Copper and zinc speciation in the solution of a soil-sludge mixture.

Only a small fraction of the transition metals content in sludge-amended soils is soluble, and yet this fraction is a major contributor to the mobility and bioavailability of the metals. The chemical species of zinc (Zn) and copper (Cu) in the soluble fractions of soil-sludge mixtures were characterized with respect to their charge, molecular weight, and stoichiometry using ion exchange resin and gel chromatography procedures. The change in the metals' species with time after sludge application was followed for 100 d. Copper in the water extracts of the sludge-sand mixtures was found almost exclusively in low molecular weight (below 1000 Da) complexes. Higher molecular weight (around 2500 Da) dissolved organic carbon (DOC) was present in the extracts as well, but this DOC fraction exhibited little complexation. Copper was present in the extracts mainly as negatively charged species throughout the incubation period, and zinc tended to form zwitter ions. As incubation progressed, the relative content of positively charged Zn in solution increased. Complexation capacity of DOC in sludge water extract, extrapolated to infinite dilution, was 8.75 mM Ca g(-1) DOC. When the complexation capacity of the extract is near saturation, a mean Cu-DOC complex can be defined. It consists of 1.9 Cu atoms attached to DOC species containing 5.6 C atoms. Thus, the organic Cu complexes consist primarily of about two Cu ions attached to DOC species containing only five or six C atoms. Amino acids and small peptides or polycarboxylic acids, such as citric acid, thus may be important complexing agents of the metal.

Improving oral health in institutionalised elderly people by educating caregivers: a randomised controlled trial.

OBJECTIVES: This cluster-randomised controlled trial assessed whether oral health care education (OHCE) for nursing home caregivers would achieve improvements in clients' oral health. METHODS: Twenty-two nursing homes were randomly allocated to intervention or control group. Clients were examined at baseline and at follow-up visits 1- and 6-months after caregivers received OHCE. Main outcome measures were denture plaque, denture-induced stomatitis, dental plaque and gingivitis. Differences in group means/medians were compared with adjustment for cluster randomisation. RESULTS: Clients' baseline oral health was poor. After OHCE, the intervention group's oral health scores improved significantly. Reductions in denture plaque scores (0-4 scale) exceeded those of the control group by 1.15 (95%CI=0.83, 1.47) at 1 month and by 1.47 (95%CI=1.13, 1.80) at 6 months. Denture-induced stomatitis prevalence reduced significantly over 6 months compared to the control group (P<0.0001). Group differences in favour of the intervention group were 0.41 (95%CI=0.18, 0.65) at 1 month and 0.34 (95%CI=0.14, 0.53) at 6 months for dental plaque (0-3 scale), and 0.17 (95%CI= -0.01, 0.35) at 1 month and 0.28 (95%CI 0.15, 0.42) at 6 months for gingivitis (0-2 scale). Key differences remained significant after adjustment for clustering effects. The provider's costs would currently be approximately pounds 6700 per year to deliver the intervention to a Health Authority with 100 homes. CONCLUSIONS: Although final levels of residents' oral health were still short of ideal, this study clearly shows that, for a modest cost, OHCE can improve caregivers' knowledge, attitudes and oral health care performance for elderly, functionally dependent clients.

Oral health care among nursing home residents in Avon.

OBJECTIVE: To assess personal oral health care standards among frail, elderly and infirm nursing home residents prior to developing and evaluating a health promotion intervention. DESIGN: Descriptive survey, interview and clinical data. SETTING: 22 randomly selected nursing homes in the Bristol area. METHOD: 412 residents with denture(s) and/or natural teeth, and giving informed consent to the study were interviewed about dental attendance and current dental problems. A clinical examination assessed levels of oral and denture hygiene, denture-related stomatitis, gingivitis, calculus and root caries. RESULTS: Less than half the subjects (mean age 84.5 years) were ambulant. Over 70% had not seen a dentist for over 5 years, and 22% reported a current dental problem. Among denture wearers, 82% were unable to clean their dentures; staff cleaned dentures for 64%. Denture-related stomatitis affected 33%, and unhygienic dentures were worn by 95% of subjects. Among dentate subjects (mean number of teeth 11.6), 75% were unable to clean their teeth yet none received regular assistance. On average, two-thirds of each tooth surface were covered in plaque. Gingivitis was moderately severe. Calculus was present in 82% of subjects and root caries in 63% of subjects. CONCLUSIONS: Most residents required help with oral health care but many did not receive it. Residents' levels of plaque and associated dental disease were high. Staff did not effectively perform oral health care appropriate to residents' needs. Further research to evaluate an oral health care training programme for care staff is planned.

Behind the screens: care staff observations on delivery of oral health care in nursing homes.

OBJECTIVE: To identify qualitatively carer staff attitudes, practices and critical comments related to oral health care of functionally dependent nursing home clients. DESIGN: Open-ended questions included in a longer quantitative questionnaire. SETTING: 22 randomly selected nursing homes in the Bristol area. SUBJECTS: 416 carers employed in these homes. RESULTS: The majority of carers thought that clients had a right to good oral health, accepted the carers' role in helping clients with oral and denture hygiene, but recognised that oral health care provision was deficient. However, some carers believed oral health care to be solely the clients' responsibility despite high disability levels. Main barriers to providing oral health care were low prioritization of oral health by nursing management, lack of co-operation from cognitively impaired clients, and lack of training. Carers were critical of homes' lack of arrangements for routine professional dental checks, lack of commitment to staff training, low standards of oral health care by colleagues, and lack of provision of oral hygiene aids and cleansing materials for clients. Many responses indicated ways in which nursing home oral health care could be improved. Carers reported contrasting experiences of dental treatment, and deplored recent decreased availability of subsidized dental care. CONCLUSIONS: Carers' generally positive attitudes towards clients' oral health care should encourage health educators. Insights gained from qualitative data can help to identify the less obvious causes for poor oral care delivery, which can then be addressed in education and training initiatives in nursing home settings.

Direct quantification of unadsorbed viruses in suspensions of adsorbing colloids with the enzyme-linked immunosorbent assay.

Quantification of two plant viruses in suspensions of homoionic Ca-bentonite was conducted by applying to the enzyme-linked immunosorbent assay plates either the virus-clay mixture (direct method) or the supernatant obtained after the clay was allowed to settle (classic method). Both methods showed a similar dependence of free virus content on clay concentration. A higher content at equilibrium was measured for both viruses by the direct method. The advantage of using the direct over the classic method is discussed.

Cardiac function in obstructive sleep apnea patients following uvulopalatopharyngoplasty.

Obstructive sleep apnea syndrome (OSAS) is associated with severe cardiac arrhythmias and conduction abnormalities. Cor pulmonale and right-sided heart failure may ensue. Uvulopalatopharyngoplasty (UPPP) is one of several treatment modalities suggested for OSAS. Tracheotomy and CPAP treatment in adult OSAS patients and adenotonsillectomy in children with OSAS were shown to lead to improvement in some cardiac parameters. Cardiac function was prospectively evaluated in 19 OSAS patients before and after UPPP. No significant changes after surgery were noted on electrocardiographic studies. Improvement in global and regional function of both ventricles was seen in 91% of the patients. A trend toward significant elevation in left ventricular ejection fraction and a statistically significant increase in right ventricular ejection fraction were observed (45% +/- 9% to 50% +/- 7% [p = 0.007]). Our results support performance of UPPP in selected OSAS patients for relief of potentially life-threatening cardiac pathologies.

[Treatment results of valgus corrective supratubercular tibial head osteotomy in medial hemi-gonarthritis]. / Behandlungsergebnisse der valgisierenden supratuberkulären Tibiakopfkorrekturosteotomie bei medialer Hemigonarthrose.

A total of 175 cases of valgus tibial head corrective osteotomy were carried out from 1973 till 1983 and 1988 respectively. It's long term results and the short term results were respectively compared. The importance of the preoperative planning, attention to the operation's indications and operating at the early stage of the complaint were found to be the most important factors for good results.

[Semi-malignant giant cell synovioma as an incidental finding in open dislocated fracture of the upper ankle joint]. / Das semimaligne Riesenzellsynovialom als Zufallsbefund bei einer offenen Luxationsfraktur des oberen Sprunggelenkes.

A rare statement is demonstrated with reference to a case concerning a sixteen years old girl who caught an open luxation fracture of her upper ankle joint by a sudden fall from a horse on August 8, 1988. During the operative treatment a spontaneously loosing soft tissue tumor of plumlike size could be obtained. The histological analysis proved a semimalignant giant cell-synovialom.

Increased expression of Fc gamma receptor in cancer patients and tumor bearing mice.

In this study we report on some lines of ongoing research performed in our laboratory, in relation to the increased expression of FcR on tumor cells, as well as on cells present in the tumor-bearing host, and its possible role in tumor progression. In a previous study we have shown that a Polyoma virus (PyV)-induced anaplastic carcinoma (SEYF-a tumor) contained an FcR-expressing subpopulation of tumorigenic cells. We tested the effect of in vivo passaging of FcR-expressing and of non-FcR-expressing sub-populations of SEYF-a tumor cells on the expression of FcR, as revealed by the ability of these cells to bind the 2.4G2 monoclonal antibody, which is directed against mouse Fc gamma 2b/gamma 1R. It was found that upon in vivo passaging these two sub-populations became practically identical in their ability to bind anti-Fc gamma R antibody. On the other hand, in vitro passaging of FcR-expressing SEYF-a cells resulted in a gradual decrease in the expression of Fc gamma R. These results, indicating that the expression of Fc gamma R on tumor cells, per se, is dependent on a factor present in the in vivo environment were confirmed using 3T3 cells transformed in vitro by PyV (C) and forming tumors at first injection to mice (CTC). C cultures of various clones did not express Fc gamma R, while CTC cultures (cultures from tumors) became positive. We also detected an increase in the level of a soluble form of Fc gamma 2b/gamma 1R in the circulation of mice bearing PyV induced tumors. This increase paralleled the appearance of palpable tumors. A similar pattern of increase was observed in mice inoculated with the c-H-ras transformed tumorigenic clone 8/F/5, but not in mice inoculated with non-tumorigenic 3T3 cells. Data published by us show that metastatic breast cancer patients had significantly elevated Fc gamma R levels on their peripheral blood mononuclear cells (PBMC). Experiments presented here indicate a direct correlation between increased Fc gamma R levels on PBMC and tumor mass in colon, ovary and lung metastatic carcinoma patients. The possibility that malignantly transformed cells have the potential to cause proliferation of Fc gamma R expressing T cells was tested. It was found that extract derived from r-H-ras transformed 3T3 cells triggers the proliferation of a T cell hybridoma expressing Fc gamma R.