Appropriate size and inflation of the laryngeal mask airway.

We have compared size 3 and size 4 laryngeal masks in 30 females and size 4 and size 5 in 30 males for success rate of insertion, incidence of airleak and pressure exerted on the pharynx. First, the ex vivo volume-pressure relationship of the mask was obtained. Second, after insertion of a mask, the cuff was inflated with the recommended maximum volume of air and intracuff pressure measured.

Short-term administration of tall oil phytosterols improves plasma lipid profiles in subjects with different cholesterol levels.

To assess the short-term cholesterol-lowering potential of sitostanol-containing tall oil plant sterols, 22 subjects consumed fixed-food diets over two 10-day periods with or without 21.2 mg/kg body weight/d tall oil phytosterols (sitosterol 62%, sitostanol 21%, campesterol 16%, and campestanol 1%) in a randomized crossover study design. On day 10 of each diet, plasma lipoprotein cholesterol levels, plasma phytosterol concentrations, and cholesterol biosynthesis rates were determined.

A change in resistance? A survey of epidural practice amongst obstetric anaesthetists.

Five hundred members of the Obstetric Anaesthetists Association were surveyed regarding their technique for identification of the epidural space. Eighty-one per cent of the questionnaires were returned completed. Fifty-nine per cent of respondents first learned a loss of resistance to air technique, 33.

Phytosterols partially explain differences in cholesterol metabolism caused by corn or olive oil feeding.

To examine whether phytosterols in polyunsaturated oils account for their differential action on lipid metabolism compared with monounsaturated oils, 16 normolipidemic individuals consumed three 10-day experimental diets containing corn oil (high in polyunsaturated fatty acids and phytosterols), olive oil (high in monounsaturated fatty acids and low in phytosterols), or olive oil supplemented with phytosterols given at twice the level naturally found in corn oil (high in monounsaturated fatty acids and phytosterols). Plasma total cholesterol concentrations after both the olive oil and the olive oil-phytosterol treatments were higher (P < 0.001) than those after the corn oil treatment.

A phase I/II clinical trial to evaluate a combination of recombinant human platelet-derived growth factor-BB and recombinant human insulin-like growth factor-I in patients with periodontal disease.

The primary objective of this study was to assess the safety of recombinant human (rh) platelet-derived growth factor-BB (PDGF-BB) and (rh) insulin-like growth factor-I (IGF-I) when applied to periodontal osseous defects in humans; a secondary objective was to begin to accrue data on the therapeutic dose of these growth factors (GFs) required to stimulate periodontal regeneration. Thirty-eight human subjects possessing bilateral osseous periodontal lesions were assigned to one of two treatment groups in a split-mouth design. Following full-thickness flap reflection, test sites received local application of the therapeutic drug delivered in coded syringes by a "masked" investigator.

Comparison of manual and automated probing in an untreated periodontitis population.

Diagnosis of periodontal disease progression involves recording two probing attachment level measurements over an adequate time interval. A diagnostic instrument which exhibits less measurement variability allows for increased sensitivity and earlier disease detection. Traditionally, a manual probe with an occlusal stent of the cementoenamel junction (CEJ) as a reference landmark has been the method of choice.

Enantiospecific inhibition of ligature-induced periodontitis in beagles with topical (S)-ketoprofen.

Systemic and topical administration of non-steroidal anti-inflammatory drugs (NSAIDs) has been shown to reduce periodontal disease progression in both animal models and human subjects. Our present research focuses on single enantiomers of these agents to examine whether enantiospecific therapy will be efficacious in slowing periodontitis. The purpose of this study was to evaluate the inhibitory effects of (S)-ketoprofen on experimentally induced alveolar bone loss in beagle dogs.

A feasibility study evaluating rhBMP-2/absorbable collagen sponge device for local alveolar ridge preservation or augmentation.

This two-center human clinical trial evaluated recombinant human bone morphogenetic protein-2 delivered in an absorbable collagen sponge (rhBMP-2/ACS) for either alveolar ridge preservation after tooth extraction or augmentation of localized osseous defects. This 24-month study comprised two parts: a 4-month acute safety and bone induction period (Part I) followed by a 20-month, osseointegration, functional restoration, and long-term safety evaluation (Part II). The primary objective of Part I, discussed in this article, was to evaluate the short-term safety and technical feasibility of the rhBMP-2 device implantation.

A systems approach to asthma care.

This two-year asthma intervention focuses on provider education emphasizing early diagnosis of asthma, early use of oral steroids, proper use of inhalation devices, objective monitoring of patient status, and use of daily preventive treatment. Patient education is an integral part of treatment. This approach supports the primary care physician as the provider and coordinator of care by supplying monitoring and treatment devices, books, diaries, home care services, and allergy consultation.

Haplosporidium nelsoni (MSX) epizootic in the Piscataqua River Estuary (Maine/New Hampshire, USA.).

A major epizootic of Haplosporidium nelsoni occurred during 1995 in the Piscataqua River Estuary, near the northern distributional limit of the parasite. Prevalence of H. nelsoni in samples of oysters, Crassostrea virginica, collected between 5 September and 18 December 1995 from sites in Maine and New Hampshire ranged from 15 to 81%, with up to 50% systemic infections.

Polypeptide growth factors for periodontal regeneration.

The regeneration of periodontal attachment apparatus is particularly difficult to achieve, primarily because of the presence of many different kinds of tissue that must be restored to produce a functional unit. Traditional methods aimed at regenerating the periodontium have limited indications, and their results are not predictable. Recently, investigators have begun to understand the cellular processes necessary for repair and regeneration of periodontal tissues.

Inhibition of peri-implant bone loss with the nonsteroidal anti-inflammatory drug flurbiprofen in beagle dogs. A preliminary study.

There is increasing interest in how pathways of tissue destruction around dental implants are similar as for teeth and how these pathways can be modulated to slow loss of supporting bone. The purposes of this study were to develop a short-term animal model to study the effect of the nonsteroidal anti-inflammatory drug flurbiprofen, on slowing the rate of induced peri-implant bone resorption. A total of 20 cylindrical titanium implants were placed in 2 beagle dogs using a low-trauma surgical technique.

Medical leases and patient referrals under Oklahoma law: are they mutually exclusive?

This article discusses the impact of Oklahoma's new patient referral law on leases between medical care providers. The statute appears to ban certain practices that could be quite common, so the article offers some advice on how to avoid running afoul of the statute.

Thermal balance and metabolic rate during upper respiratory tract infection in infants.

Sequential recordings were made in the first five months after birth of metabolic rate, environmental temperature, and body temperature during sleep at home in 17 infants, each with an older sibling. Further recordings were made whenever an older sibling developed an upper respiratory tract infection (URTI), again four to six days later, and again two weeks later, aiming to achieve recordings before, during, and after an URTI in the infant. The temperature of the room and wrapping of the infant were determined according to their usual practice by the parents.

The molecular evolution of G protein-coupled receptors: focus on 5-hydroxytryptamine receptors.

Phylogenetic comparisons between homologous proteins can provide information on the rates of molecular evolution of the proteins. G protein-coupled receptors are a "superfamily" of proteins which exist in species ranging from yeast to man. Based on an analysis of the percentage of amino acid homology between various species, the rate of molecular evolution of G protein-coupled receptors can be estimated at approx 1% per 10 million years.

Knowledge and skills needed for collaborative work.

The need for collaboration and cooperation in health care delivery is not news. But one of the first requests often made by leaders and others promoting collaborative work in organizations is for a "facilitator course." As the authors developed more knowledge about the real need, they understood that many of the barriers to collaborative work and learning in organizations can be reduced only by the top leaders, not by expert facilitators.

Blocking Periodontal Disease Progression with Anti-Inflammatory Agents.

Recent advances in the identification of specific immuno-inflammatory pathways of periodontal disease have encouraged investigators to attempt to modulate some of these host responses in an attempt to slow the periodontal disease process. Some of the best known mediators of these immuno-inflammatory pathways are prostaglandins. The action of prostaglandins can be inhibited through the use of non-steroidal anti-inflammatory drugs (NSAIDs).

Blocking periodontal disease progression with anti-inflammatory agents.

Recent advances in the identification of specific immuno-inflammatory pathways of periodontal disease have encouraged investigators to attempt to modulate some of these host responses in an attempt to slow the periodontal disease process. Some of the best known mediators of these immuno-inflammatory pathways are prostaglandins. The action of prostaglandins can be inhibited through the use of non-steroidal anti-inflammatory drugs (NSAIDs).

How much wrapping do babies need at night?

In a longitudinal, population based study, overnight temperature recordings were made in the bedrooms of 152 babies aged 3-18 weeks and the insulation provided by their bedclothing was assessed. Outdoor temperatures for the study nights were also available. Parents applied more insulation on colder nights with lower bedroom temperatures than on warmer nights (mean 8.