Dental implant failures in Utah and US veteran cohorts

INTRODUCTION

Approximately, 5.5 million dental implants are estimated to be surgically placed in the United States yearly, with an anticipated long-term failure rate ranging from 3% to 10%. At the Salt Lake City Dental Clinic within the Department of Veterans Affairs (VHA), specific protocols have been established to mandate that clinicians present every dental implant case for review by a committee. To understand the effectiveness of this approach, a comparative data analysis was undertaken to compare local dental implant failure data against national VHA data.

METHODS

Leveraging electronic health records of veterans spanning from 2000 to 2021, we gathered procedural records related to dental implant placement or failure, demographic information, and medical history for individuals who received dental care at various dental clinics within the nationwide VHA network. Subsequently, statistical analyses were conducted using mixed-effects Poisson regression models with cluster-robust standard errors. Incident rate ratios (IRRs) for Utah-specific and nationwide cohorts were ascertained.

RESULTS

The Utah VHA dental clinical data showed that there was a slightly lower prevalence of implant failure at 6.7% compared to the national cohort, which had a rate of 6.9%. The implant level failure rates were also low, with 4.20 (confidence interval [CI]: 3.68, 4.81) per 1000 implant placements per year for Utah cohorts. The adjusted IRR indicated a relative 16% reduction in risk among Utah Veterans (IRR 0.84, 95% CI [0.76-0.92]; p < 0.001).

CONCLUSIONS

The stringent protocols in place at Salt Lake City, which integrate evidence-based practices and expert opinion for evaluating patient suitability for dental implant placement and subsequent care, contributed to the reduced risk among Utah Dental Clinic veterans pool compared to veterans of other states.

Measurement of Direct-Photon Cross Section and Double-Helicity Asymmetry at sqrt[s]=510 GeV in p[over →]+p[over →] Collisions

We present measurements of the cross section and double-helicity asymmetry A_{LL} of direct-photon production in p[over →]+p[over →] collisions at sqrt[s]=510  GeV. The measurements have been performed at midrapidity (|η|<0.25) with the PHENIX detector at the Relativistic Heavy Ion Collider. At relativistic energies, direct photons are dominantly produced from the initial quark-gluon hard scattering and do not interact via the strong force at leading order. Therefore, at sqrt[s]=510  GeV, where leading-order-effects dominate, these measurements provide clean and direct access to the gluon helicity in the polarized proton in the gluon-momentum-fraction range 0.02<x<0.08, with direct sensitivity to the sign of the gluon contribution.

Modes and Mechanisms of Pacific Decadal-Scale Variability

The modes of Pacific decadal-scale variability (PDV), traditionally defined as statistical patterns of variance, reflect to first order the ocean's integration (i.e., reddening) of atmospheric forcing that arises from both a shift and a change in strength of the climatological (time-mean) atmospheric circulation. While these patterns concisely describe PDV, they do not distinguish among the key dynamical processes driving the evolution of PDV anomalies, including atmospheric and ocean teleconnections and coupled feedbacks with similar spatial structures that operate on different timescales. In this review, we synthesize past analysis using an empirical dynamical model constructed from monthly ocean surface anomalies drawn from several reanalysis products, showing that the PDV modes of variance result from two fundamental low-frequency dynamical eigenmodes: the North Pacific-central Pacific (NP-CP) and Kuroshio-Oyashio Extension (KOE) modes. Both eigenmodes highlight how two-way tropical-extratropical teleconnection dynamics are the primary mechanisms energizing and synchronizing the basin-scale footprint of PDV. While the NP-CP mode captures interannual- to decadal-scale variability, the KOE mode is linked to the basin-scale expression of PDV on decadal to multidecadal timescales, including contributions from the South Pacific.

The emergent rhizosphere: imaging the development of the porous architecture at the root-soil interface

The rhizosphere is the zone of soil influenced by a plant root and is critical for plant health and nutrient acquisition. All below ground resources must pass through this dynamic zone prior to their capture by plant roots. However, researching the undisturbed rhizosphere has proved very challenging. Here we compare the temporal changes to the intact rhizosphere pore structure during the emergence of a developing root system in different soils. High resolution X-ray Computed Tomography (CT) was used to quantify the impact of root development on soil structural change, at scales relevant to individual micro-pores and aggregates (µm). A comparison of micro-scale structural evolution in homogenously packed soils highlighted the impacts of a penetrating root system in changing the surrounding porous architecture and morphology. Results indicate the structural zone of influence of a root can be more localised than previously reported (µm scale rather than mm scale). With time, growing roots significantly alter the soil physical environment in their immediate vicinity through reducing root-soil contact and crucially increasing porosity at the root-soil interface and not the converse as has often been postulated. This 'rhizosphere pore structure' and its impact on associated dynamics are discussed.

Kinetic energy offsets for multicharged ions from an electron beam ion source

Using a retarding field analyzer, we have measured offsets between the nominal and measured kinetic energy of multicharged ions extracted from an electron beam ion source (EBIS). By varying source parameters, a shift in ion kinetic energy was attributed to the trapping potential produced by the space charge of the electron beam within the EBIS. The space charge of the electron beam depends on its charge density, which in turn depends on the amount of negative charge (electron beam current) and its velocity (electron beam energy). The electron beam current and electron beam energy were both varied to obtain electron beams of varying space charge and these were related to the observed kinetic energy offsets for Ar⁴⁺ and Ar⁸⁺ ion beams. Knowledge of these offsets is important for studies that seek to utilize slow, i.e., low kinetic energy, multicharged ions to exploit their high potential energies for processes such as surface modification. In addition, we show that these offsets can be utilized to estimate the effective radius of the electron beam inside the trap.

Phase-Tuned Entangled State Generation between Distant Spin Qubits

Quantum entanglement between distant qubits is an important feature of quantum networks. Distribution of entanglement over long distances can be enabled through coherently interfacing qubit pairs via photonic channels. Here, we report the realization of optically generated quantum entanglement between electron spin qubits confined in two distant semiconductor quantum dots. The protocol relies on spin-photon entanglement in the trionic Λ system and quantum erasure of the Raman-photon path information. The measurement of a single Raman photon is used to project the spin qubits into a joint quantum state with an interferometrically stabilized and tunable relative phase. We report an average Bell-state fidelity for |ψ^{(+)}⟩ and |ψ^{(-)}⟩ states of 61.6±2.3% and a record-high entanglement generation rate of 7.3 kHz between distant qubits.

Charge Radii of Neutron Deficient ^{52,53}Fe Produced by Projectile Fragmentation

Bunched-beam collinear laser spectroscopy is performed on neutron deficient ^{52,53}Fe prepared through in-flight separation followed by a gas stopping. This novel scheme is a major step to reach nuclides far from the stability line in laser spectroscopy. Differential mean-square charge radii δ⟨r^{2}⟩ of ^{52,53}Fe are determined relative to stable ^{56}Fe as δ⟨r^{2}⟩^{56,52}=-0.034(13)  fm^{2} and δ⟨r^{2}⟩^{56,53}=-0.218(13)  fm^{2}, respectively, from the isotope shift of atomic hyperfine structures. The multiconfiguration Dirac-Fock method is used to calculate atomic factors to deduce δ⟨r^{2}⟩. The values of δ⟨r^{2}⟩ exhibit a minimum at the N=28 neutron shell closure. The nuclear density functional theory with Fayans and Skyrme energy density functionals is used to interpret the data. The trend of δ⟨r^{2}⟩ along the Fe isotopic chain results from an interplay between single-particle shell structure, pairing, and polarization effects and provides important data for understanding the intricate trend in the δ⟨r^{2}⟩ of closed-shell Ca isotopes.

Salmonella serovars and antimicrobial resistance patterns on a sample of high seroprevalence pig farms in England and Wales (2003-2008)

Following the introduction of a national abattoir-based monitoring programme for Salmonella in pigs, advisory visits were made to pig farms in England and Wales with high Salmonella seroprevalence assessed by muscle tissue fluid (meat juice) ELISA. Samples (n = 15 790), including pooled pen floor faeces (n = 12 136), were collected for Salmonella culture from 296 farms, between October 2003 and February 2008. Salmonella was isolated from 4489 (28%) of all samples collected, including 3301 (27%) of pooled pen floor faecal samples, from 270 (91%) of farms visited. Salmonella Typhimurium and S. Derby were the most prevalent serovars, representing 64% and 16% of isolates serotyped, respectively. The main phage types of S. Typhimurium identified were U288 and DT193. Antimicrobial resistance (AMR) was seen in 92% of isolates tested, with the highest frequencies of resistance occurring to tetracyclines (T), sulphonamide compounds (SU), ampicillin (AM), sulphamethoxazole/trimethoprim (SXT), streptomycin (S) and chloramphenicol (C). Fifty-nine AMR patterns were observed, the most frequent of these being T, AM, SXT, C, S, SU, seen in 35% of isolates tested. Multi-drug resistance was commonly found, with 67% of isolates submitted for AMR testing showing resistance to between four and nine antimicrobials.

Consistency and precision of landmark identification in three-dimensional cone beam computed tomography scans

The purpose of this study was to quantify the consistency and precision of locating three-dimensional (3D) anatomic landmarks. The hypotheses tested are that these landmarks have characteristic and variable error patterns associated with their type and location. The consistency and precision of nine orthodontists identifying 32 landmarks of 19 patients were quantified. The cone beam computed tomography (CBCT) data were acquired using a Hitachi CB MercuRay system. Prior to the study, all examiners were calibrated with respect to the definitions of the landmarks and on the use of the software program (Dolphin) for identifying the landmarks. In addition, a reference guide was provided that had the definitions and sample images of the landmarks. Data were collected in spreadsheets as x, y, and z co-ordinates and statistically analysed to determine the mean and standard deviation (SD). The mean location for a given landmark on a given patient served as the reference point. The mean of the distances from the reference point was used as the consistency, while the SD of this mean was used as a measure of precision. The error in the x, y, and z planes was calculated in order to determine the specific characteristics of each landmark. The consistency in landmark location and precision did not differ significantly among the nine examiners. Sella turcica was the most consistently (0.50 mm) and most precisely (0.23 mm) identified anatomic landmark. The most inconsistent landmark was porion-right (2.72 mm) and the most imprecise landmark was orbitale-right (1.81 mm). Due to the lack of even distribution of the errors, careful use of these landmarks for analysis purposes is needed.

THE INFLUENCE OF HIGH PROTEIN DIET ON THE KIDNEYS

Seven groups of rats were fed on diets containing protein varying in amount from 1.36 to 40.13 per cent derived mainly from grain, casein, meat, and milk with carbohydrate, fat, and vitamines. From a number of animals one kidney was removed to double the load on the remaining one. The time of feeding was from 9 weeks to 6 months. Blood uric acid, blood urea nitrogen determinations, and microscopic examinations of the kidneys revealed no evidence of kidney damage. There was evidence of kidney hypertrophy consisting of increased weight of the kidney, large diameters of the capillary tufts, convoluted tubules, and kidneys in the animals receiving high protein diet. The nephrectomized animals that ate high protein had no kidney changes save hypertrophy and this amounted to an increase in weight of an average of 0.54 gm. or 85 per cent of the average weight of the right kidneys of the controls.

New insights into pigmentary pathways and skin cancer

The ability of cells to respond to and to mitigate environmental stress is crucial for their survival. Constitutive and facultative pigmentation have evolved in order for human skin to contend with high levels of terrestrial ultraviolet radiation (UVR). When this melanin 'shield' is compromised, individuals are exposed to increased skin cancer risk. The purpose of this review is to discuss new insights into the genetic basis of phenotypic risk factors for skin cancer, their connection to pigmentation and tanning, the precise molecular connections linking UVR to the tanning response, and potential methods of modulating pigmentation that avoid genotoxic damage. Highly translational implications of this research include a scientific basis on which to counsel patients regarding the carcinogenicity of UVR exposure related to tanning and potential new tanning agents that may actually protect against skin cancer by circumventing the need for UVR exposure.

Investigating glutamate receptor-like gene co-expression in Arabidopsis thaliana

There is increasing evidence of the important roles of glutamate receptors (GLRs) in plant development and in adaptation to stresses. However, the studies of these putative ion channels, both in planta and in Xenopus oocytes, may have been limited by our lack of knowledge of possible GLR heteromer formation in plants. We have developed a modification of the single-cell sampling technique to investigate GLR co-expression, and thus potential heteromer formation, in single cells of Arabidopsis thaliana leaves. Micro-EXpression amplification (MEX) has allowed us to amplify gene transcripts from a single cell, enabling expression of up to 100 gene transcripts to be assayed. We measured, on average, the transcripts of five to six different AtGLRs in a single cell. However, no consistent patterns of co-expression or cell-type-specific expression were detected, except that cells sampled from the same plant showed similar expression profiles. The only discernible feature was the detection of AtGLR3.7 in every cell examined, an observation supported by GUS staining patterns in plants stably expressing promoter::uidA fusions. In addition, we found AtGLR3.7 expression in oocytes induces a Ba2+-, Ca2+- and Na+-permeable plasma membrane conductance.

Comparison of cone beam computed tomography imaging with physical measures

OBJECTIVES

The goal of this study was to determine the accuracy of measuring linear distances between landmarks commonly used in orthodontic analysis on a human skull using two cone beam CT (CBCT) systems.

METHODS

Measurements of length were taken using volumetric data from two CBCT systems and were compared with physical measures using a calliper applied to one human adult skull. Landmarks were identified with chromium steel balls embedded at 32 cranial and 33 mandibular landmarks and the linear measures were taken with a digital calliper. The skull was then scanned with two different CBCT systems: the NewTom QR DVT 9000 (Aperio Inc, Sarasota, FL) and the Hitachi MercuRay (Hitachi Medico Technology, Tokyo, Japan). CT data including the landmark point data were threshold segmented using CyberMed's CB Works software (CB Works 1.0, CyberMed Inc., Seoul, Korea). The resulting segmentations were exported from CB Works as VRML (WRL) files to Amira software (Amira 3.1, Mercury Computer Systems GmbH, Berlin, Germany).

RESULTS

The error was small compared with the gold standard of the physical calliper measures for both the NewTom (0.07+/-0.41 mm) and CB MercuRay (0.00+/-0.22 mm) generated data. Absolute error to the gold standard was slightly positive, indicating minor compression relative to the calliper measurement. The error was slightly smaller in the CB MercuRay than in the NewTom, probably related to a broader greyscale range for describing beam attenuation in 12-bit vs 8-bit data.

CONCLUSIONS

The volumetric data rendered with both CBCT systems provided highly accurate data compared with the gold standard of physical measures directly from the skulls, with less than 1% relative error.

Office-based anaesthesia

Office-based anaesthesia is a young but rapidly growing speciality practice. In patient selection, surgical procedures, and anaesthetic techniques this practice is similar to standard ambulatory surgery; however, the liability and risks of office-based anaesthesia are greater. The anaesthesiologist's major challenge is to insist on patient safety in this developing field.

The absence of lymphatics in normal and atherosclerotic coronary arteries in man: a morphologic study

It has been suggested by various investigators that the impairment of lymphatic drainage from the coronary arteries may play a role in predisposition to coronary atherosclerosis, the pathogenesis of which is certainly multifactorial. In our study, no lymphatic vessels were found in the walls of the coronary arteries (adventitia, media and intima) in 51 human hearts from patients ranging in ages from 3 months to 83 years with normal coronary arteries, coronary atherosclerosis, and cardiomyopathy. Visualized lymphatics were located solely in the periadventitial area, and these lymphatics were more irregular in hearts from older persons. With injection, histology, and electronmicroscopy methods we could not detect penetration of lymphatics into the wall of coronary trunks in normal as well atherosclerotic arteries. In all coronary arteries studied, and particularly in the atherosclerotic lesions, blood vasa vasorum could be visualized. In the atherosclerotic areas, vasa vasorum (angiogenesis) could be seen penetrating into the media and intima. Many of the thin-walled vasa vasorum could easily be mistaken for lymphatics. The absence of lymphatics draining the epicardial coronary arteries may be a predisposing factor to coronary atherosclerosis.

Computer-assisted simulations in orthodontic diagnosis and the application of a new cone beam X-ray computed tomography

Computational simulations which include three-dimensional (3-D) image processing and biomechanical calculations should provide useful information to our research and orthodontic clinic as a clinical tool defined as 'thinking'. In this review, 1) biomechanical simulations applied to predict the mandibular growth; 2) mathematical models of virtual bone cells and 3) 3-D images and solid model simulations for surgical planning are introduced. In biomechanical simulation, biting force, electromyographic (EMG) activity and cephalograms of 32 subjects were applied. Computational results of mathematical model were compared with actual bone growth in a rat. Three-dimensional image and solid model of 14 patients were utilized for their treatment planning. From the results, several concepts of our simulations were confirmed: 1) reaction forces generated by masticatory muscles at the condyle control the direction of mandibular growth; 2) some mathematical models have the possibility to describe the process of bone growth; 3) 3-D image processing software and solid models are necessary for diagnosis and planning of orthognathic surgery. We also believe that the orthodontists can more accurately predict the affects of surgical procedures and orthodontic tooth movement using the new cone beam X-ray computed tomography (CT) (CB MercuRay; Hitachi Medico Technology, Tokyo, Japan) and its advanced application software.

Micro X-ray computed tomography analysis for the evaluation of asymmetrical condylar growth in the rat

OBJECTIVES

To investigate the influence of forced lateral bite on mandibular growth, micro X-ray computed tomography (CT) was used for the purpose evaluating condylar cartilage and cancellous bone formation in 10 male Wister rats (3 weeks of age). SETTINGS AND SAMPLE POPULATION: The rats were divided into two groups--experimental and control. In experimental group, an inclined crown was cemented onto the maxillary incisors to produce 2.5 mm shift toward the left side during mastication. Right-left differences in whole mandibular length, mandibular height, condylar size, trabecular structure of the condylar head and three-dimensional (3-D) finite element analysis were assessed using 3-D images reconstructed from micro X-ray CT scans when the mice had reached 21 weeks.

MEASUREMENTS AND RESULTS

Asymmetrical growth was found in the experimental group, in which the left condylar head became thicker and shorter than the right condylar head during development. When comparing the left and right condyles of the experimental animals, histomorphometric analysis from micro X-ray CT showed that the bone volume (BV) of the cancellous bone, the surface area of the cancellous bone (BS), the BS/BV ratio, the BV fraction (BV/TV), and the trabecular thickness and trabecular number were less for the right condyle than for the left condyle.

CONCLUSIONS

These findings suggested that artificial changes in the mastication do influence the growth of condylar head, condylar bone trabecular structure, and mineralization.

Modeling of structure, quality, and function in the orthodontic patient

The advantages of three-dimensional (3-D) imaging technology and solid modeling make it possible to visualize the morphological information. However, lacking in this 'digital patient' is the motion and mechanical properties observed in the living patient. Functional diagnostic techniques such as electromyography and motion analysis could complement the morphological characteristics to be applied in orthodontics. In this review, new computer-assisted analyzing methods are introduced which include visualization of: 1) the 3-D structure and bone density distribution; 2) masticatory-generated forces by using automated finite element modeling (FEM); and 3) the 3-D jaw movement and its motion analysis. In each study, the data from X-ray computed tomography scanning, electromyograms, biting pressure, and digital jaw movement analysis (six axes) are used for calculation. By using these applications, growing changes in bone mineral density distribution of the mandibular cortical bone have been clarified, automated finite element modeling has indicated stress distribution in the craniofacial skeleton, and patient-specific 3-D images of the mandible have been depicted as a motion picture. These studies were completed in 124 living subjects (75 females, 49 males) between 8 and 33 years of age. From these results, malfunctions during mastication were evaluated clearly with the individual patient craniofacial structures and its characteristics. These computer-based visualization techniques can be used to derive much clinically useful information, and to improve the combined evaluation of both static characteristics and dynamic function.

Oral and pharyngeal reflexes in the mammalian nervous system: their diverse range in complexity and the pivotal role of the tongue

The oral cavity and pharynx are anatomically separate but functionally integrated regions of the head. The two regions are involved in complex motor responses that include feeding, chewing, swallowing, speech, and respiration. The multiple sensory receptors that innervate these two regions provide the first link in reflexes that control muscles of the entire head, upper gastrointestinal tract, and airway. Most of the reflexes affect the diversity of muscles that compose the tongue, which is vital to all stages of feeding and which continually affects the patency of the airway. Oral-pharyngeal reflexes are evident in the mammalian fetus and continually emerge as the animal or human matures. Some of the first reflexes in the oral region are geared toward nourishment. As the central nervous system matures and the oral and pharyngeal regions develop morphologically, new reflexes develop. Many of these reflexes are protective both of the tissue in the oral cavity, such as the tongue, and of the upper airway in preventing aspiration. While simple reflexes can be evoked in isolation, most reflexes combine with more complex oral and pharyngeal responses such as chewing and vocalization. Oral-pharyngeal reflexes demonstrate a range in complexity. Some sensory stimuli will evoke a series of responses, as is often evident in the infant, and other stimuli will evoke a complex multiple-level recruitment of muscles in a sequence, as in pharyngeal swallowing. Certain sensory inputs evoke an entire motor behavior pattern, such as taste avoidance or facial expression. The oral-pharyngeal reflexes are critical to maintaining life and ultimately serve functions that the oral and pharyngeal regions have in common, such as communication, feeding, and breathing.

A randomized, double-blind comparison of the efficacy and tolerability of once-daily modified-release diltiazem capsules with once-daily amlodipine tablets in patients with stable angina

A randomized, double-blind, parallel-group study comparing the efficacy and tolerability of once-daily diltiazem capsules with amlodipine tablets in patients with stable angina. After a run-in period of 1 to 3 weeks, 34 patients received once-daily diltiazem and 33 patients received amlodipine. Patients received either diltiazem, 240 mg/day, or amlodipine, 5 mg/day, for 2 weeks followed by diltiazem, 360 mg/day, or amlodipine, 10 mg/day, for 2 weeks. Standard treadmill exercise testing was the primary efficacy assessment. Patients also recorded incidence of angina attacks and use of glyceryl trinitrate spray. Both treatments gave significant improvement in time to onset of angina and time to maximal exercise. With the exception of amlodipine, 5 mg/day, both treatments gave significant increases in time to 1-mm ST segment depression. Diltiazem, 360 mg/day, gave a significant decrease in rate pressure product. There were no significant treatment differences in any of the exercise test parameters. Both treatments reduced incidence of angina attacks and use of glyceryl trinitrate spray. The incidence of edema was significantly less in patients receiving diltiazem. In conclusion, both treatments were effective in controlling patients' angina, but diltiazem was better tolerated, with a lower incidence of edema.

Lymphatic drainage of the heart in the laboratory rat

We showed in the Sprague Dawley rat that the principal ascending cardiac lymphatic is similar in location to that of man and dog and can be readily visualized by injection of a small amount of T1824 blue dye (Evans) into the apex of the left ventricle. We also showed that it is possible to ligate and thereby obstruct this principal cardiac lymphatic near its entry beneath the left atrial appendage. This latter technique may be useful for studying in a small relatively inexpensive laboratory animal the effects of blocking cardiac lymph drainage on inflammatory and infectious processes implicated in myocardial and coronary artery disease.

A three-dimensional, quantitative computed tomographic study of changes in distribution of bone mineralization in the developing human mandible

The three-dimensional distribution of highly mineralized cortical bone on the buccal surface of the mandible was evaluated using quantitative computed tomography. The study was completed in 34 living persons (21 females and 13 males) between the ages of 9 and 32 yr of age with symmetrical mandibles. The geometrical distribution of the highly mineralized areas (>1250 mg/cm(3)) was determined by three-dimensional reconstruction of images. The pattern of distribution was evaluated by superimposing a 9 by 9-mesh grid over the lateral view of the mandible and adapting it to the same anatomical landmarks for different aged participants. Individuals demonstrated four different patterns of distribution of highly mineralized buccal cortical bone. The youngest had highly mineralized bone in the corpus of the mandible and along the anterior ramal border. In older individuals, the mineralization changed to include the mid- and posterior ramus. Highly mineralized bone was not found within the condylar, coronoid, or gonial angle regions of any participant. A comparison of the mineralization pattern between the left and right lateral mandibular views showed bilateral symmetry with similar patterns of distribution. Comparison of the number of grids occupied by highly mineralized cortical bone with the age of the participant, mandibular length, gonial angle, and cross-sectional area of the masseter muscle produced the highest correlation coefficient with the size of the masseter muscle.

TRANSPORTERS RESPONSIBLE FOR THE UPTAKE AND PARTITIONING OF NITROGENOUS SOLUTES

The acquisition and allocation of nitrogenous compounds are essential processes in plant growth and development. The huge economic and environmental costs resulting from the application of nitrogen fertilizers make this topic very important. A diverse array of transporters varying in their expression pattern and also in their affinity, specificity, and capacity for nitrogenous compounds has been identified. Now the future challenge is to define their individual contribution to nitrogen nutrition and signalling processes. Here we have reviewed recent advances in the identification and molecular characterization of these transporters, concentrating on mechanisms existing at the plasma membrane. The review focuses on nitrate, ammonium, and amino acid transporter familes, but we also briefly describe what is known at the molecular level about peptide transporters and a recently identified family implicated in the transport of purines and their derivatives.

Cortical bone mineral density in asymmetrical mandibles: a three-dimensional quantitative computed tomography study

The three-dimensional distribution (3D) of the highest mineralized cortical bone was evaluated in 32 subjects between the ages of 8 and 30 years with asymmetrical mandibles using quantitative computed tomography (QCT). The geometrical distribution of the highest mineralized areas (> 1250 mg/cm3) representative of mandibular cortical bone was determined by 3D reconstruction of the images. The length of the mandible on each side was determined by defining a new linear measurement from the centre of the 3D reconstructed condyle to the midline of the symphysis as identified from a submental view. The cross-sectional areas of the masseter and medial pterygoid muscles were assessed from bilateral axial views through the middle of the muscles parallel to the Frankfort-Horizontal plane. Comparison between the lengths of the two mandibular sides (right-left = mm) indicated a range of asymmetries with an equal number of subjects with the left and right mandible longer. Comparison of the area of highest mineralized cortical bone between the right and left sides (R/L) to the ratio of the mandibular length (R/L) showed a high correlation coefficient (r = 0.629) suggesting that the shortest mandibular side had more highly mineralized bone. A comparison of the area of highest mineralized cortical bone between the right and left sides (R/L) to the ratio of cross-sectional areas of the muscles showed the highest correlation coefficient (r = 0.724) with the ipsilateral masseter muscle. These findings indicate that asymmetrical mandibles are associated with asymmetrical distributions of the highest mineralized cortical bone and that this is age dependent.

The use of microelectrodes to investigate compartmentation and the transport of metabolized inorganic ions in plants

Microelectrode measurements can be used to investigate both the intracellular pools of ions and membrane transport processes of single living cells. Microelectrodes can report these processes in the surface layers of root and leaf cells of intact plants. By careful manipulation of the plant, a minimum of disruption is produced and therefore the information obtained from these measurements most probably represents the 'in vivo' situation. Microelectrodes can be used to assay for the activity of particular transport systems in the plasma membrane of cells. Compartmental concentrations of inorganic metabolite ions have been measured by several different methods and the results obtained for the cytosol are compared. Ion-selective microelectrodes have been used to measure the activities of ions in the apoplast, cytosol and vacuole of single cells. New sensors for these microelectrodes are being produced which offer lower detection limits and the opportunity to measure other previously unmeasured ions. Measurements can be used to determine the intracellular steady-state activities or report the response of cells to environmental changes.

(+/-)-1-Tetralone-3-carboxylic acid and (+/-)-1-tetralone-2-acetic acid: hydrogen bonding in two gamma-keto acids

The crystal structure of (+/-)-4-oxo-1,2,3,4-tetrahydronaphthalene-2-carboxylic acid (C(11)H(10)O(3)) involves projection of the carboxyl group nearly orthogonal to the aromatic plane and hydrogen bonding of the acid groups by centrosymmetric pairing across the a edge and the center of the chosen cell [O...O = 2.705 (2) A]. Intermolecular C--H...O==C close contacts to translationally related molecules are found for both the ketone (2.55 A) and the acid (2.67 A). In (+/-)-1-oxo-1,2,3,4-tetrahydronaphthalene-2-acetic acid (C(12)H(12)O(3)), the aggregation involves centrosymmetric carboxyl dimers mutually hydrogen bonded across the bc face and the a edge of the chosen cell [O...O = 2.674 (2) A]. A 2.60 A close C--H...O==C contact is found to the carboxyl group of centrosymmetrically related molecule.

A high affinity fungal nitrate carrier with two transport mechanisms

We have expressed the CRNA high affinity nitrate transporter from Emericella (Aspergillus) nidulans in Xenopus oocytes and used electrophysiology to study its properties. This method was used because there are no convenient radiolabeled substrates for the transporter. Oocytes injected with crnA mRNA showed nitrate-, nitrite-, and chlorite-dependent currents. Although the gene was originally identified by chlorate selection there was no evidence for transport of this anion. The gene selection is explained by the high affinity of the transporter for chlorite, and the fact that this ion contaminates solutions of chlorate. The pH-dependence of the anion-elicited currents was consistent with H(+)-coupled mechanism of transport. At any given voltage, currents showed hyperbolic kinetics with respect to extracellular H(+), and these data could be fitted with a Michaelis-Menten relationship. But this equation did not adequately describe transport of the anion substrates. At higher concentrations of the anion substrates and more negative membrane voltages, the currents were decreased, but this effect was independent of changes in external pH. These more complicated kinetics could be fit by an equation containing two Michaelis-Menten terms. The substrate inhibition of the currents could be explained by a transport reaction cycle that included two routes for the transfer of nitrate across the membrane, one on the empty carrier and the other proton coupled. The model predicts that the substrate inhibition of transporter current depends on the cytosolic nitrate concentration. This is the first time a high affinity nitrate transport activity has been characterized in a heterologous system and the measurements show how the properties of the CRNA transporter are modified by changes in the membrane potential, external pH, and nitrate concentration. The physiological significance of these observations is discussed.

Cold shock and its effect on ribosomes and thermal tolerance in Listeria monocytogenes

Differential scanning calorimetry (DSC) and fatty acid analysis were used to determine how cold shocking reduces the thermal stability of Listeria monocytogenes. Additionally, antibiotics that can elicit production of cold or heat shock proteins were used to determine the effect of translation blockage on ribosome thermal stability. Fatty acid profiles showed no significant variations as a result of cold shock, indicating that changes in membrane fatty acids were not responsible for the cold shock-induced reduction in thermal tolerance. Following a 3-h cold shock from 37 to 0 degrees C, the maximum denaturation temperature of the 50S ribosomal subunit and 70S ribosomal particle peak was reduced from 73.4 +/- 0.1 degrees C (mean +/- standard deviation) to 72.1 +/- 0.5 degrees C (P < or = 0.05), indicating that cold shock induced instability in the associated ribosome structure. The maximum denaturation temperature of the 30S ribosomal subunit peak did not show a significant shift in temperature (from 67.5 +/- 0.4 degrees C to 66.8 +/- 0.5 degrees C) as a result of cold shock, suggesting that either 50S subunit or 70S particle sensitivity was responsible for the intact ribosome fragility. Antibiotics that elicited changes in maximum denaturation temperature in ribosomal components also elicited reductions in thermotolerance. Together, these data suggest that ribosomal changes resulting from cold shock may be responsible for the decrease in D value observed when L. monocytogenes is cold shocked.

Cold shock induction of thermal sensitivity in Listeria monocytogenes

Cold shock at 0 to 15 degrees C for 1 to 3 h increased the thermal sensitivity of Listeria monocytogenes. In a model broth system, thermal death time at 60 degrees C was reduced by up to 45% after L. monocytogenes Scott A was cold shocked for 3 h. The duration of the cold shock affected thermal tolerance more than did the magnitude of the temperature downshift. The Z values were 8.8 degrees C for controls and 7.7 degrees C for cold-shocked cells. The D values of cold-shocked cells did not return to control levels after incubation for 3 h at 28 degrees C followed by heating at 60 degrees C. Nine L. monocytogenes strains that were cold shocked for 3 h exhibited D(60) values that were reduced by 13 to 37%. The D-value reduction was greatest in cold-shocked stationary-phase cells compared to cells from cultures in either the lag or exponential phases of growth. In addition, cold-shocked cells were more likely to be inactivated by a given heat treatment than nonshocked cells, which were more likely to experience sublethal injury. The D values of chloramphenicol-treated control cells and chloramphenicol-treated cold-shocked cells were no different from those of untreated cold-shocked cells, suggesting that cold shock suppresses synthesis of proteins responsible for heat protection. In related experiments, the D values of L. monocytogenes Scott A were decreased 25% on frankfurter skins and 15% in ultra-high temperature milk if the inoculated products were first cold shocked. Induction of increased thermal sensitivity in L. monocytogenes by thermal flux shows potential to become a practical and efficacious preventative control method.

Murmurs associated with mitral annular calcification and aortic sclerosis

BACKGROUND

Auscultation of patients with mitral annular calcification on echocardiography revealed a particular constellation of findings.

OBJECTIVE

To test the hypothesis that a particular auscultatory constellation provides a high degree of certainty in diagnosing the combination of mitral annular calcification and aortic sclerosis so often found in the elderly.

METHODS

Two groups of patients were studied to evaluate the particular auscultatory constellation under consideration which consisted of: (1) a harsh ejection systolic murmur heard from the 2nd right interspace to the cardiac apex and usually loudest between the 3rd left interspace and the apex; (2) the murmur radiates from the apex towards the left axilla and radiates poorly or not at all from the 2nd right interspace to the neck, and (3) the 2nd heart sound at the cardiac base is normal in intensity, and no ejection clicks are present. Group 1 consisted of patients with mitral annular calcification on echocardiographic examination, and group 2 consisted of patients in whom the particular constellation of auscultatory findings was present and who were then referred for echocardiographic assessment.

RESULTS

The particular auscultatory constellation under investigation allowed the diagnosis of the presence of the combination of mitral annular calcification and aortic sclerosis with substantial accuracy.

CONCLUSION

The findings in this exploratory study suggest that the pathologic combination of mitral annular calcification and aortic sclerosis can be diagnosed with a reasonably high degree of certainty in elderly patients, if the particular auscultatory configuration is identified.

Determination of mosquito bloodmeal pH in situ by ion-selective microelectrode measurement: implications for the regulation of malarial gametogenesis

Malarial gametocytes circulate in the peripheral blood of the vertebrate host as developmentally arrested intra-erythrocytic cells, which only resume development into gametes when ingested into the bloodmeal of the female mosquito vector. The ensuing development encompasses sexual reproduction and mediates parasite transmission to the insect. In vitro the induction of gametogenesis requires a drop in temperature and either a pH increase from physiological blood pH (ca pH 7.4) to about pH 8.0, or the presence of a gametocyte-activating factor recently identified as xanthurenic acid (XA). However, it is unclear whether either the pH increase or XA act as natural triggers in the mosquito bloodmeal. We here use pH-sensitive microelectrodes to determine bloodmeal pH in intact mosquitoes. Measurements taken in the first 30 min after ingestion, when malarial gametogenesis is induced in vivo, revealed small pH increases from 7.40 (mouse blood) to 7.52 in Aedes aegypti and to 7.58 in Anophĕles stephensi. However, bloodmeal pH was clearly suboptimal if compared to values required to induce gametogenesis in vitro. Xanthurenic acid is shown to extend the pH-range of exflagellation in vitro in a dose-dependent manner to values that we have observed in the bloodmeal, suggesting that in vivo malarial gametogenesis could be further regulated by both these factors.

Xenopus oocytes as an expression system for plant transporters

The Xenopus oocyte provides a powerful system for the expression and characterisation of plant membrane proteins. Many different types of plant membrane proteins have been expressed and characterised using this system. As there are already several general reviews on the methodology for oocyte expression of channel proteins, we have summarised the particular advantages and disadvantages of using the system for the characterisation of plant cotransporter proteins. As an example of how the system can be used to identify transporters, we describe evidence for a low affinity nitrate transporter in oocytes injected with poly(A) RNA extracted from nitrate-induced barley roots. Furthermore, we describe evidence that the expression of some transporters in oocytes can modify the properties of endogenous membrane proteins. We conclude that although care must be taken in the interpretation of results and in choosing appropriate controls for experiments, oocyte expression is an excellent tool which will have an important role in characterising plant membrane proteins.

A high affinity nitrate transport system from Chlamydomonas requires two gene products

A nitrate-regulated cluster of genes involved in nitrate transport and assimilation has been identified in Chlamydomonas reinhardtii. Mutant strains of the alga, which are defective in some aspect of transport and assimilation have been used to assign functions to these genes. This analysis has suggested that two gene products are necessary to obtain a functional high affinity nitrate system in Chlamydomonas [Quesada et al. (1994) Plant J. 5, 407-419]. In this paper we have tested this hypothesis by injecting Xenopus oocytes with mRNA prepared from these two cDNAs, Nrt2;1 and Nar2, and then assaying the oocytes for nitrate transport activity. Oocytes injected with single types of mRNA did not show any nitrate transport activity. Furthermore, Nar2 mRNA was toxic to oocytes, with nearly 60%, of the oocytes dead 3 days after the injection. However, when oocytes were injected with a mixture of two mRNAs prepared from Nrt2;1 and Nar2, a high affinity nitrate transport activity could be measured. However, the Km for nitrate of this transport system was 28 microM which is higher than the value of 1.6 microM which had been obtained by the analysis of mutant phenotypes. The pH-dependence of the nitrate-elicited currents was consistent with a proton-cotransport mechanism. These results prove that two gene products are required to produce a functional high affinity nitrate transport system and that this process does not involve transcriptional regulation.

Improved efficacy and safety of controlled-release diltiazem compared to nifedipine may be related to its negative chronotropic effect

The objective of this study was to assess the safety and efficacy of long-acting preparations of two commonly used calcium antagonists with particular reference to their effects on heart rate. Twenty patients with chronic stable angina were recruited to a double-blind, double-dummy crossover study of controlled-release diltiazem (diltiazem CR) versus sustained-release nifedipine (nifedipine SR) and underwent clinical assessment, symptom and adverse event reporting, and repeated treadmill exercise tests over a 10- to 11-week period. The main outcome measures were heart rate at rest and exercise, incidence of angina and nitroglycerin use, treadmill exercise performance (duration, time to angina, time to 1-mm ST-segment depression, heart rate at equivalent maximal exercise, and maximal ST-segment depression), and adverse events. Diltiazem CR significantly reduced heart rate at rest and equivalent exercise and incidence of angina and nitroglycerin use compared with nifedipine SR. Exercise duration time to angina and time to 1-mm ST-segment depression (but not maximal ST-segment depression) were all significantly improved by diltiazem CR. Diltiazem CR also caused significantly fewer adverse events than nifedipine SR. Calcium antagonists with negative chronotropic effects (eg, diltiazem CR) are safer and more efficacious as monotherapy in chronic stable angina than dihydropyridines (eg, nifedipine SR) even when a long-acting formulation of the latter is used.

Mandibulofacial adaptations in a juvenile animal model of temporomandibular joint arthritis

Juvenile rheumatoid arthritis (JRA) is a chronic systemic disease of childhood that affects synovial joints including the temporomandibular joint (TMJ). Individuals with JRA of the TMJ frequently show aberrations in mandibulofacial development. Since the basis for these developmental perturbations is poorly understood, they remain a perplexing clinical problem to manage. To begin dissecting the mechanisms for altered craniofacial development in JRA of the TMJ, we characterized the gross morphologic adaptations in the facial skeleton in a juvenile animal model of TMJ arthritis. Arthritis was induced in ten 87-day-old male rabbits by intra-articular challenge with ovalbumin. Eight sham-challenged and 4 unchallenged rabbits were used as controls. Serial lateral head cephalograms, taken at 73 (T1), 87 (T2), 108 (T3), 129 (T4), and 150 (T5) days of age, were evaluated by linear measures of maxillary, mandibular, and posterior dental height dimensions. Differences in the absolute dimensions and relative percent incremental changes were compared by ANOVA and Fisher's test. The body weights, as well as the absolute measures and incremental changes in maxillary and posterior dental height dimensions, were not significantly different between the antigen-challenged and control groups. In contrast, absolute measures of posterior mandibular height, condylar neck height, and total mandibular length were significantly smaller (P < 0.05) in antigen-challenged rabbits than in both control groups at T5. Furthermore, the antigen-challenged rabbits demonstrated significantly smaller (P < 0.05) relative increases in all measures of mandibular length, and in total posterior mandibular and condylar neck heights. Cephalometric superimpositions on the cranial base and tantalum implants confirmed these quantitative observations. This investigation demonstrates mandibulofacial developmental aberrations in experimental JRA-like disease of the TMJ that are similar to those observed in humans with this disease.