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Aspirin use in the United States remains high because of its diverse and beneficial activities. In adults at risk for cardiovascular thrombotic events, low-dose aspirin is an excellent preventive agent; however, its antiplatelet properties have contributed to a perceived increased risk for bleeding after dental extractions. This article discusses recent evidence regarding the thrombotic risks associated with discontinuing aspirin use in patients who take aspirin daily and presents a new recommendation for continuing low-dose aspirin during invasive dental procedures.

Viral genes sufficient and required for herpes simplex virus type 1 (HSV-1) reactivation were identified using neuronally differentiated PC12 cells (ND-PC12 cells) in which quiescent infections with wild-type and recombinant strains were established. In this model, the expression of ICP0, VP16, and ICP4 from adenovirus vectors was sufficient to reactivate strains 17 + and KOS. The transactivators induced similar levels of reactivation with KOS; however, 17 + responded more efficiently to ICP0. To identify viral transactivators required for reactivation, we examined quiescently infected PC12 cell cultures (QIF-PC12 cell cultures) established with HSV-1 deletion mutants R7910 (ΔICP0), KD6 (ΔICP4), and in 1814, a virus containing an insertion mutation in VP16. Although growth of these mutant viruses was impaired in ND-PC12 cells, R7910 and in 1814 reactivated at levels equivalent to or better than their respective parental controls following stress (i.e., heat or forskolin) treatment. After treatment with trichostatin A, in 1814 and 17 + reactivated efficiently, whereas the F strain and R7910 reactivated inefficiently. In contrast, KD6 failed to reactivate. In experiments with the recombinant KM100, which contains the in 1814 mutation in VP16 and the n212 mutation in ICP0, spontaneous and stress-induced reactivation was observed. However, two strains, V422 and KM110, which lack the acidic activation domain of VP16, did not reactivate above low spontaneous levels after stress. These results demonstrate that in QIF-PC12 cells ICP0 is not required for efficient reactivation of HSV-1, the acidic activation domain of VP16 is essential for stress-induced HSV-1 reactivation, and HSV-1 reactivation is modulated uniquely by different treatment constraints and phenotypes.

Joseph D Foley,1 Craig S Miller,2 J Darrell Sneed,1 Jeffrey L Ebersole,2 Richard J Kryscio,3 John T McDevitt,4 Charles L Campbell5 1Gill Heart Institute and Division of Cardiovascular Medicine, Department of Internal Medicine, 2Department of Oral Health Practice, College of Dentistry, 3Department of Statistics, University of Kentucky, Lexington, KY, 4Departments of Bioengineering and Chemistry, Rice University, Houston, TX, USA; 5Division of Cardiololgy, University of Tennessee at Chattanooga, Erlanger Health Systems, TN, USA Abstract: Alcohol septal ablation (ASA) is employed to relieve the pressure gradient associated with symptomatic hypertrophic cardiomyopathy. Serum concentrations of cardiac troponin I, creatine kinase MB band, brain natriuretic protein, matrix metalloproteinase-9, myoglobin, C-reactive protein, tumor necrosis factor-alpha, soluble CD40 ligand, interleukin-6, adiponectin, interleukin-1ß, myeloperoxidase, and soluble intercellular adhesion molecule-1 were determined at baseline and at 8, 16, 24, and 48 hours in patients with hypertrophic cardiomyopathy presenting for ASA. Comparisons were made with 107 healthy control subjects. Sixteen hours following ASA, serum levels rose over 800-fold for cardiac troponin I, 70-fold for creatine kinase MB band, and 11-fold for myoglobin (P

A computational cognitive model of Web navigation is a working computer system that simulates human users searching for items in a Web site. A fully working model must automate aspects of human perception, decision making and physical control. To successfully predict human behavior, these automated processes must be consistent with the cognitive and physical limitations of human users. Predicted behavior might include which links users select, when they select them and when they backtrack to previous pages. In this chapter, the necessary capabilities of a working model are described in detail. These include processes that simulate users scanning a page of links, assessing each link, selecting a link and deciding when to backtrack. Accurately modeling link assessment for a variety of users is critical for successful predictions and is perhaps the greatest challenge in creating a useful model. Several approaches to link assessment are presented. The implementation details of one model are described, which are then evaluated by correlating the model's timing predictions to results from user studies.

Educators are increasingly acknowledging that practical problems in computer science demand basic competencies in experimentation and data analysis. However, little effort has been made towards explicitly identifying those empirical concepts and skills needed by computer scientists, nor in developing methods of integrating those concepts and skills into CS curricula. In this paper, we identify a core list of empirical competencies and motivate them based on established courses outside of computer science, their potential use in standard CS courses, and their application to real-world problems. Sample assignments that facilitate the integration of these competencies into the CS curriculum are also discussed.

Burning mouth disorder (BMD) is a chronic, oral pain condition associated with burning sensations of the tongue, lips, and mucosal regions of the mouth. Diagnosis of the condition is complicated by the fact that a variety of systemic and local factors can be contributory. Treatment goals are to reduce symptoms by eliminating identifiable abnormalities. Secondary lines of therapy include pharmacotherapeutic approaches that target neuropathologic mechanisms that appear to be active.

To compare the usefulness of the in vitro quiescently infected (QIF)-PC12 cell model(30) with the in vivo rabbit eye model of latency for the study of herpes simplex virus (HSV) genes implicated in reactivation from latency.HSV-1 strains 17+/pR20.5/5 and 17+/pR20.5/5/LAT, that were previously constructed by insertion of genes encoding beta-galactosidase, green fluorescent protein (GFP) or the latency associated transcript (LAT) open reading frame in the U(S)5 region,(34) were used to examine viral growth and inducible reactivation in the two models.17+/pR20.5/5 exhibited diminished reactivation phenotype when compared with wild type 17+ in neuronal cells (i.e., QIF-PC12 cell model) and the rabbit eye model of latency. 17+/pR20.5/5/LAT, which contains the deregulated LAT gene, reactivated at wild type levels. Analysis of growth in neurally differentiated (ND)-PC12 cells demonstrated a low proportion of QIF cells expressed virus-encoded signals during the quiescent infection and a direct relationship between lytic viral growth in neuronal cells and reactivation phenotype. Even though 17+/pR20.5/5/LAT produced a more severe acute infection in the rabbit cornea, the different reactivation efficiency of 17+/pR20.5/5 and 17+/pR20.5/5/LAT in vivo and in vitro was not attributed to different viral genome copy number in the cells harboring cryptic genomes.We conclude that 1) viral growth in neuronal cells correlates with reactivation phenotype in vivo and in vitro, 2) 17+/pR20.5/5 is attenuated in viral growth and reactivation in both models, and 3) 17+/pR20.5/5/LAT demonstrates wild-type phenotype for reactivation in both models. Attenuation of 17+/pR20.5/5 could be the result of the disruption of U(S)5 or a second site mutation. If the attenuation is the result of U(S)5 disruption, a gene that provides anti-apoptotic functions,( 41,42) this attenuation is more than compensated for by the expression of the LAT ORF. Overall, the findings indicate that the QIF-PC12 cell model is useful for segregating phases of reactivation, and particularly studying the inductive events involved in reactivation of a cryptic viral genome in neurally differentiated cells.

Background. Oropharyngeal cancer has a low 5-year survival rate in the United States, indicating that much remains to be learned about risk and survival factors. The purpose of this research was to identify factors that contribute to risk of and survival from this disease in a region associated with high tobacco use. Methods. A retrospective chart review of 221 subjects with diagnosis of head and neck cancer at a regional University Medical Center during a 10-year period (1986 to 1995) was performed to identify relationships between risk and survival factors of oropharyngeal squamous cell carcinoma (OSCC). Data from 92 records met the inclusion criteria and were analyzed with the χ 2 test of association, the Fisher exact test, and the log-rank test for comparison of survival distributions. The software used was SAS for Windows, release 8.2. Results. Most study subjects were white men between the ages of 50 and 75 years who chronically used tobacco and alcohol. The overall median survival period of the group was 18.1 months. The percentage of subjects surviving to 3 years was 35.6%. Disparities were identified in risk and survival by sex, race, age, dwelling, anatomic site, and exposure to carcinogenic substances. In particular, the disease more adversely affected minorities and those who chronically used tobacco or alcohol. Conclusion. Our results show that, in the examined regional population, a high prevalence of tobacco use correlated with alcohol use and a lower rate of survival from OSCC than the national rate. Also, risk of and survival from OSCC are affected by demographic, geographic, and behavioral factors. This information is useful for the design and implementation of more effective preventive and intervention strategies. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:570-5)

Burning mouth syndrome (BMS) primarily affects postmenopausal women and is often difficult to treat successfully. Treatment outcomes have been problematic because of failure to distinguish between patients with BMS and patients presenting with oral burning (OB) resulting from other clinical abnormalities. The purpose of this study was to determine characteristics that might uniquely identify BMS patients from patients with OB and to determine whether proper classification influences treatment outcome.The clinical sample consisted of 69 patients (83% female) with an average age of 62 years, pain duration of 2.45 years, and visual analog scale pain rating of 49 mm (rated from 0 to 100 mm). All patients underwent a clinical exam and completed the Multidimensional Pain Inventory and Symptom Checklist 90-Revised.There were no differences between the BMS and OB groups with respect to age, pain duration, pain intensity, life interference, and levels of psychologic distress. Patients with OB demonstrated more clinical abnormalities than BMS patients. Hyposalivation and greater use of prescription medications, most notably hormone replacement therapy, were more common in the OB group compared with the BMS group. When treatment was provided that corrected an identifiable abnormality, significantly more OB than BMS patients reported greater than 50% relief from baseline pain rating.These data indicate that while BMS and OB groups may initially present with similar clinical and psychosocial features, they are distinguishable with careful diagnosis that often enables successful management of symptoms for each group.

The purpose of this article is to report a case of severe stomatitis in a patient with pediatric epilepsy taking divalproex sodium. The case was reviewed with detailed oral examinations. This 5-year-old child developed severe stomatitis 18 months after institution of divalproex sodium. Cessation of the medication was associated with resolution of the stomatitis. A review of the pertinent literature is also provided. Stomatitis is a rare but potentially serious adverse effect of divalproex sodium administration. (J Child Neurol 2002;17: 225-227).

Objective. Human papillomavirus (HPV) infection is a significant risk factor for uterine cervical carcinoma. However, the role of HPV infection in oral squamous cell carcinoma (OSCC) is less well defined. To determine the significance of the relationship of this virus in the progressive development of oral cancer, we estimated the risk of HPV detection in normal oral mucosa, precancerous oral tissue, and oral carcinoma using meta-analysis. Study design. Case reports and clinical series published in English-language journals were retrieved by searching MEDLINE (January 1980-August 1998). Review articles were also examined to identify additional studies. Studies that used biochemical, immunologic, microscopic, or molecular analyses to detect HPV in tissue or cells derived from normal oral mucosa (n = 25), benign leukoplakia (n = 21), intraepithelial neoplasia (ie, dysplasia and carcinoma in situ; n = 27), and oral cancer (n = 94) were included in the meta-analysis. Information on sample size, age, sex, method of tissue preservation (ie, fresh, frozen, paraffin-embedded), assay, primer amplification region (early, late), high-risk versus low-risk genotype, and use of tobacco or alcohol was abstracted by one author (C.S.M.). Results. Data from 94 reports that analyzed 4680 samples were included in the meta-analysis. Analyses made by means of a random-effects model with and without adjustments for assay sensitivity showed increased probability of HPV detection in tissue with precancerous and cancerous features compared with normal mucosa. The likelihood of detecting HPV in normal oral mucosa (10.0%; 95% confidence interval [CI], 6.1%-14.6%) was significantly less than of detecting benign leukoplakia (22.2%; 95% CI, 15.7%-29.9%), intraepithelial neoplasia (26.2%; 95% CI, 19.6%-33.6%), verrucous carcinoma (29.5%; 95% CI, 23%-36.8%), and OSCC (46.5%; 95% CI, 37.6%-55.5%). Adjustment of findings for differences in assay sensitivity indicated that these estimates may be conservative. Overall, HPV was between 2 and 3 times more likely to be detected in precancerous oral mucosa and 4.7 times more likely to be detected in oral carcinoma than in normal mucosa. The pooled odds ratio for the subset of studies directly comparing the prevalence of HPV in normal mucosa and OSCC was 5.37, confirming the trend observed in the overall sample. The probability of detecting high-risk HPVs in OSCCs was 2.8 times greater than that of low-risk HPVs. Conclusion. This meta-analysis indicates that HPV is detected with increased frequency in oral dysplastic and carcinomatous epithelium in comparison with normal oral mucosa. The findings provide further quantitative evidence that oral infection with HPV, particularly with high-risk genotypes, is a significant independent risk factor for OSCC. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:622-35)

We previously described a novel in vitro model of a non-productive herpes simplex virus type 1 (HSV-1) infection in neurally differentiated (ND)-PC12 cells that allows for inducible virus replication upon forskolin and heat stress (HS) treatment. In this research, we further characterized the model with respect to HSV-2 strain 333. We found that: (i) ND-PC12 cells are non-permissive to HSV-2 replication; (ii) HSV-2 can establish a quiescent infection, like HSV-1, in ND-PC12 cells with the transient use of acycloguanosine (ACV); however unlike HSV-1, anti-viral conditions are not obligatory to establish and maintain a quiescent state; (iii) the quiescent state is maintained in the presence of Vero cell cocultivation indicating that such cultures are free of infectious virus; and (iv) a high percentage of quiescently infected (QIF)-PC12 cell cultures (80 - 100%) produce HSV-2 in response to forskolin and HS (43 degrees C, 3 h) treatment for as long as 4 weeks post infection. These findings indicate that ND-PC12 cells can harbor HSV-2 in a cryptic and non-productive state that is reversible. This model has appealing features for studying gene expression during the establishment, maintenance and reactivation phases of the HSV-2 quiescent state in cell culture.

Empirical skills are playing an increasingly important role in the computing profession and our society. But while traditional computer science curricula are effective in teaching software design skills, little attention has been paid to developing empirical investigative skills such as forming testable hypotheses, designing experiments, critiquing their validity, collecting data, explaining results, and drawing conclusions. In this paper, we describe an initiative at Dickinson College that integrates the development of empirical skills throughout the computer science curriculum. At the introductory level, students perform experiments, analyze the results, and discuss their conclusions. In subsequent courses, they develop their skills at designing, conducting and critiquing experiments through incrementally more open-ended assignments. By their senior year, they are capable of forming hypotheses, designing and conducting experiments, and presenting conclusions based on the results.

Rat pheochromocytoma (PC12) cells differentiated with nerve growth factor (Nd-PC12) were used to investigate the establishment of a non-productive herpes simplex virus type 1 (HSV-1) infection that is reversible. The results of this work are as follows: (i) Nd-PC12 cultures could be maintained as long term (>7 weeks) non-dividing cultures only when plated on collagen-coated dishes in the absence of serum; (ii) Infection of Nd-PC12 with HSV-1 strains KOS and 17 in the transient presence of acycloguanosine (ACV) resulted in all cultures free of detectable levels of infectious virus at the time of ACV removal and ACV was not needed to maintain the non-productive quiescent state in the subsequent 8 weeks; (iii) These persistently infected and quiescent (QIF)-PC12 cultures demonstrated both spontaneous and forskolin-inducible virus production, at low (5%) and high frequencies (92-100%), respectively during the first 2 weeks post-ACV withdrawal. (iv) In contrast to other in vitro models, HSV-1 failed to reactivate following removal of nerve growth factor. (v) A high percentage of QIF-PC12 cultures (50-100%) produced virus in response to forskolin treatment as long as 7 weeks post-ACV withdrawal. (vi) Expression of HSV-1 productive genes (i.e. alpha0, alpha4, alpha27, UL30 and UL18) dropped precipitously in the presence of ACV and remained undetectable or continued to decline following its removal, whereas the levels of LAT and the host gene G3PDH remained relatively constant throughout the 31 day study period as measured by RT-PCR. These results indicate that QIF-PC12 cells offer a novel, neuronal cell culture system that may enhance our ability to study HSV-1 reactivation from a cryptic, latent-like, non-productive state in the absence of replication inhibitors.

Human herpesviruses and human papillomaviruses are ubiquitous and may cause an array of oral disease. Herpesviruses are unique because recurrent localized disease occurs after the primary infection. Human papillomaviruses are known for their ability to produce benign epithelial proliferations and increasingly are implicated in the development of oral cancer. This article reviews the pathogenesis of common oral lesions induced by these viruses.

The physiologic stress of various dental procedures (dental examination, dental prophylaxis, restoration, root canal therapy, and tooth extraction) was measured in 50 nonsmoking healthy men between the ages of 18 and 55 years (mean 34.6 years, range 21 to 53 years) with a salivary cortisol assay. Expectorated saliva was collected at four time points: 10 minutes before the start of the procedure, 15 minutes after the patient was seated, at the end of the procedure, and 1 hour after the completion of the procedure. Of the 196 samples included for analysis, mean cortisol values ranged from 0.1 to 3.8 micrograms/dl with a recovery of 100% +/- 8.4%. The mean cortisol value for the extraction group (1.09 +/- 0.42 microgram/dl) was significantly different (p < 0.05) from the mean values of the examination (0.46 +/- 0.10 microgram/dl), prophylaxis (0.64 +/- 0.64 microgram/dl), root canal (0.49 +/- 0.07 microgram/dl), and restorative (0.60 +/- 0.04 microgram/dl) groups as determined by the Duncan's multiple range test. Cortisol levels decreased from the initial reading to the end of the procedure by about 15% for patients undergoing an examination, root canal, and restorative procedure. Cortisol levels at the end of the procedure were elevated in the prophylaxis (55%) and extraction (148%) groups compared with the baseline cortisol recording. A minority of patients in the prophylaxis group had elevated cortisol levels throughout dental treatment, whereas cortisol levels were elevated during treatment in 80% of patients undergoing extraction. These data suggest that the adrenal stress response associated with tooth extraction(s) is greater than that associated with other routine dental procedures.

This study determined the prevalence of human papillomavirus16/18 DNA in deparaffinized oral carcinoma specimens on slides with the use of the different sensitivities of in situ hybridization and a technique that combines polyermase chain reaction and in situ hybridization. Human papillomavirus DNA was not detected in the 30 biopsy specimens analyzed by in situ hybridization alone using biotinylated DNA probes specific for human papillomavirus16/18. Twenty of 30 specimens (66.7%) were found to have human papillomavirus DNA (p < 0.001) with the use of the polymerase chain reaction-in situ hybridization technique. Human papillomavirus 16 was detected in 18 of 26 specimens (69.2%), and 7 of 25 carcinomas (28%) were found to contain human papillomavirus 18. Dual infections were present in 5 of 21 (23.8%) specimens. Human papillomavirus DNA was more prevalent in men (75%) than women (57.1%). However, there was no difference in the mean age of patients with oral carcinoma (men, 67.8 years; women, 67.5 years) who had human papillomavirus and those who did not (67.2 years). Carcinomas associated with dual infections occurred at a lower mean age (59.4 years) than those associated with a single human papillomavirus type (p < 0.005). We conclude that the polymerase chain reaction-in situ hybridization technique enhances our ability to demonstrate human papillomavirus types highly associated with oral squamous cell carcinoma.

The effectiveness of the Viratype Omniprobe in situ human papillomavirus tissue hybridization kit (Digene Diagnostics) was evaluated for the detection of HPV DNA in common orofacial lesions. Seventy mucocutaneous lesions were hybridized with a biotinylated Omniprobe that was specific for HPV types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56. Eighteen (25.7%) of the specimens analyzed had intranuclear positive signals for HPV. Probing with HPV 6/11, 16/18, and 31/33/35 to delimit the HPV genotype yielded HPV DNA 6/11 in 16 (88.9%) of the Omniprobe-positive specimens. Only squamous papilloma and condyloma acuminatum were found to harbor HPV DNA. Sites most frequently infected were the labial and buccal mucosa (21.7%) and the floor of the mouth (17.4%). These results suggest that hybridization with the Omniprobe provides appropriate sensitivity and specificity for detecting HPV in some benign proliferations of the oral cavity. However, the detection of HPV in oral squamous cell carcinoma, lichen planus, and keratoacanthoma remains problematic until more sensitive and specific molecular techniques are used.

Replication of herpes simplex virus type 1 was enhanced in fibroblast cultures when cells were ultraviolet irradiated 12 to 48 hours before infection. Maximum enhancement (340% increase) occurred at exposures of 9.6 J/m2 in DNA-repair competent fibroblasts. Repair deficient xeroderma pigmentosum cells responded to lower ultraviolet exposures (1.6 to 5.6 J/m2) with lower levels of enhancement (37% to 140%). Ultraviolet irradiation of host cells before infection increased viral DNA synthesis, but did not alter the ability of the cell to adsorb virus. Prostaglandins were not shown to contribute to the process. These results suggest that ultraviolet-enhanced replication of herpes simplex virus may be associated with DNA-repair activities, and that ultraviolet-enhanced herpes simplex virus replication should be further examined for its contribution to herpes simplex virus recurrence in vivo.

The authors surveyed 5,002 dental outpatients to determine the prevalence and patterns of drug use. They found that drug use increased significantly with age and that a significant number of patients took medications that had potential for adverse dental effects. Thus, dentists should be aware of patient medications and the effects those drugs have on dental treatment.

The purpose of this study was to compare the sensitivity of ViraType in situ hybridization kit (Life Technologies, Inc. [LT] and PathoGene (Enzo Diagnostics, Inc. [ED]) in situ hybridization kit for human papillomavirus (HPV) DNA detection in oral tissue. Forty benign oral lesions histologically suspicious for HPV infection were analyzed. Specimens were hybridized with DNA probes specific for HPV types 6/11, 16/18, and 31/33/35 [LT] and HPV types 6/11, 16/18, and 31/33/51 [ED]. Positive hybridization reactions were seen for HPV DNA type 6/11 only. Hybridization occurred significantly more often (p less than 0.01, McNemar Exact Test) in LT probed specimens (20/40) than ED assayed sections (12/40). HPV DNA sequences were found in 100% condyloma acuminata (13/13), 100% verruca vulgaris (4/4), and 13% squamous papilloma (3/23) using the LT system. The ED probes yielded positive signals in 77% condyloma acuminata (10/13), 25% verruca vulgaris (1/4), and 4.4% squamous papilloma (1/23). A more intense hybridization signal was exhibited using the LT system. The results indicate that the LT probes and detection reagents are more sensitive for detecting HPV DNA in oral mucosal specimens.

The carbon dioxide laser is a surgical device increasingly important to dentistry. The advantages of laser use in the treatment of oral disease have been well documented. Such benefits include bloodless incisions, accurate tissue destruction, reduced pain, minimal swelling, excellent hemostasis, and limited postoperative tissue morbidity. Little information exists currently regarding laser use in the management of medically complex patients, most notably patients with infectious diseases. This article reports the use of the carbon dioxide laser for reducing the risks of disease transmission in the surgical management of an human immunodeficiency virus (HIV) seropositive patient.

A cognitive model for learning associations between words and objects is presented. We first list basic constraints to which the model must adhere. The constraints arise from two sources. First they stem from observed psychological phenomena including typicality effects, extension errors observed from children and belief-dependent behavior. Secondly they arise from our choice to integrate the model in a unified theory of cognition. In presenting the constraints to the model's construction, we motivate our design decisions while describing our algorithm that takes a symbolic, production-based approach. The model's adherence to the constraints is further supported by some empirical results.

In the last decade, saliva has been advocated as a non-invasive alternative to blood as a diagnostic fluid. However, use of saliva has been hindered by the inadequate sensitivity of current methods to detect the lower salivary concentrations of many constituents compared to serum. Furthermore, developments in the areas related to lab-on-a-chip systems for saliva-based point of care diagnostics are complicated by the high viscosity and heterogeneous properties associated with this diagnostic fluid. The biomarker C-reactive protein (CRP) is an acute phase reactant and a well-accepted indicator of inflammation. Numerous clinical studies have established elevated serum CRP as a strong, independent risk factor for the development of cardiovascular disease (CVD). CVD has also been associated with oral infections (i.e. periodontal diseases) and there is evidence that systemic CRP may be a link between the two. Clinical measurements of CRP in serum are currently performed with "high sensitivity" CRP (hsCRP) enzyme-linked immunosorbent assay (ELISA) tests that lack the sensitivity for the detection of this important biomarker in saliva. Because measurement of salivary CRP may represent a novel approach for diagnosing and monitoring chronic inflammatory disease, including CVD and periodontal diseases, the objective of this study was to apply an ultra-sensitive microchip assay system for the measurement of CRP in human saliva. Here, we describe this novel lab-on-a-chip system in its first application for the measurement of CRP in saliva and demonstrate its advantages over the traditional ELISA method. The increased sensitivity of the microchip system (10 pg ml(-1) of CRP with 1000-fold dilution of saliva sample) is attributed to its inherent increased signal to noise ratio, resulting from the higher bead surface area available for antigen/antibody interactions and the high stringency washes associated with this approach. Finally, the microchip assay system was utilized in this study to provide direct experimental evidence that chronic periodontal disease may be associated with higher levels of salivary CRP.

A patient with a lymphangioma involving the labial commissure is reported. Key features of this disorder include its occurrence in young patients, asymptomatic nature, compressibility, and slow growth. Clinicians should understand that the lymphangioma may appear as a soft, grayish-blue, dome-shaped nodule, an irregular and papillary vesicular mass, or as a diffuse swelling. Appropriate clinical and radiographic tests are recommended before surgical excision. Histologically, the features of the lymphangioma may closely resemble those of a hemangioma.

A cellular blue nevus located on the palate of a 72-year-old female is reported. This intraoral finding is uncommon and should be distinguished from clinical entities it closely resembles. Practitioners should be aware that a pigmented palatal lesion in fact may be a malignant melanoma. Surgical excision with microscopic examination is the only means by which an accurate diagnosis can be made.

A patient with white sponge nevus involving the buccal mucosa, labial mucosa, and soft palate is reported. The salient clinical and histological features of the disease were discussed. This diagnosis should be considered when bilateral white lesions of buccal mucosa are encountered. Early onset, a familial history, and the asymptomatic nature are key features to the disease. If historical data and clinical features are suspect, an incisional biopsy is adequate for diagnosis.