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OBJECTIVE: In many Danish communities, school-based fluoride programs are offered to children with high caries risk in adjunct to tooth brushing. The purpose of this field trial was to compare the caries-preventive effectiveness of two different fluoride programs in 6-12 year olds. BASIC RESEARCH DESIGN: Clinical controlled trial. CLINICAL SETTING: The 2-year study was conducted in Public Dental Clinics in a multicultural low-socioeconomic suburban area of Odense, Denmark with an elevated prevalence of caries compared to the city average. PARTICIPANTS: 1,018 children (aged 6-12 years) from 9 different schools were enrolled after informed consent and their class unit was randomly allocated to one of two fluoride programs. INTERVENTIONS: One group received a semi-annual fluoride varnish applications (FV) and the other group continued with an existing program with fluoride mouth rinses once per week (FMR). All children received oral hygiene instructions and comprehensive dental care at the local Public Dental Clinics throughout the study period. MAIN OUTCOME MEASURES: Increment of caries lesions in permanent teeth at both cavitated and initial caries levels. RESULTS: The groups were balanced at baseline. After two years, 961 children (94.4%) were reexamined. The FV group showed a mean DMFS increment of 0.36 compared to 0.41 in the FMR group. The corresponding values for initial caries lesions were 0.83 and 0.91 respectively. CONCLUSION: There were no statistically significant differences in caries development over two years among children participating in a school-based fluoride varnish or mouth rinse program.

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PURPOSE: Retinal photocoagulation can improve the visual prognosis of patients with diabetic maculopathy complicated with clinically significant macular oedema. However, this effect covers a wide variation of visual outcome with some patients improving and other patients worsening several visual acuity steps. Therefore, parameters are needed that can be used to ensure that treatment is modified or avoided in those patients who are at risk of experiencing visual loss. METHODS: The change in visual acuity shortly after laser photocoagulation for diabetic maculopathy was assessed in 95 eyes of 79 patients as a part of a routine quality assessment programme, and was compared to the age at onset of diabetes, the pre-treatment duration of diabetes, the number of retinopathy lesions and the number of laser applications given to treat the maculopathy. RESULTS: On average visual acuity was unchanged at the post treatment control (mean=-0.04, SD=0.15), however, with a wide variation (range: -0.44 to 0.33). There was no correlation between the change in visual acuity and any of the studied background parameters. CONCLUSIONS: It is concluded that the treatment intervention rather than the general disease state is the main determining factor for the visual prognosis after laser photocoagulation for diabetic maculopathy. Other parameters should be identified to act as a basis for differentiating and improving laser photocoagulation of diabetic maculopathy. One such possible parameter might be the distance of retinopathy lesions and laser applications from the retinal fixation area.

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BACKGROUND: The physical activity pattern in society has in recent years changed from necessary occupational activity to voluntary activities during leisure-time. How this change in lifestyle affects the selection of dietary intakes is presently unknown. OBJECTIVES: The aim of the present study was to investigate the different effects of high vs. low-intensity exercise on the following day's dietary energy intake and macronutrient selection. DESIGN: The study was designed as a controlled randomized cross-over study which compared food selection and energy intake the day following a low-intensity vs a high-intensity exercise bout. We included 32 healthy normal-weight subjects of four subgroups (young males, young females, old males and old females). On two different occasions they performed either 60 min low-intensity (30% of VO2max) or 30 min high-intensity (60% of VO2max) exercise during 24h measurements of energy expenditure. The energy intake and macronutrient selection of the subsequent day was assessed by offering them an adlibitum buffet at breakfast and at lunch. RESULTS: Following the low-intensity exercise the subjects chose a diet with an energy percentage from fat similar to that of their habitual diet-36.7% (95% CI: 34.3, 39.0) vs 35.6% (95% CI: 33.0, 38.2; NS). Following the high-intensity exercise they chose a diet with 39.9% (95% CI: 37.2, 42.6) fat, which was 3.2% (95% CI: 0.6, 5.9) higher than following the low-intensity exercise (P<0.05) and 4.2% (95% CI: 1.1, 7.4) more than their habitual diet (P<0.01). CONCLUSIONS: The present study shows that changing the type of activity of a single exercise bout from 30% of maximal aerobic capacity for 60 min to 60% for only 30 min resulted in consumption of a diet the following day with a higher fat energy percentage compared with the diet selected after the low-intensity exercise. However, the higher fat content diet did not result in a higher energy intake.

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The mandible and forearm bone mineral content and dental and periodental state were studied in 15 patients, aged 26 to 65 years, on home parenteral nutrition due to short bowel syndrome and compared to the findings in a normal population. The bone mineral content was measured by dual-photon absorptiometry. All patients were on free oral intake as a supplement to the parenteral nutrition. Forty-seven percent of the patients showed mandibular osteoporosis. Thirty-three percent had osteoporosis in the forearm and also radiographic signs of osteoporotic fractures of the columna. The dental and periodental state did not differ from that of the normal Danish population of the same age. Thus, patients on home parenteral nutrition due to short bowel syndrome seem to have a high risk of developing systemic osteoporosis, including the jaws, but apparently do not have a higher risk for deterioration of the dental or periodental state.

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The aims of the present study were to examine possible effects of age and sex on energy expenditure independent of differences in body composition, and to develop prediction equations for individual estimation of energy expenditure. The study is based on 235 female and 78 male subjects ranging in age from 15 to 64 y and with body mass indexes (in kg/m2) ranging from 16.9 to 50.5. Basal metabolic rate (BMR), sleeping energy expenditure, and 24-h energy expenditure were measured with standardized protocols by indirect calorimetry in respiratory chambers. Anthropometric data were also recorded. Spontaneous physical activity (SPA) was estimated by a radar system during the chamber stay. About 90% of the variation in 24-b energy expenditure could be explained by differences in fat-free mass, fat mass, SPA, and duration of exercise (SEM: 526 kJ/d), whereas age and sex did not contribute significantly. When comparing energy expenditure adjusted for body composition and activity between two age groups (20-30 y, n = 98 and 50-65 y, n = 39), BMR was 4.6% lower in the older group (P = 0.04) and there was a tendency toward a lower sleeping energy expenditure in the older group (P = 0.06). No sex difference in any energy expenditure measurement could be found after differences in body composition and activity were taken into account. In conclusion, no sex effect and no linear decrease in energy expenditure was found with increased age and the middle-aged subjects had lower BMR than younger subjects independent of body size, body composition and activity.

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BACKGROUND: The purpose was to analyze changes in the mandible and the forearm bone mineral content and oral state in patients on home parenteral nutrition due to short bowel syndrome in relation to the bone mineral values and oral findings in a normal population. METHODS: The bone mineral content was measured by dual-photon absorptiometry and the dental and periodontal state were studied in 15 adults patients (12 women, and 3 men, aged 26 to 65 years). All patients were on free oral intake as a supplement to the parenteral nutrition. RESULTS: Forty-seven percent of the patients (2 males, 2 young and 3 elderly females) showed mandibular osteoporosis (Z-scores < -2.00), and all young females showed Z-scores < 0. Moreover, 34% of the patients showed osteoporosis in the forearm bones (Z-scores < -2.00) and also radiographic signs of osteoporotic fractures of the columna. The dental and the periodontal state in the patients did not differ clearly from that of the normal Danish population of the same age. CONCLUSIONS: Such patients seem to have a high risk of developing systemic osteoporosis, including the jaws, but apparently do not show a higher risk for deterioration of the dental or periodontal state than age-matching normals from the same population.

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Osteoporosis is suspected as a risk factor in periodontal disease, but previous studies have failed to establish a relationship. Possible explanations for this could be lack of precise methods for assessment of osteoporosis in the jaws and confounding of the result by other factors such as age, gender, or smoking. In the present study 12 female patients with osteoporotic fractures (Group O) and 14 normal women (Group N) were examined clinically for plaque (VPI), gingival bleeding (GBI), and loss of attachment on the 6 Ramfjord index teeth. Bone mineral content (BMC) of the mandible and forearm was determined by dual photon scanning. Results were presented as arithmetic means +/- standard error, and differences between groups were tested by 2-sample t-test. The two groups were comparable with respect to age (O: 68.3 +/- 1.8 years, N: 68.1 +/- 1.5 years), menopausal age (O: 47.5 +/- 1.8 years, N: 47.2 +/- 1.3 years), and smoking habits (O: 4 smokers, N: 3 smokers). The osteoporotic women had significantly lower BMC values than controls in the mandible (O: 0.63 +/- 0.04 in U/cm2; N: 0.78 +/- 0.02 in U/cm2, P < 0.01) and forearm (O: 1.05 +/- 0.05 in U/cm; N: 1.28 +/- 0.05 in U/cm, P < 0.01). No significant differences were found with respect to plaque (O: 46.67 +/- 10.00%, N: 36.67 +/- 6.67%) and gingival bleeding (O: 46.67 +/- 11.67%, N: 43.33 +/- 10.00%), whereas significantly greater loss of attachment was seen in osteoporotic women (O: 3.65 +/- 0.18 mm, N: 2.86 +/- 0.19 mm, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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Tetracyclines have been widely used as adjuncts in periodontal therapy due to the antimicrobial efficacy of these drugs. Recently, their ability to inhibit host-derived matrix metalloproteinases (collagenase and gelatinase) and bone resorption in organ culture has also been invoked as a therapeutic rationale. The current study was undertaken to determine whether tetracyclines can inhibit alveolar bone loss in vivo due to a non-antimicrobial action of these drugs. Experimental periodontitis was induced by inoculating adult, male Sprague-Dawley rats with P. gingivalis (strain 381) following kanamycin/ampicillin pretreatment. Doxycycline, non-antimicrobial chemically-modified tetracycline (CMT-1) and vehicle alone were administered daily to 3 infected groups of rats (n = 6 rats per group; each group housed in a sterilized inflatable isolator) beginning 10 days after P. gingivalis inoculation. The control group (n = 6; non-infected rats) received only vehicle. After 5 weeks of daily drug administration by gastric intubation, the experiment was terminated and blood samples were taken from each animal to determine antibody levels against P. gingivalis. Plaque samples were collected from each group of animals before and after P. gingivalis inoculation and at the end of the experiment for microbiological examination. The jaws were removed from each rat, defleshed and then analyzed morphometrically and radiographically to assess bone loss. Serum antibody levels against P. gingivalis were significantly elevated in the 3 infected groups compared to the non-infected controls. This, together with the microbiologic findings, indicated that these groups of rats were infected with P. gingivalis.(ABSTRACT TRUNCATED AT 250 WORDS)

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LongoVital is a herbal tablet with documented immunostimulatory effects in man. In the present study the effect of LongoVital on development of periodontal disease was investigated in a rat model. Fifty-four conventional rats, 5 wk old, were distributed into the following groups: A) untreated, uninfected; B) untreated, infected with Actinomyces viscosus and Porphyromonas gingivalis wk 8; C) treated with LongoVital 80 mg x 3/wk, wk 5-14, uninfected; D) treated with LongoVital 80 mg x 3/wk, wk 5-14, infected with A. viscosus and P. gingivalis wk 8; E) treated with LongoVital 200 mg x 1 in wk 8 and 80 mg wk 9-14, uninfected; F) infected with A. viscosus and P. gingivalis wk 8, subsequently treated with LongoVital 200 mg x 1 in wk 8 and 80 mg wk 9-14. All animals were killed when they were 15 wk old, and periodontal bone support was assessed radiographically. Statistically significant bone loss was found in untreated, infected rats, as compared with untreated, uninfected rats. In LongoVital-treated animals, no significant difference was seen in bone level between infected and uninfected rats. These results indicate that LongoVital-treated rats were protected against periodontal bone loss caused by infection with A. viscosus and P. gingivalis. Furthermore, the protection seemed effective both when LongoVital was administered prophylactically and after exposure to periodontal pathogens. The active components of LongoVital, as well as the mechanisms responsible for the protection, remain obscure.

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Expression of the c-met proto-oncogene is common iii small cell lung cancer (SCLC) cell lines. The product of this proto-oncogene is the receptor for hepatocyte growth factor (HGF), also known as scatter factor (SF) and hepatopoietin A. We examined the effect of HGF/SF on 8 SCLC cell lines of which six expressed c-Met and 2 control cell lines did not. The effect was monitored by growth curves, in vitro migration in Boyden chambers. and by examination of morphology. Three cell lines responded in one or more of the following ways: Growth inhibition, morphological alterations. and increased migration in Boyden chambers. We conclude that functional c-Met receptors are frequently expressed in SCLC and may contribute to the behaviour of this tumour type.

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Anaerobic Gram-negative bacteria dominate in periodontitis locations, while Gram-positive bacteria characterize healthy sites. A well-established Gram-positive flora might therefore inhibit the colonization of Gram-negative pathogens. The purpose of the present investigation was to examine whether endogenous S. sanguis could prevent, or reduce, periodontal bone loss in rats infected with a virulent P. gingivalis strain. Sixty specific pathogen-free Wistar rats were divided into 6 groups. Doxycycline was administered in the drinking water for 2 weeks to the groups A, B, C, and D to suppress the preexisting microflora in the mouth. Rats in groups A and C were subsequently inoculated with an S. sanguis strain, isolated from one of the rats, once a day for 5 d. Infection with P. gingivalis 381 was then carried out for 5 d in groups A, B, and E. Group F was not treated with doxycycline nor infected with bacteria and served as untreated control. Six weeks after the P. gingivalis inoculation, the rats were killed. Periodontal bone levels were assessed radiographically and morphometrically, and serum antibody against P. gingivalis 381 was determined by a fluorescence immunoassay. Periodontal bone support, determined radiographically, was reduced in group B (doxycycline-treated, P. gingivalis-inoculated) compared with the other groups. In contrast, the morphometric determination showed no differences between the groups. In group B antibody levels against two different P. gingivalis 381 cell surface antigens were significantly elevated.(ABSTRACT TRUNCATED AT 250 WORDS)

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Germ-free rats were monoinfected with Porphyromonas gingivalis strains 381 or A7A1-28 for 42 or 84 days. Both strains induced substantial destruction of alveolar bone and soft tissue when compared to non-infected controls, but the patterns were different. Strain A7A1-28 was associated with increased activity of host collagenase and gelatinase at 42 days, whereas the activity was elevated to a lesser extent at 84 days. Strain 381 showed a moderate increase in host proteinase activity at 42 days, and this remained unchanged until day 84. Strain A7A1-28 was associated with more bone loss than strain 381 by a morphometric analysis that detects horizontal bone loss in the maxilla. Strain 381 was associated with more bone loss than strain A7A1-28 by a radiographic method that detects vertical intrabony defects in the mandible. Infection with one strain gave rise to serum and salivary antibodies strongly reactive to the infecting strain and moderately reactive to antigens from the other strain. This indicates that some antigenic similarity exists between the strains and that there are also strain or perhaps serotype differences in antibody responses induced by infection. Thus two strains of P. gingivalis differing in antigenicity and pathogenicity in the mouse model of the subcutaneous abscess cause substantial periodontal destruction in the germ-free rat. The disease pattern is, however, different, with strain A7A1-28 inducing mostly horizontal bone loss and strain 381 mostly vertical.

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Adhesive fimbriae from Porphyromonas gingivalis are cell surface structures which may be important in the virulence of this oral pathogen and thus may serve as a critical or target antigen. Immunization with highly purified 43-kDa fimbrial protein protected against periodontal tissue destruction when tested in the P. gingivalis-infected gnotobiotic rat model. A similarly highly purified 75-kDa cell surface component did not provide protection. Heat-killed whole-cell and sonicated cell surface extracts which contain the 43-kDa protein as well as the 75-kDa component were protective also. This study indicates that the fimbrial protein may serve as a model for the development of effective vaccines against periodontitis, a major human oral disease.

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Long-term high-dose glucocorticosteroid treatment may be suspected as causing profound marginal periodontal bone loss due to the immunosuppressive/antiinflammatory effects and due to the osteoporotic side-effects. This study comprised an analysis of the loss of the mandibular and forearm bone mineral content (BMC), measured in vivo by dual-photon scanner, in relation to the concomitant changes of the periodontal indices (visible plaque, gingival bleeding, loss of attachment) in 17 acute nephrotic dentate patients undergoing intensive steroid treatment for 12 months. The measurements were performed at start of treatment, when all patients were considered healthy as regards the skeleton, and at the 6-month and 12-month follow-up. The mean BMC loss at the standard sites of the mandible and the forearm bones was 5.6%/year at both sites. No significant changes could be demonstrated in the periodontal indices (P greater than 0.10), and no relation was found between the mandibular BMC loss and the periodontal condition (R = 0.06, P greater than 0.10). In conclusion, profound marginal periodontal bone loss does not seem to be a prominent side-effect of long-term glucocorticosteroid treatment, although the degree of induced osteopenia in the mandible corresponds to that in other cortical bones of the skeleton.

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Fetal rat neocortex grafted into lesion cavities made in the newborn rat neocortex can exchange multiple axonal connections with the host brain. Most previous studies demonstrating efferent transplant-to-host brain connections have used fluorescent retrograde tracers injected into the host brain (Castro et al. 1985, 1987; Floeter and Jones 1984; O'Leary and Stanfield 1989). Other studies have used anterograde axonal tracing with either tritium-labelled amino acids impregnating the transplant and its efferents (Floeter and Jones 1985) or horseradish peroxidase injected into the transplants (Chang et al. 1984, 1986). In the present study we used the anterograde axonal tracer Phaseolus vulgaris-leucoagglutinin (PHA-L) to examine in detail the course and termination of the efferent neocortical graft fibers. Twenty-six newborn rats had the right frontal cortex forepaw area removed by vacuum aspiration, while anesthetized by hypothermia. A piece of fetal frontal cortex 14-16 embryonic days old (E14-16) was immediately thereafter placed in the lesion, and the recipient rats allowed to survive for 5-7 months. At this time the rats were reoperated under sodium pentobarbital (Nembutal) anesthesia and the transplants iontophoretically injected with PHA-L. Two weeks later the animals were again anesthetized, perfused, and processed for PHA-L immunocytochemistry and routine histology. Analysis of acetylcholinesterase- (AChE) and Nissl-stained sections showed graft survival in 19 of the 26 animals used in this study. When these 19 brains were processed for PHA-L immunocytochemistry, 5 of them were found with certainty to have the PHA-L injection confined to the transplant. Based on these cases PHA-L-reactive fibers arising from labelled transplant neurons were traced into the ipsilateral host neocortex adjacent to the transplant and found to project through the subcortical white matter to the ipsilateral parietal neocortical area 1, and claustrum. Callosal fibers were traced to the contralateral frontal neocortical forelimb and parietal areas. Transplant fibers were also observed to descend through the caudate putamen in the dispersed fiber bundles of the internal capsule to distribute as terminal branches and varicose fibers within the mesencephalic periaqueductal gray, red nucleus, deep mesencephalic nucleus, and intermediate gray of the superior colliculus, as well as in the pontine gray. Similar fibers and terminations were present in the caudate putamen, the reticular, ventrobasal, centrolateral, posterior, and parafascicular thalamic nuclei.(ABSTRACT TRUNCATED AT 400 WORDS)

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In these studies we have attempted to show that cell surface structures are critical antigens for protection against P. gingivalis-induced periodontal destruction. Fimbrillin, and in particular a synthetic 20-amino-acid fimbrillin peptide, exerts a protective effect in gnotobiotic rats, thus identifying them as potentially useful in the development of a vaccine.

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In previous work, allografts of fetal (E13-16) neocortical tissue transplanted into neocortical lesion cavities in newborn (PND 0-1) rats developed an impermeable blood-brain barrier (BBB) as shown by intravascular administration of horseradish peroxidase and by immunohistochemical staining for endogenous IgG. The present study examines the time course for the formation of the graft BBB by staining for endogenous IgG and also looks at transplants with extended survival times of 1-2 years. At two weeks post-transplantation, the grafts of all ten animals of this group showed evidence of IgG immunoreactivity within the graft parenchyma. This was greatest at the pial surface and adjacent to the ventricular surface of the transplant. By three weeks after transplantation, only four of nine grafts showed graft vessel permeability and this was confined to the area under the pia. At four weeks survival, one of nine grafts showed a small rostral patch of IgG reactivity, and a second animal showed very light, diffuse transplant labeling. The remaining seven animals were devoid of transplant IgG reactivity. At 11.5-28 months, three out of seven grafts had reaction product in the graft, indicating BBB permeability to IgG. In two of these older transplants, permeability was confined to the area around larger blood vessels, while one additional animal (28 months) showed dense labeling immediately below the pial surface. As in normal rats, host brain labeling was only found in circumventricular organs. These results show that circulating macromolecules are excluded from most CNS grafts within the first month of transplantation. This process progresses from the center of grafts and requires the longest time to complete in subpial regions possibly associated with healing of the pia. Some older grafts show leakage of protein which may relate to aging of the transplant or to a low-level graft rejection.

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LongoVital (LV) (DK. reg. no. 5178/75) is a herbal based tablet enriched with recommended doses of vitamins. The present study was undertaken to investigate prevention of recurrent aphthous ulceration (RAU) during daily intake of LV for six months as compared with placebo in a double-blind, randomised clinical, cross-over 1-year study. The population comprised 29 otherwise healthy minor RAU patients (18F, 11M) mean age 36 (18-67), with an estimated average number of recurrences the previous year of 12.8 (3-30). The number of recurrences was significantly reduced on treatment with LV during the latter four of the six months (p less than 0.01) where 31% were totally free of recurrences. Subjective all-over evaluation of treatment period was significantly in favour of LV. LV induced no adverse reactions and is the first harmless systemic treatment which has proved better than placebo in the prevention of RAU.

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