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A randomized, two-compartment calculus clinical study of twelve-weeks duration was conducted among a group of calculus-forming subjects in the St. Louis area. The purpose of this parallel and double-blind clinical study was to compare the effect of a dentifrice containing 5.0% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% PVM/MA copolymer and 0.243% sodium fluoride in a silica base, to that of a placebo dentifrice, with regard to supragingival calculus formation. The study examiner, using the Volpe-Manhold Calculus Index, selected a panel of calculus-prone men and women who had completed a one-month placebo regimen. The Volpe-Manhold Calculus Index scores and the number of completely calculus-free sites were recorded. One-hundred and fifteen subjects were entered into the study. After an oral soft and hard tissue examination, the subjects were given a complete oral prophylaxis and randomly assigned to use either the placebo or test dentifrice for a 12-week home-use period. They were prohibited from using any other means of oral hygiene during the study. After completing 12 weeks of twice-daily brushing at home using their assigned toothpaste and a standard soft-bristled toothbrush, subjects were again assessed for supragingival calculus deposits and calculus-free sites. The dentifrice containing 5.0% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% PVM/MA copolymer and 0.243% sodium fluoride in a silica base, inhibited supragingival calculus formation by 54.4%, as compared to a 0.243% sodium fluoride silica-based placebo dentifrice. The mean Volpe-Manhold Calculus Index scores were compared statistically and the difference indicated statistical significance at probability of 0.01 by means of an analysis of covariance (ANCOVA). The number of calculus-free sites, a second parameter of efficacy, also was compared and demonstrated an absolute difference of 32.6% in favor of the group using the dentifrice containing potassium nitrate, soluble pyrophosphate and PVM/MA copolymer compared to a placebo dentifrice (37.8% vs 5.2%, respectively). An analysis of covariance indicated that this improvement showed statistical significance at a probability of 0.01.

Analysis of the cytoskeletal components of early murine embryos has detected expression of two keratin proteins, K#8 and K#18, at the 4-8-cell stage. Comparable data for human embryos do not exist, although several processed pseudogenes corresponding to K#8 and K#18 have been discovered in the human genome. Because only genes that are expressed in pre-germ-line and germ-line cells can give rise to processed pseudogenes, the existence of human K#8 and K#18 processed pseudogenes is prima facie evidence for expression of keratins K#8 and K#18 in the early human embryo. We have cloned and determined the complete sequence of a processed pseudogene corresponding to another acidic human keratin. Comparison of its sequence with known sequences of other mammalian keratins indicates that the pseudogene arose from a reverse transcript of a correctly initiated and terminated functional human K#19 gene. This implies expression of K#19 keratin in addition to K#8 and K#18 in the early human embryo. We have proposed previously that K#19 evolved specifically to redress unbalanced production of various basic keratins, and our current evidence, that it is expressed at an early stage of development, implies that K#19 may fulfill this same role during human embryogenesis.

In Hawai‘i, health care is a commodity, not a human right: those who can afford it receive care, those who cannot often don't. As health workers and health professional students, we witness the consequences that public policies and budget considerations have on people, on patients, on the health of those that we are dedicated to assisting. Beginning with a case study, we examine the historical antecedents leading to the increasing migration of Micronesians to Hawai‘i, examine the special relation that “Compact of Free Association” citizens have with the United States, and seek to reframe the political discussion regarding their health care status in this state as a debate in which medical considerations, not political or economic ones, should be the primary voice.