Noise exposure of commercial divers in the Norwegian Sector of the North Sea.

It is well known that exposure to high noise levels can adversely affect human hearing. Legislation exists in Europe to control or restrict the level of noise to which employees may be exposed during the course of their work. While the noise levels to which a worker may be exposed is well defined in air, human sensitivity to noise is different in high-pressure and mixed-gas conditions. Relatively little research exists to define human hearing in these circumstances, and few measurements exist of the levels of noise to which divers working in these conditions are exposed. A study using specially designed equipment has been undertaken in Norwegian waters to sample the noise levels present during typical saturation dives undertaken by commercial divers working in the Norwegian oil and gas industry. The divers were working in heliox at depths of 30 msw and 120 msw. It found noise levels were generally dominated by self-noise: flow noise while breathing and communications. The noise levels, both when corrected for the difference in hearing sensitivity under pressure in mixed gas and uncorrected, would exceed legislated limits for noise exposure in a working day without the use of noisy tools.

Do patients report quality of life improvements after fitting of their unilateral bone conducting hearing implant?

OBJECTIVE: The audiological benefits of a bone conducting hearing implant are well documented; however, there is a paucity of literature comparing pre- and post-operative quality of life benefits. This study assessed the quality of life status before and after the device is implanted. METHODS: A prospective study was conducted of all adult bone conducting hearing implants inserted in a teaching hospital between 2012 and 2017. All patients completed the Glasgow Health Status Inventory, a validated quality of life questionnaire, before and three to six months after implantation. RESULTS: Sixty-two patients received a unilateral bone conducting hearing implant. All scores except the social score improved post-operatively. The paired t-test showed that the differences in the means for the Glasgow Health Status Inventory total, general and physical scores were statistically significant at the 5 per cent level (p < 0.0001). CONCLUSION: This study, one of the few to assess quality of life pre- and post-implantation, showed a vast improvement in patients' perceived quality of life from the pre- to the post-operative phase.

Investigation of regional mechanisms responsible for poor oral absorption in humans of a modified release preparation of the alpha-adrenoreceptor antagonist, 4-amino-6,7-dimethoxy-2-(5-methanesulfonamido-1,2,3,4 tetrahydroisoquinol-2-yl)-5-(2-pyridyl)quinazoline (UK-338,003): the rational use of ex vivo intestine to predict in vivo absorption.

Modified release (MR) formulations are used to enhance the safety and compliance of existing drugs by improving their pharmacokinetics. Predicting the likely success of MR formulations is often difficult before clinical studies. A systematic in vitro approach using mouse and human tissues was adopted to rationalize the in vivo pharmacokinetics of 9- and 15-h MR formulations of an alpha-adrenoreceptor antagonist, 4-amino-6,7-dimethoxy-2-(5-methanesulfonamido-1,2,3,4 tetrahydroisoquinol-2-yl)-5-(2-pyridyl)quinazoline (UK-338,003). Immediate release UK-338,003 was well absorbed in humans consistent with moderate Caco-2 cell monolayer permeability. In contrast, 9- and 15-h modified release formulations showed marked reductions in C(max) (47.1 and 68.9%) and AUC(0-72) (32.6 and 54.0%). Colonic intubation resulted in 81.3 and 73.8% reductions in C(max) and AUC(0-72). Mechanistic studies in isolated mouse tissues showed that colonic UK-338,003 permeability (P(app) < 0.5 x 10(-6) cm/s) was at least 40 times lower than that for ileum with marked asymmetry. UK-338,003 was found to be a substrate for P-glycoprotein (PGP) with a weaker interaction for multidrug resistance-associated protein-type transporters in mouse intestine. PGP inhibition dramatically increased colonic UK-338,003 permeability to the levels observed in ileum. Low UK-338,003 apical to basolateral permeability was also observed in ex vivo human distal intestine, but both the asymmetry and increase in permeability after PGP inhibition were significantly lower. In conclusion, the poor absorption of MR UK-338,003 in humans can be explained by a combination of PGP-dependent efflux and low intrinsic permeability in the lower bowel. Regional permeability studies in ex vivo tissues used during drug development can highlight absorption problems in the distal bowel and assess the feasibility of developing successful MR formulations.

Regulation of topoisomerase II by murine mastocytoma cells.

Nuclei from K21 murine mastocytoma cells do not form topoisomerase II-DNA adducts in response to amsacrine in the absence of a cytoplasmic factor tentatively identified as a type of casein kinase (Darkin, S.J. and Ralph, R.K. (1991) Biochim. Biophys. Acta 1088, 285-291). The stimulatory activity was present in extracts from cells grown in horse serum but not in calf serum. Activity was lost following growth arrest by serum deprivation. In contrast, topoisomerase II activity in isolated nuclei did not decline during growth arrest. These results suggest that the resistance of some non-cycling tumour cells to anti-cancer drugs may result from decreased activation of topoisomerase II.

Multiple P2Y receptor subtypes in the apical membranes of polarized epithelial cells.

Apical ATP, ATP, UTP and UDP evoked transient increases in short circuit current (I(SC), a direct measure of transepithelial ion transport) in confluent Caco-2 cells grown on permeable supports. These responses were mediated by a population of at least three pharmacologically distinct receptors. Experiments using cells grown on glass coverslips showed that ATP and UTP consistently increased intracellular free calcium ([Ca(2+)](i)) whilst sensitivity to UDP was variable. Cross desensitization experiments suggested that the responses to UTP and ATP were mediated by a common receptor population. Messenger RNA transcripts corresponding to the P2Y(2), P2Y(4) and P2Y(6) receptors genes were detected in cells grown on Transwell membranes by the reverse transcriptase - polymerase chain reaction. Identical results were obtained for cells grown on glass. Experiments in which I(SC) and [Ca(2+)](i) were monitored simultaneously in cells on Transwell membranes, confirmed that apical ATP and UTP increased both parameters and showed that the UDP-evoked increase in I(SC) was accompanied by a [Ca(2+)](i)-signal. Ionomycin consistently increased [Ca(2+)](i) in such polarized cells but caused no discernible change in I(SC). However, subsequent application of apical ATP or UTP evoked a small rise in I(SC) but no rise in [Ca(2+)](i). UDP evoked no such response. As well as evoking increases in [Ca(2+)](i), the ATP/UTP-sensitive receptors present in Caco-2 cells thus allow direct control over ion channels in the apical membrane. The UDP-sensitive receptors, however, appear to simply evoke a rise in [Ca(2+)](i).

P2Y2 receptor-mediated inhibition of ion transport in distal lung epithelial cells.

1 Rat foetal distal lung epithelial cells were plated onto permeable supports where they became integrated into epithelial sheets that spontaneously generated short circuit current (ISC). 2 Apical ATP (100 microM) evoked a transient fall in ISC that was followed by a rise to a clear peak which, in turn, was succeeded by a slowly developing decline to a value below control. Apical UTP evoked an essentially identical response. 3 UDP and ADP were ineffective whilst ATP had no effect when added to the basolateral solution. These effects thus appear to be mediated by apical P2Y2 receptors. 4 The rising phase of the responses to ATP/UTP was selectively inhibited by anion transport inhibitors but persisted in the presence of amiloride, which abolished the inhibitory effects of both nucleotides. Thus, apical nucleotides appear to evoke a transient stimulation of anion secretion and sustained inhibition of Na+ absorption. 5 Basolateral isoprenaline (10 microM) elicited a rise in ISC but subsequent addition of apical ATP reversed this effect. Conversely, isoprenaline restored ISC to its basal level following stimulation with ATP. Apical P2Y2 receptors and basolateral beta-adrenoceptors thus allow their respective agonists to exert mutually opposing effects on ISC.

Culture substrate-specific expression of P2Y2 receptors in distal lung epithelial cells isolated from foetal rats.

ATP and UTP did not evoke [Ca2+]i signals in rat foetal lung epithelial cells grown on glass but elicited clear responses in cells grown into functionally polarised epithelia on permeable supports. Moreover, P2Y2 receptor mRNA could not be detected in cells on glass by the polymerase chain reaction but this mRNA species was clearly expressed by polarised cells. P2Y2 receptor expression thus appears to be a feature of the polarised phenotype.

Prostanoids and adrenaline release: a study of [3H]adrenaline efflux from the rabbit isolated, perfused, adrenal gland.

[3H]Adrenaline was incorporated in an isolated perfused preparation of the rabbit adrenal gland and the effects of indomethacin, PGE2 and PGI2 on its release were investigated. Efflux of [3H]adrenaline was elicited by electrical stimulation of the splanchnic nerve (60 s at 5 Hz). Indomethacin (3 and 30 microM) had no effect on stimulation-induced efflux. PGE2 (30, 90 and 300 nM) reduced the efflux; with 90 nM PGE2 the inhibition amounted to approximately 30%. PGI2, in concentrations from 90 to 600 nM, was without effect. These findings indicate that release of [3H]adrenaline from the rabbit adrenal gland is not subject to modulation by endogenous adrenal prostaglandins; however, PGE2 may play a role in some pathological situations.

Conservative management of lower second premolar impaction.

Lower second premolars account for approximately 24 per cent of impactions, excluding third molars, even though most reports in the literature relating to impacted teeth address the maxillary canine, with relatively few reports on the lower second premolar. Conservative management involves surgical exposure of the crown, however, subsequent premolar eruption is unpredictable. A case is described in which removal of a deciduous second molar was followed by eruption of an unfavourably inclined premolar located deep within the alveolus. Sufficient time must be allowed for eruption and in the present case 16 months elapsed before the tooth had erupted to the level of the occlusal plane.

Current concepts on functional appliances and mandibular growth stimulation.

The mode of action of functional appliances, particularly in relation to stimulating mandibular growth, is a controversial subject. Many of the reports concerning growth effects of functional appliances have been characterized by poor methodology. In assessing functional appliances, results from prospective randomized clinical trials should be given prominence. On the basis of available evidence, it cannot be concluded that functional appliances are effective in stimulating and increasing mandibular growth in the long term. Although favourable growth changes have been reported following phase 1 therapy, they are generally not substantial and long term stability appears to be poor.

Terminology of facial morphology in the vertical dimension.

Consideration of facial type plays an important role in the formulation of an orthodontic treatment plan and prognosis of treatment. Of particular importance is the vertical relationship, that is, whether an individual is long-faced (dolichofacial), or short-faced (brachyfacial). The vertical facial type provides a clue regarding the growth direction of the facial complex, and should be used with an anteroposterior classification to describe a patient's face. The potential for confusion in communicating vertical facial types exists due to the nature of the terminology in use. For example, the term dolichoprosopic as used in the Bimler analysis has an opposite meaning to the term dolichofacial. It would seem prudent that if such terminology is to be employed there should be some attempt at standardization, and at least an appreciation of the derivations of the terms, and their differences.

Mechanical properties of some polymer materials used for tooth positioners.

The chemical composition, thermal behaviour and mechanical properties of three tooth positioner materials, Urethane P1 (P1), White Rubber (WR) and Elastocryl (EL) were investigated. Infra-red spectrophotometry indicated the P1 polyurethane material to be of the polyether type, and EL to be a blend of poly(ethyl methacrylate) and poly(methyl methacrylate) while WR appeared to be filled cis-poly (isoprene) (natural rubber). The glass transition temperature (Tg) for EL was determined as approximately 10 degrees C, and for both P1 and WR the Tg was less than -50 degrees C. The stress relaxation behaviour was assessed in compression by measuring the stress variation with time. The results for all three materials conformed to the superelastic theory of rubber elasticity. EL exhibited both a more rapid rate and higher degree of stress relaxation than did P1 and WR. Recovery from deformation was assessed by compressing cylinders for given periods of time and then measuring the level of reduced residual strain of the material with time. All three materials exhibited significant residual strain (epsilon(t)) over 'clinically relevant' time periods, and the reduced residual strain (epsilon(t)/epsilon(O)) following deformation was greater for EL than P1 or WR. There was some indication that the three materials have some permanent set following deformation. It was concluded that, in considering desirable mechanical properties of tooth positioner materials, EL is the least suitable of the three examined, with none of the materials being ideal.

Analyses of craniofacial and dental morphology in monozygotic twins discordant for cleft lip and unilateral cleft lip and palate.

The Michigan Cleft Twin Sample data was analyzed in order to investigate dental arch and craniofacial morphology. The present study consisted of 12 monozygotic twins discordant for either cleft lip or unilateral cleft lip and palate. Individuals having CL (repaired) alone did not differ from their unaffected counterparts in dental arch and skeletal morphology. Repaired UCLP subjects were characterized by having a shorter and more posteriorly positioned maxilla. Although reduction of dental arch width as a result of scar contraction following surgery was evident, the effects of scar tissue pull did not affect maxillary basal width.

The Rocky Mountain-Samuel Bulkley Travelling Fellowship.

Rocky Mountain Orthodontics and The Australian Society of Orthodontists Foundation for Research and Education provide a Fellowship to enable a new orthodontic graduate the opportunity to spend time overseas engaged in research. The present discussion deals not so much with the details of the research (which are to be published), but rather provides an overview of the Fellowship activities, and aims to encourage present postgraduate students to apply for the award.

Eicosanoids: physiology update and orthodontic implications.

The eicosanoids are members of a group of substances comprising prostaglandins and leukotrienes which are released by a host of mechanical, thermal, bacterial and other insults and contribute importantly to the signs and genesis of inflammation (Brain and Williams 1990, Dusting 1989 Moncada et al. 1985, Salmon and Higgs 1987). In this review we examine the increasing number of reports on the actions of eicosanoids on the dentoalveolar complex. In addition, since it is desirable for the orthodontist to have a sound knowledge, not only of the roles of eicosanoids in tooth movement, but also of their basic general physiology, an overview of the latter area is presented.

Smoking patterns in adolescent orthodontic patients and school children.

Smoking is known to be widely practised by young adults and teenagers, a fact that is of immediate importance to the orthodontic profession as it is now well accepted that smokers have poorer periodontal health than non-smokers. The aim of the present study was to determine the level of smoking in teenage orthodontic patients and compare it with that in the general teenage population and, further, to examine how these smoking habits are influenced by the subjects' attitudes. Patients were surveyed as to their smoking habits and attitudes. All were between 10 and 18 years of age and undergoing active fixed-appliance therapy. The same survey was distributed to a local primary (elementary) school and local secondary (high) schools. Of the 729 school respondents, 29 per cent were classified as smokers; of the 333 respondents in the orthodontic group, 11 per cent were classified as smokers. Although the level of smoking amongst orthodontic patients appears to be lower than that for the general adolescent population, significant numbers of patients smoke on a regular basis, and a small proportion of these is under 13 years of age. Because they have regular contact over a number of years with their adolescent patients, orthodontists are in a favourable position to reinforce non-smoking behavior.

Orthodontic tooth movement after extraction of previously autotransplanted maxillary canines and ridge augmentation.

A case report is detailed in which autotransplanted maxillary canines were removed and the spaces closed. Substantial surrounding bone loss was associated with the upper right canine, and a bone graft was needed to reestablish normal dentoalveolar ridge morphology. Bone was taken from the maxillary tuberosity and placed in the canine extraction site, fixed with a bone screw, and covered with GoreTex. Seven months after placement of the bone graft, the GoreTex and stabilizing screw were removed to allow for consolidation of the bone. The upper left canine and lower second premolars were extracted, and fixed appliances were placed in both arches to align the teeth and close the spaces. Protraction of the upper right first premolar and retraction of the lateral incisor into the graft site were kept slow and constant with continued periodontal assessment. During the space closure, there was some concern that the bone in the graft site might resorb, leaving the teeth with compromised periodontal support. However, no significant periodontal attachment loss occurred despite ongoing concern about the amount of keratinized tissue. Perhaps the relatively slow rate of tooth movement provided for bone to be maintained and recreated ahead of the tooth. Almost complete closure of the upper canine extraction spaces was achieved. The upper premolars were substituted for the maxillary canines, and unfavorable prosthetic options were thus avoided. The lower arch was aligned, and the extraction spaces completely closed.

Effects of adrenoceptor antagonists and neuronal uptake inhibitors on dimethylphenylpiperazinium-induced release of catecholamines from the rabbit isolated adrenal gland and guinea-pig atria.

Isolated rabbit adrenal glands were perfused with Krebs-Henseleit solution at 37 degrees C and the catecholamine storage sites were labeled with [3H]epinephrine. Release of radioactivity was evoked by 2-min periods of perfusion with dimethylphenylpiperazinium (DMPP, 100 microM). DMPP-induced efflux of radioactivity was decreased by desipramine (1 microM), cocaine (30 microM), phenoxybenzamine (1 and 10 microM), phentolamine (1, 3 and 10 microM) and propranolol (1 microM). The reduction in DMPP-induced efflux cannot be accounted for by interactions with alpha adrenoceptors, as prazosin (1 microM) and yohimbine (1 microM) were without effect. There also was no correlation between inhibition of DMPP-induced efflux and ability of the drugs to inhibit catecholamine uptake as phentolamine (1 microM) and propranolol (1 microM) did not affect the incorporation of [3H]epinephrine by the gland. In guinea-pig atria, in which the catecholamine storage sites had been labeled with [3H]norepinephrine, efflux of radioactivity was elicited by 1-min periods of contact with DMPP. DMPP-induced efflux of radioactivity from atria was decreased by desipramine (1 microM), cocaine (30 microM), phenoxybenzamine (1 and 10 microM), phentolamine (1 and 10 microM) and propranolol (1 microM) but not by prazosin (1 microM) or yohimbine (1 microM). The inhibition of DMPP-induced efflux in guinea-pig atria could not be correlated with alpha adrenoceptor antagonism or blockade of neuronal uptake. There were differences between the two preparations in the degree of inhibition of DMPP-induced release produced by the above drugs.(ABSTRACT TRUNCATED AT 250 WORDS)