Effects of reduced sedentary time on resting, exercise and post-exercise blood pressure in inactive adults with metabolic syndrome - a six-month exploratory RCT

Evidence on the long-term effects of reducing sedentary behaviour (SB) on blood pressure (BP) is scarce. Therefore, we performed a sub-analysis of the BP effects of a six-month intervention that aimed at reducing SB by 1 h/day and replacing it with non-exercise activities. Sixty-four physically inactive and sedentary adults with metabolic syndrome (58% female, 58 [SD 7] years, BP 143/88 [16/9] mmHg, SB 10 [1] h/day) were randomised into intervention (INT, n = 33) and control (CON, n = 31) groups. Resting BP and BP at each stage during and after a graded maximal bicycle ergometer test were measured before and after the intervention. SB, standing, moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA) were measured in six-second intervals at baseline and during the whole six-month intervention using hip-worn accelerometers. The analyses were adjusted for BP medication status. The intervention resulted in a 40 min/day reduction in SB and concomitant 20 min/day increase in MVPA. Resting systolic BP was lower in the CON group before and after the intervention. No group x time interactions were observed in resting BP or BP during exercise at submaximal or maximal intensities, or during recovery. The changes in LPA and MVPA were inversely correlated with the changes in BP during light-to-moderate intensity exercise. An intervention that resulted in a 40 min/day reduction in SB for six months was not sufficient at influencing BP at rest, during or after exercise in adults with metabolic syndrome. However, successfully increasing LPA or MVPA might lower BP during light-to-moderate-intensity activities.

Sedentary time associates detrimentally and physical activity beneficially with metabolic flexibility in adults with metabolic syndrome

Metabolic flexibility (MetFlex) describes the ability to respond and adapt to changes in metabolic demand and substrate availability. The relationship between physical (in)activity and MetFlex is unclear. This study aimed to determine whether sedentary time, physical activity (PA), and cardiorespiratory fitness associate with MetFlex. Sedentary time, standing, and PA were measured with accelerometers for 4 weeks in 64 sedentary adults with metabolic syndrome [37 women, 27 men; 58.3 (SD 6.8) years]. Fitness (V̇o2max; mL·kg-1·min-1) was measured with graded maximal cycle ergometry. MetFlex was assessed with indirect calorimetry as the change in respiratory exchange ratio (ΔRER) from fasting to insulin stimulation with hyperinsulinemic-euglycemic clamp and from low-intensity to maximal exercise. Carbohydrate (CHOox) and fat oxidation (FATox) were calculated from respiratory gases. High sedentary time associated with higher fasting RER [β = 0.35 (95% confidence interval: 0.04, 0.67)], impaired insulin-stimulated MetFlex (ΔRER) [β=-0.41 (-0.72, -0.09)], and lower fasting FATox [β=-0.36 (-0.67, -0.04)]. Standing associated with lower fasting RER [β=-0.32 (-0.62, -0.02)]. Higher standing time and steps/day associated with higher fasting FATox [β = 0.31 (0.01, 0.61), and β = 0.26 (0.00, 0.53)]. Light-intensity and total PA associated with better insulin-stimulated MetFlex [β = 0.33 (0.05, 0.61)], and β = 0.33 (0.05, 0.60)]. Higher V̇o2max associated with higher CHOox during maximal exercise [β = 0.81 (0.62, 1.00)], as well as during insulin stimulation [β = 0.43 (0.13, 0.73)]. P values are less than 0.05 for all associations. Sedentary time and PA associate with MetFlex. Reducing sitting and increasing PA of even light intensity might aid in the prevention of metabolic diseases in risk populations through their potential effects on energy metabolism.NEW & NOTEWORTHY High accelerometer-assessed sedentary time associates with metabolic inflexibility measured during hyperinsulinemic-euglycemic clamp in adults with metabolic syndrome, and more light-intensity and total physical activity associate with more metabolic flexibility. Physical activity behaviors may thus play an important role in the regulation of fuel metabolism. This highlights the potential of reduced sedentary time and increased physical activity of any intensity to induce metabolic health benefits and help in disease prevention in risk populations.

Effects of reducing sedentary behavior on cardiorespiratory fitness in adults with metabolic syndrome: A 6-month RCT

INTRODUCTION

Poor cardiorespiratory fitness (CRF) is associated with adverse health outcomes. Previous observational and cross-sectional studies have suggested that reducing sedentary behavior (SB) might improve CRF. Therefore, we investigated the effects of a 6-month intervention of reducing SB on CRF in 64 sedentary inactive adults with metabolic syndrome in a non-blind randomized controlled trial.

MATERIALS AND METHODS

In the intervention group (INT, n = 33), the aim was to reduce SB by 1 h/day for 6 months without increasing exercise training. Control group (CON, n = 31) was instructed to maintain their habitual SB and physical activity. Maximal oxygen uptake (VO_2max ) was measured by maximal graded bicycle ergometer test with respiratory gas measurements. Physical activity and SB were measured during the whole intervention using accelerometers.

RESULTS

Reduction in SB did not improve VO_2max statistically significantly (group × time p > 0.05). Maximal absolute power output (W_max ) did not improve significantly but increased in INT compared to CON when scaled to fat free mass (FFM) (at 6 months INT 1.54 [95% CI: 1.41, 1.67] vs. CON 1.45 [1.32, 1.59] W_max /kg_FFM , p = 0.036). Finally, the changes in daily step count correlated positively with the changes in VO_2max scaled to body mass and FFM (r = 0.31 and 0.30, respectively, p < 0.05).

DISCUSSION

Reducing SB without adding exercise training does not seem to improve VO_2max in adults with metabolic syndrome. However, succeeding in increasing daily step count may increase VO_2max .

Associations of sedentary time, physical activity, and fitness with muscle glucose uptake in adults with metabolic syndrome

OBJECTIVE

The objective of the study was to investigate the associations of sedentary time, physical activity, and cardiorespiratory fitness with skeletal muscle glucose uptake (GU).

METHODS

Sedentary time and physical activity were measured with accelerometers and VO₂ max with cycle ergometry in 44 sedentary adults with metabolic syndrome. Thigh muscle GU was determined with [¹⁸ F]FDG-PET imaging.

RESULTS

Sedentary time (β = -0.374), standing (β = 0.376), steps (β = 0.351), and VO₂ max (β = 0.598) were associated with muscle GU when adjusted for sex, age, and accelerometer wear time. Adjustment for body fat-% turned all associations non-significant.

CONCLUSION

Body composition is a more important determinant of muscle GU in this population than sedentary time, physical activity, or fitness.

Maximal Exercise Capacity in Chronic Kidney Disease Stage 4-5 Patients Transitioning to Renal Replacement Therapy or Continuing Conservative Care: A Longitudinal Follow-Up Study

INTRODUCTION

Chronic kidney disease (CKD) is associated with impaired maximal exercise capacity (MEC). However, data are scarce on the development of MEC in CKD stage 4-5 patients transitioning to renal replacement therapy (RRT).

METHODS

We explored the change in MEC measured in watts (Wlast4) with 2 consecutive maximal bicycle stress ergometry tests in 122 CKD stage 4-5 patients transitioning to dialysis and transplantation in an observational follow-up study.

RESULTS

Mean age was 58.9 ± 13.9 years and 43 (35.2%) were female. Mean time between the baseline and follow-up ergometry tests was 1,012 ± 327 days and 29 (23.8%) patients had not initiated RRT, 50 (41.0%) were undergoing dialysis, and 43 (35.2%) had received a kidney transplant at the time of the follow-up ergometry test. The mean Wlast4 was 91 ± 37 W and 84 ± 37 W for the baseline and follow-up ergometry tests, respectively (p < 0.001). The mean Wlast4 declined between the baseline and follow-up ergometry tests in patients not requiring RRT (p = 0.001) and transplant recipients (p = 0.005), but not in dialysis patients (p = 0.478). There were no differences in the ratio of Wlast4 of the follow-up to the baseline ergometry tests (∆Wlast4) between patients on different treatment modalities at the time of the follow-up test (p = 0.097). Mean capillary blood bicarbonate was significantly associated with ∆Wlast4 after adjusting for age and treatment modality in the multivariate linear regression analysis (β = 0.226, p = 0.012).

CONCLUSION

MEC declined or remained poor in advanced CKD patients transitioning to RRT or continuing conservative care in this observational study. Mean capillary blood bicarbonate was independently associated with the development of MEC.

Association between cardiorespiratory fitness and metabolic health in overweight and obese adults

BACKGROUND

Cardiorespiratory fitness (CRF) has been inversely associated with insulin resistance and clustering of cardiometabolic risk factors among overweight and obese individuals. However, most previous studies have scaled CRF by body mass (BM) possibly inflating the association between CRF and cardiometabolic health. We investigated the associations of peak oxygen uptake (V̇ O2peak) and peak power output (Wpeak) scaled either by BM-1, fat free mass (FFM-1), or by allometric methods with individual cardiometabolic risk factors and clustering of cardiometabolic risk factors in 55 overweight or obese adults with metabolic syndrome.

METHODS

V̇ O2peak and Wpeak were assessed by a maximal cycle ergometer exercise test. FFM was measured by air displacement plethysmograph and glucose, insulin, HbA1c, triglycerides, and total, LDL, and HDL cholesterol from fasting blood samples. HOMA-IR and metabolic syndrome score (MetS) were computed.

RESULTS

V̇ O2peak and Wpeak scaled by BM-1 were inversely associated with insulin (β=-0.404 to -0.372, 95% CI=-0.704 to -0.048), HOMA-IR (β=-0.442 to -0.440, 95% CI=-0.762 to -0.117), and MetS (β=-0.474 to -0.463, 95% CI's=-0.798 to -0.127). Other measures of CRF were not associated with cardiometabolic risk factors.

CONCLUSIONS

Our results suggest that using BM-1 as a scaling factor confounds the associations between CRF and cardiometabolic risk in overweight/obese adults with the metabolic syndrome.

Standing is associated with insulin sensitivity in adults with metabolic syndrome

OBJECTIVES

To determine how components of accelerometer-measured sedentary behavior (SB) and physical activity (PA), and fitness are associated with insulin sensitivity in adults with metabolic syndrome.

DESIGN

Cross-sectional.

METHODS

Target population was middle-aged (40-65 years) sedentary adults with metabolic syndrome. SB, breaks in SB, standing, and PA were measured for four weeks with hip-worn accelerometers. VO₂max (ml/min/kg) was measured with maximal cycle ergometry. Insulin sensitivity was determined by hyperinsulinaemic-euglycaemic clamp (M-value) and fasting blood sampling (HOMA-IR, insulin). Multivariable regression was used for analyses.

RESULTS

Sixty-four participants (37 women; 58.3 [SD 6.8] years) were included. Participants spent 10.0 (1.0) h sedentary, 1.8 (0.6) h standing, and 2.7 (0.6) h in PA and took 5149 (1825) steps and 29 (8) breaks daily. In sex-, age- and accelerometer wear time-adjusted model SB, standing, steps and VO₂max were associated with M-value (β = -0.384; β = 0.400; β = 0.350; β = 0.609, respectively), HOMA-IR (β = 0.420; β = -0.548; β = -0.252; β = -0.449), and insulin (β = 0.433; β = -0.541; β = -0.252; β = -0.453); all p-values < 0.05. Breaks associated only with M-value (β = 0.277). When further adjusted for body fat %, only standing remained significantly associated with HOMA-IR (β = -0.381) and insulin (β = -0.366); significance was maintained even when further adjusted for SB, PA and fitness. Light and moderate-to-vigorous PA were not associated with insulin sensitivity.

CONCLUSIONS

Standing is associated with insulin sensitivity markers. The association with HOMA-IR and insulin is independent of adiposity, PA, SB and fitness. Further studies are warranted, but these findings encourage replacing sitting with standing for potential improvements in insulin sensitivity in adults at increased type 2 diabetes risk.

Physical inactivity from youth to adulthood and adult cardiometabolic risk profile

Adults with a low physical activity (PA) level are at increased risk for cardiometabolic diseases, but little is known on the association between physical inactivity since youth and cardiometabolic health in adulthood. We investigated the association of persistent physical inactivity from youth to adulthood with adult cardiometabolic risk factors. Data were drawn from the ongoing Cardiovascular Risk in Young Finns Study with seven follow-ups between 1980 and 2011 (baseline age 3-18 years, n = 1961). Physical activity data from a standardized questionnaire was expressed as a PA-index. Using the PA-index, four groups were formed: 1)persistently physically inactive (n = 246), 2)decreasingly active (n = 305), 3)increasingly active (n = 328), and 4)persistently active individuals (n = 1082). Adulthood cardiometabolic risk indicators included waist circumference, body mass index (BMI), blood pressure, and fasting lipids, insulin, and glucose. Clustered cardiometabolic risk was defined using established criteria for metabolic syndrome. Persistently physically inactive group was used as a reference. Compared to the persistently physically inactive group, those who were persistently active had lower risk for adult clustered cardiometabolic risk (RR = 0.67;CI95% = 0.53-0.84; Harmonized criteria), obesity (BMI > 30 kg/m², RR = 0.76;CI95% = 0.59-0.98), high waist circumference (RR = 0.82;CI95% = 0.69-0.98), and high triglyceride (RR = 0.60;CI95% = 0.47-0.75), insulin (RR = 0.58;CI95% = 0.46-0.74) and glucose (RR = 0.77;CI95% = 0.62-0.96) concentrations as well as low high-density lipoprotein cholesterol (HDLC) concentration (RR = 0.78;CI95% = 0.66-0.93). Comparable results were found when persistently physically inactive individuals were compared with those who increased PA. The results remained essentially similar after adjustment for education, diet, smoking, and BMI. Persistently physically inactive lifestyle since youth is associated with an unfavorable cardiometabolic risk profile in adulthood. Importantly, even minor increase in PA lowers the cardiometabolic risk.

Elevated Troponin T and Enlarged Left Atrium Are Associated with the Incidence of Atrial Fibrillation in Patients with CKD Stage 4-5

INTRODUCTION

Atrial fibrillation (AF) and CKD are commonly coexisting conditions. However, data on epidemiology of AF in patients with CKD stage 4-5 is scarce.

METHODS

We prospectively enrolled 210 consecutive non-dialysis patients with CKD stage 4-5 between 2013 and 2017. Follow-up data on AF incidence along with medical history, laboratory tests, and echocardiography at baseline were gathered.

RESULTS

At baseline, mean age was 62 years, estimated glomerular filtration rate 12.8 mL/min, and 73/210 (34.8%) participants were female. Altogether, 41/210 (19.5%) patients had a previous diagnosis of AF. After median follow-up of 46 [IQR 27] months, new-onset AF occurred in 33/169 (19.5%) patients (69.9 events/1,000 person-years). In the Cox proportional hazard model, age >60 years (HR 4.27, CI 95% 1.57-11.64, p < 0.01), elevated troponin T (TnT) >50 ng/L (HR 3.61, CI 95% 1.55-8.37, p < 0.01), and left atrial volume index (LAVI) >30 mL/m2 (HR 4.82, CI 95% 1.11-21.00, p = 0.04) were independently associated with the incidence of new-onset AF.

CONCLUSION

The prevalence and incidence of AF was markedly high in this prospective study on patients with CKD stage 4-5. Elevated TnT and increased LAVI were independently associated with the occurrence of new-onset AF in patients with severe CKD.

Interatrial block, P terminal force or fragmented QRS do not predict new-onset atrial fibrillation in patients with severe chronic kidney disease

Background

The prevalence of left atrial enlargement (LAE) and fragmented QRS (fQRS) diagnosed using ECG criteria in patients with severe chronic kidney disease (CKD) is unknown. Furthermore, there is limited data on predicting new-onset atrial fibrillation (AF) with LAE or fQRS in this patient group.

Methods

We enrolled 165 consecutive non-dialysis patients with CKD stage 4–5 without prior AF diagnosis between 2013 and 2017 in a prospective follow-up cohort study. LAE was defined as total P-wave duration ≥120 ms in lead II ± > 1 biphasic P-waves in leads II, III or aVF; or duration of terminal negative portion of P-wave > 40 ms or depth of terminal negative portion of P-wave > 1 mm in lead V₁ from a baseline ECG, respectively. fQRS was defined as the presence of a notched R or S wave or the presence of ≥1 additional R waves (R’) or; in the presence of a wide QRS complex (> 120 ms), > 2 notches in R or S waves in two contiguous leads corresponding to a myocardial region, respectively.

Results

Mean age of the patients was 59 (SD 14) years, 56/165 (33.9%) were female and the mean estimated glomerular filtration rate was 12.8 ml/min/1.73m². Altogether 29/165 (17.6%) patients were observed with new-onset AF within median follow-up of 3 [IQR 3, range 2–6] years. At baseline, 137/165 (83.0%) and 144/165 (87.3%) patients were observed with LAE and fQRS, respectively. Furthermore, LAE and fQRS co-existed in 121/165 (73.3%) patients. Neither findings were associated with the risk of new-onset AF within follow-up.

Conclusion

The prevalence of LAE and fQRS at baseline in this study on CKD stage 4–5 patients not on dialysis was very high. However, LAE or fQRS failed to predict occurrence of new-onset AF in these patients.

Experimental and numerical dataset of Microbond test using optical fibres for strain

This data article provides useful information often required for numerical modeling of the so-called microbond tests. It includes the experimental and simulation data of the microbond testing using Fibre Bragg Grating (FBG) fibres for optical strains. Microbond testing was performed on five different droplets of varying embedded length and diameter to collect the data. Finite element simulation was carried out and modelling was validated, by using two variables force and strain, to collect the data. The output data of the fitted models is given and is also visualized via graphs of force-strain derivative curves. The data of the simulations is provided for different finite element mesh densities. Here, to clarify the type and form of the data for the use by readers, the energy distribution curves describing various functionalities of the droplet, fibre and interface are presented. For further reading, the interpretation and analysis of this data can be found in a research article titled “3D interfacial debonding during microbond testing: Advantages of local strain recording” (R. Dsouza et al., 2020) [1].

P0252TROPONIN T AND LEFT ATRIAL VOLUME INDEX ARE ASSOCIATED WITH THE OCCURRENCE OF NEW-ONSET ATRIAL FIBRILLATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 4-5

Background and Aims

Atrial fibrillation (AF) and chronic kidney disease (CKD) are common and often co-existing conditions. However, little is known on the prevalence and incidence of AF in patients with CKD stage 4-5.

Method

We prospectively recruited 210 consecutive non-dialysis patients with CKD stage 4-5 between 2013 and 2017. Follow-up data on AF occurrence as well as baseline medical history, laboratory tests and echocardiography were collected.

Results

At baseline, mean age was 62 years, 73/210 (34.8%) of the participants were female, mean estimated glomerular filtration rate was 12.8ml/min and 41/210 (19.5%) patients had a prior diagnosis of AF. After median follow-up of 46 [IQR 27] months, new-onset AF was detected in 33/169 (19.5%) patients (69.9 events/1000 person-years). Overall, 22/33 (66.7%) of patients with new-onset AF were identified with a triggering condition, most commonly severe infection or surgery, and 21/33 (63.6%) were receiving renal replacement therapy (dialysis or acquired kidney transplant) at the time of AF detection, respectively. In Cox proportional hazard model age &gt;60 years (HR 4.27, CI95% 1.57-11.64, p&lt;0.01), elevated troponin T (TnT) &gt;50ng/l (HR 3.61, CI95% 1.55-8.37, p&lt;0.01) and left atrial volume index (LAVI) &gt;30ml/m2 (HR 4.82, CI95% 1.11-21.00, p=0.04) independently predicted the occurrence of new-onset AF. Furthermore, the predictive effect of the covariates was cumulative (Figure 1).

Conclusion

The incidence rate of AF was remarkably high in this prospective study on patients with CKD stage 4-5. Elevated TnT and increased LAVI are associated with the occurrence of new-onset AF in patients with severe CKD.

P4420Is exercise-induced cardiac troponin release caused by skeletal muscle injury?

Background

Cardiac troponins (cTn) are highly sensitive and specific markers for cardiac injury and a key element in the diagnosis of acute coronary syndrome. Strenuous exercise is known to induce increases in cTn, but the causative factors remain ambiguous. It is also equivocal whether exercise induced skeletal muscle injury is associated with cTn elevation.

Purpose

The aim of this study was to identify independent predictors for the rise in cardiac troponin T (cTnT) and I (cTnI) concentration and to focus on the relationship between skeletal muscle injury measured by skeletal troponin I (skTnI) and cTn elevations after a marathon race in a large group of male recreational runners.

Methods

A total of 40 recreational runners participating in the marathon in our city were recruited. The study included baseline visit (prerace) and immediate post-race sampling.

Results

The post-marathon cTnT concentration rose above the reference limit in 38 (95%) participants and the detection limit for cTnI was exceeded in 34 (85%) participants. Similarly, a 10-fold increase in skTnI concentration was observed and elevated post-race values were seen in all participants. There was no significant correlation between the post-race cTnT or cTnT change and post-race skTnI (Spearman's rho = 0.249, p=0.122, rho = 0.285, p=0.074). However, post-race cTnI and change in cTnI were associated with post-race skTnI (rho = 0.404, p=0.01, rho = 0.460, p=0.003) and creatine kinase (r=0.368, p=0.019) concentration. Subjective exertion or self-reported muscle symptoms did not correlate with post-race cTnT, cTnI or skTnI levels.

Post-Race cTnT <40 Post-Race cTnT ≥40 p-value n=18 n=22 Age, years 53.3±12.2 44.0±11.9 0.002 Active training, years 12.0 (9.3) 17.0 (15.8) 0.190 Muscle symptoms 7 (38.9) 11 (52.4) 0.523 Creatinine kinase, ug/l 406 (137) 399 (319) 0.163 N-terminal proBNP ng/l 137±168 158±277 0.783 Skeletal Troponin I, ng/ml 28.6 (41) 56.7 (143) 0.199

Figure 1

Conclusions

Cardiac troponin became abnormal in almost all runners after marathon race. The exercise-induced rise in cardiac troponin I is related to simultaneous release of skeletal troponin I. The mechanism of this association remains uncertain, but clinicians should be cautious when interpreting post-exercise troponin levels without clinical symptoms and signs of myocardial ischemia.

Kick Scooter Injuries in Children and Adolescents: Minor Fractures and Bruise

BACKGROUND:

Kick scooters are popular among children in both transportation and recreational activities. The aim of this retrospective study was to assess the incidence of and injury patterns associated with kick scooter accidents in school-aged children and adolescents.

METHODS:

All 171 patients at the age of 7-15 years who were treated for kick scooter-related injuries in the metropolitan Helsinki area, Southern Finland from January 2008 to December 2013 were included. Electronic medical records were reviewed and Pediatric Trauma Scores and Injury Severity Scores were utilized to assess the injuries.

RESULTS:

The annual number of patients increased from 7 in 2008 to 55 in 2013. Almost all patients (94%, n = 161) were injured after a fall from their own height. Most patients (n = 118; 69%) were diagnosed with a fracture but only 26 patients (15%) required surgical procedures under general anesthesia. Pediatric Trauma Scores were low and only one patient had an Injury Severity Score > 15 which can be considered major trauma.

CONCLUSION:

Most injuries acquired from kick scooter injuries were easily treatable fractures and bruises. Considering the background population of 105,000 in the respective age group and the 6-year period of data collection from tertiary care, scooting seems a safe means of increasing the physical activity levels of school-aged children and adolescents.

Method for 3D fibre reconstruction on a microrobotic platform

Automated handling of a natural fibrous object requires a method for acquiring the three-dimensional geometry of the object, because its dimensions cannot be known beforehand. This paper presents a method for calculating the three-dimensional reconstruction of a paper fibre on a microrobotic platform that contains two microscope cameras. The method is based on detecting curvature changes in the fibre centreline, and using them as the corresponding points between the different views of the images. We test the developed method with four fibre samples and compare the results with the references measured with an X-ray microtomography device. We rotate the samples through 16 different orientations on the platform and calculate the three-dimensional reconstruction to test the repeatability of the algorithm and its sensitivity to the orientation of the sample. We also test the noise sensitivity of the algorithm, and record the mismatch rate of the correspondences provided. We use the iterative closest point algorithm to align the measured three-dimensional reconstructions with the references. The average point-to-point distances between the reconstructed fibre centrelines and the references are 20-30 μm, and the mismatch rate is low. Given the manipulation tolerance, this shows that the method is well suited to automated fibre grasping. This has also been demonstrated with actual grasping experiments.

Parent-reported food allergy requiring an avoidance diet in children starting elementary school

AIM

To evaluate the prevalence of parent-reported food allergies requiring avoidance diet at early school age.

METHODS

The school health nurses interviewed, by using a structured questionnaire on the required diet at school, the parents of all the 1542 children starting elementary school in a Finnish town with 210,000 inhabitants.

RESULTS

An allergy to basic foods was found in 41 (2.7%) children: 1.5% to milk, 1.1% to eggs and 1.0% to grains. An allergy to nuts was present in 3.1% and to fruits and vegetables in 5.8%, both with known cross-sensitization to pollens. In all, 9.2% of the children reported some allergy. Milk, egg and grain allergies were associated with soy, nut and spice allergies.

CONCLUSION

Over 2% of the 1542 Finnish first-graders reported allergies to basic foods (milk, eggs or grains) requiring special avoidance diets at school. The figure suggests that avoidance diets started in the first years of life still unnecessarily continued.

Dietary carbohydrate modification alters serum metabolic profiles in individuals with the metabolic syndrome

BACKGROUND AND AIMS

Whole-grain cereals and diets with a low glycemic index may protect against the development of type 2 diabetes and heart disease, but the mechanisms are poorly understood. We studied the effect of carbohydrate modification on serum metabolic profiles, including lipids and branched chain amino acids, and dependencies between these and specific gene expression pathways in adipose tissue.

METHODS AND RESULTS

Twenty subjects with metabolic syndrome were selected from the larger FUNGENUT study population, randomized either to a diet high in oat and wheat bread and potato (OWP) or rye bread and pasta (RP). Serum metabolomics analyses were performed using ultra-performance liquid chromatography coupled to electrospray ionization mass spectrometry (UPLC/MS), gas chromatography (GC) and UPLC. In the OWP group multiple proinflammatory lysophosphatidylcholines increased, while in the RP group docosahexaenoic acid (DHA 22:6n-3) increased and isoleucine decreased. mRNA expression of stress reactions- and adipose tissue differentiation-related genes were up-regulated in adipose tissue in the OWP group. In the RP group, however, pathways related to stress reactions and insulin signaling and energy metabolism were down-regulated. The lipid profiles had the strongest association with the changes in the adipose tissue differentiation pathway when using the elastic net regression model of the lipidomic profiles on selected pathways.

CONCLUSION

Our results suggest that the dietary carbohydrate modification alters the serum metabolic profile, especially in lysoPC species, and may, thus, contribute to proinflammatory processes which in turn promote adverse changes in insulin and glucose metabolism.

Weight reduction modulates expression of genes involved in extracellular matrix and cell death: the GENOBIN study

OBJECTIVE

Lifestyle and genetic factors interact in the development of obesity and the metabolic syndrome. The molecular mechanisms underlying the beneficial dietary modifications are, however, unclear. We aimed to examine the effect of the long-term moderate weight reduction on gene expression in adipose tissue (AT) and to identify genes and gene clusters responsive to treatment and thereby likely contributing to the development of the metabolic syndrome.

DESIGN

Randomized controlled and individualized weight reduction intervention.

SUBJECTS

Forty-six subjects with impaired fasting glycemia or impaired glucose tolerance and features of metabolic syndrome, aged 60+/-7 years were randomized either to a weight reduction (WR) (n=28) or a control (n=18) group lasting for 33 weeks.

MEASUREMENTS

Oral and intravenous glucose tolerance tests and subcutaneous AT biopsies were performed before and after the intervention. Gene expression of AT was studied using microarray technology in subgroups of WR (with weight reduction > or =5%, n=9) and control group (n=10). The results were confirmed using quantitative PCR.

RESULTS

In the WR group, glucose metabolism improved. Moreover, an inverse correlation between the change in S (I) and the change in body weight was found (r=-0.44, P=0.026). Downregulation of gene expression (P<0.01) involving gene ontology groups of extracellular matrix and cell death was seen. Such changes did not occur in the control group. The tenomodulin-gene was one of the most downregulated genes (-39+/-16%, P<0.0001). Moreover, its expression correlated with insulin sensitivity (r=-0.34, P=0.005) before the intervention and with body adiposity both before (r=0.42, P=0.007) and after (r=0.30, P=0.056) the intervention.

CONCLUSION

Genes regulating the extracellular matrix and cell death showed a strong downregulation after long-term weight reduction. This likely reflects a new stable state at the molecular level in AT. Further studies are warranted to elucidate the mechanisms of these genetic factors.

Challenges in capillary pressure microinjection

Capillary pressure microinjection is a popular method for the delivery of samples into cells. Needs for automatic reliable microinjection systems are growing, but the current systems do not possess ideal characteristics and many researchers do not even recognize the limits of the current systems. In many cases for example, the experiments are influenced by so called influx or efflux. This paper discusses the limits and challenges related to the automatic microinjection of single adherent cells. The discussion focuses on the reasons for the variability of the injected volume and shows the complexity of the problem. Solutions are outlined and future steps sketched. Future developments in the field of microinjection are proposed.

One-year compliance and effects of amine and stannous fluoride on some salivary biochemical constituents and oral microbes in institutionalized elderly

Due to old age and poor general health, the institutionalized elderly have often not been used as research subjects for the investigation of oral health protocols. Because the number of elderly is increasing, they are an important target group for the development of oral hygiene aids. This trial was designed to investigate whether the institutionalized elderly could successfully use an amine-fluoride- and stannous-fluoride-containing mouthwash and toothpaste during a 12-month period. A dental hygienist visited the subjects weekly, instructed them, and recorded their self-reported compliance. Plaque and saliva samples were taken at three-month intervals. Some salivary biochemical constituents reflecting mucosal integrity were analyzed. The carrier status of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus, Prevotella intermedia, and Prevotella nigrescens was studied by the polymerase chain-reaction method, and acidogenic bacteria and yeasts by dip-slide methods (Orion Diagnostica, Espoo, Finland). Of those 98 subjects originally included, 44 elderly (30 women and 14 men; mean age, 81.7 +/- 5.9 yrs) completed the trial. Their observations were positive or very positive regarding the use of mouthwash and toothpaste. The number of residents with P. gingivalis decreased statistically significantly throughout the trial, while the carrier status of the other periodontal bacteria and mutans streptococci remained on the same level. The number of subjects with high counts (> or = 10(5) cfu/mL) of yeasts decreased during the study: 26.2% at baseline, 9.1% one year later, respectively. Biochemical analyses of salivary immunoglobulins showed no effect on IgA and IgM levels, but IgG reduced significantly. Albumin and other salivary protein concentrations were found to have a decreasing tendency. Thus, the overall effect of the protocol was beneficial with regard to subjects' oral health as measured in this study. The residents were pleased to participate, but the number of drop-outs was very high, confirming the expected difficulties with the utilization of a group of frail elderly as research subjects.

Acute paediatric ankle trauma: MRI versus plain radiography

OBJECTIVE

To evaluate the diagnosis of acute physeal ankle fractures on plain radiographs using MRI as the gold standard.

METHODS

Sixty consecutive children, 29 with a clinical diagnosis of lateral ligament injury and 31 with physeal ankle fractures, were examined using both radiographs and MRI in the acute period. The imaging data were reviewed by three "masked" radiologists. The fracture diagnosis and Slater-Harris classification of radiographs were compared with findings on MRI.

RESULTS

Plain radiography produced five of 28 (18%) false negative and 12 of 92 (13%) false positive fracture diagnoses compared with MRI. Six of the 12 false positive fractures were due to a misclassification of lateral ligament disruption as SH1 fractures, Altogether a difference was found in 21% of cases in either the diagnosis or the classification of the fractures according to Salter-Harris. All bone bruises in the distal tibia and fibula and 64% of bone bruises in the talus were seen in association with lateral ligament injuries. Talar bone bruises in association with fractures occurred on the same side as the malleolar fracture; talar bone bruises in association with lateral ligament disruption were seen in different locations. The errors identified on radiographs by MRI did not affect the management of the injury.

CONCLUSIONS

The incidence of false negative ankle fractures in plain radiographs was small and no complex ankle fractures were missed on radiographs. The total extent of complex fractures was, however, not always obvious on radiographs. In an unselected series of relatively mild ankle injuries, we were unable to show a single case where the treatment or prognosis based on plain radiography should have been significantly altered after having done a routine MRI examination. Plain radiography is still the diagnostic cornerstone of paediatric ankle injuries.

High numbers of viral RNA copies in the central nervous system of mice during persistent infection with Theiler's virus

The low-neurovirulence Theiler's murine encephalomyelitis viruses (TMEV), such as BeAn virus, cause a persistent infection of the central nervous system (CNS) in susceptible mouse strains that results in inflammatory demyelination. The ability of TMEV to persist in the mouse CNS has traditionally been demonstrated by recovering infectious virus from the spinal cord. Results of infectivity assays led to the notion that TMEV persists at low levels. In the present study, we analyzed the copy number of TMEV genomes, plus- to minus-strand ratios, and full-length species in the spinal cords of infected mice and infected tissue culture cells by using Northern hybridization. Considering the low levels of infectious virus in the spinal cord, a surprisingly large number of viral genomes (mean of 3.0 x 10(9)) was detected in persistently infected mice. In the transition from the acute (approximately postinfection [p.i.] day 7) to the persistent (beginning on p.i. day 28) phase of infection, viral RNA copy numbers steadily increased, indicating that TMEV persistence involves active viral RNA replication. Further, BeAn viral genomes were full-length in size; i.e., no subgenomic species were detected and the ratio of BeAn virus plus- to minus-strand RNA indicated that viral RNA replication is unperturbed in the mouse spinal cord. Analysis of cultured macrophages and oligodendrocytes suggests that either of these cell types can potentially synthesize high numbers of viral RNA copies if infected in the spinal cord and therefore account for the heavy viral load. A scheme is presented for the direct isolation of both cell types directly from infected spinal cords for further viral analyses.

UDP-galactose transporter is required for Theiler's virus entry into mammalian cells

Theiler's murine encephalomyelitis viruses (TMEV) are divided into two groups: high-neurovirulence strains, such as GDVII, cause fatal encephalitis, while low-neurovirulence strains, such as BeAn and DA, cause persistent infection and demyelination in mice. Cell surface sialic acid is bound by the low-neurovirulence DA and BeAn viruses, but not by the high-neurovirulence GDVII virus. We have identified a clone from a BHK-21 cell cDNA library that mediates TMEV entry and infection by viruses of both TMEV groups in a receptor-negative BHK-21 cell variant (R26). The sequence of this clone is 96.4% identical to the human UDP-galactose transporter (UGT), which belongs to a family of nucleotide-sugar transporter proteins involved in the biosynthesis of complex carbohydrate structures in the trans-Golgi network. UGT mRNA from R26 cells was found to have a 490-nucleotide deletion involving the C-terminal amino acids 255 to 392 and 81 nucleotides of the 3' noncoding region. These results suggest two possibilities by which UGT may mediate TMEV entry and infection. The most likely one relates to the transporter function of adding galactose to another receptor protein. This possibility suggests the requirement for a specific glycoprotein interaction for GDVII virus cell binding and entry, e.g., galactose for GDVII and sialic acid for BeAn. Alternatively, UGT might be a TMEV receptor itself, acting via UGT cycling to the cell surface.

MRI abnormalities of foot and ankle in asymptomatic, physically active individuals

OBJECTIVE

To assess MRI changes in the ankle and foot after physical exercise.

DESIGN AND PATIENTS

Nineteen non-professional marathon runners and 19 age- and sex-matched controls volunteered for the study. All had ankle and foot MR images (1.5 T) taken in three perpendicular planes (STIR, T2F and T1FS sequences) within 3 h of running a full-length marathon (42.125 km). Three radiologists independently analysed the groups on a masked basis using a predefined form.

RESULTS

Severe bone marrow oedema was seen in one and slight bone marrow oedema in three marathon runners. Slight bone marrow oedema was found in three control subjects. Signal alteration within the soleus muscle, consistent with a grade 1 strain, was found in one marathon runner. Small punctate hyperintensities within the Achilles tendon were seen in 26% of the marathon runners and in 63% of controls (P = 0.016). An increased amount of fluid in the retrocalcaneal bursa was found in one control and in none of the marathon runners. Small amounts of fluid in the retrocalcaneal bursa were seen in 68% of marathon runners and in 53% of controls. Grade 1 or 2 peritendinous joint fluid was found around 22% of tendons, among both marathon runners and controls, most often involving the tendon sheath of the flexor hallucis longus muscle. An increased amount of joint fluid was noted in 34% of the joints of the marathon runners, and in 18% of the controls.

CONCLUSION

MRI shows several abnormalities in the ankle and foot both after marathon races and in asymptomatic physically active individuals without any preceding extraordinary strain. Recreational sports may lead to a number of positive MRI findings without correlation with clinical findings.

The in vivo expression of the collagenolytic matrix metalloproteinases (MMP-2, -8, -13, and -14) and matrilysin (MMP-7) in adult and localized juvenile periodontitis

Periodontal inflammation is characterized by irreversible degradation of periodontal ligament collagen fibers leading to loss of tooth attachment. Cultured gingival keratinocytes and fibroblasts express, in vitro, various matrix metalloproteinases (MMPs) which can degrade fibrillar collagens. We hypothesized that several MMPs are also synthesized in vivo by sulcular epithelium, and analyzed the collagenolytic MMPs (MMP-2, -8, -13, and -14) and matrilysin (MMP-7) in gingival tissue specimens and gingival crevicular fluid from adult and localized juvenile periodontitis patients by in situ hybridization, immunohistochemistry, and Western immunoblotting. MMP-2, -7, -8, and -13 were expressed in gingival sulcular epithelium. MMP-7 and -13 were also located in fibroblasts and macrophages, and MMP-8 in neutrophils. MMP-8- and -13-positive cells/mm2 were higher in periodontitis gingiva when compared with healthy control tissue (p < 0.01). In periodontal diseases, gingival sulcular epithelium expresses several, rather than a single, collagenolytic MMPs, and this proteolytic cascade is evidently responsible for the tissue destruction characteristic of adult and juvenile periodontitis.

Conservative treatment of scaphoid fractures: a follow up study

BACKGROUND AND AIMS

This investigation was made to elucidate the outcome of conservatively treated scaphoid fractures.

MATERIAL AND METHODS

63 patients with a scaphoid fracture were treated initially conservatively and examined retrospectively. The mean follow up time was 54 months.

RESULTS

In this group bone union was achieved in 56 cases (89%). Three of the patients ended up to operation because of delayed union soon after conservative treatment and three nonunions were found in the follow up appointment. One fracture did not heal because of dislocation during cast treatment and was treated with operation. Incidence of osteoarthrosis and residual symptoms were studied in the group with totally conservative treatment. Osteoarthrosis was found in 19 (32%) wrists, but no correlation with wrist problems (pain, reduced grip strength or problems at work) was found. 20 (34%) of the patients complained residual symptoms. Most of the symptoms were mild and did not impair their ability to work or cause serious problems during free time.

CONCLUSION

According to the present study conservative treatment is a safe method for the treatment of undislocated stabile scaphoid fractures.

Scientific basis of a matrix metalloproteinase-8 specific chair-side test for monitoring periodontal and peri-implant health and disease

Matrix metalloproteinases (MMPs), especially collagenase-2 (MMP-8), are key mediators of irreversible tissue destruction associated with periodontitis and peri-implantitis. MMP-8 is known to exist in elevated amounts and in active form in the gingival crevicular fluid (GCF) and peri-implant sulcular fluid (PISF) from progressing periodontitis and peri-implantitis lesions and sites, respectively. (Sorsa et al. Ann. N.Y. Acad. Sci. 737: 112-131 [1994]; Teronen et al. J. Dent. Res. 76: 1529-1537 [1997]). We have developed monoclonal antibodies to MMP-8 (Hanemaaijer et al. J. Biol. Chem. 272: 31504-31509 [1997]) that can be used in a chair-side dipstick test to monitor the course and treatment of periodontitis and peri-implantitis. Monoclonal and polyclonal antibody tests for MMP-8 coincided with the classical functional collagenase activity test from GCF and PISF (Sorsa et al. J. Periodont. Res. 22: 386-393 [1988]) in periodontal and peri-implant health and disease. In future a chair-side functional and/or immunological MMP-test can be useful to diagnose and monitor periodontal and peri-implant disease and health.

Soluble CD27 in thyroid disorders

We measured the soluble cytokine CD27 in a variety of thyroid disorders. Soluble CD27 was increased in untreated Graves' hyperthyroidism and in euthyroid ophthalmopathy. Levels of sCD27 were normal after the establishment of euthyroidism with propylthiouracil (PTU) or radio iodine in primary hypothyroidism, chronic thyroiditis, and the hyperthyroid and euthyroid phases of subacute thyroiditis. Soluble CD27 is a marker for cellular activation as in Graves' hyperthyroidism, but it is not predictive of the outcome of PTU therapy.

Comparative genomic hybridization of low-grade central osteosarcoma

Very little is known concerning the cytogenetic and molecular genetic changes of low-grade central osteosarcoma, a rare form of osteosarcoma. In the present study, we used comparative genomic hybridization (CGH) to screen for DNA sequence copy number aberrations in 10 samples from 6 patients: 7 typical low-grade central osteosarcomas, one low-grade (Grade II) central osteosarcoma, and two high-grade (III and IV) local recurrences of a low-grade central osteosarcoma Nine samples had aberrations. Six typical low-grade central osteosarcoma samples had a single DNA sequence copy number change per tumor. Three samples from more advanced tumors (a Grade II low-grade central osteosarcoma and local recurrences of Grade III and IV) had a mean of five changes per tumor. Recurrent changes affected these minimal common regions: +12q13-q14 (three tumors), +12p (two tumors), and +6p21.1-p21.3 (two tumors). Nine samples were analyzed for CDK4 and MDM2 expression and SAS amplification. One sample with a gain of chromosome 12 had a very strong expression of MDM2, strong expression of CDK4, and amplification of SAS. One sample with a gain of 12q13-q14 had strong expression of CDK4 and MDM2. Strong expression of CDK4 was found in two additional tumors; one had a gain of 12q13-q21, and the other had no changes in chromosome 12 by CGH. No alterations were detected in the CDK4, MDM2, and SAS panel in three other samples with no changes in chromosome 12 by CGH. In conclusion, the low number of DNA sequence copy number alterations reflects the relatively low malignancy of low-grade central osteosarcoma. This simplicity differs from the complex aberrations seen in conventional high-grade osteosarcomas.

Self-assessed bleeding and plaque as methods for improving gingival health in adolescents

The aim of this longitudinal study was to compare the effectiveness, in terms of cognitive and clinical changes, of two oral self-care promoting interventions based on a self-assessment of bleeding from gums or of presence of plaque. Adolescent students (age 14.0 + 0.7 years) from two health districts in Helsinki, Finland, participated in this one-year study. The self-assessment of bleeding group (n = 172) recorded bleeding during tooth brushing and inter-proximal cleaning with toothpicks on a single session. The self-assessment of plaque group (n = 156) recorded the presence of plaque with disclosing dye. Both programmes resulted in comparable clinical improvement in bleeding on probing over 9 months. Increased awareness of gingivitis was associated with clinical improvement. The subjects' socio-economic background, baseline gingival health status and age were statistically significantly associated with gingival health improvement during the follow-up. The results support earlier reports on self-assessment and suggest that both self-assessment approaches are beneficial for promoting gingival health in adolescents.

Determinants of self-assessed gingival health among adolescents

The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed gingival health and to investigate possible factors associated with the amount of self-assessed gingival bleeding. A study group comprising students enrolled in grade 7 or 8 in Helsinki, Finland (n = 172), performed a self-assessment based on two tests: the amount of bleeding after toothbrushing and after interproximal tooth cleaning with toothpicks. Clinical examinations based on bleeding on probing (BOP%) were carried out by four local community dentists. The highest observed kappa value was 0.43 for the agreement between BOP% and self-assessment when tested with different cut-off points of diagnosis. Multivariate analysis showed that clinical status and toothbrushing frequency were statistically significantly associated with self-assessed gingival bleeding in both tests. Socioeconomic status and locus of control orientation were also statistically significant factors in the toothpick test. In conclusion, the validity of self-assessment of bleeding was sufficient for monitoring adolescents' gingival health in groups. Self-assessed bleeding was explained by the same factors that were associated with clinical gingival health status.

Occlusal restorative decisions based on visual inspection--calibration and comparison of different methods

The purpose of this in vitro study was to calibrate occlusal restorative decision-making based on visual inspection (VI), and to compare it with visual inspection with magnifying (x1.25) lenses (VIM), and fibre-optic transillumination (VIF). Sixty extracted human third molars mounted in plaster were examined using VI by ten dentists three times during the calibration process. After wash-out periods, the teeth were re-examined by the same dentists using VI, VIM and VIF. The inter-examiner reproducibility for VI, expressed as Kappa (kappa) statistics (kappa +/- SD), was 0.46 +/- 0.10 before and 0.59 +/- 0.11 after the calibration process and remained at the same level after the wash-out period. Intra-examiner reproducibility was substantially higher for VI (kappa -0.68 +/- 0.15) before and after the wash-out period. There were no significant changes in restorative treatment decisions based on VIM and VIF when compared to VI. The reproducibility between the methods was good for VI vs. VIM (kappa = 0.64) and moderate for VI vs. VIF (kappa = 0.56). In contrast, the inter-examiner reproducibilities expressed as Kappa were considerably lower for VIM (kappa = 0.46 +/- 0.17) and VIF (K = 0.42 +/- 0.19). It was concluded that the inter-examiner reproducibility can be improved with a calibration process based on a simple feedback method and that inter-examiner variation, especially without calibration, may be as important a factor for restorative treatment decisions as the diagnostic method itself.

Assessment of the effect of an oscillating/rotating electric toothbrush on oral health. A 12-month longitudinal study

The aim of this 12-month parallel design controlled clinical trial was to assess the effect of the Braun Oral-B Plak Control electric toothbrush on supragingival plaque and gingival health, and to compare it with a conventional soft manual toothbrush (Jordan). A total of 111 patients aged between 20 and 63 years, from a general population, with bleeding on probing at 30% or more of all sites examined were entered into the study. At baseline, immediately after periodontal examination, all volunteers received a thorough scaling of their teeth. Volunteers in both groups were told to brush their teeth for 2 min 2 x a day. Oral hygiene instruction was given at the start of the study and was not repeated. At 3, 6 and 12 months, assessments were carried out by a single clinician who was not aware which group the volunteers belonged to. Analysis of results demonstrated that over the 12 months of the study, the Braun Oral-B Plak Control was significantly more effective in improving gingival health than the manual toothbrush. There was, however, no difference between the 2 groups in terms of plaque removal, with the number of sites with visible plaque decreasing by a similar amount in both groups. In conclusion, results indicate that the Braun Oral-B Plak Control toothbrush is safe and more effective than a manual toothbrush in improving gingival health.

Self-assessed bleeding in monitoring gingival health among adolescents

The purpose of this descriptive, cross-sectional community-based investigation was to assess the self-assessment of bleeding and plaque as methods to monitor gingival health among adolescents. Two study groups (n = 184 each) of 14-year-old Finnish school children performed either of self-assessment plaque or bleeding. Prior to that they were clinically examined by 10 dentists from the community dental service who recorded bleeding on probing from four surfaces of all teeth (BOP%) and Community Periodontal Index of Treatment Needs (CPITN) status. The self-assessment of plaque was not significantly correlated with a clinical bleeding on probing measurement (BOP%). The self-assessment of bleeding, based on observed bleeding after toothbrushing and after interproximal cleaning with toothpicks, exhibited statistically significant correlation with BOP% (r = 0.54, P < 0.001). Percent agreement was 75%, kappa agreement 0.33, sensitivity 31% and specificity 71%, respectively. In conclusion, the preliminary results suggest that the self-assessment of bleeding does not have sufficient validity for screening individuals but it could be a useful method for monitoring gingival health of populations, in particular, if the concurrent aim is to enhance periodontal awareness.

Smoking and oral health: a population survey in Finland

OBJECTIVES

A survey was conducted to study smokers' oral health behaviors and attitudes, and to determine if smokers were advised by their dentists to quit smoking.

METHODS

A random sample of 1,200 adults 15 to 64 years of age living in the province of North Karelia, Finland, was selected in each of two study years (1990 and 1991) and surveyed using a mail questionnaire. The 102-item questionnaire solicited information on smoking status, oral health behaviors, missing teeth, perceptions of tobacco's harmful effects on oral health, smoking status and quitting, and advice on smoking cessation provided by dentists. Variations in behaviors and opinions according to smoking status were analyzed.

RESULTS

Nonsmokers reported more frequent healthy oral health behaviors than did daily smokers, with the exception that no difference in toothbrushing frequencies existed among women. Daily smoking was associated with increased use of sugar in tea or coffee, and with more frequent alcohol consumption. Daily smoking was correlated with the number of missing teeth in bivariate analyses, but not in multivariate analyses. Fewer daily smokers than nonsmokers considered smoking to have harmful effects on oral health. The majority of daily smokers, however, wanted to quit. Eight percent of daily smokers reported that they had been advised by their dentist to quit.

CONCLUSIONS

Dentists need to provide patients with counseling on tobacco use because of the desire of many smokers to quit. Counseling of smokers by the oral health team requires special attention and skills, because smokers' health behaviors and attitudes appear to be less favorable to oral health compared to nonsmokers.

Self-reported gingivitis and bleeding gums among adolescents in Helsinki

The purpose of this descriptive cross-sectional community based investigation was to analyze the relationship between professionally measured and perceived gingival health in a sample of 1217 adolescents (age 14.0 +/- 0.7 yr). The responses to two questionnaire items relating to self-reporting of "gingivitis" ("inflammation of gums" in Finnish) and "bleeding from gums" are reported along with Community Periodontal Index of Treatment Needs (CPITN), percentage of bleeding sites (BOP%) and modified Papillary Bleeding Index (PBI) scores. It was found that current or past "gingivitis" was less often reported than "bleeding from gums" by this sample and that responses to both items exhibited low levels of agreement with the clinical measures. The results suggest that the self-reporting of gingival health may be useful in monitoring the gingival health of populations but does not have sufficient validity for screening individuals for gingivitis as defined by dental professionals. Furthermore, it is suggested that the term "bleeding from gums" rather than "gingivitis" should be used during clinical or group oral health promotion.

Soluble CD antigen (cytokine) expression in various hyperthyroid states and use in the assessment of propylthiouracil treatment

The soluble CD antigens sCD8, sCD23, and sCD25 are increased in untreated Graves' hyperthyroidism. These levels remain elevated when euthyroidism is established in response to propylthiouracil (PTU) therapy but decrease to control values after PTU treatment is discontinued, when euthyroidism has been established and maintained. Neither sCD8 nor sCD23 are elevated in patients with euthyroid Graves' ophthalmopathy nor in the hyperthyroid phase of subacute thyroiditis. sCD25 is increased to an intermediate degree in these disorders. Soluble CD8 > or = 450 U/ml is sensitive, specific, and predictive of PTU success as sole therapy or need for definitive therapy in untreated and PTU-treated Graves' hyperthyroidism, exceeding the predictive values of thyroid-stimulating hormone receptor antibody, thyroid peroxidase antibody, and T3 radioimmunoassay.

Comparability and discriminating power of 4 plaque quantifications

This study was designed for analysis of the discriminating power of 4 different quantifications of supragingival plaque: (1) plaque wet weight (PWW); (2) the plaque index (PlI); (3) the PLQ index measuring the coronal extension of plaque; (4) the area % of stained plaque. Different quantities of plaque were produced by adding chlorhexidine acetate (CHX), hydrogen peroxide (H2O2), or sucrose to experimental chewing gums. Total mean scores of 12 subjects in each of 3 test groups revealed that chewing of CHX gum resulted in the lowest plaque scores with all 4 quantifications and that the highest scores were recorded for the PWW or PlI of the sucrose gum users. Chewing of the H2O2 gum produced as much plaque as the sucrose gum when evaluated according to the PLQ index and exceeded the sucrose gum scores when evaluated according to the area % index. The PWW discriminated best between low, medium and high plaque scores after chewing of both CHX, H2O2 and sucrose gums. PlI scores 1 and 3 remained stable whereas the frequency of PlI score 0 strongly decreased and that of score 2 strongly increased when going from gums producing low (CHX) and medium (H2O2) to large (sucrose) amounts of plaque. The PLQ index discriminated well between low and medium but poorly between medium and large amounts of plaque. The area % index functioned well when subjects with low (CHX) and medium (H2O2) plaque scores were subgrouped into those with < 30%, 30-70% or > 70% of their tooth surfaces covered with stained plaque.(ABSTRACT TRUNCATED AT 250 WORDS)

Production of recombinant androgen receptor in a heterologous expression system

To facilitate detailed studies of androgen receptor, we have produced a full-length receptor protein and some of its deletion mutants in Spodoptera frugiperda (Sf9) insect cells, using the baculovirus expression system. Recombinant baculovirus DNA-infected Sf9 cells expressed these proteins in very high quantities, which represented as much as 30-40% of total insect cell protein at 72 h after infection. Only &lt; 1% of the recombinant protein was soluble in low-salt buffers; the majority formed electron-dense cytoplasmic aggregates 30-40 nm in diameter. These aggregates could be solubilized in 6 mol/L guanidine HCl, and biologically active receptor was generated by diluting the guanidine HCl preparation 20- to 50-fold. The full-length receptor, expressed either in a soluble or aggregated form, had characteristics typical of a native receptor: it bound steroids with high affinity and specificity, interacted with DNA in a sequence-specific fashion, and was recognized by domain-specific receptor antibodies. Androgen-receptor protein purified to homogeneity in guanidine HCl required the presence of Zn2+ ions during the refolding to reconstitute its DNA-binding form; ZnCl2 was not, however, needed to restore the receptor's steroid-binding activity.

Androgen receptor and mechanism of androgen action

Androgen receptor is the intracellular protein that mediates biological actions of physiological androgens (testosterone and 5 alpha-dihydrotestosterone). Androgen receptor belongs to a large family of ligand-dependent proteins whose function is to modulate expression of genes and gene networks in a cell- and tissue-specific manner. The present overview describes the structurally important domains of the receptor protein, and discusses several aspects in the structure-function relationship, using naturally occurring receptor mutants in androgen insensitivity patients or experimental animals as examples. In addition, characteristics of androgen receptor expressed in a heterologous system are described, and their potential usefulness in specific molecular studies discussed.