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Biomedical subjects

S Weiner

Publications and source records attributed to S Weiner.

At least 19 recordsLinked to original sources

Comparison of the accuracy of working casts made by the direct and transfer coping procedures.

STATEMENT OF PROBLEM: A working cast with dies that accurately record the prepared abutments, surrounding soft tissues, and adjacent and opposing teeth is necessary. PURPOSE: This study compared the accuracy of the direct and transfer coping methods in recording the vertical and horizontal dimensional relationship of a pair of removable dies in a working cast before and after separation from the stone base. Among the procedures used for making impressions of abutments for fixed partial dentures, the transfer coping procedure has specific advantages. In particular, where there are multiple abutments, this procedure, in which individual impressions are made of the abutments, transfer copings are made, and a transfer impression of the copings is used for seating the dies and fabrication of a dental stone base, is useful. METHODS: Two groups of working casts were fabricated from a stone master cast containing 2 ivorine teeth to simulate abutments. The first group of working casts was fabricated directly from the elastomeric impression of the abutments using a 2-pour procedure. The second group of working casts was made using the transfer coping procedure. RESULTS: When the interdie dimensions in each group were compared with that of the master cast, after separation and replacement of the dies in the stone base, the differences were less than 100 microm and similar for both the direct and transfer coping techniques. CONCLUSIONS: These findings show that either procedure is equally effective in positioning the dies in the working casts.

Analysis of Variance

The effects of maternal indomethacin therapy on human fetal branch pulmonary arterial vascular impedance.

OBJECTIVE: To examine whether maternal indomethacin therapy affects human fetal pulmonary arterial vascular impedance without constriction of the ductus arteriosus and to determine the changes in the pulmonary arterial vascular impedance in the presence of ductal constriction. STUDY DESIGN: In this cross-sectional study, 52 normal fetuses without maternal medication (control group), 33 fetuses without ductal constriction (Study group I) and 11 fetuses with ductal constriction (Study group II) during maternal indomethacin therapy between 24 and 34 weeks of gestation were examined by Doppler echo-cardiography. Blood velocity waveforms across the proximal right or left pulmonary artery were obtained and the pulsatility index (PI) of the proximal pulmonary arteries was calculated. RESULTS: In the control group, the proximal pulmonary artery PI was higher (p < 0.0001) at 24-25 weeks (n = 7) (3.73 +/- 0.33; mean +/- SD) than at 33-34 week of gestation (n = 11) (2.98 +/- 0.27). The PI was constantly greater (p < 0.005) in Study group I than in the control group. However, in this group the mean average weekly decrease in the PI of the proximal pulmonary arteries was similar to that in the control group. After 26 weeks of gestation, the PI values in Study group II were significantly higher than in the control group (27 weeks: 4.12 vs. 3.34 (p < 0.005); 30 weeks: 4.48 vs. 3.14 (p < 0.0001); 34 weeks: 4.96 vs. 3.00 (p < 0.0001), respectively). CONCLUSIONS: Human fetal pulmonary arterial vascular impedance is increased by maternal indomethacin therapy even without ductal constriction. In the presence of ductal constriction, the magnitude of the increase in the vascular impedance is related to the gestational age.

Blood Flow Velocity

Evidence for the use of fire at zhoukoudian, china

Zhoukoudian is widely regarded as having the oldest reliable evidence for the controlled use of fire by humans. A reexamination of the evidence in Layer 10, the earliest archaeological horizon in the site, shows that burned and unburned bones are present in the same layer with stone tools. However, no ash or charcoal remnants could be detected. Hence, although indirect evidence for burning is present, there is no direct evidence for in situ burning.

Journal Article

Reactivity of the human fetal pulmonary circulation to maternal hyperoxygenation increases during the second half of pregnancy: a randomized study.

BACKGROUND: The aims of the present study were to determine whether maternal hyperoxygenation affects human fetal pulmonary circulation and whether there is a gestational age-related response in the fetal pulmonary circulation to maternal hyperoxygenation during the second half of gestation. METHODS AND RESULTS: Twenty women between 20 and 26 weeks of gestation and 20 women between 31 and 36 weeks of gestation with normal singleton pregnancies were randomized to receive either 60% humidified oxygen or medical compressed air (room air) by a face mask. Fetal aortic and pulmonary valve; ductus arteriosus (DA); and right (RPA), left (LPA), and distal (DPA) pulmonary artery blood velocity waveforms were obtained by Doppler ultrasound before, during, and after maternal administration of either 60% oxygen or room air. Left and right ventricular cardiac outputs, DA volume blood flow, and RPA and LPA volume blood flows (Qp) were calculated. Foramen ovale volume blood flow (left ventricular cardiac output-Qp) was estimated. Pulsatility index (PI) values of DA, RPA, LPA, and DPA were calculated. Maternal hyperoxygenation did not change any of the measured fetal parameters between 20 and 26 weeks, whereas between 31 and 36 weeks, the PI values of RPA, LPA, and DPA decreased (P<.0001) and the PI of DA increased (P<.0001). In addition, Qp increased (P<.001), and DA volume blood flow (P<.01) and foramen ovale volume blood flow (P<.03) decreased. Left and right ventricular cardiac outputs were unchanged. All changes returned to baseline after maternal hyperoxygenation was discontinued. CONCLUSIONS: Reactivity of the human fetal pulmonary circulation to maternal hyperoxygenation increases with advancing gestation; this suggests that fetal pulmonary circulation is under acquired vasoconstriction at least after 31 to 36 weeks of gestation.

Blood Flow Velocity

The addiction of overeating: self-help groups as treatment models.

This article defines eating disorders and compares it to other addictions, gives a brief etiology, and presents two treatment models: Overeaters Anonymous and Weight Watchers International. The same personality factors that place individuals at risk for substance abuse are often found in individuals with eating disorders. These predispositions are explored from both a developmental and sociological perspective. Resources within our own communities can provide valuable interventions. Overeaters Anonymous emphasizes the psychological and spiritual components, with its main focus being the commitment to the group. Weight Watchers is also rooted in the fellowship of community but adopts a more behavioristic model. Although Weight Watchers supplies more practical strategies for managing overeating, both groups provide a framework for developing positive, adaptive, and self-nurturing modalities.

Behavior, Addictive

Strain-structure relations in human teeth using Moiré fringes.

Teeth are subjected to stress during normal function. The manner in which the resulting strain is distributed within the tooth is related to its structure. The Moiré fringe technique was used to map the in-plane strain distribution in slices from human tooth crowns under compression. The strain inside enamel is much less than in dentin, and there is a roughly 200 microm thick zone in dentin beneath the dentin enamel junction which undergoes larger strain than the central coronal dentin. This zone is softer and less mineralized than the bulk of the dentin. The strain distribution in this zone along the dentin-enamel junction shows localized maxima on both the lingual and the labial sides. This study is consistent with the hypothesis that within the dentin there are structural adaptations for transferring and minimizing stress.

Bicuspid

Rostrum of a toothed whale: ultrastructural study of a very dense bone.

The rostral bones of the toothed whale, Mesoplodon densirostris, consist mainly of hypermineralized secondary osteons and have yielded among the highest values for density (2.6 g/cm3) and mineral content (86.7%) yet reported for any bone. Scanning and transmission electron microscopy show parallel rods of mineral oriented along the length of the rostrum. These consist of platey crystals of carbonated hydroxyapatite, which, judging from electron diffraction, are extremely well and coherently aligned. The collagen component of the rostral bone consists largely of very thin fibrils aligned in longitudinal register to form tubular networks. The collagen fibrils are also aligned with the lengths of the mineral rods, which are apparently accommodated in the tubular spaces of the collagenous network. This peculiar ultrastructure clearly differs from the densely packed mineralized fibrils commonly observed in vertebrate lamellar osseous tissues, although histological examination has indicated some vestiges of "normal" primary bone surrounding the secondary osteons. Thus, the bone tissue in the rostrum is characterized by a remarkably sparse collagenous component. This ultrastructure can explain the high density, stiffness, and brittleness of the rostrum that have been observed. It also raises interesting questions about possible modes of crystal growth during ongoing mineralization in normal bone, and may have some relevance in the mechanical behavior of dense bones in pathological conditions.

Animals

Design strategies of sea urchin teeth: structure, composition and micromechanical relations to function.

The teeth of sea urchins comprise a variety of different structural entities, all of which are composed of magnesium-bearing calcite together with a small amount of organic material. The teeth are worn down continuously, but in such a way that they remain sharp and functional. Here we describe aspects of the structural, compositional and micromechanical properties of the teeth of Paracentrotus lividus using scanning electron microscopy, infrared spectrometry, atomic absorption. X-ray diffraction and microindentation. The S-shaped single crystalline calcitic fibres are one of the main structural elements of the tooth. They extend from the stone part to the keel. The diameter of the fibres increases gradually from less than 1 micron at the stone tip to about 20 microns at the keel end, while their MgCO3 contents decrease from about 13 mol% to about 4.5 mol%. Each fibre is coated by a thin organic sheath and surrounded by polycrystalline calcitic discs containing as much as 35 mol% MgCO3. This structure constitutes a unique kind of gradient fibre-reinforced ceramic matrix composite, whose microhardness and toughness decrease gradually from the stone part to the keel. Primary plates are also important structural elements of the tooth. Each primary plate has a very unusual sandwich-like structure with a calcitic envelope surrounding a thin apparently amorphous CaCO3 layer. This central layer, together with the primary plate/disc interface, improves the toughness of this zone by stopping and blunting cracks. The self-sharpening function of the teeth is believed to result from the combination of the geometrical shape of the main structural elements and their spatial arrangement, the interfacial strength between structural elements, and the hardness gradient extending from the working stone part to the surrounding zones. The sea urchin tooth structure possesses an array of interesting functional design features, some of which may possibly be applicable to materials science.

Animals

Long-term stroke risk in children with sickle cell disease screened with transcranial Doppler.

Stroke is an important complication of sickle cell disease. Stroke prediction is clinically important because it offers the possibility of primary prevention. In 1992, transcranial Doppler (TCD) evidence of elevated intracranial internal carotid or middle cerebral artery velocity was demonstrated to be associated strongly with an increased risk of ischemic stroke. This study extends the original study and includes 125 more children, longer follow-up, and intracranial hemorrhage in the stroke-risk model. Elevated time averaged mean maximum blood flow velocity, especially when velocity is 200 cm/sec or greater by TCD, was associated strongly with stroke risk. The cases not predicted by TCD point to the need for more information on the optimal timing of TCD surveillance for stroke risk.

Adolescent

Cervical ultrasonography compared with manual examination as a predictor of preterm delivery.

OBJECTIVE: Our purpose was to compare the accuracy of ultrasonographic and manual cervical examinations for the prediction of preterm delivery. STUDY DESIGN: One hundred two singleton pregnancies at high risk for preterm delivery were followed up prospectively from 14 to 30 weeks with both serial cervical ultrasonography measurements and manual examinations of the length of the cervix. The primary outcome studied was preterm (< 35 weeks) delivery. RESULTS: Excluding six induced preterm deliveries, 96 pregnancies were analyzed. The mean cervical length measured by ultrasonography was 20.6 mm in pregnancies delivered preterm (n = 17) and 31.3 mm in pregnancies delivered at term (n = 79) (p = 0.003); the mean cervical lengths measured by manual examination were 16.1 mm and 18.6 mm in the same preterm and term pregnancies, respectively (not significant). The sixteenth- and twentieth-week ultrasonographic cervical lengths predicted preterm delivery most accurately (p < 0.0005). The 25th percentiles of ultrasonographic (25 mm) and manual (16 mm) cervical lengths showed relative risks for preterm delivery of 4.8 (95% confidence interval 2.1 to 11.1, p = 0.0004) and 2.0 (95% confidence interval 0.5 to 4.7, p = 0.1), respectively; sensitivity, specificity, and positive and negative predictive values were 59%, 85%, 45%, 91%, and 41%, 77%, 28%, and 86%, respectively. CONCLUSION: Cervical length measured by ultrasonography is a better predictor of preterm delivery than is cervical length measured by manual examination. Cervical ultrasonography in patients at high risk for preterm birth seems to be most predictive of preterm delivery when it is performed between 14 and 22 weeks' gestation.

Cervix Uteri

Rotated plywood structure of primary lamellar bone in the rat: orientations of the collagen fibril arrays.

A basic structural motif of lamellar bone is the arrays of parallel collagen fibrils, with successive arrays having different orientations to form a plywood-like structure. Measurements of the angles between adjacent arrays from cryomicrotomed and vitrified thin sections of demineralized rat bone, cut approximately parallel to the lamellar boundary plane, show that most angles are around 30 degrees, although a subset are around 70 degrees. A structural model for collagen organization based on these measurements is proposed in which an individual lamellar unit (thick and thin lamellae together with transition zones) is composed of five arrays of parallel collagen fibrils, each offset by 30 degrees.

Animals

Cervical funneling: sonographic criteria predictive of preterm delivery.

Our objective was to establish sonographic criteria that are predictive of preterm delivery in patients with internal os dilatation (funneling). The study population consisted of patients with cervical funneling identified on translabial or transvaginal ultrasound examination. Funnel length, functional length, percentage funneling and funnel width were evaluated for their predictive values for preterm delivery. In the 43 patients who met the study criteria, funneling was detected at a mean gestational age of 21.4 weeks (range 16-28). Twenty-three of 31 patients (74%), manually examined immediately following the ultrasound examination, had a closed cervix. Preterm delivery occurred in 42% of patients. Funnel length of > or = 16 mm, functional length of < or = 20 mm, funneling of > or = 40% and funnel width of > or = 14 mm correlated significantly with preterm delivery. Patients with funneling of < 25%, 25-50% and > 50% had preterm delivery rates of 17%, 29% and 79%, respectively.

Adult

Human fetal right ventricular ejection force under abnormal loading conditions during the second half of pregnancy.

Our objective was to determine whether abnormal loading conditions can modify human fetal right ventricular ejection force during the second half of pregnancy. By Doppler echocardiography, we studied 73 normal fetuses between 19 and 41 weeks of gestation, 27 fetuses with hypoplastic left heart syndrome (chronic volume overload) between 18 and 38 weeks of gestation, 14 fetuses with mild to moderate constriction of the ductus arteriosus (pulsatility index (PI) between 1.0 and 1.9) and seven fetuses with severe constriction (PI < 1.0) or occlusion of the ductus arteriosus (relatively acute pressure overload) between 28 and 34 weeks of gestation. In the normal and ductal constriction/occlusion groups, blood velocity waveforms were recorded at the level of the aortic and pulmonary valves, and in the group with hypoplastic left heart syndrome at the level of the pulmonary valve. The ventricular ejection forces were calculated. In the normal group, right (RVEF; r = 0.91, p < 0.0001) and left (LVEF; r = 0.86, p < 0.0001) ventricular ejection forces increased and were equal during the second half of gestation. In the group with hypoplastic left heart syndrome the RVEF increased (r = 0.76, p < 0.0001) with advancing gestation. The RVEF (p < 0.0005) and its average weekly increase (p < 0.0001) were greater in the hypoplastic left heart syndrome group than in the normal group. In the group with mild to moderate ductal constriction, both ventricular ejection forces were similar to those of the normal group. The RVEF (p < 0.003) and its average weekly increase (p < 0.03) were lower in the group with severe ductal constriction or occlusion than in the normal group. The LVEF did not differ from that of the normal group We conclude that chronic volume overload increases and relatively acute pressure overload decreases human fetal RVEF. The right ventricular performance is modified by abnormal loading conditions.

Blood Flow Velocity

The actor-director and patient-therapist relationships: a process comparison.

The relationship between the actor and director, like that between the patient and psychotherapist, relies on intense emotional involvement. Both demand sensitivity, reciprocity, and a deep understanding of human behavior. Because dramatic action is created through continuous conflict between characters, actors must explore not only their actions, but also the reactions of those with whom they are in relationship. The process of therapy is equally interdependent. Through the relationship, therapists provide a context in which their patients can work through their conflicts. As in the rehearsal process, actions are explored in a supportive environment. This paper has presented a process comparison of the actor-director and patient-therapist relationships by proposing that both are art forms that rely on the skill of a trusted facilitator. Some of the techniques explored include: empathic attunement, emotional recall, transference, overcoming performance obstacles, improvisation, risk-taking, the pleasure principle, and creating a sense of family through new object relations. Like therapists, directors never forget that their work cannot be performed alone; it depends on interaction with the most delicate of phenomena: the human soul.

Communication

Isolation of Helicobacter pullorum from patients with enteritis.

Helicobacter pullorum, recently described as sp. nov., is commonly isolated from asymptomatic poultry. Two cases of human enteritis associated with H. pullorum, one of them in an immunocompromised patient, are reported. Problems in the correct species identification by means of phenotypic and genotypic methods are discussed and for the first time a fatty acid pattern of Helicobacter pullorum is presented.

Adult

Role of the pulmonary circulation in the distribution of human fetal cardiac output during the second half of pregnancy.

BACKGROUND: By using Doppler echocardiography, we determined the normal distribution of human fetal combined cardiac output (CCO) from the left and right ventricles. We also established weight-indexed pulmonary and systemic vascular resistances (Rpi and Rsi, respectively) and changes during the second half of pregnancy. METHODS AND RESULTS: Blood flows at the aortic and pulmonary valve annuli (LVCO and RVCO, respectively), right and left pulmonary arteries (QP), and ductus arteriosus (QDA) were calculated in 63 normal fetuses. Foramen ovale blood flow (QFO = LVCO-QP) was estimated. From 20 to 30 weeks of gestation, the proportion of QP of the CCO increased (from 13% to 25%, P < .001), while the proportion of QFO decreased (from 34% to 18%, P < .001). After 30 weeks, the proportions of QP and QFO were unchanged. At 38 weeks, the proportion of RVCO (60%) was higher (P < .05) than that of LVCO (40%). The proportion of QDA did not change significantly. The correlation between RVCO calculated from blood flow through the pulmonary valve and from QDA and QP was good (r = .97, P < .0001). RPi (P < .001) decreased from 20 to 30 weeks of gestation. From 30 to 38 weeks, RPi increased (P < .0001). Rsi increased (P < .001) from 20 to 38 weeks. The ratio of RPi to RSi decreased (P < .01) from 20 to 30 weeks and later remained unchanged. CONCLUSIONS: The human fetal pulmonary circulation has an important role in the distribution of cardiac output.

Blood Pressure

Transitional structures in lamellar bone.

Scanning electron micrographs of fractured surfaces of mineralized bone show a lamellar structure with alternating smooth and rough regions. These have been interpreted as corresponding to two distinct collagen fibril and mineral crystal orientations in a rotated plywood structure. However, in various bones, there are clear indications of transition zones between lamellae in which the fibrils, as well as the plate-like crystals, have intermediate orientations. Strong evidence for intermediate collagen fibril orientations comes from vitrified cryo-sections of demineralized bone. These show zones of fibril segments graded in length between more homogenous regions of fibrils roughly parallel to the specimen section. Evidence for intermediate crystal orientations comes from transmission electron micrographs and electron diffraction patterns of crushed bone fragments. A tentative scheme is presented for an interlamellar transition zone, involving rotation about the collagen fibril axis as well as tilting of this axis parallel to the plane of the interlamellar boundary. Although it may be convenient to think of the structure of lamellar bone as being composed of alternating thick and thin lamellae, it is probably more correct and biologically more relevant to consider one pair of lamellae as the product of a single depositional cycle of varyingly oriented collagen fibrils that subsequently mineralize.

Animals