Temporal trends and spatial distribution of research topics in anthropogenic marine debris study: Topic modelling using latent Dirichlet allocation.

The release of anthropogenic marine debris (AMD) is one of the major environmental challenges of our time. In this study, a topic model called latent Dirichlet allocation (LDA) was used to infer the research topics about AMD to provide the whole picture of the research area. The results of the LDA showed that the AMD research topics are mostly applied topics and belong to interdisciplinary or transdisciplinary research areas. Furthermore, the analysis of the temporal trends of the topics showed that topics related to such as plastic pollution exhibit an upward trend, whereas those dealing with the spatiotemporal dynamics and distribution patterns of marine debris showed a downward trend. The analysis of topic distribution over countries showed that research is scarce in landlocked countries. The findings of this study can be used as a map for the area of AMD study by various stakeholders related to marine debris issues.

Capnography Prevents Hypoxia during Sedation for Dental Treatment: A Randomized Controlled Trial.

Intravenous sedation is useful for dental treatment in patients with intellectual disabilities. However, it is often necessary to manage such patients with deep sedation because their cooperation cannot be obtained. During deep sedation, undetected hypoventilation can lead to severe complications, such as hypoxia. Recently, capnographic monitoring has been advocated as a useful technique for preventing hypoxia during sedation. This randomized control trial evaluated whether the use of capnography reduces the incidence of hypoxia during the deep sedation of patients for dental treatment. This study involved patients with intellectual disabilities who underwent dental treatment under sedation. The subjects were randomized to the intervention group (I-group) or control group (C-group). All of the patients underwent routine monitoring, as well as bispectral index (BIS) and capnographic monitoring; however, only an independent observer had access to the patients' capnographic data during the dental procedures. Sedation was maintained at a BIS of 50 to 70 by administration of propofol. In the I-group, the independent observer signaled to the dental anesthesiologist if the capnogram indicated that the patient had been suffering from alveolar hypoventilation or apnea for >15 s. In the C-group, the observer signaled to the dental anesthesiologist if the capnogram indicated that the patient had been suffering from alveolar hypoventilation or apnea for >60 s. In both groups, the dental anesthesiologists responded to the signals using appropriate airway management strategies. The primary endpoint of this study was the incidence of hypoxia during dental treatment, which was defined as oxygen saturation of <95%. Hypoxemic episodes occurred in 13.4% and 34.8% of cases in the I-group and C-group, respectively. The incidence of hypoxia was significantly lower in the I-group. These results suggest that capnographic monitoring during deep sedation for dental treatment prevents hypoxemic episodes by allowing the early detection of hypoventilation. Knowledge Transfer Statement: This is the first randomized controlled trial to examine whether the use of capnography reduces the incidence of hypoxia during deep sedation for dental treatment. The findings of this study can be used by clinicians to aid decision-making regarding dental sedation standards at individual clinics. Moreover, they can be used as high-level evidence during the production or updating of clinical guidelines for dental sedation by leading associations.

Enhanced ultrasound-induced apoptosis and cell lysis by a hypotonic medium.

PURPOSE: To test the hypothesis that non-lethal hypotonia will enhance ultrasound-induced cell killing in vitro and that the mechanism is mechanical in nature. MATERIALS AND METHODS: Hypotonic RPMI medium (146 mOsm) was used to induce non-lethal osmotic swelling of human myelomonocytic leukaemia U937 cells. Hypotonia for 10 min was started just before exposure to 1 MHz ultrasound at 0.5 or 1.0 Wcm(-2) for 10 min, or 5 min before exposure to 2.0 Wcm(-2) for 1 min. Surviving intact cells were then determined by the trypan blue dye exclusion test immediately after treatment. After 6-h incubation of the treated cells, early apoptosis and secondary necrosis were measured using a flow cytometer. Intracellular free calcium ion imaging by Fura-2 fluorescence and cellular ion scanning using a secondary ion mass spectrometer were also performed. RESULTS: Enhancement of ultrasound-induced cell lysis was observed at all intensities, and most prominently at 2.0 Wcm(-2), while apoptosis induction was significantly enhanced at intensities of 0.5 and 1.0 Wcm(-2), but not at 2.0 Wcm(-2). The enhanced cell lysis is attributed to the increased susceptibility of the cells to mechanical damage. This is consistent with previous reports describing the effects of mechanical stresses on cell membranes. Cellular ion scanning images also suggest that hypotonia has an effect on the membrane damage-and-repair mechanism of the cells. CONCLUSIONS: The results support the hypothesis that non-lethal hypotonia can enhance ultrasound-induced cell killing. These findings also suggest the 'sonomechanical' nature of the effects on the cells.

Applying secondary ion mass spectrometry to the analysis of elements in goblet cells of conjunctiva.

We investigated the location of elements in the goblet cells of rat conjunctiva by analyzing ion images produced by secondary ion mass spectrometry (SIMS) and comparing them with those produced by energy dispersive X-ray analyser (EDX). Conjunctivas of normal Spraque-Dawley rats were quenched in propane prechilled liquid nitrogen. Semi-thin sections were made with a cryo-ultramicrotome, freeze-dried, carbon-coated and observed under a light microscope, SIMS and scanning electron microscope (SEM). In the element analysis by SIMS, images of positive ions were examined with an O2+ primary ion source and images of negative ions with a Ga+ ion source. The same sections were observed and analysed with SEM-EDX. Morphological features and images of elements with SIMS and EDX were compared. Na, Mg, K, and Ca were detected as positive ions and OH, CN, P, S, and Cl as negative ions with SIMS, but C, N, O, Na, Mg, P, S, Cl, K, and Ca were detected with EDX. The spatial resolution of SIMS in element location was higher than that of EDX. Many elements were clearly located in the goblet cells on ion images by SIMS. Element ion images were demonstrated more densely in goblet cells than in other parts within conjunctiva and by SIMS compared to EDX. SIMS is a useful method for the detection of elements and their locations in ocular tissues and cells.

Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans.

Ghrelin, an endogenous ligand for the GH secretagogue receptor, was isolated from rat stomach and is involved in a novel system for regulating GH release. Although previous studies in rodents suggest that ghrelin is also involved in energy homeostasis and that ghrelin secretion is influenced by feeding, little is known about plasma ghrelin in humans. To address this issue, we studied plasma ghrelin-like immunoreactivity levels and elucidated the source of circulating ghrelin and the effects of feeding state on plasma ghrelin-like immunoreactivity levels in humans. The plasma ghrelin-like immunoreactivity concentration in normal humans measured by a specific RIA was 166.0 +/- 10.1 fmol/ml. Northern blot analysis of various human tissues identified ghrelin mRNA found most abundantly in the stomach and plasma ghrelin-like immunoreactivity levels in totally gastrectomized patients were reduced to 35% of those in normal controls. Plasma ghrelin-like immunoreactivity levels were increased by 31% after 12-h fasting and reduced by 22% immediately after habitual feeding. In patients with anorexia nervosa, plasma ghrelin-like immunoreactivity levels were markedly elevated compared with those in normal controls (401.2 +/- 58.4 vs. 192.8 +/- 19.4 fmol/ml) and were negatively correlated with body mass indexes. We conclude that the stomach is a major source of circulating ghrelin and that plasma ghrelin-like immunoreactivity levels reflect acute and chronic feeding states in humans.

Substantial production of ghrelin by a human medullary thyroid carcinoma cell line.

Ghrelin, an endogenous ligand for the GH secretagogue receptor, is a novel acylated peptide produced in the gastrointestinal endocrine cells as well as neuroendocrine cells in the hypothalamus. The Ser(3) residue of ghrelin is modified by n-octanoic acid, a modification necessary for hormonal activity. Human medullary thyroid carcinoma is known to produce a variety of gastrointestinal and neuroendocrine peptides. In the present study we investigated ghrelin production in the thyroid gland, especially in human medullary thyroid carcinoma. PCR amplification demonstrated prepro-ghrelin gene transcripts in normal human thyroid tissue and two medullary thyroid carcinoma cell lines (human TT cells and rat 6-23 cells), but not in a rat thyroid follicular cell line. TT cells showed the expression of prepro-ghrelin mRNA of about 0.6 kb by Northern blot analysis. Furthermore, production of ghrelin in TT cells was demonstrated by RIA and immunocytochemistry. Accumulation of des-n-octanoyl ghrelin in the cultured medium of the cells was confirmed. Finally, human medullary thyroid carcinoma surgical specimens showed significantly higher des-n-octanoyl ghrelin contents than normal thyroid tissues. In conclusion, we revealed that ghrelin was produced by the human thyroid parafollicular carcinoma cell line, TT cells. These findings suggest that ghrelin is produced in the thyroid C cells as well as in medullary thyroid carcinoma and may provide opportunities to investigate its physiological role in the thyroid gland.

A low dose of ghrelin stimulates growth hormone (GH) release synergistically with GH-releasing hormone in humans.

The synergistic relationship between GH-releasing secretagogue (GHS) and GH-releasing hormone (GHRH) with respect to GH secretion is well known. In the present study, we report a similar relationship between GHRH and ghrelin, a recently identified endogenous ligand for the GHS receptor. In normal male adults, various doses of ghrelin were intravenously administered alone or together with 1.0 microg/kg GHRH. At small doses of 0.08 and 0.2 microg/kg ghrelin, combined administration of the two peptides significantly stimulated GH release in a synergistic manner; the mean GH response values of the two peptide combinations were more than the summed mean GH response values of each peptide alone (P < 0.05). In addition, at 1.0 microg/kg ghrelin, the tendency of the synergistic effect was observed, although the comparison was not statistically significant probably due to a submaximal dose ceiling effect. No synergistic effects with respect to ACTH or prolactin secretion were observed. In conclusion, the synergistic interaction between ghrelin and GHRH was clearly shown and might be useful for a provocation test to diagnose GH deficiency.

Ghrelin, an endogenous growth hormone secretagogue, is a novel orexigenic peptide that antagonizes leptin action through the activation of hypothalamic neuropeptide Y/Y1 receptor pathway.

Ghrelin, an endogenous ligand for growth hormone secretagogue (GHS) receptor originally isolated from the stomach, occurs in the hypothalamic arcuate nucleus and may play a role in energy homeostasis. Synthetic GHSs have activated the hypothalamic arcuate neurons containing neuropeptide Y (NPY), suggesting the involvement of NPY in some of ghrelin actions. This study was designed to elucidate the role of ghrelin in the regulation of food intake. A single intracerebroventricular (ICV) injection of ghrelin (5-5,000 ng/rat) caused a significant and dose-related increase in cumulative food intake in rats. Ghrelin (500 ng/rat) was also effective in growth hormone-deficient spontaneous dwarf rats. Hypothalamic NPY mRNA expression was increased in rats that received a single ICV injection of ghrelin (500 ng/rat) (approximately 160% of that in vehicle-treated groups, P < 0.05). The ghrelin's orexigenic effect was abolished dose-dependently by ICV co-injection of NPY Y1 receptor antagonist (10-30 microg/rat). The leptin-induced inhibition of food intake was reversed by ICV co-injection of ghrelin in a dose-dependent manner (5-500 ng/rat). Leptin reduced hypothalamic NPY mRNA expression by 35% (P < 0.05), which was abolished by ICV co-injection of ghrelin (500 ng/rat). This study provides evidence that ghrelin is an orexigenic peptide that antagonizes leptin action through the activation of hypothalamic NPY/Y1 receptor pathway.

Effect of fluvoxamine on the pharmacokinetics of mexiletine in healthy Japanese men.

BACKGROUND AND OBJECTIVES: Fluvoxamine, a selective serotonin reuptake inhibitor, is known to inhibit several hepatic cytochrome P450 (CYP) isozymes, in particular CYP1A2. Mexiletine is mainly catalyzed by CYP2D6 and partially catalyzed by CYP1A2. Our objective was to study the potential pharmacokinetic interaction between fluvoxamine and mexiletine. METHODS: A randomized crossover design with two phases was used. A 7-day washout period separated the two treatment conditions. In the one phase, 6 healthy Japanese men received an oral dose of 200 mg of mexiletine alone (study 1); in the other phase, the men received fluvoxamine (50 mg twice a day) for 7 days, and on the eighth day they received oral mexiletine (200 mg) and fluvoxamine concomitantly (study 2). The concentrations of mexiletine were measured with HPLC. RESULTS: The area under the concentration-time curve and serum peak concentration of mexiletine in study 2 were significantly increased compared with those in study 1 (10.4 +/- 4.85 versus 6.70 +/- 3.21 microg x h/mL, P =.006 and 0.623 +/- 0.133 versus 0.536 +/- 0.164 microg/mL, P =.008, respectively). CONCLUSION: The effect of fluvoxamine on the mexiletine disposition is comparatively large, and when mexiletine and fluvoxamine are coadministered careful monitoring of mexiletine is needed.

Retinal changes in magnesium-deficient rats.

The purpose of the present study is to investigate the retina in magnesium (Mg) deficiency and elucidate the local functions of trace elements. After delivery, mother Wistar Kyoto rats were fed a low Mg diet containing 0.1 mg Mg per 100 g diet with all other nutrients and distilled and deionized water. Infant rats were suckled by their mother rats for 21 days and then fed the same Mg-deficient diet. Control mother rats were fed commercial rat pellets containing 24 mg Mg per 100 g diet and all other nutrients. The retinas were examined by electron microscopy and secondary ion mass spectrometry (SIMS) microscopy at 6 weeks of age. In the Mg-deficient rats serum Mg levels were significantly lower and calcium (Ca) levels higher than in the control rats. The retinas of Mg-deficient rats showed multifocal necrosis in the pigment epithelial cells; photoreceptor cell outer segments were deformed near the necrotic cells, and some pigment epithelial cells contained many lamellar bodies. Many photoreceptor cell nuclei showed pyknotic (apoptosis-like) changes. SIMS images showed lower Mg concentration throughout the retina of the Mg-deficient rats, and the ratio of Ca to Mg concentration was significantly higher than in the control rats. Mg deficiency induces multifocal necrosis in the retinal pigment epithelial cells and pyknotic (apoptosis-like) changes in the photoreceptor cell nuclei. The changes in Mg-deficient retinas may be due to an imbalance in the distribution of Mg and Ca trace elements.

Rapid and simple fixation-staining technique of fresh frozen cryostat sections for SIMS microscopy.

Before observing freeze-dried cryosections by ion microscopy, it is necessary to perform localization of the analysis site by light microscopy. The present study reports a rapid fixation-staining method for preparing freeze-dried or air-dried cryosections, wherein cryosections are observed after immersion in Carnoy-Lebrun fixative for 30 s and staining in undiluted Giemsa solution for 30 s. Cryostat sections of goldfish intestine and kidney tissue on the silicon wafer substratum were subsequently examined by SIMS. Positive cesium ion images showed a general histology of the intestinal villi with goblet cells. Their granules contained large amounts of sodium, magnesium, potassium and calcium on ion images. By contrast, iron, copper and CsFe ion images showed diffuse distribution throughout the sections.

Kidney produces a novel acylated peptide, ghrelin.

Ghrelin is a novel growth hormone-releasing peptide with a unique acylated structure. Here we reveal that prepro-ghrelin gene is expressed in the mouse kidney and glomerulus. We also show by reverse-phase high performance liquid chromatography coupled with radioimmunoassay that the mouse kidney does produce ghrelin. The ghrelin immunoreactivity in the mouse kidney is 6.79+/-0.48 fmol/mg (n=5), which is much more abundant than that in the mouse plasma of 0.339+/-0.029 fmol/microl (n=6). Furthermore, prepro-ghrelin gene is expressed in cultured rat mesangial cells, fibroblast-like NRK-49F cells and mouse podocytes, but not in rat epithelial cell-like NRK-52E cells. Ghrelin receptor gene is also expressed in the rat kidney. These findings demonstrate that the kidney, glomerulus and renal cells express prepro-ghrelin gene and ghrelin is produced locally in the kidney, and suggest the endocrine and/or paracrine roles of ghrelin in the kidney.

Current topics in pheochromocytoma.

Pheochromocytoma is the tumor that produces catecholamines and originates from chromaffin cells, which are differentiated from sympathoadrenal progenitor cells of neural crest under the influence of glucocorticoids. Genetic abnormalities of familial pheochromocytomas have elucidated oncogenic genetic bases of the tumor, including gene abnormalities of the RET proto-oncogene in multiple endocrine neoplasia type 2, VHL gene in von Hippel Lindau's disease or the NF1 gene in neurofibromatosis. Co-localization of various substances with catecholamines in the tumor, including neuropeptide Y, opioid peptides or adrenomedulOFF peptide elevating cAMP production, is recognized. The significance of these substances in modulating clinical features of pheochromocytomas is not fully understood.

[Brainstem hemorrhage following acute necrotizing encephalopathy].

We report here a case of acute necrotizing encephalopathy (ANE) showing brainstem hemorrhage. A 5-year-11-month-old boy with a history of febrile seizures was admitted to our hospital because of high fever and coma. Laboratory studies on admission demonstrated elevated serum transaminase and blood glucose. Brain CT was normal on admission, but 9 hours later, it showed low density areas in the bilateral thalamus, putamen, midbrain, pons and cerebellum. Brain MRI revealed abnormal short T1 and long T2 signals in the same areas. Despite promptly performed intensive care, massive brainstem hemorrhage occurred on the fourth day. EEG showed a suppression-burst pattern followed by a flat pattern on the sixth day. The patient died on the eighth day of multiple organ failure. This is the first case of massive brainstem hemorrhage that occurred in association with ANE.

Pocket oxygen tension in smokers and non-smokers with periodontal disease.

BACKGROUND: Smoking is associated with destructive periodontal disease. Pocket oxygen tension (pO2) is likely to be a major environmental determinant of the subgingival microflora, which is a primary etiological factor of the disease. This study aimed to compare the pocket pO2 in smokers and non-smokers with periodontal disease. METHODS: Pocket oxygen tension was compared in 27 smokers and 34 non-smokers by considering 2 confounding factors, probing depth and oxygen saturation of hemoglobin (S(O2)), in the gingiva. The pO2 was determined using oxygen microelectrode by polarographic method with an electronic compensation circuit for subgingival temperature. Gingival S(O2) was determined using tissue reflectance spectrophotometry. RESULTS: No significant difference was found in the modified gingival index and the plaque index between smokers and non-smokers. The pO2 was significantly lower in smokers (21.9+/-9.6 mmHg) than in non-smokers (33.4+/-8.4 mmHg). The difference was highly significant (P <0.0001) and was consistent when the confounding factors were considered. Correlation between the PO2 and probing depth approached statistical significance in smokers (r = -0.36, P = 0.0674) and significance in non-smokers (r = -0.41, P = 0.0174). Correlation of the PO2 to the gingival S(O2) was highly significant in non-smokers (r = 0.57, P = 0.0005), but no association was found in smokers (r = -0.08, P= 0.6975). CONCLUSIONS: These findings indicate that pO2 is lower in smokers than in non-smokers, and that the pO2 in smokers is not influenced by gingival oxygen sufficiency. The present study may provide the basis of understanding environmental factors possibly associated with microbial flora in the pockets of smokers.

Optically clear nuclei in papillary carcinoma of the thyroid: demonstration of one of the fixation artifacts and its practical usefulness.

To examine whether or not optically clear nuclei are one of the fixation artifacts in papillary carcinoma of the thyroid. Experiments using an optimal immersion fixation method by making thin-sliced specimens, 5 x 2 x 2 mm in size were adopted. Fixatives tested were 10% formalin, 10% buffered formalin, mixture of alcohol and formalin (4: 1), 95% alcohol, 4% phosphate-buffered paraformaldehyde, Carnoy's fixative, Bouin's fixative and various concentrations of formalin. Tested thyroid lesions in total were: cases with papillary carcinoma (38); follicular carcinoma (one); follicular adenoma (15); adenomatous goiter (11); Hashimoto's thyroiditis (two); Grave's disease (five); and normal thyroid tissue around tumor (five). Routinely processed papillary carcinoma showed a high occurrence (64.6%) of the optically clear nuclei contrasted by a low occurrence (almost 0%) in other lesions. However, this rate in papillary carcinoma decreased (< 35.3%) in all experimental groups irrespective of the choice of fixatives. Frequent occurrence (61.9-66.6%) of the optically clear nuclei was reproduced in papillary carcinoma fixed in a higher concentration of formalin (40-60%) in the experimental groups. These results demonstrated that the optically clear nuclei are one of the fixation artifacts, although still useful as a diagnostic criterion.

Relationship of the substance P to indicators of host response in human gingival crevicular fluid.

BACKGROUND: The substance P (SP) level in human gingival crevicular fluid (GCF) was studied in relation to clinical periodontal variables and to various indicators of host response in the GCF. METHODS: GCF was collected from periodontal sites with gingival inflammation and shallow or moderately deep pocket in 48 subjects. The total amount of SP and the substances based on host response factors in a 30-s sample were determined by ELISA and enzymatic methods. RESULTS: Significant correlation was found between SP and probing depth (r= 0.637, p<0.001), while correlation was weak between SP and either gingival (r= 0.177, p=0.23) or plaque index (r=0.008, p=0.96). SP also showed significant correlation with the indicators of host response: prostaglandin E2, aspartate aminotransferase, alkaline phosphatase, myeloperoxidase, interleukin-1beta, tumor necrosis factor-alpha, interleukin-8 and monocyte chemoattractant protein-1 (r=0.434-0.867, p<0.01-0.001). CONCLUSION: These results indicate that neuropeptide SP in GCF may have a potential as an indicator of periodontal inflammation and the host response.

Oxygen sufficiency in the gingiva of smokers and non-smokers with periodontal disease.

BACKGROUND: Epidemiological studies have demonstrated deteriorating effects of smoking on periodontal tissue. The aims of this study were to compare oxygen saturation of hemoglobin in the gingiva (GSo2) of smokers and non-smokers and to evaluate the chronic effect of smoking on gingival oxygen sufficiency. METHODS: GSo2 was determined using tissue reflectance spectrophotometry in 110 papillary gingival sites of 62 smokers and 100 sites of 60 non-smokers. RESULTS: No significant difference was found in GSo2 between smokers and non-smokers. In the model of ANOVA with covariates, age (P= 0.0048) and probing depth (P= 0.0012) had significant effects on GSo2. No significant effect was found in either smoking status (P= 0.3557) or the modified gingival index (MGI) (P= 0.3824). The interaction effect between smoking status and the MGI was highly significant (P = 0.0003) indicating that the effect of smoking status on the GSo2 should be compared at each level of the MGI score. GSo2 in healthy gingiva was significantly lower in smokers than non-smokers (P = 0.0014), while smokers showed higher GSo2 than non-smokers in moderately inflamed gingiva (P = 0.0356). The GSo2 in inflamed gingiva was significantly decreased compared with healthy gingiva in non-smokers (P = 0.0044), while smokers showed no significant difference between healthy and inflamed gingiva (P= 0.2772 to 0.8665). GSo2 in smokers was consistently and significantly lower than that of healthy gingiva of non-smokers (P = 0.0391 to 0.0004). CONCLUSIONS: Smokers exhibit possibly lower function of oxygen sufficiency in healthy gingiva and reduced ability to adapt the function in inflamed gingiva than non-smokers. This suggests that smokers have functional impairments in the gingival microcirculation.

Ghrelin strongly stimulates growth hormone release in humans.

Ghrelin is a recently identified endogenous ligand for the GH secretagogue receptor and is involved in a novel system for regulating GH release. However, little is known about its GH-releasing activity and other endocrine effects in humans. To address this issue, we studied the GH, ACTH, cortisol, PRL, LH, FSH, and TSH responses to synthetic human ghrelin. In four normal male adults (28-37 yr), iv ghrelin administration released GH in a dose-dependent manner and 0.2, 1.0, and 5.0 microg/kg ghrelin produced 43.3 +/- 6.0, 81.5 +/- 12.7, and 107.0 +/- 10.7 ng/mL of the GH peak values at 30 min, respectively. ACTH, cortisol, and PRL levels were also elevated after ghrelin injection, while the lowest dose (0.2 microg/kg) resulted in only minimum peak values of these hormones (22.8 +/- 3.0 pg/mL, 9.4 +/- 1.9 microg/dL, and 4.6 +/- 0.6 ng/mL, respectively). There were no significant changes in LH, FSH, or TSH levels. This is the first study showing evidence that ghrelin strongly stimulates GH release in humans.

Plaque removal efficacy of the V-shaped toothbrush with new designs in bristle arrangement.

Experimental bristle arrangements were applied to a conventional V-shaped bristle-design toothbrush in an effort to improve plaque removal efficacy in interproximal areas. A single-blind cross-over study was performed to evaluate the plaque removal efficacy of this new bristle arrangement by comparing it to either a more conventional V-shaped toothbrush or a flat-headed toothbrush. Plaque removal efficacy was determined by assessing the percentage of plaque score reduction following a single controlled brushing. The new toothbrush bristle arrangement had a significantly higher plaque removal percentage efficacy than both the V-shaped toothbrush (59.1% vs. 48.5%; p = 0.0092) and the flat-headed toothbrush (65.3% vs. 55.3%; p = 0.0260) in interproximal areas. These differences were also consistent with whole mouth comparisons. When the subjects were asked about their preferences for the three different bristle formats used in this study, there was no significant difference of opinion found. These findings indicated a superiority of the new toothbrush to the other two, more conventional toothbrush bristle styles on plaque removal efficacy with these study subjects, but no particular preference for bristle design.