program followed by bone marrow harvesting, super-intensive radio-chemotherapy and bone marrow transplant has been activated. Seven patients have been so far enrolled: preliminary results demonstrated the feasibility of the program. A larger number of cases and a longer follow-up is required for assessing the efficacy of this approach. <67> UI - 91264578 AU - Tenenbaum HC AU - Mock D AU - Simor AE IN - Samuel Lunenfeld Research Inst, Mount Sinai Hospital, 600 University Ave.,Toronto, Ont. M5G 1X5; Canada. TI - Periodontitis as an early presentation of HIV infection. SO - CMAJ Vol 144(10) (pp 1265-1269), 1991. AB - Objective: To determine whether the presence of rapidly progressive periodontitis (RPP) in people at high risk for acquired immunodeficiency syndrome (AIDS) may be the first symptom of previously unrecognized human immunodeficiency virus (HIV) infection. Design: Case series. Setting: Dental clinic. Patients: Twenty patients who presented or were referred to the dental clinic over 6 months for the treatment of unexplained RPP and were at high risk for AIDS. Outcome measures: Diagnosis of HIV infection: identification of candidal organisms in cytologic smears, determination of complete and differential blood counts and of ratio between T4 (helper) and T8 (suppressor) lymphocytes, and performance of HIV antibody assays. Main results: All of the patients were men, although sex was not an inclusion criterion. Sixteen (80%) of the 20 patients were found to have HIV infection. Four had been aware that they were HIV positive: two admitted it only when their T4:T8 ratio was known and the other two when the T4:T8 test was explained or requested. Fifteen of the patients were homosexual, three came from AIDS-endemic areas, and two had hemophilia. The RPP was responsible for alveolar bone loss in all of the patients. One patient lost bone in one site because of localized osteomyelitis. Only five patients had concurrent candidal overgrowth, and three had Kaposi's sarcoma. The mean T4:T8 ratio was 0.57 (standard deviation 0.52). Conclusions: These findings suggest that periodontal disease may be one of the first clinical presentations of previously undiagnosed HIV infection. Thus, patients at high risk for AIDS who present with aggressive periodontal disease should be investigated for possible HIV infection. However, further, prospective studies are required to confirm the contention that RPP is one of the first signs of HIV infection or AIDS. <68> UI - 91250813 AU - Stevenson JC IN - Wynn Institute for Metabolic Research, 21 Wellington Road, London NW8 9SQ; United Kingdom. TI - Paget's disease of bone. SO - Prescribers' Journal Vol 31(3) (pp 98-103), 1991. <69> UI - 91248589 AU - Mohler ER AU - Monahan B AU - Canty MD AU - Flockhart DA IN - Department of Medicine, Georgetown University Medical Center, Washington, DC 20007; United States of America. TI - Cerebral abscess associated with dental procedure in hereditary haemorrhagic telangiectasia [6]. SO - Lancet Vol 338(8765) (pp 508-509), 1991. <70> UI - 91212635 AU - Percival RS AU - Challacombe SJ AU - Marsh PD IN - Department of Oral Medicine and Pathology, UMDS, Guy's Hospital, London SE1 9RT; United Kingdom. TI - Age-related microbiological changes in the salivary and plaque microflora of healthy adults. SO - Journal of Medical Microbiology Vol 35(1) (pp 5-11), 1991. AB - The effect of age on quantitative or qualitative differences in selected bacteria of dental significance and on the carriage of opportunistic pathogens and transient oral species was determined in 79 healthy, non-denture wearing individuals divided into four age groups: 20-39 years (group A), 40-59 years (group B), 60-79 years (group C) and >= 80 years (group D). Samples of dental plaque and whole saliva were cultured on appropriate selective and non-selective bacteriological media. The total numbers of viable bacteria in saliva, and the prevalence of mutans streptococci in plaque and saliva were similar in all age groups. Similarly, there was no correlation between the numbers of spirochaetes in plaque and age. In contrast, statistically significantly higher mean proportions (p = 0.004), mean log10 viable counts (p = 0.001) and isolation frequencies (p < 0.01) of lactobacilli were found in the saliva of those aged >= 70 years compared to subjects in group A. The isolation frequency (p < 0.05) and proportions (p = 0.056) of staphylococci in saliva were also higher in those aged >= 70 years. Yeasts were isolated most often and in higher numbers from saliva in those aged >= 80 years and the proportion of yeasts was higher after 60 years of age, but these differences were not significant in comparison with results from individuals in group A. Actinomyces spp. were commonly isolated from plaque, but there was a change, with age, in the ratio of the proportions of A. viscosus and A. naeslundii so that A. viscosus predominated in elderly subjects (groups C and D). The results suggest that genuine age-related changes in the oral microflora can be detected, particularly after the age of 70 years, which are not related to denture-wearing or disease. <71> UI - 91180429 AU - Kratimenos G AU - Crockard HA IN - Department of Surgical Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG; United Kingdom. TI - Multiple brain abscess: A review of fourteen cases. SO - British Journal of Neurosurgery Vol 5(2) (pp 153-161), 1991. AB - The case notes of 14 consecutive patients with multiple brain abscesses presenting over a 14 year period were studied with respect to the incidence and presentation, the source of infection, the investigations, microbiology and the treatment and outcome. The incidence of multiple brain abscesses in non-immunocompromised patients is 13% of all intracranial abscesses. Computerized tomographic scanning is vital both in the detection of multiple abscesses and in the subsequent assessment of therapy. The source of infection in half of our patients was the teeth or the paranasal sinuses. Streptococci were isolated in 63% of the patients; staphylococci in 21%. This has obvious implications for the antibiotic policy. Intracranial surgery, with few exceptions, had a diagnostic and management role rather than a curative one; identification of the causative organism was its prime purpose. CSF, obtained by lumbar punctures, did not provide any positive cultures and should not be contemplated in view of the inherent hazards. The elimination of the primary focus of infection was a most important step in the management of this condition. Multiple brain abscesses represent a potentially curable condition, provided appropriate antibiotics are used, the primary septic focus is eliminated and the intracranial complications are anticipated by the use of frequently repeated CT scans. <72> UI - 91119692 AU - Pallasch TJ AU - Slots J IN - Department of Periodontology, School of Dentistry, University of Southern California, Los Angeles, CA 90089-0641; United States of America. TI - Antibiotic prophylaxis for medical-risk patients. SO - Journal of Periodontology Vol 62(3) (pp 227-231), 1991. <73> UI - 91112738 AU - Huang T-S AU - Lee F-P AU - Chen L-K IN - Dept of Otolaryngology, Chang Gung Memorial Hospital, 199 Tung-Hwa North Rd, Taipei; Taiwan. TI - Radiographically confirmed cochlear otospongiosis among the Chinese. SO - Annals of Otology, Rhinology & Laryngology Vol 100(3) (pp 232-235), 1991. AB - A high-resolution computed tomography (HRCT) study on 55 patients with surgically confirmed clinical otosclerosis confirms the existence of cochlear otospongiosis among the Chinese. Positive radiographic results of cochlear otospongiosis (13 ears, 12%) were found in patients with mixed-type deafness but in none with conductive hearing loss. Although there is a positive correlation between audiologic and radiographic findings, the HRCT results showed a lower positive rate and less severity than anticipated from the audiologic results. However, compared with the occurrence and extension of radiographic findings in similar studies of white people, it would seem to support our previous contention that the disease is indeed milder in Chinese people. Cochlear otospongiosis with extensive labyrinthine demineralization was found in three young patients with rapidly progressive hearing loss. This is important evidence of the overlooked fact that cochlear otospongiosis may also be one of the causes of sensorineural hearing loss in the Chinese. Thus, a high index of suspicion of the existence of this inner ear disorder is of paramount importance, and in such cases an HRCT study should be performed and sodium fluoride given to prevent further hearing deterioration. <74> UI - 91111040 AU - Grondahl H-G IN - University of Gothenburg, Gothenburg; Sweden. TI - An expanding technology in search of a direction. SO - International Journal of Technology Assessment in Health Care Vol 6(4) (pp 610-619), 1990. AB - Oral radiology still seems to be expanding depending upon increasing availability of dental care. It is widely used more or less routinely, although investigations on efficacy, cost-benefit, and cost-effectiveness are sparse. Such studies should be encouraged and decision-making courses included in dental curricula. Decision-making aids and clinical algorithms should be developed to increase efficiency of oral radiology and to help in the abandonment of its routine use. <75> UI - 91082189 AU - Mraz J AU - Gescher A AU - Cross H AU - Shaw AJ AU - Flek J IN - Institute of Hygiene and Epidemiology, Prague; Czechoslovokia. TI - New findings in the metabolism of N,N-dimethylformamide - consequences for evaluation of occupational risk. SO - Science of the Total Environment Vol 101(1-2) (pp 131-134), 1991. AB - Using a novel gas chromatographic method, specific mercapturic acids produced in the biotransformation of several formamide analogues have been quantified. Thus, N-acetyl-S-(N-methylcarbamoyl)cysteine, derived from an important industrial solvent N,N-dimethylformamide, was found to be a minor metabolite in rodents but an important one in humans. Because manifestations of hepatotoxicity of formamide analogues were always linked with the production of mercapturic acids, the risk from exposure to DMF in humans appears to be higher than that estimated from toxicological experiments on laboratory animals. <76> UI - 91075232 AU - Fife TD AU - Finegold SM AU - Grennan T IN - Reed Neurological Research Ctr, 710 Westwood Plaza,Los Angeles, CA 90024; United States of America. TI - Pericardial actinomycosis: Case report and review. SO - Reviews of Infectious Diseases Vol 13(1) (pp 120-126), 1991. AB - Pericardial actinomycosis is rare and frequently goes unrecognized during life, a circumstance due in part to a paucity of clinical manifestations and to a low rate of positivity in cultures. We present a case report of pericardial actinomycosis and a review of 18 other cases reported in the literature since 1950. Possible risk factors include aspiration pneumonia, alcohol abuse, and periodontal disease. Actinomyces may cause purulent pericarditis that evolves into cardiac tamponade or constrictive pericarditis. Clues to the identity of the causative organism (e.g., draining sinus tracts and the presence of sulfur granules) are frequently absent, and cultures often fail to yield the organism. Histologic examination of material obtained by biopsy is often necessary to make the diagnosis. Most cases originate from a thoracopulmonary site of actinomycosis and spread directly to the pericardium. Widespread dissemination to extrathoracic organs is uncommon. Treatment consists of high-dose, long-term antimicrobial therapy as well as drainage of the pericardial space. <77> UI - 91042005 AU - Ben-Shlomo Y AU - Nadanovsky P IN - Department of Epidemiology and Public Health, University College London, London WC1E 6EA; United Kingdom. TI - Toothpaste and Crohn's disease (III). SO - Lancet Vol 336(8730) (pp 1581-1582), 1990. <78> UI - 91038934 AU - Dajani AS AU - Bisno AL AU - Chung KJ AU - Durack DT AU - Freed M AU - Gerber MA AU - Karchmer AW AU - Millard HD AU - Rahimtoola S AU - Shulman ST AU - Watanakunakorn C AU - Taubert KA IN - Office of Scientific Affairs, American Heart Association, 7320 Greenville Avenue,Dallas, TX 75231; United States of America. TI - Prevention of bacterial endocarditis. Recommendations by the American Heart Association. SO - JAMA Vol 264(22) (pp 2919-2922), 1990. <79> UI - 91016536 AU - De Geest AFE AU - Schoolmeesters I AU - Willems JL AU - De Geest H IN - Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven; Belgium. TI - An analysis of the level of dental care in cardiac patients at risk for infective endocarditis. SO - Acta Stomatologica Belgica Vol 87(2) (pp 95-105), 1990. <80> UI - 90389755 AU - Scheutz F IN - Department of Child Dental Health and Community Dentistry, Royal Dental College, Aarhus; Denmark. TI - HIV infection and dental care: Views and experiences among HIV-seropositive patients. SO - AIDS Care Vol 2(1) (pp 37-42), 1990. AB - This study reports the views and experiences of HIV-seropositive individuals within the Danish Dental Care System. One hundred and thirty-five consecutive HIV-seropositive outpatients visiting the infectious departments at three Danish hospitals completed a structured questionnaire anonymously; participation rate was 96%. Refusal of dental treatment due to HIV-seropositivity had been experienced by 10.4% of the sample (95% CI: 7.1-20.3%), although more (24.4%) knew someone who had been rejected at a dental clinic. Rejection was seen more often among those who had informed a dentist of HIV-seropositivity than among those who had not; 17.8% compared to 3% (P = 0.06). Only 25.4% (18.3-33.6%) favoured the idea of special dental units for referral for routine treatment. Negative attitudes and behaviour against HIV-infected people were characterized as discriminatory by 83.5% (76.0-89.3%). Most of the participants seem to have established an open and confident relationship with their attending dentist with regard to their HIV-seropositivity and to a lesser extent, their sexuality. When patients told their dentists about their HIV-seropositivity, this was clearly reflected in increased infection control. <81> UI - 90382663 AU - Gemma M AU - Ferrazza C IN - Department of Anaesthesia, 1st Neurologico ''C. Besta'', Via Celoria 11, 20133 Milano; Italy. TI - ''Dental trauma'' to oral airways. SO - Canadian Journal of Anaesthesia Vol 37(8) (pp 951), 1990. <82> UI - 90381500 AU - Loughead JL AU - Mughal Z AU - Mimouni F AU - Tsang RC AU - Oestreich AE IN - University of Cincinnati, College of Medicine, 231 Bethesda Avenue, Cincinnati, OH 45267-0541; United States of America. TI - Spectrum and natural history of congenital hyperparathyroidism secondary to maternal hypocalcemia. SO - American Journal of Perinatology Vol 7(4) (pp 350-355), 1990. AB - Fourteen cases of congenital hyperparathyroidism secondary to maternal hypocalcemia have been reported. We report two additional cases that highlight the wide spectrum of the disease. We extensively studied the parathyroid function of these infants to test the hypothesis that the biochemical hyperparathyroidism found in these infants would be transient in nature, since the presumed etiology (maternal and subsequent fetal hypocalcemia) should disappear soon after birth with establishment of enteral feedings. Infant 1 was born to a mother with idiopathic hypoparathyroidism with poor compliance to therapy and documented hypocalcemia in pregnancy. Severe congenital demineralization and intrauterine fractures with clinical and radiologic bowing of the long bones were obvious. Bone mineral content and bone mineral content/bone width ratio, measured by photon absorptiometry, were both markedly below normal. Infant 2 was born to a mother with postsurgical hypoparathyroidism with excellent compliance. The mother was normocalcemic. The infant was clinically and radiologically asymptomatic. The bone mineral content was just at the lower limit of normal, but bone mineral content/bone width ratio was below the normal limits. Biochemical features include elevation of cord serum parathyroid hormone (1-84, radioimmunoasasy) in both cases, coexisting with serum calcium, phosphorus concentrations within normal limits. Serum parathyroid hormone fell to within normal ranges by 9 days of age in both infants. With no treatment, bone mineral content at 1 month of age was normal in both infants. <83> UI - 90366961 AU - Locker D AU - Slade GD AU - Leake JL IN - Department of Community Dentistry, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ont. M5G 1G6; Canada. TI - The response rat problem in oral health surveys of older adults in Ontario. SO - Canadian Journal of Public Health. Revue Canadienne de Sante Publique Vol 81(3) (pp 210-214), 1990. AB - We undertook two surveys of older adults in Ontario to estimate the proportion in need of dental treatment. Because we expected low response rates, these studies were designed to assess 1) the effect of response enhancement strategies on participation, and 2) the extent of bias in estimates of treatment needs resulting from less than acceptable response rates. Our response enhancement strategies did not improve response rates substantially. In both surveys, there were significant differences in the characteristics of responders and non-responders. Nevertheless, there was little difference in crude estimates of the prevalence of treatment needs and adjusted estimates taking account of non-response bias. We conclude that, while high response rates should always be the aim, low response rates do not necessarily compromise the results of descriptive epidemiological studies. <84> UI - 90296647 AU - Deutsch T AU - Carson ER AU - Harvey FE AU - Lehmann ED AU - Sonksen PH AU - Tamas G AU - Whitney G AU - Williams CD IN - Computer Centre, Semmelweis University, Kulich Gy. ter. 5, H-1089 Budapest; Hungary. TI - Computer-assisted diabetic management: A complex approach. SO - Computer Methods & Programs in Biomedicine Vol 32(3-4) (pp 195-214), 1990. AB - This paper describes the architecture of, and the main reasoning methods involved in, a computer system developed to assist in diabetic management. The system integrates (i) a database module used for blood glucose monitoring, (ii) an interpreter module used to analyse the adequacy of diet and insulin treatment for diabetics, and (iii) and advisory module suggesting alterations in diet and/or insulin regimen in order to improve glycaemic control. The analysis of blood glucose profiles and hypoglycaemic episodes, as well as the suggestions for altered diet and insulin therapy, are based on qualitative and quantitative models of insulin effect and carbohydrate absorption using meal-time related glucose balance and distance from the preselected target (DFT) glucose values as focal concepts in the reasoning process. During the sequence of consultations with the system, a dynamic model of carbohydrate metabolism is gradually adjusted in order to constitute an appropriate simulation for the specific patient. This model is used to confirm the suggestions made by the ADVISOR program and to assist the health care professional in selecting the best control action by predicting the blood glucose profiles resulting from alternative control policies. <85> UI - 90227527 AU - Clarke NG AU - Hirsch RS IN - University of Adelaide, Adelaide, 5001 SA; United States of America. TI - Periodontal disease (II). SO - New England Journal of Medicine Vol 323(2) (pp 134), 1990. <86> UI - 90174481 AU - Katsunuma T AU - Iikura Y AU - Nagakura T AU - Saitoh H AU - Akimoto K AU - Akasawa A AU - Kindaichi S IN - Department of Allergy, National Children's Hospital, 3-35-31 Taishido, Setagaya-Ku, Tokyo 154; Japan. TI - Exercise-induced anaphylaxis: Improvement after removal of amalgam in dental caries. SO - Annals of Allergy Vol 64(5) (pp 472-475), 1990. AB - We present a case of exercise-induced anaphylaxis with improvement following the removal of dental amalgam. Although her symptoms were unresponsive to various kinds of therapy until removal of the amalgam, her symptoms related to exercise improved remarkably after the removal. The increase in plasma histamine levels for exercise provocation test also improved. This suggests that sensitivity to metals might cause exercise-induced asthma in some patients. <87> UI - 90152750 AU - Willcox MDP AU - Drucker DB AU - Hillier VF IN - Department of Oral Medicine, Turner Dental School, University of Manchester, Higher Cambridge Street, M13 9PT, Manchester; United Kingdom. TI - Cohesion between oral streptococci and Neisseria pharyngis on saliva-coated glass, in the presence and absence of sucrose. SO - Microbios Vol 61(248-249) (pp 197-205), 1990. <88> UI - 90136867 AU - Wennstrom JL AU - Papapanou PN AU - Grondahl K IN - Department of Periodontology, School of Dentistry, University of Gothenburg, S-400 33 Gothenburg; Sweden. TI - A model for decision making regarding periodontal treatment needs. SO - Journal of Clinical Periodontology Vol 17(4) (pp 217-222), 1990. AB - The aim of this study was to present a tentative model for decision making regarding periodontal treatment needs, based on the amount of remaining periodontal bone support. In the model presented, a maintained alveolar bone height of one third of the root length at the age of 75 years was regarded to be a reasonable goal. The data analyzed were derived from a patient sample of 194 dentate individuals aged 25-70 years from whom 2 full mouth series of intraoral radiographs, approximately 10 years apart, were available. For teeth present at both examinations, the radiographs were evaluated with respect to alveolar bone levels at the mesial and distal aspect of the teeth, i.e., the distance between the cemento-enamel junction and the most coronal level of the bone support. Longitudinal alveolar bone level change was determined for each tooth site and the alteration in alveolar bone height per 5-year interval between 25 and 75 years of age was described. Based on the calculated mean bone loss data, a rate factor was determined for each tooth site and used in the final description of the alveolar bone level for each particular tooth site at ages 30, 35, 40, ..., and 70 years, depicting the amount of bone loss beyond which therapeutic intervention has to be made in order to meet the defined goal of the tentative model. The relevance of the model and its applicability are discussed. <89> UI - 90124247 AU - Speller DCE AU - Shanson DC AU - Ayliffe GAJ AU - Cooke EM IN - Microbiology Department, Bristol Royal Infirmary, Bristol BS2 8HW; United Kingdom. TI - Acquired immune deficiency syndrome: Recommendations of a Working Party* of the Hospital Infection Society. SO - Journal of Hospital Infection Vol 15(1) (pp 7-34), 1990. <90> UI - 90078507 AU - Persson R AU - Svendsen J IN - Department of Periodontics, University of Washington, Seattle, WA 98195; United States of America. TI - The role of periodontal probing depth in clinical decision-making. SO - Journal of Clinical Periodontology Vol 17(2) (pp 96-101), 1990. AB - This restrospective study examines the role of periodontal probing depth in clinical decision-making. The expected values of no treatment and surgical and non-surgical therapies were obtained by combining the probability of each treatment outcome and utility values denoting the preference for each outcome. The expected value for non-surgical therapy was higher for sextants exhibiting a positive response to initial therapy than sextants which did not respond to initial therapy (0.735 versus 0.706). This trend was not observed for sextants treated surgically. Surgical therapy was effective over all levels of disease severity and was the preferred form of therapy with respect to reduction of probing depth except for sextants exhibiting 4 to 5 mm pockets. In this latter situation, the expected value at 3 years for non-surgical and surgical therapy was 0.795 and 0.792, respectively. Neither form of therapy could consistently achieve periodontal probing depths equal to or less than 3 mm throughout a given sextant. This study facilitates the selection of an optimal therapeutic strategy with respect to periodontal probing depth. <91> UI - 90076247 AU - Lunn RH TI - A decade of consensus conferences. SO - CRANIO J CRANIOMANDIBULAR PRACT, Vol 7(3) (pp 171-177), 1989. <92> UI - 90075610 AU - Sterne JA AU - Curtis MA AU - Gillett IR AU - Griffiths GS AU - Maiden MFJ AU - Wilton JMA AU - Johnson NW IN - MRC Dental Research Unit, Periodontal Diseases Programme, London Hospital Medical College, 30-32 Newark Street London E1 2AA; United Kingdom. TI - Statistical models for data from periodontal research. SO - Journal of Clinical Periodontology Vol 17(3) (pp 129-137), 1990. AB - Many factors have been hypothesised either to characterise groups and individuals at risk for periodontal disease or to be markers of periodontal breakdown. In order to identify these as associated either with disease status or progression, a statistical association between the factor and a measure of disease will have to be demonstrated. The statistical modelling of data arising from periodontal research presents special problems. These include the large number of measurements made in each subject, the large magnitude of measurement error compared to the changes in attachment level, the analysis of longitudinal studies, the lack of a measure of instantaneous rate of attachment loss and controversies over the nature of the progression of the disease. We consider statistical methods currently available in the light of these difficulties and identify areas in which further research is necessary. <93> UI - 90046720 AU - Bockman RS AU - Weinerman SA IN - Endocrine Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021; United States of America. TI - Steroid-induced osteoporosis. SO - Orthopedic Clinics of North America Vol 21(1) (pp 97-107), 1990. AB - Prolonged administration of glucocorticoids causes accelerated loss of bone, which leads to osteopenia and an increased incidence of fractures. The clinical presentation of cortisol excess is one of progressive demineralization, primarily of trabecular bone, resulting in fractures of the vertebral bodies and ribs. Bone dissolution is greatest during the initiation of steroid therapy and can result in the loss of up to 20 per cent of trabecular bone in the first year. Bone loss slows with prolonged therapy; cortical bone is relatively spared so that appendicular skeleton fractures are not typically a part of this syndrome. The rate of bone loss is greatest in those individuals who have high bone remodeling rates. Histologically, one finds decreased trabecular volume and increased bone resorption with an increase in osteoclast number and activity, along with decreased bone formation and mineralization rate. Adjuvant medical therapies that block accelerated bone resorption may protect against steroid-induced osteoporosis. <94> UI - 90040789 AU - Van Trigt L AU - Kreuger H AU - Westerman RF AU - Hull FM IN - Oudezijds Voorburgwal 127-3, 1012 EP Amsterdam; Netherlands. TI - Morbidity at an Amsterdam inner city clinic in relation to drug use. SO - Family Practice Vol 6(4) (pp 299-302), 1989. AB - In a small clinic in a deprived area of Amsterdam, a city with a high incidence of recreational drug use, sexually transmitted diseases and social problems, the association between drug use and disease was notable. Frequent presentation with sexually transmitted diseases, repeated trauma, unexplained recurrence of infections of the skin and respiratory tract, or severe dental caries may alert the physician to the possibility of recreational drug use and with it an increased possibility of HIV related illness. The group of drug users staying permanently in the city appeared to be ageing without being replenished by youngsters. Very young drug users were mainly 'drug tourists' from neighbouring countries who were without medical insurance or money. <95> UI - 90028841 AU - Karuza J AU - Miller WA AU - Thines T AU - Cantos A IN - School of Dental Medicine, SUNY, Buffalo, NY 14214; United States of America. TI - Psychosocial antecedents and consequences of periodontal disease: A new agenda. SO - Gerodontology Vol 7(3-4) (pp 117-120), 1988. <96> UI - 90028839 AU - Beck JD IN - Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27514; United States of America. TI - Epidemiologic changes in older adult periodontal disease. SO - Gerodontology Vol 7(3-4) (pp 103-107), 1988. <97> UI - 90022108 AU - Linke HAB AU - Gannon JT AU - Obin JN IN - Department of Microbiology, New York University Dental Center, 421 First Avenue, New York, NY 10010; United States of America. TI - Clinical survey of Entamoeba gingivalis by multiple sampling in patients with advanced periodontal disease. SO - International Journal for Parasitology Vol 19(7) (pp 803-808), 1989. AB - A clinical survey of Entamoeba gingivalis was conducted in patients with advanced periodontal disease. A total of 100 specimens were taken from 10 patients (four females and six males) who were each sampled at 10 disto-facial random sites. The oral hygiene of the persons scored from good to fair to poor and very poor. The age of the test persons ranged from 20 to 68 years. All persons examined harbored E. gingivalis: the minimum prevalence was four sites positive out of 10 and the maximum prevalence was 10 sites positive out of 10 for the protozoan. It is recommended that for reliable testing of the presence of E. gingivalis at least five-10 different sites should be examined within the periodontium of each patient. Data reported earlier in the literature on the incidence of E. gingivalis - obtained after a single sampling per individual - are believed to be on average too low and, therefore, should be interpreted with caution. <98> UI - 90019712 AU - Benn DK IN - Department of Community Dental Health and Dental Practice, University College London, 66-72 Gower Street, London WC1E 6EA; United Kingdom. TI - A review of the reliability of radiographic measurements in estimating alveolar bone changes. SO - Journal of Clinical Periodontology Vol 17(1) (pp 14-21), 1990. AB - Despite their widespread use, dental radiographs have numerous shortcomings for measuring alveolar bone changes. In order to develop guidelines for improving the reliability of radiographic measurements, factors affecting the formation of an image were reviewed. These were considered regarding the design of a clinical monitoring system, capable of detecting the loss of small amounts of alveolar bone crest from serial films. Dentists need a monitoring system to assess whether bone loss is pogressing or to judge whether a treatment is successful. 2 models were constructed to predict how long it would take to detect marginal bone loss occurring at a linear rate of 0.1 mm/year. The 1st model assumed a CEJ-crest measurement error of +/-0.3 mm and the second +/- 0.9 mm, both using a 0.1 mm measuring interval. These error values were derived from the literature. The 1st model predicted it would take between 7 and 13 years for the system to measure a 1.0 mm loss in crest height caused by an actual loss of between 0.7 and 1.3 mm. The 2nd model predicted that a 1.0 mm measurement would occur between 1 and 19 years, caused by an actual crestal bone loss of between 0.1 and 1.9 mm. From these models, it appears that routine screening of patients by general dental practitioners for small amounts of bone loss is unlikely to be successful without the use of (i) repositionable stentless film holders to standardise the irradiation geometry, (ii) a very accurate reproducible measuring technique which (iii) will probably require an automatic computer-based measuring system. Previous reports on the measurement of bone loss less than 1.0 mm are most likely measurement errors. A method of selecting radiographic examination time intervals is suggested. <99> UI - 90019711 AU - Maiden MFJ AU - Carman RJ AU - Curtis MA AU - Gillett IR AU - Griffiths GS AU - Sterne JAC AU - Wilton JMA AU - Johnson NW IN - MRC Dental Research Unit, Periodontal Diseases Programme, London Hospital Medical College, 30-32 Newark Street, London E1 2AA; United Kingdom. TI - Detection of high-risk groups and individuals for periodontal diseases: Laboratory markers based on the microbiological analysis of subgingival plaque. SO - Journal of Clinical Periodontology Vol 17(1) (pp 1-13), 1990. AB - Periodontal microbiology is reviewed with regard to the potential of certain characteristics to serve as markers of high risk groups or individuals for periodontal diseases. The generally accepted associations between particular organisms and the various periodontal diseases are discussed. The usefulness of various clinical study designs is reviewed. The ecology of the subgingival plaque microflora is discussed and a number of suggestions for future research are made. We have concluded that there is no monospecific aetiology to any of the various periodontal conditions. Nevertheless, we give particular attention to the role of the black-pigmented bacteroides based upon our belief that they, and Bacteroides gingivalis in particular, are fundamental to our understanding of the biology of periodontal diseases in humans and other animals. Consequently, the contribution of its various virulence factors and their potential as markers of disease susceptibility and activity is addressed. <100> UI - 90017450 AU - Munoz C AU - Filly RA AU - Golbus MS IN - Department of Radiology, Section of Diagnostic Ultrasound, University of California, 500 Parnassus Ave, San Francisco, CA 94143-0628; United States of America. TI - Osteogenesis imperfecta type II: Prenatal sonographic diagnosis. SO - Radiology Vol 174(1) (pp 181-185), 1990. AB - Sonograms of fetuses at risk for congenital lethal osteogenesis imperfecta (osteogenesis imperfecta type II) were retrospectively reviewed blindly and correlated with pregnancy outcomes. Six of eight cases of type II osteogenesis imperfecta were correctly diagnosed with use of the proposed criteria of multiple fractures, demineralization of the calvaria, and femoral length more than 3 standard deviations below the mean for gestational age. The two cases not diagnosed had sonographic abnormalities but did not meet all three criteria. Among 18 pregnancies genetically at risk for the disease but with normal outcomes, all sonograms were normal, meeting none of the proposed criteria. Among an additional 25 fetuses with osteochondrodysplasias, no case satisfied all three of the proposed diagnostic criteria. With use of strict standards for the diagnosis of type II osteogenesis imperfecta, this disease can be distinguished from other fetal skeletal abnormalities. In a pregnancy at risk for recurrence of osteogenesis imperfecta, a normal sonogram after 17 weeks excludes this lethal condition. <101> UI - 90015972 AU - Heimdahl A AU - Mattsson T AU - Dahllof G AU - Lonnquist B AU - Ringden O IN - Department of Oral Surgery, Pedodontics, Medicine Division of Clinical Hematology and Oncology, Huddinge University Hospital, Karolinska Institute, Box 4064, S-141 04 Huddinge; Sweden. TI - The oral cavity as a port of entry for early infections in patients treated with bone marrow transplantation. SO - Oral Surgery, Oral Medicine, Oral Pathology Vol 68(6) (pp 711-716), 1989. AB - Before treatment of 181 patients with bone marrow transplantation (BMT) for leukemia, severe aplastic anemia, or metabolic disorders, the oral condition was examined clinically and roentgenologically. Fifty-three patients (29%) had chronic dental infections (osteitis) that needed treatment before BMT. In 10 of 181 cases (6%), BMT was postponed because of oral infections. Septicemia during the neutropenic phase was caused by oral microorganisms (alpha streptococci) in 24 of 59 (41%) patients with microbiologically proven septicemia. Septicemia with alpha streptococci was associated with graft-versus-host disease prophylaxis with methotrexate and subsequent increased frequency of oral ulcerations. No difference was observed in the frequency of reactivation of latent herpes simplex virus infection between different graft-versus-host disease prophylaxis regimens. Reactivation was more frequent in patients conditioned with total body irradiation than in patients conditioned without total body irradiation. Antiviral prophylaxis, with subsequent decreased frequency of oral herpes simplex reactivation, appeared to contribute to a low frequency of septicemia with alpha streptococci. <102> UI - 90012727 AU - Block MA AU - Dailey GE III AU - Muchmore DE IN - Division of General Surgery, Scripps Clinic Medical Group, Inc., La Jolla, CA 92037; United States of America. TI - Bone demineralization, a factor of increasing significance in the management of primary hyperparathyroidism. SO - Surgery Vol 106(6) (pp 1063-1069), 1989. AB - The significance of bone demineralization was evaluated for 97 patients treated surgically for primary hyperparathyroidism since 1980. Of 31 patients studied by bone densitometry, 16 showed moderate to severe osteoporosis. In approximately 20% of the total group, bone demineralization, including a bone fracture problem in some, was the dominant or a major indication for operation. Serial bone studies in six patients taken preoperatively or in patients not operated on for primary hyperparathyroidism showed an average loss of bone mineral density of 0.9% per year, whereas in four patients treated surgically serial studies showed an average increase of 9.8% per year. Although estrogen intake reduced serum calcium levels, significant bone demineralization or fractures were present in four patients aged 40 to 59 years and in five patients more than 60 years of age who had taken estrogens for many years. We conclude that in primary hyperparathyroidism, bone demineralization (1) justifies surgical correction in a significant number of patients; (2) should be evaluated, especially in elderly women; (3) is not prevented by estrogen intake, which may instead confuse decision making; (4) is reversed after surgical correction, but suggestions of incomplete reversal emphasize importance of this factor; (5) should be considered in postoperative management; and (6) involves many variables. <103> UI - 89282527 AU - Houwen B IN - Department of Laboratory Medicine, Foothills Hospital, Calgary, Alta.; Canada. TI - The use of inference strategies in the differential diagnosis of microcytic anemia. SO - Blood Cells Vol 15(3) (pp 509-532), 1989. AB - A new expert system developed on a Macintosh personal computer using a commercially available artificial intelligence shell was compared with four different discriminant functions (DFs) for the differentiation of microcytic anemia into etiologic categories. Several databases were used with a different composition but all contained at least some samples from thalassemic individuals and from patients with iron deficiency anemia. The DFs analyzed were those proposed by England and Fraser, Green and colleagues, Mentzer, and by Shine and Lal. None of the databases performed satisfactorily when used singly, whereas very high false-positive rates were obtained by one of them. The diagnostic efficiency was somewhat improved by combining several DFs. An expert system using an artificial intelligence 'shell' with an 'interference engine' was developed using cluster analysis and a set of learning examples. The input necessary for the system to achieve a conclusion consists of MCV, RBC, and RDW as well as statement as to whether the patient has anemia. Based upon the values of these parameters, the expert system will give an 'advice' regarding the probabilities for thalassemia, iron deficiency, and/or other probabilities such as previous transfusions, anemia of chronic disease, laboratory error, etc. In a prospective trial, the system functioned with an accuracy of better than 85%. <104> UI - 89281521 AU - Christen AG AU - McDonald JL Jr AU - Olson BL AU - Christen JA IN - Department of Preventive and Community Dentistry, Indiana University School of Dentistry, 1121 West Michigan Street, Indianapolis, IN 46202; United States of America. TI - Smokeless tobacco addiction: A threat to the oral and systemic health of the child and adolescent. SO - Pediatrician Vol 16(3-4) (pp 170-177), 1989. <105> UI - 89268480 AU - Whyte AM AU - Hayward MWJ IN - Department of Radiology, University Hospital of Wales, Cardiff; United Kingdom. TI - Agenesis of the salivary glands: A report of two cases. SO - British Journal of Radiology Vol 62(743) (pp 1023-1026), 1989. AB - Congenital absence of the major salivary glands is uncommon with only a few reported cases in the world literature. Agenesis may be partial or total; the more severely affected patients suffer from a dry mouth, an increased rate of dental decay and difficulty in wearing dentures. Following exclusion of the more common causes of a dry mouth by the clinician, the diagnosis of salivary gland agenesis can be confirmed by computed tomography (CT) and a 99Tcm-pertechnetate scintiscan. <106> UI - 89240175 AU - Bruckstein AH IN - Department of Medicine, St Vincent's Medical Center of Richmond, Staten Island, NY 10310; United States of America. TI - Update on colorectal cancer. Risk factors, diagnosis, and treatment. SO - Postgraduate Medicine Vol 86(3) (pp 83-92), 1989. AB - Colorectal cancer is more common in the Western world than in underdeveloped countries. Diet, longevity, heredity, and presence of other bowel diseases may affect the incidence. Diagnosis is based on results of routine laboratory st