The T cells in peripheral taste tissue of healthy human adults: predominant memory T cells and Th-1 cells

A healthy taste system is important to the maintenance of nutrition and overall quality of life, and taste disorders are associated with many inflammatory states. We previously determined the immune cells in normal human gustatory tissue; they are predominantly dendritic cells and CD4 T cells with a few macrophages and B lymphocytes present. There are, however, few reports of the subtypes of resident lymphocytes in or near taste tissues. The present study further characterized the distribution and population of the major subtypes of T cells in situ within biopsies of healthy human fungiform papillae (FP). Immunohistochemical analyses indicated that T-helper (Th)1 cells (CCR5+) were more predominant in FP than Th2 T cells (CCR4+). CD45RO+ memory T cells were the principal T cells in gustatory tissue, whereas CD45RA+ naive T cells were uncommon. Regarding subcompartments of the tissue, most intraepithelial lymphocytes of FPs were gamma/delta T cells, whereas the major subtype of lymphocytes in the lamina propria were alpha/beta T cells. Regulatory T cells that express CTLA-4 (CD152) and interleukin-2 receptors (IL-2R, CD25) were found at low levels in FP. The T cells stand ready to respond to inflammatory and infectious insults and may play a role in the taste alterations observed during acute and chronic inflammatory states.

Sour ageusia in two individuals implicates ion channels of the ASIC and PKD families in human sour taste perception at the anterior tongue

BACKGROUND

The perception of sour taste in humans is incompletely understood at the receptor cell level. We report here on two patients with an acquired sour ageusia. Each patient was unresponsive to sour stimuli, but both showed normal responses to bitter, sweet, and salty stimuli.

METHODS AND FINDINGS

Lingual fungiform papillae, containing taste cells, were obtained by biopsy from the two patients, and from three sour-normal individuals, and analyzed by RT-PCR. The following transcripts were undetectable in the patients, even after 50 cycles of amplification, but readily detectable in the sour-normal subjects: acid sensing ion channels (ASICs) 1a, 1beta, 2a, 2b, and 3; and polycystic kidney disease (PKD) channels PKD1L3 and PKD2L1. Patients and sour-normals expressed the taste-related phospholipase C-beta2, the delta-subunit of epithelial sodium channel (ENaC) and the bitter receptor T2R14, as well as beta-actin. Genomic analysis of one patient, using buccal tissue, did not show absence of the genes for ASIC1a and PKD2L1. Immunohistochemistry of fungiform papillae from sour-normal subjects revealed labeling of taste bud cells by antibodies to ASICs 1a and 1beta, PKD2L1, phospholipase C-beta2, and delta-ENaC. An antibody to PKD1L3 labeled tissue outside taste bud cells.

CONCLUSIONS

These data suggest a role for ASICs and PKDs in human sour perception. This is the first report of sour ageusia in humans, and the very existence of such individuals ("natural knockouts") suggests a cell lineage for sour that is independent of the other taste modalities.

Immune cells of the human peripheral taste system: dominant dendritic cells and CD4 T cells

Taste loss or alterations can seriously impact health and quality of life due to the resulting negative influence on eating habits and nutrition. Infection and inflammation are thought to be some of the most common causes of taste perception disorders. Supporting this view, neuro-immune interactions in the peripheral gustatory system have been identified, underlying the importance of this tissue in mucosal immunity, but we have little understanding of how these interactions influence taste perception directly or indirectly. This limited understanding is evident by the lack of even a basic knowledge of the resident immune cell populations in or near taste tissues. The present study characterized the distribution and population of the major immune cells and their subsets in healthy human anterior, lingual, fungiform papillae (FP) using immunohistochemistry. Dendritic cells (DCs) were the predominant innate immune cells in this tissue, including four subtypes: CD11c(+) DCs, DC-SIGN+ immature DCs, CD83(+) mature DCs, and CD1a(+) DCs (Langerhans cells). While most DCs were localized beneath the lamina propria and only moderately in the epithelium, CD1a(+) Langerhans cells were exclusively present within the epithelium and not in sub-strata. A small number of macrophages were observed. T lymphocytes were present throughout the FP with CD4(+) T cells more prevalent than CD8(+) T cells. Very few CD19(+) B lymphocytes were detected. The results show that DCs, macrophages, and T lymphocytes are the constitutive guardians of human FP taste tissue, with DCs and CD4 T cells being dominant, while B lymphocytes are rare under normal, healthy conditions. These observations provide a basic anatomical foundation for the immune response in the healthy human tongue as a basis for subsequent disease-related studies, but none of the present data indicate that the immune cell populations identified are, in fact, altered in individuals with abnormal taste perception.

Mesenchymoma: an unusual tumour of the lip

The purpose of this paper is to present a case report of a benign mesenchymoma involving the lip. A brief review of relevant literature is presented.

Analysis of a Human Fungiform Papillae cDNA Library and Identification of Taste-related Genes

Various genes related to early events in human gustation have recently been discovered, yet a thorough understanding of taste transduction is hampered by gaps in our knowledge of the signaling chain. As a first step toward gaining additional insight, the expression specificity of genes in human taste tissue needs to be determined. To this end, a fungiform papillae cDNA library has been generated and analyzed. For validation of the library, taste-related gene probes were used to detect known molecules. Subsequently, DNA sequence analysis was performed to identify further candidates. Of 987 clones sequenced, clustering results in 288 contigs. Comparison of these contigs with genomic databases reveals that 207 contigs (71.9%) match known genes, 16 (5.6%) match hypothetical genes, eight (2.8%) match repetitive sequences and 57 (19.8%) have no or low similarity to annotated genes. The results indicate that despite a high level of redundancy, this human fungiform cDNA library contains specific taste markers and is valuable for investigation of both known and novel taste-related genes.

The effect of physical abuse on children's social and affective status: a model of cognitive and behavioral processes explaining the association

This study proposes a model explaining the association between physical abuse of children and children's social and affective status as one in which children's social expectations and behavior, developed within the context of abusive parenting, mediate current functioning in these two outcome domains. Subjects included one hundred 9 to 12-year-old physically abused children recruited from consecutive entries onto the New York State Register for Child Abuse for New York City and 100 case-matched classmate nonabused comparison children. Sociometric assessments were carried out in classrooms, interviews were conducted with the children and their parents, and teachers, parents, and classmates rated the children's behavior. Path analysis was utilized to test the conceptually derived models. Children's social expectations regarding peers, and two social behaviors--aggressive behavior and prosocial behavior--were found to mediate between abuse and positive and negative social status, as well as between abuse and positive and negative reciprocity. Social expectations and withdrawn behavior mediated between abuse and positive social status, but only where withdrawn behavior was a function of social expectations. Social expectations were generally found to mediate between abuse and internalizing problems. Negative social status (peer rejection) added to social expectations in producing internalizing problems. Identification of these mediating pathways can serve to guide secondary preventive intervention efforts so that they best address the problems abused children face in the absence of adequate parental and peer support as the children enter adolescence.

Polychlorinated biphenyl accumulation differs among pumpkinseed sunfish during experimental field exposure: the role of invertebrate prey

The relative importance of aqueous vs. trophic exposure of fish to polychlorinated biphenyls (PCBs) was investigated. The potential role of different invertebrate prey upon PCB accumulation by fish was also investigated. Pumpkinseed sunfish (Lepomis gibbosus) were exposed in the upper Hudson River under conditions that either permitted feeding upon different local prey assemblages, or excluded local prey from fish diets. Total [PCB] was 5x greater in fish exposed to local prey versus those not permitted to feed on local prey. Further, fish with trophic exposure to PCBs exhibited a chlorine shift, a significantly higher proportion of more chlorinated isomers than fish with only aqueous exposure. Total [PCB] differed among benthic invertebrate assemblages. Phytophilous invertebrates had lower [PCB] than benthic invertebrates, and also had lower concentrations of the more chlorinated isomers. Short-term (7-day) exposure of fish did not permit differentiation of PCB accumulation in fish according to differences in diet of native prey assemblages.

Risk factors for infective endocarditis: oral hygiene and nondental exposures

BACKGROUND

The risks of infective endocarditis (IE) associated with various conditions and procedures are poorly defined.

METHODS AND RESULTS

This was a population-based case-control study conducted in 54 Philadelphia, Pa-area hospitals from 1988 to 1990. Community-acquired IE cases unassociated with intravenous drug use were compared with matched community residents. Subjects were interviewed for risk factors. Diagnoses were confirmed by expert review of medical record abstracts with risk factor data removed. Cases were more likely than controls to suffer from prior severe kidney disease (adjusted OR [95% CI]=16.9 [1.5 to 193], P:=0.02) and diabetes mellitus (adjusted OR [95% CI]=2.7 [1.4 to 5.2], P:=0.004). Cases infected with skin flora had received intravenous fluids more often (adjusted OR [95% CI]=6.7 [1.1 to 41], P:=0.04) and had more often had a previous skin infection (adjusted OR [95% CI]=3.5 [0.7 to 17], P:=0.11). No association was seen with pulmonary, gastrointestinal, cardiac, or genitourinary procedures or with surgery. Edentulous patients had a lower risk of IE from dental flora than patients who had teeth but did not floss. Daily flossing was associated with a borderline decreased IE risk.

CONCLUSIONS

Within the limits of the available sample size, the data showed that IE patients differ from people without IE with regard to certain important risk factors but not regarding recent procedures.

Analysis of in situ protease activity in chronic adult periodontitis patients: expression of activated MMP-2 and a 40 kDa serine protease

BACKGROUND

Periodontitis is characterized by extensive destruction of the gingival tissues and associated supporting structures of the teeth. Although the pathogenesis of the various forms of this disease is not completely understood, host-derived proteases are believed to have an important role. In this study, we analyzed human tissue samples from chronic adult periodontitis patients to assess the levels of specific proteases and determine the effect of pH and tetracyclines on their activity.

METHODS

Gingival tissue samples were obtained from patients with chronic adult periodontitis (probing depths ranged from 5 to 9 mm) and periodontally healthy controls. Tissue extracts were prepared and analyzed for protease activity by zymography and Western blotting.

RESULTS

Maximal protease activity from clinically normal and diseased tissues was observed at pH 8. Latent matrix metalloproteinase (MMP)-9 and MMP-2 were expressed in all samples examined, while active MMP-2 was detected only in tissues obtained from patients with clinical disease. The MMP activities were differentially inhibited by derivatives of tetracycline. At pH 6, a protease with a mass of approximately 40 kDa was observed in diseased samples. The enzymatic activity was inhibited by phenylmethylsulfonyl fluoride, suggesting it is a serine protease.

CONCLUSIONS

The results of the current study substantiate the proposed role of host-derived proteases in the pathogenesis of chronic adult periodontitis. Specifically, they indicate that activated MMP-2 and a 40 kDa serine protease are involved in tissue destruction associated with this form of periodontal disease and also suggest that tissue pH influences protease activity in situ.

In situ localization and characterization of active proteases in chronically inflamed and healthy human gingival tissues

BACKGROUND

Studies have indicated an important role for host-derived proteases in the pathogenesis of periodontal disease. The objectives of this study were: 1) to develop an assay measuring protease activity in situ and 2) to localize and characterize the enzymatic activity in intact inflamed and healthy gingiva.

METHODS

Gingival specimens were prepared and over-laid with a quenched fluorescent substrate. Protease activity was visualized by fluorescence microscopy and correlated with histologic features.

RESULTS

In inflamed tissues, enzymatic activity was detected mainly in the connective tissue (predominantly matrix metalloproteases) and, to some extent, in the epithelium (predominantly serine proteases). In contrast, clinically healthy tissues failed to exhibit significant amounts of protease activity. Quantitative and qualitative characteristics of protease activity in intact tissues were found to be pH dependent.

CONCLUSIONS

The method described here enabled assessment of active proteases in intact tissues where cell-cell and cell-matrix interactions had been maintained. Our results indicate that there are substantial differences in the distribution of specific proteases between clinically healthy and inflamed periodontal tissues.

Dental and cardiac risk factors for infective endocarditis. A population-based, case-control study

BACKGROUND

Although antibiotic prophylaxis against infective endocarditis is recommended, the true risk factors for infective endocarditis are unclear.

OBJECTIVE

To quantitate the risk for endocarditis from dental treatment and cardiac abnormalities.

DESIGN

Population-based, case-control study.

SETTING

54 hospitals in the Philadelphia area.

PATIENTS

Persons with community-acquired infective endocarditis not associated with intravenous drug use were compared with community residents, matched by age, sex, and neighborhood of residence.

MEASUREMENTS

Information on demographic characteristics, host risk factors, and dental treatment was obtained from structured telephone interviews, dental records, and medical records.

RESULTS

During the preceding 3 months, dental treatment was no more frequent among case-patients than controls (adjusted odds ratio, 0.8 [95% CI, 0.4 to 1.5]). Of 273 case-patients, 104 (38%) knew of previous cardiac lesions compared with 17 controls (6%) (adjusted odds ratio, 16.7 [CI, 7.4 to 37.4]). Case-patients more often had a history of mitral valve prolapse (adjusted odds ratio, 19.4 [CI, 6.4 to 58.4]), congenital heart disease (adjusted odds ratio, 6.7 [CI, 2.3 to 19.4]), cardiac valvular surgery (adjusted odds ratio, 74.6 [CI, 12.5 to 447]), rheumatic fever (adjusted odds ratio, 13.4 [CI, 4.5 to 39.5]), and heart murmur without other known cardiac abnormalities (adjusted odds ratio, 4.2 [CI, 2.0 to 8.9]). Among case-patients with known cardiac lesions--the target of prophylaxis--dental therapy was significantly (P = 0.03) less common than among controls (adjusted odds ratio, 0.2 [CI, 0.04 to 0.7] over 3 months). Few participants received prophylactic antibiotics.

CONCLUSIONS

Dental treatment does not seem to be a risk factor for infective endocarditis, even in patients with valvular abnormalities, but cardiac valvular abnormalities are strong risk factors. Few cases of infective endocarditis would be preventable with antibiotic prophylaxis, even with 100% effectiveness assumed. Current policies for prophylaxis should be reconsidered.

Markers of cell proliferation in normal epithelia and dysplastic leukoplakias of the oral cavity

The expression of several markers of epithelial cell proliferation was analyzed to establish baseline data for future chemoprevention studies of oral premalignant lesions. Punch biopsies (n = 60) from three different sites of oral mucosa (bucca, lateral tongue, and the floor of the mouth) were obtained from 20 normal donors of both sexes. After formaldehyde fixation and paraffin embedding, immunohistochemistry was used to detect the proliferation markers Mib-1, cyclin D1, and centromere-associated protein CENP-F. Analysis of sections stained for the three markers showed similar patterns, i.e., a low labeling index (LI) in the basal layer and a high LI in the parabasal layer at all three intraoral sites. No proliferative activity was seen above the parabasal layer (superficial layer). All sites showed similar Mib-1 LI values for the proliferative markers. The tongue epithelium exhibited higher parabasal LIs of cyclin D1 and CENP-F than did the other two sites. No significant differences were detected between smokers and nonsmokers. The data from normal mucosa were compared with those from low (n = 30)- and high (n = 17)-grade dysplastic leukoplakias. The Mib-1 LI showed a very significant change, with a 9-fold increase in the basal layer LI in dysplastic leukoplakias. Cyclin D1 and CENP-F showed similar trends with increments of up to 7-fold in the basal layer of high-grade dysplasia. Although the proliferative activity of the parabasal layer was similar in normal and leukoplakic epithelia, the superficial layer showed a significant increment in proliferative activity mainly in high-grade leukoplakia. These studies suggest that proliferation markers in the basal and superficial cells of premalignant lesions may serve as surrogate end point biomarkers for chemoprevention trials.

Benchmarks of social treatment for children with autism

Data on the social behavior of typical children may inform practitioners and researchers regarding the appropriate goals of intervention for children with autism. This study assessed the ongoing levels of naturally occurring social behavior in 64 preschool-aged children. A 2 x 2 factorial design was used to analyze population (children with autism and typical children) and age (3 years 3 months vs. 4 years 4 months) differences at the time of preschool entry. Predictable population differences were found for key social behaviors of proximity to children, social bids from children, and focus of engagement on children, as well as for behavioral context variables of verbalizations, adult focus, and atypical behaviors. No differences were found in the amount of time spent focused on toys or objects. There were also no differences in the presenting behaviors of younger and older children with autism. Results are discussed in terms of implications for establishing early social intervention goals.

Clinical disorders of smell and taste

Renewed attention to chemosensory dysfunction has revealed that a substantial portion of the population are affected during their lives, many simply as a result of aging. The authors discuss terminology, assessment, etiology, and prognosis and compare current understanding with that presented by Mackenzie in 1884.

An assessment of the usefulness of the Duke criteria for diagnosing active infective endocarditis

We evaluated the usefulness of the Duke criteria for diagnosing cases of active infective endocarditis (IE). Patients were identified prospectively over a 3-year period at 54 hospitals in the Philadelphia metropolitan area. Three of us independently reviewed abstracted hospital records and classified 410 patients as definite, probable, or possible cases of IE or as probable noncases. We then applied the Duke criteria to this sample to assess the degree of agreement between our diagnoses and the diagnoses based on these new criteria. Agreement was good to excellent, ranging from 72% to 90%, depending on the case definition used. The sensitivity of the Duke criteria was also good to excellent, varying from 71% to 99%, again depending on case definition used. Specificity was lower (0-89%). We conclude that use of the Duke criteria will result in little underdiagnosis of IE but that it may result in overdiagnosis of IE; therefore, these criteria should be applied prospectively to determine their clinical usefulness.

Analgesic efficacy and safety of an intraoral lidocaine patch

The effectiveness of intraoral II-docaine patches was tested by asking participants to rate the pain experienced after insertions of a 25-gauge needle. Needlesticks were performed at baseline and at various time points after patch placement. Each needlestick included contact with the periosteum. Lidocaine patches achieved significantly better analgesia than the placebo within 2.5 to five minutes after placement. Drug-related side effects were minimal and venous blood levels of lidocaine were low, averaging 10 to 14 times less than those achieved with a typical injection of lidocaine plus epinephrine. The authors conclude that the lidocaine patches used in this study are effective and safe in reducing needle insertion pain in adults.

Utilization of electron probe microanalysis in gadolinium-treated mice

Gadolinium is used as a contrast media for magnetic resonance imaging and, experimentally, to block Kupffer cell phagocytosis. In this study, we utilize electron probe microanalysis to determine the subcellular localization of gadolinium chloride (GdCl3) administered to mice in a short-term toxicology study. Male CD-1 mice were administered 0.0, 2.5, or 8.0 mg/kg GdCl3 iv for 14 consecutive weekdays. Liver-associated enzymes were significantly elevated in high-dose animals only and correlated histologically with multifocal, hepatocellular degeneration associated with a neutrophilic infiltrate. Morphological investigations were performed on high-dose animals. Hepatocytes and Kupffer cells had morphologic features of cellular injury consisting of swollen mitochondria and vesiculated profiles of endoplasmic reticulum. Hepatocytes, Kupffer cells, bile canaliculi, and neutrophils in the liver contained discrete aggregates of electron-dense granular material, as did pulmonary interstitial macrophages, splenic macrophages, and mesangial cells of the renal glomerulus. The intracellular granular material in the liver, lung, spleen, and kidney was confirmed as gadolinium by qualitative electron probe microanalysis. These results document both hepatic and extra-hepatic accumulation of gadolinium in cells of the mononuclear phagocytic system and highlight the importance of electron probe microanalysis in toxicologic assessment.

Incidence of infective endocarditis in the Delaware Valley, 1988-1990

This population-based study aimed to determine the incidence of native, prosthetic, and bioprosthetic valve nosocomial infective endocarditis (IE), and IE associated with the use of injected drugs. Patients with IE during 27 months over the years 1988 to 1990, and residing in any of 6 counties in the Philadelphia metropolitan area were identified. An expert panel reviewed all patients to verify the diagnosis. Incidence rates were estimated after adjustment for failure to recruit and underreporting. Of 853 potential patients, 670 (79%) met the inclusion criteria. The overall incidence rate of IE was 11.6 cases/100,000 person-years (95% confidence interval [CI] 10.8 to 12.4). The rates for specific types of IE were: 4.45 (95% CI 3.97 to 4.94) for community-acquired native valve, 0.94 (95% CI 0.72 to 1.12) for prosthetic valve, 0.94 (95% CI 0.71 to 1.16) for nosocomial, and 5.34 (95% CI 4.80 to 5.87) for IE associated with use of injected drugs. Previous population studies found overall incidence rates of 1.7 to 4 cases/100,000 person-years, similar to our rate for community-acquired native valve IE. Type-specific rates have not been previously reported. The higher overall rate in this study is partly related to the high prevalence of injection drug use in our area.

Parent, teacher, and peer ratings of physically abused and nonmaltreated children's behavior

Behavior ratings by parents, teachers, and classmates of physically abused fourth to sixth graders, identified from the New York City Maltreatment Register, and case-matched classroom controls, showed substantial concurrence among informants: Parents and teachers both rated significantly more behavioral disturbance in the abused children, and peers' ratings were significantly correlated with adults' ratings, especially those by teachers. Children's exposure to spouse or partner physical abuse, which had a substantial prevalence among both child-abusing and control families, reduced the difference in disturbance ratings between children who were themselves physically abused and those who were not. Overall, we conclude that physically abused children show pervasive behavioral disturbance, in that parents, teachers, and classmates all see higher levels of behavior problems and lower levels of socially desirable behavior in them compared to their nonmaltreated peers.

Assessing diagnostic criteria for active infective endocarditis

A study was performed to describe agreement among experts on their classification of patients, in the absence of information concerning risk factors, as to the presence of infective endocarditis (IE). The study also assessed the clinical characteristics that enabled the experts to determine that a patient had IE. All patients with a discharge diagnosis of IE were identified prospectively from 54 hospitals in the Delaware Valley over a 3-year period. Patients were part of a case-control study of risk factors for IE. Three infectious disease experts independently reviewed abstracted hospital records and classified each of 151 eligible patients as a definite, probable or possible case, or a probable noncase, both based on clinical judgement and using a modified standard definition. Experts were more likely to classify a patient as a definite case of IE on the basis of clinical judgement than by using the modified standard definition. Agreement between reviewers was 92 to 95% when they were distinguishing only probable non-cases from others. Agreement between reviewers on specific categories was lower (40 to 58%). The number of positive blood cultures was a strong predictor of a patient's being classified as a case, as was the type of infecting organism. It is concluded that experts are willing to make a definitive diagnosis of IE on the basis of blood culture information alone. Further supporting evidence, such as the presence of vegetation on an echocardiogram, is needed when blood culture results are ambiguous.

The effects of physical abuse on children's social relationships

Social behavior and peer status of 87 physically abused 8-12-year-old urban children were compared with those of 87 case-matched nonmaltreated classmates. Peer nominations and peer ratings were collected in classrooms, social networks were assessed by child interview, family variables were assessed by interviewing mothers, and behavior problems were rated by parents and teachers. Significant findings were that abused children had lower peer status and less positive reciprocity with peers chosen as friends; they were rated by peers as more aggressive and less cooperative and by parents and teachers as more disturbed; and their social networks showed more insularity, atypicality, and negativity. Social behavior as perceived by peers accounted for a significant portion of the variance in social status; global disturbance measures did not add to this association. Results are discussed in terms of a context of family violence in the development of social maladjustment.

Non-oral etiologies of oral malodor and altered chemosensation

A number of non-oral causes for oral malodor have been discussed. Several well documented etiologies for non-oral malodor include renal failure, cirrhosis of the liver, and diabetes mellitus. Each of these conditions has been examined using analytical instrumentation. In addition there appear to be several other metabolic conditions involving enzymatic and transport anomalies (such as trimethylaminuria) which lead to the systemic production of volatile malodors that manifest themselves as halitosis and/or altered chemoreception. Our studies include patients who have been referred to us after being examined by numerous clinical specialists with no identification or relief from their problem. This is due in part to the intermittent nature of many of these problems as well as an apparent lack of knowledge concerning many of these metabolic problems and their relation to oral symptoms.

Regulation of breast cancer cell cycle progression by growth factors, steroids and steroid antagonists

The control of human breast cancer cell proliferation in vitro is known to involve complex interactions between steroid hormones, peptide hormones and growth factors. Little is known, however, of the mechanisms by which these factors, alone or in combination, control cell cycle progression and the expression of specific genes involved in cell cycle control. A pre-requisite for such studies is a cellular system in which non-proliferating or slowly proliferating cells can be maintained in a defined environment and stimulated to progress through the cell cycle by addition of hormones and growth factors. Such a system has been developed for T-47D human breast cancer cells: quiescent or slowly proliferating cells maintained in a serum-free medium can be stimulated to increase their rate of cell cycle progression upon a single addition of insulin, IGF-I, EGF, TGF alpha or bFGF. Oestradiol alone was ineffective but caused a significant increase in % S phase cells when added in the presence of insulin. Progestins, in the presence of absence of insulin, had a biphasic effect with an initial increase in cell cycle progression followed by cell cycle arrest. Both antioestrogens and the antiprogestin, RU 486, in the absence of oestrogen or progestin, were potent inhibitors of insulin-induced proliferation. Increases in cell cycle progression were invariably accompanied by acute increases in c-fos and c-myc mRNA levels. Induction of c-myc by oestrogen and progestin was inhibited by antioestrogens and RU 486, respectively. These data illustrate that the culture of breast cancer cells in a serum-free, chemically defined environment provides an excellent model in which to define the role of individual factors involved in breast cancer growth control. The biological data derived from this system provide a basis for identifying and characterizing genes involved in the control of cell cycle progression in human breast cancer.

Promoting reciprocal interactions via peer incidental teaching

This study evaluated peer incidental teaching as a strategy for increasing reciprocal peer interactions by children with autism. Three typical preschoolers were trained as peer tutors for 3 young children with autism. During a classroom free-play session, peer tutors used incidental teaching to obtain verbal labels of preferred toys by children with autism. A multiple baseline across the 3 target children showed replicated positive effects of the intervention. Adult supervision and assistance were then faded systematically, with resulting maintenance of increased reciprocal interactions. Multiple measures of the extent and limits of generalization suggested that 1 child increased interactions in free-play periods throughout the day, but none of the children showed increases at lunch. Teacher and peer ratings supported the social validity of positive findings.

Age and social competence in preschoolers' decoding of facial expression

This study examines the relationship between social competence and decoding of emotions in children aged between three and five years. Children were shown videotaped scenarios depicting emotional situations and were asked to choose which of three facial expressions, representing happiness, sadness and fear, would be most appropriate for the character in the situation. Children's level of social competence was assessed by a standardized questionnaire completed by their parents. Results showed that subjects with relatively higher social skills were better decoders than subjects with relatively lower social skills, and that decoding performance improved with age. The results are discussed in terms of the role of non-verbal behavioural skills in general social competence.

Arteriovenous malformation of the maxillary sinus: an unusual clinical presentation

Arteriovenous (AV) malformation is a rare vascular lesion of the jaws with a benign clinical presentation. As a result, AV malformation may be excluded from a presurgical differential diagnosis, with catastrophic results. Review of the pertinent literature showed no documentation of AV malformation in the maxillary sinus, and therefore we present the case of a 43-year-old white man with a history of blunt trauma to the paranasal region, whose differential diagnosis included a vascular lesion.

Representativeness of the "Ramfjord teeth" for epidemiologic studies of gingivitis and periodontitis

Data from the Veterans Administration Dental Longitudinal Study of 736 men each examined four times were analyzed to determine how representative the six "Ramfjord Teeth" (RT) were of the rest of the dentition for epidemiologic studies of gingivitis and periodontitis. Correlation coefficients were calculated between scores for gingival inflammation generated by the RT and scores for the teeth in the rest of the mouth; the correlation coefficients between the two scores tended to be high. Sensitivity, specificity and predictive values were calculated for periodontal pathology classified on the basis of the pocket depths of the six RT. Reliance on the RT resulted in systematic underestimation of the prevalence and incidence of deep periodontal pockets. The RT are more than adequately representative of the rest of the dentition for epidemiologic studies of gingivitis, but are inadequate surrogates of the rest of the mouth for epidemiologic studies of periodontitis.

Farber lipogranulomatosis: an unusual presentation in a black child

Farber disease, a rare, inherited condition of lipid metabolism usually appears within the first two months of life. The patients may die in the first few years of life or may live into the second decade. We believe this patient to be the first black American reported with Farber disease. Additionally, the characteristics of the disease in this patient were at variance with previously reported cases.

Design and analysis considerations for a longitudinal study of periodontal disease

Perception and concern for the health changes in our aging population led the Veterans Administration to initiate an interdisciplinary and longitudinal investigation of the aging process, the Veterans Administration Normative Aging Study, in 1963. A cohort of the 2,280 healthy men of this study self-selected to enroll in the dental longitudinal study, an investigation of oral health in these healthy males. In 1968, 1,221 men between the ages of 25 and 75 began with a baseline cycle of 5 general series of examinations, including an interim health history and survey of dietary habits; masticatory performance and taste thresholds; salivary analyses; oral cytologic and radiographic survey and comprehensive clinical data on caries and periodontal status. Design considerations for the Dental Longitudinal Study included prospective planning of specific oral variables to be recorded, and provision of collection techniques to allow for additional analyses based on a wide menu of retrospective data. The volunteer cohort was screened to obtain men who met stringent general health criteria, who represented wide socioeconomic ranges and would likely remain geographically stable. Importantly, enrollment in the parent study was without regard for dental status or oral health. Administrative design considerations included orderly transfer for exam data to machine-readable format by use of optical scan forms designed to register specific oral variables, with security preserved for the primary source records and rapid record retrieval. Additional data collection requiring manual coding was designed to transfer spreadsheets of clinical impressions and diagnoses to computer retrieval protocols. Provisions for recording of exceptional circumstances, i.e., salient oral pathology, were recognized and the optical scan forms modified to index and retrieve such cases.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison between chlordiazepoxide and CL 218,872, a synthetic non-benzodiazepine ligand for benzodiazepine receptors, on serotonin and catecholamine turnover in brain

Serotonin (5-HT) and catecholamine (CA) turnover rates in midbrain-hindbrain were investigated in rats treated with the benzodiazepine chlordiazepoxide (CDP) or with the anxiolytic triazolopyridazine CL 218,872. A single injection of CDP (2.5-20 mg/kg) decreased 5-HT but not CA turnover rates. Seven daily CDP injections decreased the turnover rates of both 5-HT and CA. In contrast, neither acute nor chronic administration of CL 218,872 (2.5-20 mg/kg) altered baseline turnover rates of 5-HT or CA. Since CL 218,872 has a selective affinity for Type I benzodiazepine receptors, these results suggest that stimulation of Type I receptors is not sufficient to decrease 5-HT or CA turnover rates in midbrain-hindbrain. More importantly, these results question the long-held belief that benzodiazepines exert their anxiolytic and depressant effects through reductions in 5-HT and CA turnover respectively.

Six-year report of the periodontal health of fixed and removable partial denture abutment teeth

There were minimal differences in longitudinal periodontal effects when fixed and removable partial dentures were compared. Both treatment alternatives provide long-term periodontal health and should be considered for the restoration of a partially edentulous arch. Regardless of treatment, conscientious home care and professional prophylaxis are recommended.

A comparison between chlordiazepoxide and CL 218,872--a synthetic nonbenzodiazepine ligand for benzodiazepine receptors on spontaneous locomotor activity in rats

Spontaneous locomotor activity was investigated in rats treated with chlordiazepoxide (CDP) or CL 218,872, a synthetic nonbenzodiazepine ligand for benzodiazepine receptors. Acute administration of CDP (2.5 mg/kg) increased activity, whereas a higher dose (10 mg/kg) decreased activity. Acute injection of CL 218,872 (2.5-10 mg/kg) produced a significant dose-dependent suppression of locomotor activity, a finding at variance with a previous report that anxiolytic doses of CL 218,872 are devoid of depressant side effects. Chronic pretreatment with CDP or CL 218,872 (10 mg/kg daily for 6 days) produced a tolerance to the sedative effect of CDP (10 mg/kg), but not to the activity suppressant action of CL 218,872 (10 mg/kg).

Subarachnoid hemorrhage precipitated by cocaine snorting

We studied two cases of subarachnoid hemorrhage that occurred within several minutes of "snorting" cocaine. In one case the bleeding was from an anterior communicating artery aneurysm, and in the other case from an arteriovenous malformation in the temporoparietal region. To our knowledge, this hazard of cocaine abuse has not been previously reported.

Discriminative stimulus properties of fenfluramine: evidence for serotonergic involvement

Rats were trained to discriminate 3 mg/kg fenfluramine (FEN) from saline using a milk-reinforced (FR 10 schedule) two-lever operant task. To assess the involvement of the serotonin (5-HT) system in elicitation of the FEN cue, 5-HT compounds were tested for their ability to substitute for or to antagonize the the discriminative stimulus produced by FEN. Following acquisition, the FEN cue was dose-dependent, had a rapid onset (10 min) and a long duration (12 h), and was stereospecific. The putative 5-HT receptor antagonists methysergide and cinanserin antagonized the FEN discriminative stimulus, while chlordiazepoxide, an indirect inhibitor of 5-HT turnover, did not. The FEN cue was also antagonized by the selective 5-HT reuptake inhibitor fluoxetine. Norfenfluramine, p-fluoro-amphetamine, and p-chloroamphetamine, compounds structurally and pharmacologically similar to FEN, substituted for FEN, whereas fluoxetine, cinanserin, methysergide, and chlordiazepoxide did not. The 5-HT precursor 5-hydroxytryptophan partially generalized to the FEN cue. It was further shown that the discriminative stimulus properties of FEN are not based on its anorectic action. These results suggest that the cue properties of FEN might be partially mediated through an interaction with the 5-HT system.

Inverse correlation of collagen production to anchorage independence and tumorigenicity in W8- and M-cell lines

Collagen production by fibroblasts has been shown to be transformation sensitive and to correlate inversely with tumorigenicity. Therefore, it is of interest to determine if carcinoma cell collagen production is similar to fibroblast collagen production. Since there are few carcinoma model systems available for this study that have cultured cells with increasing tumorigenic potential, a new series of cell lines, referred to as M-cells, were developed from the well-described rat liver epithelial cell line W8, originally established by I. B. Weinstein. The W8 cell line is a N-acetoxy-2-acetylaminofluorene-treated, weakly tumorigenic rat liver cell derived from the parent K16 cell line. The M-cells were serially selected by isolating cell lines from tumors and reinjecting them into animals. Although these M-cells maintain their epithelial characteristics, their overall protein production, their type of collagen, and their ability to form undifferentiated carcinomas in vivo, they progressively exhibit increasing tumorigenic potential, increasing anchorage independence, and decreasing collagen production. The W8 and M-cells maintain decreasing amounts of collagen type I trimer production, which most likely contributes to the decreasing connective tissue stroma observed in their carcinomas. This cell system provides a new model to examine epithelial cell surface and extracellular substrate attachment interactions.

Effect of high doses of naloxone on shuttle avoidance acquisition in rats

Administration of high doses of naloxone intraperitoneally (2.5-10.0 mg/kg) resulted in a dose-related impairment of avoidance response acquisition in a shuttle avoidance paradigm in rats. Naloxone in this dose range produced a significant decrease in the number of intertrial responses but did not result in a significant dose-response. Escape latencies were not affected by naloxone administration at any dose tested. The effect of naloxone on activity and nociception are implicated as possible causes of the observed behavior. The results are discussed as behavioral evidence supporting theories postulating multiple opiate receptors.

Association between smoking different tobacco products and periodontal disease indexes

Six indexes of periodontal health were recorded in cigarette smokers, pipe/cigar smokers and nonsmokers from the Veterans Administration Dental Longitudinal Study. These indexes included calculus deposition, plaque accumulation, gingival inflammation, periodontal pocket depth, alveolar bone loss and tooth mobility. Cigarette smokers had significantly more calculus deposition than pipe/cigar smokers, although both smoker groups had more calculus than nonsmokers. Cigarette smokers accumulated slightly less plaque than pipe/cigar smokers, and both smoker groups accumulated less plaque than nonsmokers. Gingival inflammation and tooth mobility did not differ between smokers and nonsmokers, nor between the two smoker groups. Cigarette smokers had significantly greater pocket depth than nonsmokers, in contrast to pipe/cigar smokers who were not different from nonsmokers. Radiographic measurements indicated that cigarette smokers had significantly more alveolar bone loss than either pipe/cigar or nonsmokers. After covariance adjustment for age and calculus, all smokers had less plaque, gingival inflammation and tooth mobility than nonsmokers, similar periodontal pocket depth, but only cigarette smokers had greater bone loss. This finding of greater alveolar bone loss in cigarette smokers suggests a tobacco product-related effect in systemic physiologic action.

Oral aspects of aging

The physician who is aware of oral problems can play an essential role in providing comprehensive care for the elderly. The average person 65 years or older visits the physician at least six times a year, but is seen by the dentist about once a year. Because of more frequent contact, the physician has a greater opportunity to identify important dental problems of the geriatric patient.

Non-steroidal anti-inflammatory drugs in the reduction of human alveolar bone loss

Aspirin (ASA) and indomethacin are inhibitors of prostaglandin synthesis and reduce bone resorption in tissue culture stimulated by preparations obtained from human gingival tissue. In a retrospective study, we attempted to determine whether ASA or ASA plus indomethacin exert a bone resorption inhibiting effect on human alveolar bone. Dental radiographs of 75 patients with a history of arthritis and long-term ingestion (greater than 5 years) of ASA were compared with dental radiographs of 75 healthy male volunteers from the VA Dental Longitudinal Study (DLS). Proximal bone loss was measured using a Schei Ruler graded on a 10-point scale. The data indicated that the ASA population presented with significantly fewer sites of 10% or greater mesial and distal bone loss than the healthy control population (P less than 0.05). Mean percentage bone loss for the entire dentition was also lower in the ASA group, although the difference was not statistically significant. As there is no evidence to suggest that inhibition of alveolar bone loss is a natural concomitant of the arthritic process, we conclude that the inhibition of bone loss found in this study was due to the chronic ingestion of ASA or ASA and indomethacin.

Influence of cigarette, pipe, and cigar smoking, removable partial dentures, and age on oral leukoplakia

Oral leukoplakia, a potentially malignant lesion, has been associated with tobacco smoking, but few studies have investigated the influence of different products on lesion prevalence. In the current study 925 healthy male subjects from the Veterans Administration Dental Longitudinal Study were examined for lesion site and prevalence. The participants were grouped according to smoking status: nonsmokers, smokers of cigarettes, cigars, a pipe, cigars plus a pipe, or cigarettes plus another tobacco product. In addition, the amount of product smoked, presence of a removable partial denture, and age were examined to determine their relation to leukoplakia prevalence. The data indicated that cigar smokers had significantly fewer lesions than the other smoker groups and that persons smoking a pipe or a pipe plus cigars had the highest prevalence. Heavy cigarette smokers had significantly more palatal lesions than light to moderate cigarette smokers. While removable partial dentures did not appear to affect lesion prevalence significantly, older smokers, persons of 50 years and above, had a significantly higher prevalence than persons less than 50 years of age.

Generalization between benzodiazepine- and triazolopyridazine-elicited discriminative cues

Using a milk reinforced two-lever operant procedure, rats were trained to discriminate 3 mg/kg chlordiazepoxide (CDP) from saline. Following this, generalization experiments were conducted with the triazolopyridazine CL 218,872, a synthetic non-benzodiazepine (BDZ) ligand for the BDZ receptor. CL 218,872 produced CDP lever selection in a dose related fashion and thus generalized to the standard CDP treatment. However, this generalization was antagonized by the concurrent administration of pentylenetetrazol or amphetamine, but not by strychnine or bicuculline. Also, there was evidence for cross tolerance for a sedative effect between CDP and CL 218,872.

Effects of age and dentition status on measures of food acceptability

The current cross-sectional investigation was undertaken to determine whether observed losses in masticatory function due to missing teeth impair perceptual estimates of food acceptability. To quantify the effect of impaired masticatory ability, 566 male participants from the Veterans Administration Dental Longitudinal Study were subdivided into three age groups (less than 40 years, 40 to 49 years, and 50 or more years) and three dentition categories (intact, partially compromised, and compromised). Bivariate analysis revealed that dentition status significantly influenced the acceptance modalities of taste, texture, perceived ease of chewing, and frequency of ingestion. Age, per se, had little effect. Significant changes in the acceptance variables were noted only in persons with compromised dentition. These findings suggested that a moderate degree of unreplaced tooth loss had no significant effect on perceptual estimates of food acceptability, and unilateral intact dentition can provide sufficient masticatory performance for maintaining food acceptance.

The effects of fenfluramine and fluoxetine on the acquisition of the conditioned avoidance response in rats

This study tested a behavior-suppressing punishment system and how its activity may be altered by agents known to interrupt or enhance serotonergic (5-HT) transmission. Holtzman male albino rats were tested for shuttle box avoidance acquisition and intertrial responding either 1 or 8 h following daily injection of fenfluramine (FEN) or fluoxetine (FXT). When the drug-test interval was 1 h, a time when both drugs are presumably potentiating 5-HT activity, avoidance acquisition and intertrial responding were impaired. When testing occurred 8 h after drug treatment, a time when 5-HT level are unaltered by FXT and are maximally reduced by FEN, these drugs had no effect on avoidance acquisition, but FEN produced an increase in intertrial responses whereas FXT did not. These results support the proposal of an inhibitory 5-HT system. Furthermore, these data demonstrate that FEN is capable of exerting a biphasic action on intertrial responding and suggest that the time interval between drug administration and behavioral testing is a crucial variable when investigating FEN.