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Biomedical subjects

J A Ship

Publications and source records attributed to J A Ship.

At least 19 recordsLinked to original sources
PubMed1992

Salivary gland function and glucose metabolic status.

To study the relationship between glucose metabolic status and salivary gland function in different-aged persons, subjects with diabetes mellitus (DM = 11), impaired glucose tolerance (IGT = 26), and controls (n = 26), aged 24 to 93, were examined in the oral physiology component of the Baltimore Longitudinal Study of Aging. All were generally healthy (except DM) and nonmedicated. The controls and subjects with IGT were classified using World Health Organization criteria, and diabetic status was assessed using Hb1Ac levels. Unstimulated and 2% citrate-stimulated parotid and submandibular salivary flow rates were collected, and subjective responses to questions about salivary hypofunction were evaluated. No statistically significant differences were observed between the three groups, nor between young and old subjects with altered glucose metabolism. These findings suggest that among well-controlled individuals with altered glucose metabolism, salivary gland function is not significantly impaired.

Adult↗
PubMed1992

Salivary gland 99mTc-scintigraphy: a grading scale and correlation with major salivary gland flow rates.

Sequential salivary gland scintigraphy with 99mTc-technetium pertechnetate (Tc-99) is a safe, minimally invasive test for study of major salivary glands. However, its relationship to salivary function has not been investigated in detail. We have investigated the relationship between major salivary gland flow rates and Tc-99 scans and developed a new rating scale using scans of a control group with normal salivary function. Salivary flow rates and Tc-99 scans were obtained from healthy, non-medicated subjects (n = 33) and from xerostomic patients (n = 22). There were significant differences between the groups for salivary flow rates and Tc-99 ratings. Significant correlations were found between salivary flow rates and Tc-99 ratings in the control and xerostomic groups. The Tc-99 rating scale proved reliable in assessing salivary dysfunction, and showed a high inter-examiner correlation. These results demonstrate the usefulness of salivary gland scintigraphy in assessing major salivary gland flow rates and the utility of a new rating scale.

Adult↗
PubMed1992

Salivary gland function and aging: a model for studying the interaction of aging and systemic disease.

This review describes an approach to examining the interaction of aging and systemic disease on a key aspect of oral physiology, salivation. The approach requires several steps: defining general health, and a specific physiological function, at different ages; defining a disease of interest and the influence of the disease on the specific physiological function; and determining if the disease can affect performance of the physiological function with increased age.

Aging↗
PubMed1992

Oral sequelae of common geriatric diseases, disorders, and impairments.

The oral cavity is responsible for two essential functions: the production of speech and the initiation of alimentation. All of the specialized oral tissues and sensory systems that allow for the execution of these functions are susceptible to age-, disease-, and treatment-related changes, and alterations in any one or more function may result in deleterious consequences to the host and impact on the quality of life. Oral physiology is generally believed to be age-stable in healthy individuals; however, in the presence of single or multiple medical diseases and their treatment, these functions deteriorate. This article focuses on the influence of common geriatric diseases, disorders, and impairments on oral health and function. Data are presented to suggest that oral health is altered in the presence of heart, cerebrovascular, liver, and renal diseases, cancer, COPD, diabetes, pneumonia, and influenza. Arthritic, hearing, visual, orthopedic, and speech impairments multiple medical problems. Finally, adjustments in treatment and management strategies may be necessary for older patients with these diseases and impairments.

Aged↗
PubMed1991

Oral mucosal appearance is unchanged in healthy, different-aged persons.

Oral mucosal status in 182 different-aged, healthy, community-dwelling persons was evaluated. Ninety-four men and 88 women, ranging in age between 20 and 95 years, participated in this study. Oral mucosal status was assessed according to both subjective complaints and a semiquantitative clinical rating scale. No changes in either criterion were detected with increasing age. Oral mucosal status of the older subjects of this study was comparable to that found in a previous study with a randomly enrolled, noninstitutionalized older population in Iowa. The results of this study suggest that aging per se does not lead to changes in the appearance of oral mucosa.

Adult↗
PubMed1991

An assessment of salivary function in healthy premenopausal and postmenopausal females.

The elderly represent the most rapidly growing segment of the U.S. population, and the majority of this group are females. The average woman can anticipate living about a third of her life beyond menopause, and many U.S. women undergo hormonal replacement in an attempt to relieve menopausal symptoms. Little is understood about the relationship between menopause, hormonal replacement therapy, and the oral structures, although oral discomfort, xerostomia, and salivary hypofunction have been associated with postmenopausal women. The effects of menopausal status and estrogen therapy on subjective reports of oral dryness and discomfort and objective measurements of major salivary gland output were assessed in 43 healthy premenopausal and postmenopausal females. No complaints of xerostomia or burning mouth and no alterations in the quantity of saliva occurred in this population. This study suggests that among healthy women salivary gland function is not significantly influenced by menopause or hormonal replacement therapy.

Adult↗
PubMed1991

How much saliva is enough? 'Normal' function defined.

Saliva is important for the preservation and maintenance of oral health. It is unclear, however, how much saliva is required to maintain normal oral function. Major salivary gland flow rates, objective measurements of oral health, and subjective complaints of oral problems were assessed in different-aged, healthy persons. Results suggest that the comparison of major salivary gland flow rates of an individual with population standards to identify patients susceptible to the effects of salivary dysfunction is unreliable. Changes in salivary function over time are a more meaningful gauge of the impact of saliva on oral health. The clinician should monitor salivary production to identify patients with declining salivary gland output.

Adult↗
PubMed1991

Epidemiology of acquired immune deficiency syndrome in persons aged 50 years or older.

Acquired immune deficiency syndrome (AIDS) has afflicted persons of all ages, yet only recently has attention been devoted to AIDS in older persons. To examine the epidemiology of AIDS in persons greater than or equal to 50 years old in the United States, we analyzed cases reported to the Centers for Disease Control. The number reported annually in persons greater than or equal to 50 years old increased from 13 in 1981 to 3,562 in 1989. Through December 1989, 11,984 had been reported, representing 10% of all cases. Although male homosexual contact accounted for most cases in persons aged 50-69, blood transfusion became a more common means of exposure with increasing age, accounting for 28% of cases in persons aged 60-69 and 64% of cases in individuals aged greater than or equal to 70. The proportion of women increased from 6.1% in persons with AIDS aged 50-59 to 28.7% of those aged greater than or equal to 70. The proportion of AIDS diagnoses made in the same month as death increased from 16% in persons aged 50-59 to 37% in those aged greater than or equal to 80, suggesting either more rapid progression of disease or increasing delay in diagnosis. As the incidence in older persons continues to increase, clinicians caring for older patients must become more familiar with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Oral mucosal status and major salivary gland function.

Normal salivary function is considered to be critical for the maintenance of healthy oral mucosa. However, few studies have examined mucosal changes in patients with objectively documented salivary gland performance. In the present report, the mucosal status of 298 subjects being evaluated in a dry mouth clinic was assessed. A complete oral examination was performed and unstimulated and stimulated salivary samples were collected separately from the parotid and submandibular/sublingual glands. Data were analyzed according to diagnosis and salivary output after the assignment of an oral mucosal rating to each subject. In general, the mucosal surfaces were well preserved and infections were not seen. Patients evaluated for Sjögren's syndrome and radiation-induced xerostomia had the lowest salivary gland performance but displayed a mucosal status similar to denture-wearing healthy subjects or patients with normal salivary flow who had idiopathic xerostomia. However, those patients with a total lack of salivary flow rarely had normal-appearing oral mucosa. These results confirm a role for saliva in oral mucosal preservation and also suggest that other factors may act to maintain oral mucosal integrity.

Adolescent↗
PubMed1990

Diminished submandibular salivary flow in dementia of the Alzheimer type.

Dementia of the Alzheimer Type (DAT) is the most common type of dementia among the elderly. Alzheimer's disease is a major public health problem, yet little is known about the potential oral consequences of the disease. Because saliva is believed to be essential for the preservation of oral health and function, salivary gland fluid output was evaluated in a population of essentially healthy patients with early-stage DAT. Unstimulated and stimulated parotid and submandibular salivary gland secretions were collected from 28 nonmedicated and otherwise healthy DAT patients, and 35 age-matched healthy controls. Submandibular saliva flow rates were significantly lower among the patients with DAT compared to controls, while parotid flow rates did not differ. The results suggest a selective impairment in submandibular gland function in essentially healthy patients with early-stage DAT.

Aged↗
PubMed1990

Muscarinic regulation of potassium transport in a human submandibular epithelial cell line.

Results of previous studies suggest that the transport of K+ by salivary ducts is under muscarinic control. The mechanisms by which this regulation occurs have not been well defined, however. In this paper, we describe mechanisms involved in the muscarinic regulation of K+ (86Rb) transport in HSG-PA, an epithelial cell line derived from human submandibular gland duct. Stimulation of HSG-PA cells by carbachol, a muscarinic agonist, increases both 86Rb influx and efflux, which results in a decrease in the equilibrium content of 86Rb within the cells. Increases in both fluxes are dose dependent with respect to carbachol concentration, and both responses can be blocked by atropine, a muscarinic antagonist. The carbachol-stimulated 86Rb fluxes appear to be calcium dependent since 1) the calcium ionophore A23187 increases 86Rb fluxes in these cells, 2) cells loaded with 1,2-bis(2-aminophenoxy)ethane- N,N,N',N'-tetraacetic acid (BAPTA; a calcium chelator) exhibit a reduced ability to respond to carbachol stimulation, and 3) removal of extracellular calcium concentration reduces the carbachol-stimulated effects. Treatment of HSG-PA cells with 10(-7) M phorbol myristate acetate (PMA) partially blocks the carbachol-stimulated changes in 86Rb fluxes, suggesting that protein kinase C plays a role in this response. PMA also partially blocks A23187-stimulated 86Rb influx, suggesting that activation of protein kinase C inhibits muscarinic-stimulated K+ influx by blocking either the Ca2+ signal (X. He, X. Wu, and B.J. Baum. Biochem. Biophys. Res. Commun. 152: 1062-1069, 1988), steps subsequent to this effect, or both.(ABSTRACT TRUNCATED AT 250 WORDS)

Atropine↗
PubMed1989

Relationship between saliva production and oropharyngeal swallow in healthy, different-aged adults.

We have evaluated the possible relationship between major salivary gland fluid secretion rate and characteristics of the oral phase of swallowing in 35 different-aged, healthy men and women. All subjects displayed normal function of the parotid and submandibular glands and oral swallow patterns on ultrasound evaluation that were comparable to previous reports. In this study group we found no significant relationships between salivary flow rates (unstimulated, stimulated) and any oral swallow measure. Evidence of a subtle, age-related oral motor change (multiple hyoid and tongue gestures) was seen but swallow duration times did not show a linear relationship to age. This study demonstrates that healthy individuals, despite a wide range in their salivary gland fluid secretory capacity, are generally similar in the characteristics of their oropharyngeal swallow.

Adult↗
PubMed1989

Beta-adrenergic responsiveness in a human submandibular tumor cell line (A253).

Salivary epithelial functions are regulated by the autonomic nervous system. In this regard, we have been studying the morphology and neuroreceptor composition of A253, an immortal cell line isolated from a human submandibular carcinoma (Giard et al., JNCI, 51:1417-1421, 1973). Phase contrast and electron microscopic observations indicate that A253 cells are of epithelial origin. Physiologically, A253 cells possess beta-adrenergic, but not alpha-adrenergic or muscarinic-cholinergic receptors. The beta-adrenergic receptors (BARs) are composed primarily of a single class of high affinity, beta 2-subtype receptors as judged by [3H]dihydroalprenolol antagonist binding studies. The BARs are functional inasmuch as isoproterenol stimulation increases both intracellular cAMP content and [3H]mannose incorporation into endogeneous glycoproteins. Differences in ultrastructure and neuroreceptor composition between A253 and other immortal salivary tumor cell lines are discussed.

Cell Line↗
PubMed1989

AIDS and HIV-1 infection: clinical entities in geriatric dentistry.

The number of AIDS cases in individuals 50 years of age or older in the United States is reported to exceed 9000. Contaminated blood and blood transfusions are major contributors to HIV-1 infection in this age group. Sexual transmission and infection through intravenous drug abuse are also potential avenues of HIV-1 transmission in the older population. AIDS presents with a variety of clinical manifestations, including dementia, frequently seen in non-HIV-1-infected older people. Neurological deficiencies associated with AIDS are very common and may lead to misdiagnosis in the elderly. The observed incubation period of HIV-1 infection is longer than previously estimated, increasing the risk of older individuals exposed to HIV-1 in the past to develop AIDS. Oral manifestations may present as one of the early clinical signs of AIDS. Little is known concerning AIDS in the geriatric population. It demands consideration by dental professionals treating older individuals belonging to one of the exposure categories of the disease.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Trends in oral health in the aging population.

Increased survival of the natural dentition, persistence of periodontal disease, deterioration of prior dental restorations, root surface caries, and continued incidence of oral cancer represent a complex of emerging oral health problems of the aged in the United States. Additional data on the epidemiology of oral mucous membrane syndromes will help to characterize the prevalence of these diseases in the aging population as well. Improvement in the utilization and accessibility of dental services by the aging cohorts will contribute to the prevention of oral disease in the future. Combined with the substantial growth in the size of this cohort of the population and alterations in the prevalence of these oral health status indicators, changes in the need for and projected utilization of professional oral health services can continue to be anticipated. Clinical research directed toward assessment of efficacy of treatment modalities for prevention of dental disease and maintenance of dental health are essential for the projection of dental health manpower needs for the future. This should also lead to the development of appropriate academic and training programs to meet the changing needs of the elderly.

Aged↗