Genetic variation in Vibrio parahaemolyticus isolated from the aquacultural environments.

UNLABELLED: Environmental strains of Vibrio parahaemolyticus, a foodborne pathogen, were isolated from milkfish and grouper aquaculture facilities in southern Taiwan and characterized by pulsed-field gel electrophoresis (PFGE) and polymerase chain reaction targeting on the virulence-associated and genomic island (VPaI) marker genes. Analyses of 62 environmental isolates, including two putative pathogenic isolates, by NotI-PFGE revealed 11 pulse-type clusters with a similarity of 85%. Some of the T3SS2α-associated genes (vopB2, vopC and vopT) were not present in all of these two putative pathogenic isolates. Marker genes of VPaI-1 (MTase gene), VPaI-2 (VP0636) and VPaI-3 (VP1073 and VP1077) were detected in 14-100% of the environmental isolates examined, and the VP1073 and VP1077 of VPaI-3 marker genes were not detected. This study confirmed the high genetic variability of the environmental isolates including the putative pathogenic strains and identified some marker genes of VPaI in the environmental V. parahaemolyticus isolates. SIGNIFICANCE AND IMPACT OF THE STUDY: Vibrio parahaemolyticus is a prevalent seafood-borne enteropathogen with the appearance of pandemic O3:K6 strains in 1996. This study characterized the environmental nontoxigenic and toxigenic isolates by pulsed-field gel electrophoresis and the presence of marker genes of genomic islands. Results showed that the T3SS2α-associated genes are not present in all environmental tdh(+) isolates, and the presence of movable elements may contribute to genetic variation in the environmental V. parahaemolyticus isolates.

[Needle breakage during mandibular block anaesthesia: prevention and retrieval]. / Naaldbreuk tijdens mandibulaire blokanesthesie. Preventie en behandeling.

Disposable needles for dental local anaesthesia do not break easily. Still, needle breakage does occur, and is mainly caused by unexpected movements of the patient or pre-use bending of the needle by the dentist. If a dental needle breaks while administering local anaesthesia, the dentist should prevent panic. If the patient opens his mouth wide the needle might still be visible. If so, the needle is removed. If the needle is no longer visible, the site where the needle has penetrated the mucosa should be marked with a permanent marker. The dentist will contact a maxillofacial surgeon for immediate consultation. The maxillofacial surgeon will try to retrieve the broken dental needle under general anaesthesia.

Effects of copper sulfate on ion balance and growth in tilapia larvae (Oreochromis mossambicus).

Newly hatched tilapia larvae were exposed to sublethal concentrations of Cu2+ (0, 30, 50, and 100 microg/L) and lethal concentrations of Cu2+ (200 and 400 microg/L) for 24-96 h. The interaction of the exposure dose and time was related to the Cu2+ accumulation rate, which showed a higher accumulation rate with sublethal concentrations of Cu2+ within 24 h compared to the other treatments. Furthermore, Cu2+ contents in the whole body of larvae significantly increased following Cu2+ exposure times up to 96 h. Cu2+ in the medium produced a dose-response effect on Na+ and K+ contents in larvae after 96 h of exposure time. Changes in Ca2+ contents statistically significantly decreased and were shown to be dose-responsive for larval exposure times exceeding 72 h. Changes of Ca2+ contents were more sensitive than those of Na+ and K+ with Cu2+ treatment of early larvae. Notably Na+ and K+ contents showed significant increases of 17-23% in larvae exposed to low concentrations of Cu2+ (30-50 microg/L) for 24-72 h as compared to control larvae. Cu2+ caused no significant effect on body Cl- content or osmolality except at 100 microg/L Cu2+ for 24 h in tilapia larvae as compared to the control. However, there was a restoration phenomenon in larvae exposed to 100 microg/L Cu2+ for longer than 72 h. The water content of larvae exposed to Cu2+ for 96 h significantly decreased. The yolk absorption rate of tilapia larvae was significantly suppressed when they were exposed to Cu2+ medium containing 30, 50, 100, 200, or 400 Cu2+ microg/L from 72 h post transfer. These results obviously show that larvae are sensitive to Cu2+ during early development.

Rate-induced resyllabification revisited.

This paper presents the results of a rate scaling speech production experiment which seeks to replicate and examine in greater detail the results of a set of experiments reported in Stetson (1951). Stetson observed, based on a set of pioneering articulatory experiments, that coda consonants resyllabify as onset consonants in syllables repeated at fast speech rates. In the current experiment, speakers produced repetitions of simple CV and VC syllables in time to a metronome pacer which systematically changed in period. Data indicate that, while durational patterns for CV and VC syllables are very different at slow rates, the patterns tend to converge at fast rates. However, closer examination of fast rate tokens, reveals that differences between CV and VC tokens persist at fast rates, even though such tokens are generally heard as CV tokens. These results are discussed with respect to the nature of CV and VC organization and the effect of the rate-changing task.

Effects of syllable affiliation and consonant voicing on temporal adjustment in a repetitive speech-production task.

This paper presents the results of an acoustic speech-production experiment in which speakers repeated simple syllabic forms varying in consonantal voicing in time to a metronome that controlled repetition rate. Speakers exhibited very different patterns of tempo control for syllables with onsets than for syllables with codas. Syllables with codas exhibited internal temporal consistency, leaving junctures between the repeated syllables to take up most of the tempo variation. Open syllables with onsets, by contrast, often exhibited nearly proportional scaling of all of the acoustic portions of the signal. Results also suggest that phonemic use of vowel duration as a cue to voicing acted to constrain temporal patterns with some speakers. These results are discussed with respect to possible models of local temporal adjustment within a context of global timing constraints.

Detecting the medically compromised patient in dentistry by means of the medical risk-related history. A survey of 29,424 dental patients in The Netherlands.

BACKGROUND: This study focuses on the detection of medically compromised dental patients in the Netherlands by means of a validated patient-administered medical risk-related history (MRRH). Due to social changes and scientific innovations in the past decade, more medically compromised patients will be needing special dental treatment. METHODS: The medical problems of 29,424 dental patients (age 18 years and over) from 50 dental practices in the Netherlands were registered by means of the MRRH. The patients were classified according to the ASA risk-score system, which was modified for dental treatment. An inventory of the number and nature of medical problems and the modified ASA risk score was drawn up in relation to dental treatment and age. RESULTS: The average age of the patients was 37.1 +/- 13.5 years. According to the current guidelines, dental treatment must be modified if the patient has an ASA score of III or IV. A relatively high percentage of patients ages 65-74 (23.9%) and 75 or over (34.9%) did have an ASA score of III or IV. Furthermore, the medical problems were classified into 10 categories, and the relationship to age was examined. The conditions that increased with age were hypertension and cardiovascular, neurological, endocrinological, infectious, and blood diseases. CONCLUSIONS: For the dental practice, these results mean that the MRRH can play an important role in adapting dental treatment to the specific needs of patients. This is especially important in the case of elderly patients.

[Medical accidents in the dental practice. Survey of 471 dentists in the Netherlands]. / Medische accidenten in de tandartspraktijk. Rapportage door 471 tandartsen in Nederland.

OBJECTIVE: To determine frequency and nature of medical accidents in Dutch dental practice in relation to type and time of treatment, with and without the use of the MRRH; frequency and nature of the professional assistance. METHOD: Dentists MRRH-users (n = 51) and control dentists (n = 420) recorded medical accidents by name, using a registration form, followed by an anonymous survey. RESULTS: 91 accidents were reported by name by 471 dentists. This contrasted with 300 accidents recorded by 380 dentists in an anonymous survey. No life threatening accidents were reported. Syncope and hyperventilation were frequent. Most of the accidents occurred during local anaesthesia or during treatment, as the procedure became more stressful. Two-third of the accidents could possibly have been prevented by means of a medical history. Medical assistance was requested in 6% of the cases. CONCLUSION: Life threatening disorders were not reported, possible because in the Netherlands no intravenous sedation or general anaesthetic is used in general dental practice.

Labiovelar compensation in back vowels.

Various studies have revealed apparent motoric compensation between articulatory structures such as the jaw and lips which contribute to articulatory goals of vocal tract constriction. The present study, like Perkell et al. [J. Acoust. Soc. Am. 93, 2948-2961 (1993)] and Savariaux et al. [J. Acoust. Soc. Am. 98, 2428-2442 (1995)], investigates the possibility of compensation between labial protrusion and constriction and dorsovelar constriction-a relationship based on the similarity of the acoustic effects of such articulatory goals. The present study differs from these earlier studies in that it assumes an articulatory model of gestures, and it examines nonperipheral back vowels. X-ray microbeam records of American English speakers producing back vowels under various stress conditions were investigated. Results reveal systematic speaker differences in the direction of correlation between measures of labial and dorsal position. These results show that speakers differ as to whether they exhibit coupling between labial and dorsal activity in the lowering of back vowel timbre.

The validity of a medical risk-related history for dental patients in Belgium.

The aim of this study was to establish whether a patient-administered medical risk-related history (MRRH) for dental patients was valid. The MRRH, which was developed in the Netherlands, has now been tested in Belgium, where it was completed by total of 99 patients. Their answers were compared with the results of a verbal history, taken by a physician experienced in pre-assessment control. This verbal history was considered the 'gold standard'. The sensitivity and specificity of the medical questionnaire proved to be sufficiently high (88 per cent and 98 per cent respectively) and Cohen's Kappa displayed close agreement (0.87). These figures were only slightly lower than those obtained in Holland. The MRRH is valid for the registration of medical problems in dental patients but the answers need to be checked personally by the dental practitioner. Since the present trial was a limited one, the study will be expanded to nine countries in Europe.

The supraglottal articulation of prominence in English: linguistic stress as localized hyperarticulation.

The results of an articulatory investigation of the supraglottal correlates of linguistic prominence in English, and a proposal of a unified description of linguistic stress are reported. Three models of stress are evaluated: that prominence expands jaw movement, that stress expands an abstract articulatory scale involving the opening and closing of the vocal tract, and that stress involves a localized shift toward hyperarticulate speech. A corpus of x-ray microbeam records of sensible speech is studied, within which the stress pattern is controlled and is checked by means of an intonational analysis. Jaw movement data yield similar results to earlier studies, but kinematic differences interpreted with reference to a gestural theory suggest that different subjects use different articulatory strategies to articulate stress contrasts. In addition, the jaw, lip, and tongue interact in the articulation of stress in subject dependent ways. Thus the articulation of stress should be formulated in terms of abstract articulatory goals, rather than in terms of individual articulator positioning. Finally, the data show that stress affects the articulation of nonsonority distinctions such as backness in vowels and point of articulation in consonants. A hyperarticulation model of stress is discussed in terms of these results.

[Importance of proper implementation of the case history in the prevention of stomatological diseases]. / Znachenie previl'nogo oformleniia istorii bolezni v predotvrashchenii stomatologicheskikh zabolevanii.

In connection with ageing of population and an increasing number of older patients visiting the dental practice with multiple diseases, special prevention of possible medical complication during dental treatment is necessary. The advances in dentistry increase the chance of these complications. There is however no consensus about history taking in dental practice. For getting the maximum amount of information about the patient's health a Risk-Related Medical History (RRMH) patient-administered is proposed, that is checked by the dentist. The RRMH was composed in accordance with the modified ASA physical risk score. It allows to dyfine general patient's physical condition and to advise measures for prophylaxis of medical complication. The medical questionnaire showed a high sensitivity and specificity. In a study among 5000 patients the results of this history was analysed. The RRMH is simple and comfortable, it allows to obtain relible medical information in short time both for the dentist and for the patient.

A risk-related patient-administered medical questionnaire for dental practice.

This study deals with an improved medical questionnaire designed on the basis of the results of previous studies. The form consists of 27 items, each subdivided into a main question and one or more subquestions. The medical problems involved are categorised according to the risk-classification system of the American Society of Anaesthesiologists (ASA). An affirmative answer to the main question always results in ASA class II; the subquestions are designed to discriminate between ASA classes II, III and IV. For each of the 27 medical problems in the questionnaire, the implications for dental treatment are explained and an ASA risk classification proposed. The questionnaire can also be a useful tool in medical pre-assessment control.

The correlation of P-center adjustments with articulatory and acoustic events.

To evaluate articulatory models of perceptual center (P-center) location, listeners performed perceptual adjustments on stimuli which were extracted from a corpus of articulatory data. To avoid streaming effects, the stimuli were not edited to obtain temporal variation; instead, they varied in stress and segmental content. Adjustments were evaluated as to their simultaneity with acoustic and articulatory events. The first experiment yielded various articulatory and acoustic correlates of P-center location; the second yielded different articulatory predictors and no acoustic effective predictors. Multiple correlation analyses showed a variation from P-center locations predicted by the articulatory events that were associated with other predictors. Thus, P-center locations do not correspond to any particular kinematic articulatory event, but rather to a complex of events taken from throughout the stimuli. These results are discussed in terms of their relevance to a model of P-centers as indices of underlying gestural timing.

Medical risk classification of dental patients in The Netherlands.

This study centers on the general health of dental patients, evaluated on the basis of the physical status classification system of the American Society of Anesthesiologists (ASA). A total of 4,087 patients completed a risk-related, patient-administered questionnaire. On the basis of their medical data, a computerized ASA classification was determined for each patient: 63.3 percent were in ASA class I, 25.7 percent in class II, 8.9 percent in class III, and 2.1 percent in class IV. After verification and/or consultation with the physician, the dentist also determined the ASA class, and this was compared with the computerized outcome. The agreement expressed as a kappa value was 0.64; the computer result generally placed the patient in a higher category of medical risk. The computer-determined ASA classes differed among the various dental practices (chi 2 = 262.9; df = 138; P < .01). It is possible to estimate the risk class of dental patients on the basis of standardized medical information only; however, the definitive ASA class can only be determined after verification of the patient's reply or, in some cases, after consultation with a physician.

Detecting medical problems in dentistry: a survey of 4,087 patients in The Netherlands.

OBJECTIVES: This study was conducted to determine whether a medical history could be an effective means of detecting medical problems in dental patients. METHODS: A risk-related patient-administered medical questionnaire was completed by 4,087 patients in 47 dental practices. The data collected were summarized by means of descriptive statistics; the number of medical problems and the relationship between these problems and the age of the patient were analyzed. RESULTS: In all, 37.2% of these patients reported at least one medical problem. Hypertension, chronic bronchitis, allergies and medication were the items most frequently mentioned. The frequencies of heart disease, hypertension, endocrinologic and neurologic disorders increased with age, while allergies and chronic obstructive pulmonary disease were evenly distributed over the different age groups. The differences between the health of the patients in the various dental practices were not significant. CONCLUSIONS: On the basis of these results, it can be concluded that taking a medical history by means of a patient-administered questionnaire is an effective method of detecting medical problems of dental patients.

Validity of a risk-related patient-administered medical questionnaire for dental patients.

In this study the validity of a patient-administered risk-related medical questionnaire for dental patients was tested. The answers given on the questionnaire were compared with the results of a verbal history taken by a physician. This verbal history was considered the "gold standard." The sensitivity and specificity of the medical questionnaire appeared to be sufficiently high, and the kappa values of the separate questions were satisfactory. The questionnaire was found to be valid in the registration of medical problems in dental patients, but combination of the two methods is recommended.

[Medical history. Risk factors and prevention in dental practice]. / De medische anamnese. Risicoschatting en preventie in de algemene praktijk.

The need for the taking of a medical history when dealing with dental patients, is discussed from two different points of view. The medically compromised patient, according to article 9 part 3 of the regulation 'Special dentistry' in The Netherlands must be recognized by a medical history so adequate preventive treatment will avoid unnecessary medical intervention. As part of the EC proposals on the education of dental practitioners, the prevention of medical emergencies in the dental practice is important as well. A structured medical history based on risk classification and preventive measures meets both options.

[Do dentists agree on dental anaesthesia?]. / Lokale verdoving. Medische complicaties.

Hundred-and-ten dentists, both practitioners and teachers, attending a postgraduate course in medical emergencies, were unanimous in their choice of anaesthetics and medical anamnesis, the importance of avoiding toxicity and also in the unpredictability and infrequency of allergic reactions. There was no consensus on the importance of the aspiration test to avoid intravascular injection.