Forced oscillation technique. Reference values for total respiratory resistance obtained with the Siemens Siregnost FD5.

Total respiratory resistance (Rrs) was measured by the application of a sine wave of airflow to the mouth at an oscillation frequency of 10 Hz. The instrument used was the Siemens Siregnost FD5. The Rrs data were correlated with height, age, sex, and weight in 73 patients and 29 healthy subjects. The patients took part in a rehabilitation program for restoration of their locomotion function. Both groups had normal lung function (VC, FEV1) and no signs of pulmonary disease. The only important determining factor for the value of the Rrs was height. The mean Rrs of 102 subjects was 0.29 +/- 0.08 kPa.1-1.s. Other studies gave values between 0.23 +/- 0.05 and 0.32 +/- 0.10 kPa.1-1.s.     

Factors influencing the likelihood of successful decisions to treat dentin caries from bitewing radiographs

The purpose of this study was to describe the role played by the ability to estimate caries depth in successfully deciding to treat dentin caries when making use of bitewing radiographs as a diagnostic test. A 10% random sample (n = 444) of Dutch dental practitioners was sent a two-wave questionnaire concerning radiographic caries diagnosis and restorative treatment decision making. The second wave consisted of simulated bitewing radiographs of 105 tooth surfaces with and without dentin caries according to two measuring standards: (a) a micro-radiographic "gold" standard and (b) a norm of expert observers. The dentists were asked to diagnose caries at 4 depths of penetration using a 5-point certainty scoring system to measure diagnostic ability; and to make a treatment decision for each surface. The overall response was 61% (273). A regression analysis was carried out using the chance per dentist of correctly deciding to treat dentin caries as the dependent variable. The degree of agreement with the experts' diagnosis of radiographic caries depth was used to create variables measuring diagnostic ability. Five significant (P less than 0.05) variables explained 60% (R2 = 0.60) of the variation in decision making. The best diagnostic ability variable explained 47% of the variation while the treatment criterion reportedly used explained 3%. We conclude that the ability of practitioners to interpret radiographs plays a major role in treatment decision making and that their reported treatment decision making criteria should not be taken at face value.     

Rapid dopamine transmission within the nucleus accumbens: Dramatic difference between morphine and oxycodone delivery

While most drugs of abuse increase dopamine neurotransmission, rapid neurochemical measurements show that different drugs evoke distinct dopamine release patterns within the nucleus accumbens. Rapid changes in dopamine concentration following psychostimulant administration have been well studied; however, such changes have never been examined following opioid delivery. Here, we provide novel measures of rapid dopamine release following intravenous infusion of two opioids, morphine and oxycodone, in drug‐naïve rats using fast‐scan cyclic voltammetry and rapid (1 min) microdialysis coupled with high‐performance liquid chromatography ‐ tandem mass spectrometry (HPLC‐MS). In addition to measuring rapid dopamine transmission, microdialysis HPLC‐MS measures changes in GABA, glutamate, monoamines, monoamine metabolites and several other neurotransmitters. Although both opioids increased dopamine release in the nucleus accumbens, their patterns of drug‐evoked dopamine transmission differed dramatically. Oxycodone evoked a robust and stable increase in dopamine concentration and a robust increase in the frequency and amplitude of phasic dopamine release events. Conversely, morphine evoked a brief (~ 1 min) increase in dopamine that was coincident with a surge in GABA concentration and then both transmitters returned to baseline levels. Thus, by providing rapid measures of neurotransmission, this study reveals previously unknown differences in opioid‐induced neurotransmitter signaling. Investigating these differences may be essential for understanding how these two drugs of abuse could differentially usurp motivational circuitry and powerfully influence behavior.     

Anal HPV 16 and 18 viral load: A comparison between HIV‐negative and ‐positive MSM and association with persistence

Does anal HPV viral load explain the difference in anal HPV persistence between HIV‐negative and ‐positive men who have sex with men (MSM)? MSM ≥18 years were recruited in Amsterdam, the Netherlands, in 2010‐2011. Anal self‐swabs were collected every 6 months and genotyped (SPF₁₀‐PCR‐DEIA‐LIPA₂₅‐system). HPV16 and HPV18 load was determined with a type specific quantitative (q)PCR, and compared between HIV‐negative and ‐positive men using ranksum test. Persistence was defined as ≥3 positive samples for the same HPV‐type. Determinants of persistent HPV16/18 infection and its association with HPV16/18 load were assessed with logistic regression. Of 777 recruited MSM, 54 and 22 HIV negative men were HPV16 and HPV18 positive at baseline, and 64 and 39 HIV‐positive MSM. The geometric mean titer (GMT) of HPV16 was 19.6 (95%CI 10.1‐38.0) and of HPV18 8.6 (95%CI 2.7‐27.5) DNA copies/human cell. HPV16 and HPV18 load did not differ significantly between HIV‐negative and ‐positive MSM (P = 0.7; P = 0.8, respectively). In multivariable analyses HPV16 load was an independent determinant of HPV16 persistence (OR 1.8, 95%CI 1.3‐2.4). No difference in anal HPV viral load was found between HIV‐positive and HIV‐negative MSM. HPV 16/18 viral load is an independent determinant of type‐specific persistence.     

Experimental gingivitis around deciduous teeth in children with Down's syndrome

Abstract. Epidemiological studies have shown that there is a high prevalence and rapid progression of periodontal disease in children with Down's Syndrome (DS). In this respect, DS children exhibit a markedly different response compared with healthy children. In order to understand the reasons for this difference, a controlled study was set up to determine the extent and the quality of the differences in the early periodontal tissue response towards dental plaque in the deciduous dentition of DS children and matched control children. In a preliminary investigation, the gingival health was estimated by determining the bleeding tendency. 9 healthy children were selected from a group of 14 and matched with 9 DS children with respect to plaque development, sulcus depth and age. The DS children had a higher bleeding tendency than the matched controls. In the DS children, moreover, a correlation was found between bleeding tendency and age. No such correlation was found in the controls. After a period of intensive oral hygiene, all cleaning of teeth was discontinued for 21 days. The amount of plaque according to the plaque index, the gingival health according to the gingival index, and the amount of crevicular leucocytes and gingival exudate were assessed at days 0, 7, 14 and 21. During the experimental phase of the study, the amount of plaque increased at a similar rate in both groups. In the DS children, the development of gingival inflammation started earlier and was more extensive. It increased after day 14, whereas in the control children, the gingival inflammation seemed to stabilize at this time. The results of the present experimental study thus confirm earlier results from epidemiological studies. The amount of gingival exudate was very low in both groups, but in the DS group it increased after day 14. In contrast to the DS children, the amount of crevicular leukocytes increased significantly in the control children from day 0 to day 21, the highest score being found on day 14. On day 7, a significantly larger amount of crevicular leucocytes was found in the DS children than in the controls. The findings of this study suggest that DS children have a different leucocyte response together with a more extensive gingival inflammation than normal children.     

Flattened condylar projection in children: reflection of seasonal growth?

'Deformed or flattened' X-ray projections of the mandibular condyle are incidentally reported in the literature. However, when studied longitudinally in a growing child, this characteristic appears to come and go in an unpredictable order. In addition, there is experimental evidence that in the rat elongated 'flattened' condyles can be cultured and that the rat condylar growth exhibits seasonal fluctuations. Therefore, the hypothesis was formulated that a part of the flattened condylar projections may reflect a temporarily active growth vector. The result of this study suggests that condylar flattened projections in children exhibit a seasonal variation and may possibly be interpreted as the reflection of a temporarily active growth vector.     

Groin dissection in the treatment of lower-extremity melanoma. Short-term and long-term morbidity.

Groin dissection was performed in 151 consecutive patients from 1970 to 1984. Groin dissections were therapeutic in 138 cases (91%) and elective in 13 (9%). One hundred forty-three patients (95%) underwent an ilioinguinal node dissection, while eight (5%) were treated with an inguinal node dissection. In 88 patients, the groin dissection was combined with isolated regional perfusion. Primary wound closure was performed in 140 patients (93%). There was no 30-day postoperative mortality. Complications included temporary seroma (26 [17%] of 151 patients), wound infection (14 patients [9%]), wound necrosis (five patients [3%]), and edema (30 patients [20%]). Residual inguinal node metastases after groin dissection did not occur. Morbidity of groin dissection did not increase when the groin dissection was combined with isolated regional perfusion. Quantification of the degree of edema in 66 patients revealed functional limitation due to edema in three patients (4.5%). This technique of groin dissection gives good results with minimal functional morbidity of the affected leg.