Congestive myelopathy caused by spinal dural arteriovenous fistulas. Anamnesis, clinical aspects, diagnosis, therapy and prognosis

BACKGROUND: The role of sampling nasopharyngeal carriage isolates of Streptococcus pneumoniae to determine characteristics of isolates causing invasive disease has not been established. METHODS: Data were compared from two 1995 studies of S. pneumoniae in Metropolitan Toronto and Peel Region (population, 3.1 million). The first was a prospective survey of nasopharyngeal (NP) carriage in child care centers. The second was a prospective surveillance for all cases of invasive disease. RESULTS: There were 545 NP S. pneumoniae isolates obtained from 532 children and 96 cases of invasive S. pneumoniae disease in children. The prevalences of reduced antibiotic susceptibility in the NP carriage and invasive studies, respectively, were: penicillin (16% vs. 11%, P=0.29); erythromycin (12% vs. 7%, P=0.25); and multiresistant (16% vs. 12%, P=0.34). The power to rule out a difference between the groups was <30% for each comparison. Trimethoprim/sulfamethoxazole resistance was more common in NP carriage isolates than invasive isolates (38% vs. 23%, P=0.02). Serotype 14 was more common in invasive isolates, whereas serogroup 6 was more common in NP carriage isolates. Antibiotic-resistant isolates were predominantly serogroups 6, 19 and 23 in both studies. CONCLUSIONS: Nasopharyngeal carriage isolates of S. pneumoniae reflect the antibiotic susceptibility rates of invasive isolates found in the same period for most antibiotics. However, even a large study like this may have limited power to detect a difference. The most common NP carriage serotypes are the same as the invasive isolates, although the rank order of specific serotypes is different. Routine surveys of S. pneumoniae NP carriage are not feasible because of the cost of serotyping and limited power of the observations, unless sample sizes are extremely large.     

Array-based multiplex analysis of candidate genes reveals two independent and additive genetic risk factors for myocardial infarction in the Finnish population

We analysed common variants of eight genes implicated previously as risk factors for coronary heart disease or myocardial infarction (MI) in a cross-sectional study on patients with a history of MI and in carefully matched controls from the Finnish population. The most common low density lipoprotein receptor mutations in Finland were also included in our analysis. Multiplex genotyping of the target genes was performed using a specific and efficient array-based minisequencing system. The 4G allele of the plasminogen activator inhibitor gene (P < 0.05) and the PlA2 allele of the glycoprotein IIIa gene (P < 0.01) were associated with an increased risk of MI in our study population. We analysed the combined effect of these risk alleles and found that the concurrent carrier status of the two genetic variants conferred a high risk for the development of MI in our sample (OR = 4.5, P = 0.001), which was particularly prominent in male subjects (OR = 6.4, P = 0.0005). This study demonstrates the application of a new powerful tool for genome analysis to yield information on the inherited determinants of susceptibility to MI. The observation of two separate genes contributing an additive risk of developing MI exemplifies the advantages of multiplex analysis of genetic variation.     

Human leucocyte antigens in pregnant women with pre-eclampsia associated with intrauterine growth retardation and in normal controls

Prenatal exposure to anticonvulsant medication has been shown to cause craniofacial dysmorphology, prenatal growth retardation, hypoplastic nails and phalanges, and visceral abnormalities. In this study we examined maxillary and mandibular stone dental casts (45) and panoramic radiographs (39) from 45 individuals with ages 4.5 to 22.0 years for changes in mesiodistal crown size of deciduous and permanent teeth, and the presence of dental anomalies. These individuals had been exposed prenatally to antiepileptic drugs (AEDs). Mesiodistal crown diameters were measured from the dental casts and converted into standard scores (Z), using published normative data from the University of Michigan Longitudinal Craniofacial Growth Series. A significant increase in mesiodistal crown dimensions of the posterior maxillary teeth was observed, specifically in primary molars and their permanent premolar successors, as well as permanent molars. Changes in tooth size were more common in females than in males. Dental maturity, assessed using the panoramic radiographs, was equal to chronologic age. An increased frequency of hypodontia was the only notable dental anomaly.     

Prevalence of asthma and asthma-like symptoms in three French cities

BACKGROUND: This study is part of the European Community Respiratory Health Survey (ECRHS), which uses a common methodology in different areas throughout the world. This paper describes the prevalences of reported asthma, asthma-like symptoms and nasal allergies, their relationships to age group and sex, and the relationships of asthma-like symptoms to current asthma, in the general population aged 20-44 years of three French urban areas. METHODS: The study population of 2804 subjects in Grenoble, 3774 in Montpellier and 3152 in Paris (18th district), randomly selected from electoral rolls, answered a postal questionnaire (stage I of ECRHS). The response rates were 77.8%, 68.6% and 74.4%, respectively. RESULTS: The prevalences were approximately 14% for wheezing, 16% for chest tightness and 4.5% for nocturnal shortness of breath in the three areas. Asthma attacks in the last 12 months were reported by 2.7% of subjects in Grenoble, 3.5% of subjects in Montpellier and 4.0% of subjects in Paris (P = 0.02). For nasal allergies, the prevalences were 28.0%, 34.3% and 30.8%, respectively (P < 0.001). Asthma was inversely correlated to age (higher prevalence in the youngest) but was not related to sex. Neither age distribution nor sex ratio explained the differences between areas. Among the asthma-like symptoms, wheezing and nocturnal shortness of breath correlated strongly with asthma, chest tightness correlated moderately and nocturnal coughing correlated poorly. CONCLUSION: The prevalences observed were higher than expected from previous comparable French studies in young adults. These results are consistent with the hypothesis of a recent increase of asthma and allergies.     

Prevalence of allergic rhinitis and atopic dermatitis among children in four regions of Finland

The primary aim of the study was to evaluate the prevalences of allergic rhinitis and atopic dermatitis and their regional differences among Finnish children. The secondary objective was to determine whether the responses to the questions used are affected by the pollen season if asked during such a season. In 1994-5, the self-reported prevalence of allergic symptoms in four regions of Finland was studied among 11,607 schoolchildren aged 13-14 years, as part of the International Study of Asthma and Allergies in Childhood (ISAAC). The prevalence of rhinoconjunctivitis during the preceding year was 16% in eastern Finland (Kuopio County, n=2821), 23% in southern Finland (Helsinki area, n=2771), 15% in southwestern Finland (Turku and Pori County, n=2983), and 16% in northern Finland (Lapland, n=3032). The respective prevalences of flexural dermatitis were 15%, 19%, 16%, and 18%. The surveys were performed in winter, except in the Helsinki area where the survey was carried out mainly in the spring pollen season. Among the children studied in autumn in Helsinki, the prevalence of rhinoconjunctivitis was 19% and that of flexural dermatitis 17%. In multivariate analysis, flexural dermatitis was slightly more common in Lapland than in all other areas. In contrast, no significant differences were found in rhinoconjunctivitis. The prevalences of both disorders were twice as high in girls as in boys. In conclusion, regional differences in the prevalence of allergic rhinitis and atopic dermatitis were small in our country, and the prevalence figures were rather similar to those reported from other European countries. Almost half of the children had suffered from at least one atopic disorder, and over one-third had had symptoms in the past year. A clear season-of-response effect was observed; the prevalence of rhinoconjunctivitis was 25% when studied during the pollen seasons in the Helsinki area.     

Comprehensive dental treatment of healthy and chronically sick children under intubation general anaesthesia during a 5-year period

OBJECTIVE: To quantify the number of extractions and/or restorations placed in chronically sick children under intubation general anaesthesia and compare these findings with healthy children. SETTING: Two large paediatric dentistry units in Central London: a tertiary referral centre dealing with severe chronic sickness in children and an undergraduate dental school with a large commitment to special needs dentistry in children. DESIGN: Prospective comparison of treatment received for (a) chronically sick children and (b) dentally anxious (otherwise fit) children receiving intubation general anaesthesia during July 1991 to June 1996 inclusive. The statistical tests used were the Shapiro-Wilks test for normality and the Mann Whitney U test for non-parametric comparison of independent groups. MAIN OUTCOME MEASURES: Mean total treatment tally (TTT)--the sum of extractions and restorations for each child presented as summary data. RESULTS: Different patterns of dental care were found between the healthy and chronically sick groups. For similar levels of disease, a significantly greater number of extractions were carried out for chronically sick children (P < 0.0001), and significantly fewer restorations (P < 0.0001). The number of pulpotomies and stainless steel crowns provided to sick children was significantly smaller than to healthy children (P < 0.0001). This paper discusses the influences of chronic ill health on dental treatment provided under general anaesthesia. CONCLUSION: The underlying medical disorder in chronically sick children significantly influences the pattern of treatment when this is provided under general anaesthesia.     

The quality of impressions for crowns and bridges received at commercial dental laboratories

OBJECTIVE: To determine the quality of impressions for crown and bridge work made in general dental practice. DESIGN AND SETTING: All impressions for crown and bridge work which had been sent to four commercial dental laboratories in the UK were assessed by two examiners, each laboratory being visited on two occasions. MATERIALS AND METHODS: 290 cases which had been received by the laboratories on the days of the visits were assessed for a number of factors related to quality. There was no selection or rejection--all impressions received were examined. RESULTS: Flexible plastic trays were used for the majority of working impressions for crown and bridge work in general dental practice (72%), many had been re-used (> 13%), defects in the recording of the prepared teeth were common, and cross infection control was not routine. CONCLUSIONS: Quality standards for impressions for crown and bridge work in general dental practice in the UK are a cause for concern if the sample of cases seen in this study is typical.     

Postoperative complications after Mainz pouch construction--with emphasis on measures to deal with narrowing of the duct aperture

Cutaneous sinus tracts in the face and neck region are often dental in origin. The purpose of this study was to characterize the clinical features and treatment of 37 consecutive cases of odontogenic cutaneous sinus tracts, collected and reviewed in a 15-year period. More than half of the patients (21 cases, 57%) were referred from medical doctors, particularly plastic surgeons and dermatologists. The sinus tracts were associated with caries (26 cases), incomplete endodontic treatment (7), crown fracture (2), vertical root fracture (1) and impacted mandibular third molar (1). They occurred most often in adolescents and adults (30 cases, 81%). The most common causative teeth were mandibular teeth (34 teeth, 85%). The chin, submental, and cheek areas were the most common sites of sinus tracts (30 cases, 81%). The majority of causative teeth (32 teeth, 80%) were treated endodontically. All fistulas healed uneventfully after proper dental treatment, without cosmetic surgery. In 63% (20 cases) of the recorded cases, complete resolution occurred within 8 weeks. Half of the patients had had fistulas for more than 6 months before receiving dental treatment, demonstrating that delays in proper diagnosis and treatment were common. As most patients suffered from unnecessary medication or surgery due to the delay of dental treatment, early dental consultation and treatment is important. Conventional endodontic treatment should be the treatment of choice if the tooth is salvageable. The increasing incidence of incomplete endodontic treatment in association with the occurrence of sinus tracts indicates that standardized endodontic therapy should be emphasized for prevention.     

Assignment of the locus for PLO-SL, a frontal-lobe dementia with bone cysts, to 19q13

PLO-SL (polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy) is a recessively inherited disorder characterized by systemic bone cysts and progressive presenile frontal-lobe dementia, resulting in death at <50 years of age. Since the 1960s, approximately 160 cases have been reported, mainly in Japan and Finland. The pathogenesis of the disease is unknown. In this article, we report the assignment of the locus for PLO-SL, by random genome screening using a modification of the haplotype-sharing method, in patients from a genetically isolated population. By screening five patient samples from 2 Finnish families, followed by linkage analysis of 12 Finnish families, 3 Swedish families, and 1 Norwegian family, we were able to assign the PLO-SL locus to a 9-cM interval between markers D19S191 and D19S420 on chromosome 19q13. The critical region was further restricted, to approximately 1.8 Mb, by linkage-disequilibrium analysis of the Finnish families. According to the haplotype analysis, one Swedish and one Norwegian PLO-SL family are not linked to the chromosome 19 locus, suggesting that PLO-SL is a heterogeneous disease. In this chromosomal region, one potential candidate gene for PLO-SL, the gene encoding amyloid precursor-like protein 1, was analyzed, but no mutations were detected in the coding region.     

Haplotypes of the ApoA-I/C-III/A-IV gene cluster and familial combined hyperlipidemia

Familial combined hyperlipidemia (FCHL) is the most frequent familial lipoprotein disorder associated with premature coronary heart disease. However, no genetic defect(s) underlying FCHL has been identified. A linkage between FCHL and the apoA-I/C-III/A-IV gene cluster has been reported but not verified in other populations. A recent study identified FCHL susceptibility haplotypes at this gene cluster. To study whether such haplotypes are also associated with FCHL susceptibility in Finns, we studied 600 well-defined Finnish FCHL patients and their relatives belonging to 28 extended FCHL families by using haplotype, linkage, sib-pair, and linkage disequilibrium analyses. The genotypes of the MspI polymorphisms were associated with total serum cholesterol (P<0.01) and apoB (P<0.05) levels in spouses, which represent the general Finnish population. However, no evidence of direct involvement of any of these loci or their specific haplotypes in the expression of FCHL in the Finnish FCHL families was found.     

Prevalence of hidradenitis suppurativa in Denmark

The morbidity of hidradenitis suppurativa can be considerable, but little is known about its epidemiology. Our purpose was to describe the one-year and point prevalences of hidradenitis suppurative and its potential precursor lesions. We obtained the histories and examined an unselected sample (599 persons) of the general population (one-year prevalence), and we performed physical examination for a consecutive sample of 507 persons undergoing screening for sexually transmitted diseases (point prevalence). The point prevalence was 4.1% (95% confidence interval [CI] = 3.0-6.0) on the basis of objective findings. The one-year prevalence of hidradenitis was 1.0% (CI = 0.4-2.2) on the basis of subject recollection only. The patients in the sample on which the point prevalence is based were younger than those in the unselected sample of the general population (p < 0.001). Hidradenitis was significantly more common in women (p = 0.037), which may result from a female preponderance of genitofemoral lesions (odds ratio [OR] = 5.4; CI = 1.5-19.3). No sex difference was found in the prevalence of axillary lesions. Hidradenitis suppurativa is significantly more common than hitherto estimated. A female preponderance of patients is confirmed, except for patients with axillary lesions. Additional longitudinal studies are necessary to assess the importance of potential precursor lesions such as non-inflamed nodules or comedones.     

Smooth-pursuit eye tracking in first-episode psychotic patients and their relatives.

In order to determine the specificity of smooth-pursuit eye tracking dysfunction to schizophrenia (SC) and the prevalences of dysfunction among functionally psychotic and normal individuals, the authors investigated pursuit tracking in a large sample of psychotic patients, normal Ss, and 1st-degree relatives (N?=?482). Ss were recruited as part of an epidemiological study of 1st-episode psychosis that used a broadly based referral network to identify all cases in a major metropolitan area over a 2.5-yr period. Ss received diagnoses of SC, schizophreniform disorder, psychotic mood disorder, and paranoid or other psychotic disorder based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). The distribution of tracking performance was bimodal for the SC Ss and their relatives, perhaps reflecting major gene action. Moreover, poor tracking ran in families. Pursuit tracking dysfunction was relatively specific to SC Ss and their relatives and occurred infrequently in other psychotic Ss and normal Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Potential cardioembolic sources in an elderly population without stroke. A transthoracic and transoesophageal echocardiographic study in randomly selected volunteers

Transoesophageal echocardiography renders a better image than transthoracic echocardiography of cardiac changes especially at the atrial level, and of atherosclerotic changes in the aorta. Although several studies on stroke patients have included transthoracic and transoesophageal echocardiography, the relevance of the reported findings remains unclear because of limited information on the prevalence of cardiac changes related to cardioembolism in a control population without stroke. In order to define a non-hospitalized group of volunteers without previous stroke or transient ischaemic attack, we randomly selected a group of 68 volunteers (mean age 65.4 years). These volunteers were divided into two groups: the elderly group, 65 years or older (n = 38) and the younger group, younger than 65 years (n = 30). The subjects underwent transthoracic and transoesophageal echocardiography, sonography of the carotid arteries, and magnetic resonance imaging of the brain. The prevalences of atrial septal aneurysm, patent foramen ovale, mitral annulus calcification, and protruding plaque in the aorta were investigated. We found atrial septal aneurysm in 13%, patent foramen ovale in 22%, protruding plaque in the aorta in 7%, and mitral annular calcification in 22% of the 68 subjects. No significant differences were found between the two age groups with the exception of mitral annular calcification, which was seen more often in the older group (P < 0.001). Total cardiac changes related to thromboembolism (including three cases with atrial fibrillation in the older group and other less common cardiac embolic sources) were more common in the older than in the younger group (23/38 vs 9/30; P < 0.05). If mitral annular calcification was excluded, no difference was found between the elderly and the younger group, 14/38 vs 8/30; ns. Even when subjects with a history of heart disease or a pathological ECG were omitted, no differences between the two age groups were found. The causal relationship between a possible embolic source and a clinical embolic event remains unsettled. The high prevalence of cardiac changes in a control population has to be considered when evaluating the significance of similar findings in patients with stroke.     

HLA-DQB1-defined genetic susceptibility, beta cell autoimmunity, and metabolic characteristics in familial and nonfamilial insulin-dependent diabetes mellitus. Childhood Diabetes in Finland (DiMe) Study Group

Familial aggregation of insulin-dependent diabetes mellitus (IDDM) is a common phenomenon, but the reasons behind it are poorly understood. To investigate whether there is heterogeneity between familial and nonfamilial forms of IDDM we compared genetic, immunological, and clinical characteristics of diabetic children with and without an affected first-degree relative in a population-based series of Finnish children with IDDM. The frequencies of HLA-DQB1 genotypes known to be associated with high (DQB1*0302/0201) or moderate (*0302/x) IDDM risk in the Finnish population were increased, while the proportions of DQB1 genotypes associated with low or decreased risk for IDDM were reduced in the 121 familial cases as compared with the 574 nonfamilial cases (32.7 vs. 21.3%, 41.3 vs. 35.9%, 18.3 vs. 31.4%, and 7.7 vs. 11.4%, respectively; P = 0.002). The frequencies and serum concentrations of islet cell antibodies, insulin autoantibodies, and antibodies to the 65-kD isoform of glutamic acid decarboxylase were similar at diagnosis in the familial and nonfamilial cases. The 31 first-affected cases in the multiple case families were younger at diagnosis than the nonfamilial cases (6.9 vs. 8.5 yr; P < 0.05). The 90 second-affected familial cases had less severe metabolic decompensation at diagnosis than either the first-affected familial or nonfamilial cases. In conclusion, familial aggregation of IDDM in Finland is at least partly explained by a higher frequency of IDDM susceptibility genes in families with multiple affected individuals. The lack of differences in autoantibody levels between the familial and nonfamilial cases indicates homogeneity rather than heterogeneity in the pathogenetic process of beta cell destruction.     

Ropy slime-producing Lactobacillus sake strains possess a strong competitive ability against a commercial biopreservative

Ambulatory AIDS patients participating in a quality of life study were recruited for an assessment of pain syndromes. Of 274 patients with pain, 151 (55%) consented to the assessment which included a clinical interview, neurologic examination, and review of medical records. The number, type, and etiology of pains were evaluated in terms of risk factors, age, sex, CD4+ lymphocyte count, and performance status. The average number of pains per patient was 2.7 (range, 1-7), yielding a total of 405 pains. The most common pain diagnoses were headache (46% of patients; 17% of all pains), joint pain (31% of patients; 12% of pains), pain due to polyneuropathy (28% of patients; 10% of pains), and muscle pain (27% of patients; 12% of pains). Pathophysiology was inferred for all pain syndromes (except for headache), 45% of pain syndromes were somatic in nature, 15% were visceral, 19% were neuropathic, and 4% were unknown, psychogenic, or idiopathic; 17% of pains were classified as headache, hence pathophysiology could not be determined. Pain resulted from diverse etiologies, including the direct effects of HIV/AIDS-related conditions (30%) pre-existing unrelated conditions (24%), and therapies for HIV/AIDS and related conditions (4%). The latter category, pain related to HIV therapies, occurred in 11% of patients. In 37% of the pains, the etiology could not be determined from the information available. In univariate analyses, lower CD4+ cell counts were significantly associated with polyneuropathy (P < 0.05) and headache (P < 0.05), and female gender was significantly associated with the presence of headache (P < 0.05) and radiculopathy (P < 0.001). These data confirm the diversity of pain syndromes in AIDS patients, clarify the prevalence of common pain types, and suggest associations between specific patient characteristics and pain syndromes. The large proportion of patients who could not be given a diagnosis underscores the need for a careful diagnostic evaluation of pain in this population.     

Hereditary pancreatitis: report of a family from Turkey

Lysinuric protein intolerance (LPI) is an autosomal recessive disorder in which transport of the cationic amino acids lysine, arginine and ornithine is defective at the basolateral membrane of the epithelial cells in the intestine and renal tubules. LPI is unusually common in Finland, but patients have been described on all continents. Linkage analysis in Finnish LPI families recently assigned the LPI gene locus to a 10 cM interval between markers D14S72 and MYH7 on the long arm of chromosome 14. In the present study linkage analysis of LPI families from six different non-Finnish populations strongly suggests genetic homogeneity in LPI. Peak lod scores were obtained at the chromosomal area between D14S72 and MYH7 with the same markers as in the Finnish families. The non-Finnish families showed no linkage disequilibrium except in an Italian family cluster, whereas strong allelic association in the Finnish families implies that LPI in Finland is caused by a founder mutation.     

Patients' needs in hospital: nurses' and patients' views

This study set out to identify the most important needs of hospital patients on surgical and medical wards and to assess the ability of nurses to identify these needs. The population consisted of 92 Finnish patients and 69 Finnish nurses. The study was carried out using a questionnaire designed on the basis of the need theory presented by Yura and Walsh. The results of the statistical analyses were presented in the form of frequencies, cross-tabulations and chi-square tests. The patients' most common needs were related to vital functions (44%), followed by those related to functional health status (38%) and environmental needs (36%). The last item on the list of expressed needs concerned reactions to functional health status (31%). Over 70% of the surgical patients suffered from problems related to sleep and rest. Less than 60% of them suffered from acute pain. Medical patients, in turn, had more frequent needs related to vital functions than did surgical patients. Three out of four medical patients suffered from acute pain. Sleep and rest disturbances, stress, bad mood and listlessness were also common problems. The nurses underestimated all patient needs, apart from environmental needs, which they regarded as the main concern of patients. There was a statistically significant difference between patients' and nurses' assessments for 38% of all needs. Moreover, there were differences in assessments between the surgical and medical wards included in the study.     

New players and puzzles in the Hedgehog signaling pathway

STATEMENT OF PROBLEM: Esthetic demands of patients and practitioners for an all-ceramic crown in both anterior and posterior regions of the dental arches has prompted the development of the Procera AllCeram crown. Long-term clinical trials that evaluate the strength and naturalness of the Procera AllCeram crown are lacking. PURPOSE: This prospective study was initiated to evaluate the clinical performance of 100 Procera AllCeram crowns after 5 years in service. MATERIAL AND METHODS: One hundred Procera AllCeram crowns were fabricated for 58 patients (20 men and 38 women). Patients were treated by 4 general dental practitioners. Crown placement involved both the anterior and posterior regions of the dental arches. Crowns were examined at baseline and once a year during the 5 years that followed and evaluated at each appointment with the California Dental Association's quality assessment system. RESULTS: Of the 97 crowns remaining in the study after 5 years, only 3 crowns had experienced a fracture through the veneering porcelain and the aluminum oxide coping material. Two additional crowns were replaced as a result of fractures of only the veneering porcelain. One crown was replaced as a result of recurrent caries. All remaining crowns were ranked as either excellent or acceptable for surface/color, anatomic form, and marginal integrity. CONCLUSION: The 5-year clinical observations and ranking with the California Dental Association's quality assessment criteria supported the conclusion that Procera AllCeram crowns may be used in all areas of the mouth.     

A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries

This paper is a review of the clinical findings from my thesis "Pulp survival and hard tissue formation subsequent to dental trauma". Traumatic injuries in children and adolescents are a common problem, and the prevalence of such injuries has increased over the last 10-20 years. The purpose of the present investigations was to evaluate the long-term results following uncomplicated crown fractures and luxations involving subsequent pulp canal obliteration. A total of 241 patients with 545 injured teeth were available for clinical examination, of whom 102 answered a questionnaire and were interviewed before oral examination. In addition, 82 permanent incisors presenting with pulp canal obliteration were followed for a period of 7 to 22 years (mean 16 years). The findings showed little pulpal response to crown fracture and subsequent restorative procedures as long as there was no concomitant periodontal injury (15-year follow-up). Approximately every fourth resin composite filling was rated as unacceptable at clinical examination. The interview showed that half of the individuals were dissatisfied with the color and/or anatomic form of the composite restoration. Pulp canal obliteration was found in all luxation categories, and 69% of the teeth demonstrated yellow crown discoloration. According to the survival curve the 20-year pulp survival rate diagnosed radiographically was 84%. Although the risk of pulp necrosis increased with time, routine endodontic intervention of teeth with ongoing pulp canal obliteration of the root canal did not seem justified.     

The etiology of vision impairment in target population

PURPOSE: research the etiology of vision impairment in target persons over 45 years old in Doumen county, Guangdong province. METHODS: Depending on the prevalences of the blindness among the person aged over 50 years, the theoretic sample rate is 1,000/4,8733 x 100% = 2.05%. The 8 districts were divided into 3 parts according to the local economic situation and the proportion of the population in the areas. In fact, the sampling rate is 932/10055 = 88.34%. RESULTS: We found that impairment < 0.3 accounted for 10.94%. The prevalence of bilateral blindness and low vision was 1.61% and 3.22%, respectively. Both prevalences of blindness and low vision were increased with age. The leading cuase of blindness was cataract (45.2%). The second was corneal opacity (16.7%). Prevalences of the low vision and the blindness were higher in females than in males (P < 0.005). CONCLUSIONS: Curable and preventable diseases were the leading cause for the blindness (70%). Prevalences of blindness and the low vision increase with age. We will continually follow up the population over 50 years of age in Doumen county.