The prevalences of cytochrome c oxidase negative and superpositive fibres and ragged-red fibres in the trapezius muscle of female cleaners with and without myalgia and of female healthy controls.

The association of cytochrome c oxidase negative fibres (COX-negative) and ragged-red fibres (RR-fibres) with work related trapezius myalgia has been proposed. Hitherto studies have been small or without control groups. The aim of the present study was to investigate the prevalences of RR-fibres and COX-negative fibres in female cleaners with (n=25) and without (n=23) trapezius myalgia and in clinically healthy female teachers (n=21). The cleaners did mainly floor cleaning requiring monotonous loading on the trapezius muscle. A questionnaire covering background data and aspects of pain (prevalence, duration, intensity and influence on daily living) was answered. Biopsies were obtained from the trapezius muscle by an open surgical technique. The three groups did not differ in prevalence of COX-negative or COX-superpositive (i.e. type-I fibres with extremely strong brownish reaction in both the COX and SDH/COX stainings) fibres. The prevalence of COX-negative fibres was age dependent. Two subgroups of RR-fibres were present when stained for COX; COX-negative (73%) and COX-superpositive (26%) fibres. Forty-two percent of the COX-negative fibres were RR-fibres and 79% of the COX-superpositive were RR-fibres. A significantly (P=0.002) higher proportion of the COX-superpositive fibres in the cleaners were RR-fibres compared to the teachers. Multivariate regression analysis revealed that age, occupation as cleaner and a tender point in the trapezius were significantly associated with increased prevalences of RR-fibres; a cleaner with a tender point had a 4.35 higher prevalence of RR-fibres compared to a teacher without a tender point. No correlations between other pain related variables and prevalence of RR-fibres were noted. In conclusion, RR-fibres but not COX-negative or COX-superpositive fibres were correlated with cleaning work tasks and with a tender point in the trapezius.

Arbitrarily primed PCR and sequencing of 16S rDNA for epidemiological typing and species identification of Burkholderia cepacia isolates from Swedish patients with cystic fibrosis reveal genetic heterogeneity.

To investigate whether arbitrarily primed (AP)-PCR and/or 16S rDNA sequencing could be used as rapid methods for epidemiological typing and species identification of clinical Burkholderia isolates from patients with cystic fibrosis (CF), a total of 39 clinical B. cepacia isolates, including 33 isolates from 14 CF patients, were fingerprinted. ERIC-2 primer was used for AP-PCR. The AP-PCR clustering analysis resulted in 14 different clusters at a 70% similarity level. The AP-PRC patterns were individual despite considerable similarities. To sequence rDNA, a broad-range PCR was applied. The PCR product included four variable loops (V8, V3, V4 and V9) of the 16S ribosomal small subunit RNA gene. The multiple sequence alignment produced 12 different patterns, 5 of them including more than one isolate. Heterogeneity of the bases in the V3 region, indicating the simultaneous presence of at least two different types of 16S rRNA genes in the same cell, was revealed in 10 isolates. Most of the CF patients were adults who had advanced disease at follow-up. Both the sequencing and the AP-PCR patterns revealed genetic heterogeneity of isolates between patients. According to the results obtained, AP-PCR could advantageously be used for epidemiological typing of Burkholderia, whereas partial species identification could effectively be obtained by sequencing of the V3 region of the 16S RNA gene.

Histochemical enzyme profile of the masseter, temporal and lateral pterygoid muscles of the European hedgehog (Erinaceus europeaus).

In man, there are large differences in histochemical fibre-type composition, distribution and size between jaw and trunk muscles, probably related to the special functions of the human stomatognathic system. In the hedgehog, the influence of alkaline and acid pre-incubations on the reaction for myofibrillar ATPase was different from that in man, suggesting a different myosin structure; the fibre composition was different also. The masseter, the superficial portion of the temporal and the lateral pterygoid muscles all showed a homogeneous fibre type profile with almost 100 per cent alkali-stable fibres. In two animals, the deep temporal muscles showed an apparent heterogeneous fibre pattern with 81 per cent alkali-stable fibres, 4 per cent alkali-labile fibres and 15 per cent ATPase-intermediate fibres; in one animal 87 per cent alkali-stable fibres and 13 per cent ATPase-intermediate fibres. There was no difference in cross-sectional area between the three fibre types within each muscle, but the fibres of the lateral pterygoid were smaller than the alkali-stable and the alkali-labile fibres of the masseter and temporal muscles. The limb and trunk muscles showed reactions for myofibrillar ATPase similar to the jaw muscles, but had a heterogeneous fibre-type profile. There was no significant difference in cross-sectional fibre area between the jaw and the limb muscles. Thus the jaw and limb muscles of the hedgehog have similar fibre types and about equal fibre size.

Changes in muscle morphology in chronic trapezius myalgia.

Muscle biopsies of the descending portion of the trapezius muscle from female patients with chronic trapezius myalgia and from healthy women were analyzed with enzyme histochemical and immunohistochemical methods. Frequency, area, and capillarization of the muscle fiber types were determined. A biochemical analysis determined the lactate concentration of mixed muscle samples and the adenosine triphosphate (ATP) and phosphocreatine levels in single muscle fibers. The patients had larger type I fibers and a lower capillary:fiber area ratio for type I and type IIA fibers. The patients also exhibited lower levels of ATP and phosphocreatine in both type I and type II fibers. It is suggested that there might have been an imbalance between the capillary supply and the cross-sectional fiber area of type I and type IIA fibers in the patients. This imbalance might be of significance in the development of muscular fatigue and pain.

Expectations of alcohol-induced positive affect: a cross-cultural comparison.

OBJECTIVE: Our aim was to investigate the extent to which positive affect is a cross-culturally expected result of drinking alcohol. This first required development of a quantitative estimate of positive affect on a common scale, an essential step neglected in previous comparative research on alcohol expectancies. METHOD: Approximately equal numbers of male and female respondents (N = 1,008; 521 women) from eight countries were asked to complete a survey inquiring about emotional and behavioral responses they expect people to experience after consuming alcoholic drinks, and about limited aspects of their own drinking habits. Multisample latent covariance structure analysis with means was applied to the data and a cross-culturally invariant model of positive affect was extracted. RESULTS: The latent construct for positive affect that emerged was defined by manifest "interpersonal warmth or closeness," "pleasure of social interactions" and "optimism." There were significant national differences in means for this factor, and self-reported drinking frequency was also marginally related to expected positive affect. CONCLUSIONS: Multisample latent covariance structure analysis with means proved a useful tool capable of addressing critical problems in comparative cross-cultural research. In addition, there were indications that the expectation of increased positive affect associated with drinking may be influenced by contextual factors and cultural traditions, making positive affect less easily attributable to the direct pharmacological action of alcohol consumption than has previously been believed.

A review of oral devices in the treatment of habitual snoring and obstructive sleep apnoea.

With recent interest in sleep apnoea, oral devices have been proposed and used increasingly to treat patients suffering from snoring and obstructive sleep apnoea (OSA). Numerous case reports have been published and studies have been carried out to determine the efficiency and mechanism of action as well as evaluate side effects, complications and costs of different oral devices in the treatment of habitual snoring and OSA. A summary of the scientific basis and current opinions regarding oral devices in the treatment of habitual snoring and obstructive sleep apnoea is presented in this article. The selection of papers was based on a computerised search of published clinical and associated studies identified by MEDLINE from 1980 to November 2000. Although there is not yet enough scientific evidence for the clinician to determine which appliance is most likely to improve symptoms for a given patient, it appears from the literature that dental devices may have a place in the treatment of habitual snoring and mild and moderate cases of OSA. However, most of the studies are case series, raising questions on validity, and few studies use appropriate control groups. The general opinion is that these patients should not be treated without a sleep study as the OSA must be diagnosed before beginning treatment with oral devices to identify patients at risk and to provide a baseline to establish the effectiveness of the treatment. The main advantages of oral devices is the relative simplicity of the treatment, its reversibility and cost-effectiveness, and the fact that they can be used as an alternate treatment in patients who are unable to tolerate nasal continuous positive airway pressure (nCPAP) or who are poor surgical risks. Side effects occur in a significant proportion of patients using the MAD. In most cases these are minor and their importance must be balanced against the efficacy of the MAD in treating snoring and OSA. n.

Symptoms and signs of mandibular dysfunction in primary fibromyalgia syndrome (PSF) patients.

Primary fibromyalgia syndrome (PFS) is a form of nonarticular rheumatism characterized by muscular pain and stiffness, commonly located in the neck-, shoulder-, back-, and pelvic regions. The most common finding in patients with mandibular dysfunction (MD) is pain or tenderness of the masticatory muscles, but tender and painful neck and shoulder muscles are also often found in relation to jaw muscle affection. Complaints presented by patients suffering from musculoskeletal conditions may overlap one another. Indeed, there may be some common causative factors for these complaints. To test the hypothesis that some complaints by PFS patients could be explained by mandibular dysfunction, we have investigated the subjective symptoms and the clinical state of the stomatognathic system in eight patients suffering from PFS. According to the Helkimo anamnestic dysfunction index, six patients were classified as having severe signs of MD. The Helkimo clinical dysfunction index revealed severe or moderate dysfunction in all patients. Recurrent headaches was reported by half of the patients. In conclusion, the present study shows that PFS patients also may suffer from mandibular dysfunction. Thus, an examination of the function of the stomatognathic system would be an important part in the investigation to elucidate possible etiological factors behind the reported complaints by PFS patients. PFS may also be of etiological importance for mandibular dysfunction.

Craniomandibular status and function in patients with habitual snoring and obstructive sleep apnoea after nocturnal treatment with a mandibular advancement splint: a 2-year follow-up.

The aim of the investigation was to evaluate the status and function of the temporomandibular joint (TMJ) and masticatory system in patients with habitual snoring and obstructive apnoea after 2 years nocturnal treatment with a mandibular advancement splint. Thirty-two patients participated in the study, ranging from 43.0 to 79.8 years of age (mean 54.4 years, SD 8.78) at the start of treatment. All patients had been referred from the ENT department for treatment with a mandibular advancement splint. The acrylic splint advanced the mandible 50-70 per cent of maximal protrusion, opened 5 mm vertically, and was used 6-8 hours per night and 5-7 nights per week. Overjet, overbite, and molar relationship were measured on dental casts. The patients were asked to answer a questionnaire concerning symptoms of craniomandibular dysfunction (CMD). They were also clinically examined in a standardized manner, including registration of range of mandibular movements, TMJ sounds, pain on movement, and palpatory tenderness of the TMJ and the masticatory muscles. None of the patients showed more than five symptoms of dysfunction either at the start of or after 2 years of treatment. A decrease in the frequency of headache was found for nine of those 18 patients that reported headache (P = 0.004). A minor, but significant decrease in overjet and overbite was found and the molar relationship was also changed. It was concluded that 2 years' treatment with a mandibular advancement splint had no adverse effects on the craniomandibular status and function, but the observed occlusal changes requires further evaluation.

Characterisation of human soft palate muscles with respect to fibre types, myosins and capillary supply.

Four human soft palate muscles, and palatopharyngeus, the uvula, the levator and tensor veli palatini were examined using enzyme-histochemical, immunohistochemical and biochemical methods and compared with human limb and facial muscles. Our results showed that each palate muscle had a distinct morphological identity and that they generally shared more similarities with facial than limb muscles. The palatopharyngeus and uvula muscles contained 2 of the highest proportions of type II fibres ever reported for human muscles. In contrast, the levator and tensor veli palatini muscles contained predominantly type I fibres. A fetal myosin heavy chain isoform (MyHC), not usually found in normal adult limb muscles, was present in a small number of fibres in all palate muscles. The mean muscle fibre diameter was smaller than in limb muscles and the individual and intramuscular variability in diameter and shape was considerable. All palate muscles had a high capillary density and an unusually high mitochondrial enzyme activity in the type II fibres, in comparison with limb muscles. No ordinary muscle spindles were observed. The fibre type and MyHC composition indicate that the palatopharyngeus and uvula muscles are functionally involved in quick movements whereas the levator and tensor veli palatini muscles perform slower and more continuous contractions. The high aerobic capacity and the rich capillarisation suggest that the palate muscles are relatively fatigue resistant. Absence of ordinary muscle spindles indicates a special proprioceptive control system. The special morphology of the palate muscles may be partly related to the unique anatomy with only one skeletal insertion, a feature consistent with muscle work at low load and tension and which may influence the cytoarchitecture of these muscles. Other important factors determining the special morphological characteristics might be specific functional requirements, distinct embryological origin and phylogenetic factors.

Microbiological evaluation of a commercial transport system for urine samples.

The aim of this study was to evaluate a commercial tube prepared with boric acid, sodium formate and sorbitol (Hemogard Vacutainer tubes, Becton-Dickinson, HG tubes). Fourteen bacterial strains were incubated in urine in HG tubes and conventional tubes. During a 24-h period, most of the microorganisms grew readily in conventional tubes at room temperature, whereas the bacterial counts were comparatively unchanged when chilled or kept in HG tubes. The bacterial counts of Alcaligenes faecalis and lactobacilli decreased by two 10 logarithms in the HG tubes, at room temperature. Experiments were also performed with the addition of various antibiotics. Ciprofloxacin caused a decrease in E. coli counts regardless of type of tube used, while the HG tubes and the conventional tubes kept chilled conserved bacterial counts upon challenge with fosfomycin, trimethoprim or mecillinam. Bedside cultures from 154 outpatients were sampled and divided into three tubes. One conventional tube was sent to our laboratory by ordinary chilled transport. Another conventional tube and one HG tube were transported to the laboratory without chilling. Cultures were performed upon arrival at the laboratory and then 24, 48 and 72 h after primary sampling. Within 24 h of sampling, no significant differences in bacterial counts were observed between chilled conventional tubes and the HG tubes at room temperature. However, in the HG tubes a significant change in enterococcal counts was noted within 48 h.

The alcohol-aggression stereotype: a cross-cultural comparison of beliefs.

University students (N = 1,008) in eight countries participated in a survey aimed at mapping cross-cultural alcohol expectancies. Multisample structured means analysis was applied to compare changes in aggressive behaviors believed to occur in connection with drinking after "many" alcoholic drinks. Most subjects expressed the belief that intoxication was associated with greater aggressiveness, but there were significant national differences unrelated to self-reported alcoholic beverage preference, frequency of drinking to intoxication, or rates of personal involvement in episodes of alcohol-related aggression. Thus, the expectation that drinking leads to aggression may be determined to a significant extent by contextual factors and cultural traditions related to alcohol use.

Fiber type composition of the human female trapezius muscle: enzyme-histochemical characteristics.

Tne anatomy of the human trapezius muscle is complex, with an extensive origin and fibers running in different directions. The muscle is commonly divided into three different muscle portions according to the fiber direction: the descending, transverse, and ascending portions. In a previous study in males, the structure of the muscle differed between different portions with respect to the enzyme-histochemical fiber-type profile. The lower regions of the descending portion and the transverse and the ascending portions had a predominance of type I fibers. The type II fibers were more frequent in the upper regions of the descending portion, and the cross-sectional fiber area in this region of the muscle was smaller. In this study, we have investigated the trapezius muscle in females and compared the results with those from males. The different portions of the female muscle had a relatively even fiber-type composition. However, there tended to be fewer type I fibers and more type IIB fibers in the descending portion of the muscle, and the fibers of the lower regions of the descending portion were somewhat larger. The fiber-type distribution pattern was similar to that of the male trapezius muscle, but the mean cross-sectional area of the fibers in the female muscle was considerably smaller. Thus, our conclusion is that the trapezius muscle of females has a similar activity pattern as that of males. The significantly smaller cross-sectional fiber area, however, may indicate a lower functional capacity which may be of importance in the development of neck and shoulder dysfunction in females.

Alcohol and ambience: social and environmental determinants of intake and mood.

An experiment was conducted in which 66 male subjects were given access to alcohol (20% vol.) and fruit juice to be mixed and tasted ad lib. A factorial design included social vs. solitary drinking conditions, laboratory vs. informal setting, and variable exposure to music. The amount of ethanol consumed (g/kg body weight) was used as an unobtrusive measure of preferred intake. The reciprocal relationship between mood and consumption was analyzed by LISREL. While euphoria has usually been perceived as a consequence of drinking, the only plausible fit to a LISREL model was obtained by assuming that the disposition to drink would be increased by positive mood changes occurring during the drinking session. An analogy between social drinking and adjunctive behaviour was supported, as alcohol consumption was directly affected by time-dependent environmental factors such as company and music. Since the presence of company also stimulated positive mood and alleviated boredom, consumption was precipitated by company indirectly as well as directly. These results emphasize the importance of direct as well as indirect environmental influences on spontaneous alcohol intake during social drinking.

Sober-state cortisol as a predictor of drunken violence.

Basal cortisol levels were compared in prisoners convicted of violent crimes, in men previously convicted of violent crimes but currently not in prison, in non-violent alcoholics, and in randomly selected control males. Most of the violent men were diagnosed with antisocial personality disorder (DSM-III-R 301.70). Morning, afternoon, and evening levels of plasma cortisol were assessed after a minimum alcohol abstinence of 24 h. The imprisoned violent men had significantly lower cortisol levels than the unimprisoned, which may reflect their prolonged alcohol abstinence and/or habituation to chronic stress. The unimprisoned violent men were heavy drinkers and their elevated sober-state cortisol may reflect temporary alcohol withdrawal or acute stress. We suggest that variations in basal cortisol are influenced more by environmental factors than by violent predisposition or antisocial personality disorder.

Confirmatory factor analysis of the AEQ-A questionnaire in Finland.

The Adolescent version of the Alcohol Expectancy Questionnaire (Brown et al., 1980) was administered to a male population sample in Finland (N = 195; median age 18.5 years). Three issues were investigated: Did the items of each subscale measure single latent constructs? Was the AEQ-A better described by a single-factor model (e.g., global positive expectancy) or by a null model implying scale independence? Were alcohol expectancies related to drinking habits? Confirmatory factor analyses by PRELIS2 and LISREL8 indicated that single-construct models were appropriate only for the Enhanced sexuality and Increased arousal scales while several items were unrelated to the postulated latent constructs in the other five scales. Adequate fits were obtained for these scales only when unrelated items were removed and/or analyses were based on nondichotomus scores derived from contentwise homogenous groups of items. Even when revised so that the each scale formally fitted a single latent construct, the resulting latent constructs were not well described by either the single-factor model or the null model. Expected social benefit in terms of the revised Enhanced or impeded social behavior scale was the most significant predictor of drinking frequency while quantity consumed per drinking occasion was significantly related to the Improved cognitive and motor abilities scale only.

Drinking, menstrual cycle, and female sexuality: a diary study.

Sexual feelings in connection with alcohol intake were investigated in 97 Finnish women aged 18 to 35 years. The subjects were drawn from a population sample and included both oral contraceptive users and nonusers. Structured diaries were used to monitor sexual feelings and alcohol intake during one menstrual cycle for each subject. Alcohol drinking was found to be significantly associated with elevated sexual interest and arousal in the post- and intermenstrual phases. We suggest that these phase-dependent effects could be due to known alcohol-mediated testosterone elevations.

Morphological characterization of the levator veli palatini muscle in children born with cleft palates.

OBJECTIVE: The aim of this study was to analyze, morphologically and biochemically, one of the soft palate muscles, the levator veli palatini (LVP), in children born with cleft palate. SUBJECTS AND METHODS: Biopsies were obtained from nine male and three female infants in connection with the early surgical repair of the hard and soft palate. Samples from five adult normal LVP muscles were used for comparison. The muscle morphology, fiber type and myosin heavy chain (MyHC) compositions, capillary supply, and content of muscle spindles were analyzed with different enzyme-histochemical, immunohistochemical, and biochemical techniques. RESULTS: Compared with the normal adult subjects, the LVP muscle from the infantile subjects with cleft had a smaller mean fiber diameter, a larger variability in fiber size and form, a higher proportion of type II fibers, a higher amount of fast MyHCs, and a lower density of capillaries. No muscle spindles were observed. Moreover, one-third of the biopsies from the infantile subjects with cleft LVP either lacked muscle tissue or contained only a small amount. CONCLUSIONS: The LVP muscle from children with cleft palate has a different morphology, compared with the normal adult muscle. The differences might be related to different stages in maturation of the muscles, changes in functional demands with growth and age, or a consequence of the cleft. The lack of contractile tissue in some of the cleft biopsies offers one possible explanation to a persistent postsurgical velopharyngeal insufficiency in some patients, despite a successful surgical repair.