Toothbrushing and flossing behaviour in young adults--a video observation.

OBJECTIVES: Video observation studies of habitual oral hygiene from the 1970s revealed a striking neglect of brushing oral surfaces and unsystematic brushing patterns with frequent movements between areas. These findings were not systematically followed up; furthermore, nothing is known about whether subjects are able to floss sufficiently. Therefore, the aim of this video study was to analyse the performance of habitual toothbrushing and flossing. METHODS: A random sample of 101 18-year-olds was included. Toothbrush and floss were provided; habitual brushing/flossing was videotaped in a standardised setting and analysed with the video coding software INTERACT. Parameters of interest were toothbrushing duration, type of brushing strokes, brushing patterns, flossed interproximal spaces and flossing technique. RESULTS: The mean brushing duration was 156.0 ± 71.1 s; duration differed only slightly between the upper and lower jaw as well as between the right, left and anterior areas. However, oral surfaces were brushed distinctly shorter than vestibular surfaces (27.1 ± 27.8 s versus 72.1 ± 31.8 s; p ≤ 0.001). Participants brushed different areas of the mouth with different types of strokes, predominantly with horizontal and circular strokes. Brushing movements frequently alternated between areas (45.1 ± 22.4) not randomly but accumulated within a jaw with a tendency to move from the right to the left. Half of the participants flossed, but only one performed sufficiently. CONCLUSIONS: There was a significant neglect of brushing oral surfaces and insufficient use of floss. Brushing patterns were similar to those observed in the 1970s. CLINICAL RELEVANCE: Understanding habitual oral hygiene behaviour is essential for improving oral hygiene instruction strategies.

The sink-specific and stress-regulated Arabidopsis STP4 gene: enhanced expression of a gene encoding a monosaccharide transporter by wounding, elicitors, and pathogen challenge.

A cDNA for the Arabidopsis STP4 gene (for sugar transport protein 4) was isolated, and the properties of the encoded protein were studied in Schizosaccharomyces pombe. The STP4 monosaccharide H+ symporter is composed of 514 amino acids and has a calculated molecular mass of 57.1 kD. RNA gel blot analyses revealed that STP4 is expressed primarily in roots and flowers of Arabidopsis. This was shown in more detail with STP4 promoter-beta-glucuronidase (GUS) plants yielding strong STP4-driven GUS activity in root tips and anthers. Wounding of plants transformed with STP4-GUS constructs resulted in a rapid increase in GUS activity in cells directly adjacent to the lesion. This was confirmed by RNase protection analyses in Arabidopsis wild-type plants showing a strong, wound-induced increase in STP4 mRNA levels. STP4 expression was induced rapidly in suspension-cultured Arabidopsis cells that were treated with the Pseudomonas syringae elicitor or with chitin or in Arabidopsis plants that were exposed to fungal attacks. Our data suggest that the role of STP4 is to catalyze monosaccharide import into classic sinks, such as root tips and anthers, and, most importantly, to meet the increased carbohydrate demand of cells responding to environmental stress.

Combined transmandibular-zygomatic approach and infratemporal craniotomy for intracranial skull base tumors.

Large intracranial skull base tumors remain surgically treacherous lesions. The preauricular transzygomatic infratemporal approach to this area has rapidly gained popularity. This article presents modifications to this approach which improved visualization and access to the infratemporal fossa. The procedure increases visualization, minimizes brain retraction, and results in improved resection and outcome. Reconstruction is rapid and there are minimal functional and cosmetic deficits.

Primary central nervous system lymphoma.

Primary central nervous system lymphomas constitute less than 2% of primary brain tumors. Although their cause is unknown, they are in some way related to immunosuppression. The typical patient is a middle-aged man who displays the syndrome of a subacute mass lesion. These tumors most commonly occur as a single, bulky mass in the hemispheric white matter or the deep gray matter, but multiple tumors occur in approximately a fourth of the patients. The findings on computed tomography are distinctive and nearly pathognomonic. The majority of these tumors are B-cell lymphomas with aggressive histologic changes. Surgical intervention should be reserved for tissue diagnosis because surgical removal does not seem to influence the outcome. Conventional therapy consists of whole-brain irradiation with or without chemotherapy. The prognosis for patients with such tumors is grim, the median duration of survival being less than 2 years with conventional therapy and the 5-year survival being less than 5%.

Imaging-based stereotaxic serial biopsies in untreated intracranial glial neoplasms.

Forty patients with previously untreated intracranial glial neoplasms underwent stereotaxic serial biopsies assisted by computerized tomography (CT) and magnetic resonance imaging (MRI). Tumor volumes defined by computer reconstruction of contrast enhancement and low-attenuation boundaries on CT and T1 and T2 prolongation on MRI revealed that tumor volumes defined by T2-weighted MRI scans were larger than those defined by low-attenuation or contrast enhancement on CT scans. Histological analysis of 195 biopsy specimens obtained from various locations within the volumes defined by CT and MRI revealed that: contrast enhancement most often corresponded to tumor tissue without intervening parenchyma; hypodensity corresponded to parenchyma infiltrated by isolated tumor cells or in some instances to tumor tissue in low-grade gliomas or to simple edema; and isolated tumor cell infiltration extended at least as far as T2 prolongation on magnetic resonance images. This information may be useful in planning surgical procedures and radiation therapy in patients with intracranial glial neoplasms.