bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic determination of root canal length in primary teeth with and without root resorption
Authors: Mente J. , Seidel J. , Buchalla W. , Koch M. J.
Published: March 2003

Aim To test an electrical device for determining root canal length in primary teeth in vitro, and to compare it with the radiographic length measurement.

Methodology Two examiners determined the root canal length of 24 extracted maxillary primary incisors (12 with visible root resorption and 12 without) using an electrical root canal meter (Tri Auto ZX, Morita, Dietzenbach, Germany). The instrument was left in the root canal after the second examination and a radiograph was taken. The whole tooth was cleared by immersion in methylsalicylate and subsequently photographed. Both radiographs and photographs of cleared teeth were measured and compared with the electronic measurements.

Results The evaluation of the radiographs showed a mean distance between the instrument tips and apices of 0.60 (± 0.41) mm; evaluation of the cleared teeth showed an equivalent distance of 0.62 (± 0.40) mm. The mean distance between instrument tip and acceptable working length (determined with the clearing method) was 0.26 (± 0.24) mm in teeth without resorption and 0.29 (± 0.30) mm in teeth with resorption.

Conclusion The presence of resorption in primary teeth did not affect the accuracy of electrical measurement of root canal length in vitro. The application of this method in primary teeth should be evaluated further.
A prospective clinical trial investigating the efficacy of a method of preparing subpopulations of antibody‐free spermatozoa from the ejaculates of antibody‐positive patients
Authors: GRUNDY  , KILLICK  , HAY  , LESNY  , MAGUINESS  , ROBINSON
Published: March 2003

Couples undergoing in vitro fertilization treatment (IVF) were invited to take part in a controlled prospective clinical trial. The aim was to determine the effect on the fertilization rate of a technique devised to obtain an antibody‐free preparation of spermatozoa from an antibody‐positive ejaculate. Oocytes collected during IVF were allocated into one of two groups, ensuring that quality and maturity were comparable in each. One group, the control, was inseminated with Percoll‐processed spermatozoa. The experimental group was inseminated with identical numbers of Percoll‐processed spermatozoa which had been treated to obtain an antibody‐free preparation. The treatment was found to have no beneficial effect on the fertilization rate at IVF. Laboratory studies were also performed on the ejaculates of antibody‐positive volunteers to determine whether this treatment led to any effects, whether beneficial or detrimental, on sperm function. Membrane integrity was found to be unaffected, as was the percentage of spermatozoa undergoing the spontaneous acrosome reaction following overnight incubation. The percentage of spermatozoa undergoing the ionophore‐induced acrosome reaction following treatment, however, was higher than that of the controls. The results of sperm–zona pellucida binding studies were equivocal. The findings indicated that the treatment procedure could not be justified for use in IVF, but may be beneficial for intrauterine insemination.
Manipulation of postnatal testosterone levels affects phallic and clitoral development in infant rhesus monkeys
Authors: Brown  , Nevison  , Fraser  , Dixson
Published: March 2003

Male primates exhibit marked elevation of circulating testosterone levels during the early postnatal period. The aim of this project was to test whether experimental manipulation of circulating testosterone levels in male and female infant rhesus monkeys affected development of the external genitalia during the first six months of life. Four groups of infants were studied. Seven control male infants exhibited high circulating testosterone levels during the first three months of life. Seven males were treated with a GnRH agonist (avorelin) from the first week of life onwards, which suppressed the postnatal testosterone surge. Ten control females exhibited low circulating testosterone levels during the early postnatal period. Administration of testosterone to 10 females resulted in high circulating levels in these infants. Fortnightly blood samples and genital measurements were taken from all infants during the first six months of life. Growth of the penes of avorelin‐treated males was significantly retarded when compared to control males. Average length of the penis at six months of age was significantly (p = 0.012) smaller for avorelin‐treated males (25.2 ± 2.8 mm) than for control males (37.3 ± 3.0 mm). Avorelin‐treated males attained only around 50% detachment of the prepuce from the glans of the penis, while control males averaged 90% detachment. Treatment of females with testosterone resulted in significant growth of the clitoris in comparison to control females. The growth rates of the penes of control males and clitorides of testosterone‐treated females were similar and greatest during the first two months of life. Gain in body weight was not affected by either hormonal manipulation. It is concluded that manipulation of circulating testosterone levels during the early postnatal period affects penile and clitoral development of infant rhesus monkeys. This postnatal period may therefore represent an important stage in penile development in primates.
Screening for microdeletions on the long arm of chromosome Y in 53 infertile men
Authors: SEIFER  , AMAT  , DELGADO‐VISCOGLIOSI  , BOUCHER  , BIGNON
Published: March 2003

About 30% of couple infertilities are of male origin. They appear in some cases de novo and are considered idiopathic. The aim of our work was to evaluate, in these cases, the prevalence of microdeletions of the long arm of chromosome Y, within the AZF a, b and c regions using molecular biology techniques. Men with azoospermia or oligozoospermia resulting from hereditary, endocrine or obstructive causes, or with a constitutional cytogenetic abnormality were excluded. Fifty‐three infertile men with azoospermia or oligozoospermia, as determined by a spermiogram, were studied. Of these, 34 were idiopathic and 7 exhibited a past history of genital infection or biological abnormalities, suggesting partial obstruction of the genito‐urinary tract. A further 8 men had a varicocele and 11 cases with a history of cryptorchidism were also studied. Peripheral blood DNA was extracted from each patient, then amplified by multiplex PCR with STS genomic markers from the three Y chromosome AZF zones. PCR products were then analysed on agarose gels. In view of the difficulty of confirming the absence of a signal in molecular biology, each case suspected of having a deletion was checked by multiplex PCR through coamplification with the SRY marker. Five men with microdeletions of the long arm of the Y chromosome were diagnosed among the 53 patients. All of them included the AZFc zone and the intragenic DAZ gene markers. Furthermore, a larger Y chromosome deletion encompassing the 3 AZF zones was diagnosed, and confirmed by cytogenetic analysis. All Y chromosome microdeletions were observed in the 34 truly idiopathic azoospermia/oligozoospermia cases, corresponding to a proportion of 14.7% (or 9.4% considering the whole population of 53 infertile men). The relatively high proportion of microdeletions found in our series suggests the need for strict patient selection to avoid unnecessary screening for long arm Y chromosome microdeletions.
Semen quality changes among 2343 healthy Slovenian men included in an IVF‐ET programme from 1983 to 1996
Authors: ZORN BRANKO , VIRANT‐KLUN IRMA , VERDENIK IVAN , MEDEN‐VRTOVEC HELENA
Published: March 2003

To determine whether semen quality in Slovenians has changed over 14 years (1983–96), we analysed retrospectively the semen of 2343 healthy men with a normal spermiogram, who were partners of women with tubal infertility included in the IVF‐ET programme. Age at semen collection, duration of sexual abstinence, semen volume, sperm concentration, total sperm count, percentage of spermatozoa with progressive motility, and normal morphology were determined. Multiple regression analysis was used to assess the changes in sperm characteristics according to the year of semen collection, year of the man's birth and the duration of sexual abstinence. Semen volume, sperm concentration, sperm count and total sperm motility did not change between 1983 and 1996, whereas between 1988 and 1996 rapid progressive sperm motility decreased by 0.95% per year (p < 0.0001). Semen volume, sperm concentration, and sperm count increased with duration of sexual abstinence. After adjustment for the year of semen collection and duration of sexual abstinence, multiple regression analysis showed that sperm concentration decreased by 0.67% per each successive year of birth (p = 0.03). Thus the sperm concentration decreased from 87.6 × 106/mL in men born in the 1940s to 77.3 × 106/mL in those born between 1956 and 1960. After 1960, sperm concentration was found to increase. In 2343 healthy men, no decline in semen quality, except in rapid progressive motility, was observed in the study period. Lower sperm concentration was found among men born between 1950 and 1960. This could be related to worse socio‐economic status, stress or negative environmental factors in this time period.
Prostate cancer in Taiwan: epidemiology and risk factors
Authors: Pu Yeong‐Shiau
Published: March 2003

The incidence of prostate cancer (PC) has been rapidly increasing in the past 10 years in Taiwan. It became the sixth common cancer in males in 1996 and resulted in 540 deaths in 1998. It was estimated that the incidence of PC would be up to 14 per 105 in the year 2000, 3‐fold higher than that in 1990. Three factors may be responsible for the increase of PC in Taiwan: use of prostate specific antigen, population aging and high fat diet. A case‐control study on the risk factors of PC in a patient population comprised mainly of veterans (63%) in Taiwan showed that PC patients tended to have engaged in more physical activity (adjusted odds ratio (OR): 2.16), have a lower body mass index (OR 2.0) and be less likely to consume vegetables cooked with pork lard (OR 0.47). About half of our patients had locally advanced or metastatic diseases upon diagnosis. This staging distribution was consistent in most major institutions in Taiwan and was fairly unchanged over time in the past two decades. The incidence of latent PC in Taiwan was not investigated until a pathological review of 49 cystoprostatectomy specimens recently revealed unsuspected PC in 32.7% and high‐grade prostate intra epithelial neoplasia in 49% of the prostates removed. As the incidence of PC grows rapidly in Taiwan, this disease warrants more attention from the public and the authorities. More efforts should also be directed to the investigation on the risk factors for PC in the new millennium.
New concepts in operative andrology: a review*
Authors: Silber Sherman J.
Published: March 2003

Several recently published, or about to be published, controversial issues in operative andrology are clarified and reviewed in this paper. The microsurgical technique for sperm retrieval for nonobstructive azoospermia, the round spermatid controversy and the varicocoele dilemma (why does everybody keep doing varicocoelectomy for male factor infertility?) are presented with salient points that have recently been presented elsewhere and referenced. Finally, at the end, we review briefly what is known about the likelihood of genetic transmission of infertility from male factor patients to their offspring as a result of the new ICSI technology.
Spermatogenic disturbance induced by di‐(2‐ethylhexyl) phthalate is significantly prevented by treatment with antioxidant vitamins in the rat
Authors: Ishihara Masaru , Itoh Masahiro , Miyamoto Kensaku , Suna Shigeru , Takeuchi Yoshiki , Takenaka Ikumasa , Jitsunari Fumihiko
Published: March 2003

Phthalate esters, now regarded as endocrine disruptors, are widely used in the plastics industry. In particular, di‐(2‐ethylhexyl) phthalate (DEHP) is produced in large quantities, and is used in blood storage bags, catheters and haemodialysis instruments. Previous studies have demonstrated that treatment of rats with DEHP induces testicular atrophy with liver enlargement, although the precise nature and mechanism of the action of DEHP on these organs remains unclear. In the present study, we produced an experimental model of DEHP‐induced spermatogenic disturbance in rats by feeding them a DEHP‐containing diet. Liver enlargement occurred in rats fed either a 1 or 2% DEHP‐containing diet. However, testicular atrophy accompanied by aspermatogenesis was induced by feeding with the 2% but not with the 1% DEHP‐containing diet. This suggests that the critical DEHP dose for gonadotoxicity is higher than that for hepatotoxicity. Using the 2% DEHP‐dose, the effect of simultaneous administration of antioxidant vitamins (= vitamins C and E) was next examined. It was found that the vitamin supplementation significantly prevented the testicular injury. The results suggest that antioxidant vitamins can protect the testes from DEHP‐toxicity.
Apoptosis related gene products in differentiated and tumorigenic rat Leydig cells and following regression induced by the cytotoxin ethane dimethanesulphonate
Authors: Woolveridge Ian , Taylor Matthew F. , Rommerts Focko F. G. , Morris Ian D.
Published: March 2003

Androgen secreting Leydig cells in the adult are differentiated with a very low turnover, however, Leydig cell tumours can arise spontaneously or after treatment with toxins. This study in the rat investigated whether changes in components of programmed cell death could be involved. In contrast to their absence in differentiated Leydig cells, antiapoptotic Bcl‐2 and proapoptotic Bax were expressed in tumours. Bak and Bcl‐xl were found in both tumour and normal Leydig cells. Apoptosis was induced in subcutaneous implants of Leydig cell tumour by ethane dimethanesulphonate (EDS) which is known to kill differentiated Leydig cells. The marked regression of the tumour following EDS treatment was transient and re‐growth occurred between 6 and 14 days later. Tumour regression and growth was associated with a similar weight pattern in the seminal vesicles caused by changes in serum testosterone. During tumour regression, clusterin and Bax proteins were elevated but Bak, Bcl‐xl and Bcl‐2 were unchanged. Fas‐R, Fas‐L and Bax were upregulated after tumour regression had taken place. These data show that Leydig cell tumours possess many of the apoptosis related gene products and can die by apoptosis, however, regulation is clearly different in differentiated and mitotic Leydig cells.
Differential patterns of inhibin secretion in response to gonadotrophin stimulation in normal men
Authors: Kinniburgh D. , Anderson R. A.
Published: March 2003

Inhibin B is produced by the testis, and its constituent α and βB subunits have been localized immunohistochemically to Leydig as well as Sertoli cells in both rodent and human testes. Whether Leydig cells contribute to circulating inhibin B concentrations, however, is uncertain. We have investigated this by selectively stimulating Leydig and Sertoli cells with hCG and FSH, respectively. The study was a randomized crossover trial, investigating responses to 225 IU recombinant FSH or 3000 IU hCG administered s/c 4–6 weeks apart. Ten normal men were recruited to participate. Blood was taken twice before treatment and after 8, 24, 48, 72 and 96 h. Serum was assayed for FSH, LH and testosterone by radioimmunoassay (RIA); inhibin B and pro‐αC inhibin forms by ELISA. Administration of hCG, but not FSH, caused a rapid increase in blood testosterone levels, which reached a maximum after 72 h (22.2 ± 2.7–50.1 ± 4.5 nmol/L, p < 0.001). Inhibin B concentrations in blood were unchanged following either treatment. Conversely, pro‐αC concentrations increased following both treatments. FSH administration resulted in a gradual increase in pro‐αC concentrations (369 ± 18 pg/mL pre‐treatment to 453 ± 33 pg/mL after 96 h, p=0.013). Administration of hCG resulted in a more rapid response, with pro‐αC concentrations rising from 384 ± 23 pg/mL pre‐treatment to a peak at 48 h of 535 ± 45 pg/mL (p=0.007). This response was more rapid than that of testosterone. These results demonstrate that adult human Leydig, as well as Sertoli, cells secrete inhibin α subunit in response to gonadotrophin stimulation but provide no evidence for the secretion of inhibin B from Leydig cells. The lack of change in inhibin B secretion in response to FSH suggests that more prolonged or intense stimulation of Sertoli cells may be required for secretion of the dimeric form.
Origin of acinar cell regeneration after atrophy of the rat parotid induced by duct obstruction
Authors: TAKAHASHI SHIGERU , SCHOCH ESTELLE , WALKER NEAL I.
Published: March 2003

Acinar cell regeneration in the rat parotid gland after atrophy induced by a one week period of duct obstruction was examined using histology, immunohistochemistry and transmission electron microscopy (TEM). For immunohistochemistry, antibodies to 5‐bromo‐2′‐deoxyuridine (BrdU), injected one hour before tissue collection, and cytokeratin were employed. When clips were removed from the duct, only ductal epithelial cells remained; all acinar cells had been deleted. Some duct cells were BrdU positive. After three days, newly‐formed acini comprising immature acinar cells had appeared; many of the cells were BrdU positive and mitotic figures were readily identified. Thereafter progressive acinar cell maturation and proliferation occurred, parotid gland weight returning to control levels by 7 days. Peak BrdU labelling indices for duct and acinar cells were on days 0 and 4, respectively. By TEM, cytoplasmic organelles in epithelial cells of transitional duct‐acinar structures seen at 2 days were poorly developed. Immature acinar cells seen on day 3 contained zymogen granules and had increased endoplasmic reticulum and mitochondria. By day 5, maturing acinar cells had abundant endoplasmic reticulum and zymogen granules, resembling acinar cells in control glands. These observations indicated origin of acinar cell precursors from duct cells during regeneration of the acinar cell‐free atrophic gland. Subsequent expansion of the acinar cell population was dependent on maturation and proliferation of these newly‐formed cells.
Collagen synthesis in rat skin and ileum fibroblasts is affected differently by diabetes‐related factors
Authors: VERHOFSTAD MICHIEL H.J. , BISSELING TANYA M. , HAANS ELOY M.H. , HENDRIKS THIJS
Published: March 2003

Untreated diabetes reduces wound strength: a concomitant reduction in collagen deposition has been found in cutaneous wounds but not in intestinal anastomoses. This raises the question if collagen synthesis in fibroblasts from skin and intestine reacts differently to the diabetic state. Fibroblast lines were established from healthy rat skin and ileum. Diabetic rat serum was collected from hyperglycaemic rats 3 days after intravenous injection of streptozotocin (200 mg/kg). Fibroblast cultures were grown to confluency in foetal calf serum and maintained in various concentrations of glucose, insulin, normal or diabetic rat serum. Collagen synthesis was measured by incorporation of [3H]‐proline into Collagenase‐Digestible‐Protein.

Collagen synthesis in fibroblasts from both skin and ileum was not affected by increasing glucose concentrations. Insulin strongly and specifically stimulated collagen synthesis in skin fibroblasts whereas in ileum fibroblasts only a nonspecific increase of total protein synthesis was observed. In skin fibroblasts, diabetic rat serum stimulated collagen synthesis to a significantly lesser extent than normal rat serum, whereas in ileum fibroblasts stimulation by serum was far less explicit and no difference was observed between normal and diabetic serum.

The fact that ileum fibroblasts respond less strongly to culture in diabetic serum than skin fibroblasts may explain our prior finding that wound collagen accumulation in intestinal anastomoses is virtually unaffected during diabetes and supports the existence of tissue‐specific healing responses.
Colchicine therapy for hepatic murine schistosomal fibrosis: image analysis and serological study
Authors: BADAWY AFKAR A. , EL‐BADRAWY NAWAL M. , HASSAN MONA M. , EBEID FATMA A.
Published: March 2003

Colchicine in a dose of 200 μg kg body weight/day (5 days/week) was administered to groups of Schistosoma mansoni infected mice 12 weeks post infection, either alone or following previous praziquantel therapy at the 8th week of infection. Certain groups received colchicine for 6 weeks and others received it for 10 weeks. Colchicine alone did not significantly change the light microscopic appearance of schistosomal liver fibrosis, or hepatic collagen content estimated histomorphometrically, and did not reduce the elevated IL‐2 serum level. Colchicine induced hepatic injury consisted of intense inflammatory reaction in granuloma and portal tracts, hepatocytic degeneration, and elevation of serum AST and ALT levels. Colchicine seemed to postpone granulomatous reaction healing and collagen deposition rather than inhibiting collagen formation or degrading it. Colchicine inhibited proliferation of hepatocytes of infected mice by expanding G2‐M phases of cell cycle, thus reduced Ag NOR count and raised cell ploidy and cyclic AMP serum level. Subsidence of schistosomal infection by praziquantel prior to colchicine therapy greatly reduced inflammatory cellular reaction, significantly diminished hepatic collagen deposition and serum IL‐2 level, minimized the elevated nuclear ploidy and cyclic AMP serum level that followed colchicine therapy when administered alone.
Colonization of the respiratory and genital tracts of female mice with Mycoplasma pneumoniae and protection afforded to the genital tract by prior respiratory colonization
Authors: FURR PATRICIA , TAYLOR‐ROBINSON DAVID
Published: March 2003

Mycoplasma pneumoniae, strain MY12763, colonized the throats of 6 BALB/c female mice for at least 18 days after intranasal inoculation. The same strain colonized, in high titre, the vagina of 9 of 10 progesterone‐treated BALB/c mice for at least 35 days, but none of 10 oestradiol‐treated mice. Mice were less susceptible to genital‐tract colonization with the multiple broth‐passed FH strain of M. pneumoniae, only 3 of 10 becoming colonized. The 6 mice inoculated intranasally with strain MY 12763 were immune to genital‐tract colonization with the same strain, whereas 10 mice without respiratory‐tract colonization were susceptible. Protection of the genital tract in this way was at least as effective as that afforded by previous genital‐tract colonization. In a further experiment, 26 immunocompetent BALB/c mice colonized previously in the respiratory tract were resistant to vaginal colonization, whereas 20 BALB/c nude mice, similarly colonized in the respiratory tract, were susceptible in the vagina, illustrating the importance of cell‐mediated immunity. The possible relevance of the findings to the human situation is discussed.
Animal models of acute hepatic failure
Authors: Manibur Rahman Tony , Hodgson
Published: March 2003

The understanding and treatment of acute hepatic failure has developed rapidly over the last 40 years reducing morbidity and mortality from this syndrome. Progress has been made by the study of animal models that reflect the clinical, biochemical and histological pattern of the syndrome seen in man. This is of increasing importance with the use of therapeutic intervention, liver transplantation and the use of extra‐corporeal liver support devices.

This review examines and critically appraises the various approaches to the study of acute hepatic failure in animal models, including both surgical and pharmacological approaches.
Cytokine expression by cultured osteoblasts from patients with osteoporotic fractures
Authors: Walsh  , Birch Mark A. , Fraser William D. , Ginty Andrew F. , Gallagher James A.
Published: March 2003

Human osteoblasts were derived in culture from explants of bone from patients who had recently suffered osteoporotic fractures and from patients with no evidence of osteoporosis. The expression of cytokine mRNA in these osteoblasts was subsequently determined by reverse transcriptase‐linked polymerase chain reaction (RT‐PCR). We have detected mRNA for IL‐1β, IL‐3, IL‐6, IL‐8, TNF‐α and ‐β, and the three TGF‐β isoforms in the cells. The profile of cytokines expressed by osteoblasts derived from patients with osteoporotic fractures was consistent with profiles observed in osteoblasts derived from patients with no evidence of reduced bone mass — the latter included children undergoing corrective surgery and adult subjects ranging from 31 to 80 years undergoing elective surgery for osteoarthritis and other bone pathologies.
Subtractive hybridization – genetic takeaways and the search for meaning
Authors: Byers Richard J. , Hoyland Judith A. , Dixon Janet , Freemont Anthony J.
Published: March 2003

Gene expression profiling relies on mRNA extraction from defined cell systems, which in the case of pathological processes necessarily results in the use of small quantities of tissues, sometimes as little as a few cells. This obviates the use of many systems of gene expression profiling and is best carried out using cDNA amplified by poly(A) reverse transcription polymerase chain reaction, which is capable of generating material representative of all the expressed genes in samples as small as one cell. Analysis of this material using subtractive hybridization compares the genes expressed at different stages of a biological/pathological process allowing identification of the all the genes upregulated during the process. The identification of the genes present is not dependent on their prior description or on the choice of genes used in a screen and as such the method is ideal for identifying novel genes or unsuspected genes. We have used the method to identify genes involved in normal osteoblastic differentiation and in Paget's disease of bone and it has been widely used to study normal differentiation and pathological processes in a number of systems. The method, its applications and its relationship with the other methods of gene expression profiling are reviewed.
Experimental observations in the rat on the influence of cadmium on skin wound repair
Authors: Lansdown Alan B.G. , Sampson B. , Rowe A.
Published: March 2003

Wound healing in the skin depends upon the availability of appropriate trace metals as enzyme cofactors and structural components in tissue repair. The present study forms part of a series of experimental investigations to examine the influence of xenobiotic elements with no known nutritional function and which are known to compete with essential trace metals. It was designed to investigate further the importance of trace metals in wound healing as an aid to wound management and to identify mechanisms of nonhealing which constitute a major problem in human medicine.Surgically induced skin wounds in young adult male Wistar rats were exposed topically to 0.2 ml of 0.01, 0.10 or 1.0% cadmium chloride (aq.) daily for up to 10 days. Control wounds received de‐ionized water only. Wounds exposed to cadmium chloride at 0.01 or 0.10% healed in a similar fashion to controls and exhibited a comparable histological profile with metallothionein distribution. Wounds receiving 1.0% cadmium chloride failed to heal or fully re‐epithelialize within 7 days and animals were humanely killed. They showed a persistent mass of inflammatory cell infiltration, oedema, wound debris and aberrant epidermal cell growth. Metallothionein concentrations in the epidermis and fibroblasts of the papillary dermis increased greatly by 5 days postwounding and remained high through the observation period.Cadmium was identified in the liver, kidney and wound sites. In the wound, 1.0% cadmium chloride induced statistically significant (P > 0.001) changes in local concentrations of zinc and calcium at key stages in the healing process, and as a consequence disturbed the trace metal balance necessary for normal wound repair. Zinc levels were increased twofold after 7 days, but calcium was markedly reduced. Local changes in the distribution of metallothionein indicate interaction of cadmium and trace metal carrier proteins as a probable mechanism for impaired wound healing. The cytotoxicity of cadmium is considered to be largely responsible.
Dens invaginatus in a primary canine: a case report
Authors: Holan Gideon
Published: March 2003

This article describes an unusual case of dens invaginatus in a primary canine. A 5‐year‐old boy presented with an infected mandibular primary canine. A perapical radiograph showed a developmental disturbance in the crown diagnosed as dens invaginatus. A necrotic pulp has been removed from the tooth and the root canal obturated with a resorbable paste. Six weeks later the tooth was found to be asymptomatic. A composite restoration replaced the temporary filling material. Dens invaginatus may appear in the primary dentition, and early diagnosis is important for preventative treatment.
Caries prediction model in pre‐school children in Riyadh, Saudi Arabia
Authors: Al Ghanim  , Adenubi  , Wyne  , Khan
Published: March 2003

Objectives. To evaluate the significance of variables such as oral hygiene, dietary habits, socio‐economic status and medical history of a child in assessing the level of caries risk and to generate a caries prediction model for pre‐school Saudi children.

Design. Cross‐sectional study of pre‐school children.

Setting. Clinics and schools in Riyadh, Saudi Arabia.

Sample and methods. A sample of 446 Saudi pre‐school children, 199 males and 247 females, with a mean age of 4·13 years, were selected at random from clinics and schools. Selection was limited to subjects who either had no caries (dmft= 0) or who had high caries experience (dmft > 8). Each child was examined for caries experience and oral hygiene status. Their mothers were interviewed through a standardized questionnaire for information about oral hygiene habits of the children, diet history, childhood illness and socio‐economic status.

Results. There was a highly significant difference between the two groups in: debris index (P<0.0001), age child started tooth brushing, (P<0·0001), age breastfeeding was stopped (P<0·005), nocturnal bottle feeding with milk formula (P<0·0001), use of sweetened milk (P<0·0001), frequency of use of soft drinks (P<0·0005), frequency of consumption of sweets (P<0·0001), and age at first dental visit (P<0·0001). A caries prediction model developed through stepwise multivariate Logistic Regression (LR) analyses showed debris index, use of sweetened milk in bottle, frequency of consumption of soft drinks, frequency of intake of sweets and child’s age at the first dental visit to be significant. Predictive probability of the model was 86·31% with a sensitivity of 90·1% and a specificity of 80·6%.

Conclusions. Risk factors for dental caries have been identified and a caries prediction model has been developed for Saudi pre–school children. The prediction model, if verified, may provide dentists with guidance in identifying high caries risk Saudi pre‐school children as targets for preventive programmes
Comprehensive dental care for children with rampant caries under general anaesthesia
Authors: Vinckier F. , Gizani S. , Declerck D.
Published: March 2003

Abstract.
Objective. Critical reflection on treatment strategy for dental rehabilitation of young children with rampant caries using day‐stay general anaesthesia at a university dental clinic.

Design. Cross‐sectional analysis of 98 cases.

Setting. The study was undertaken at the university paediatric dental clinic of Leuven, Belgium.

Sample and methods. The sample consisted of 98 healthy patients referred for dental treatment under general anaesthesia with a mean age of 4·8 (± 1·1) years and mean dmft‐score of 9·3 (± 3·0). Data were obtained by history taking, clinical examination, questionnaires (filled in by parents) and standardized data records (filled in by dentists and nurses in the recovery area and day‐stay clinic).

Results. Most patients were referred by their private dentist (74·5%) because of a need for extensive dental treatment in an uncooperative child. Induction of anaesthesia was upsetting in a significant number of cases (68% of children). The mean duration of the whole procedure was 80·9 (± 24·7) minutes. A mean number of 7·2 (± 2·9) primary teeth were filled and 1·8 (± 2·0) extracted per patient. Post‐operative problems (nausea/vomiting, temperature rise) were seen in only 8·2% of the patients.

Conclusions. The technique used at this centre allows for extensive dental treatment of young children with a high level of acceptability and minimal morbidity, using day‐stay general anaesthesia. Based on this review, it became clear that less upsetting methods for the induction of anaesthesia need to be explored. Criteria for the administration of antibiotics need to be defined more clearly and the use of stainless steel crowns should be envisaged for restorations on primary molars. The global outcome of this treatment provision in children at high caries risk should be evaluated over a longer period, including an evaluation of oral health status, restorative treatment (conservation vs. extraction) and behavioural aspects.
Mucus extravasation phenomenon in newborn babies: report of two cases
Authors: Gatti A.F. , Moreti M.M. , Cardoso S.V. , Loyola A.M.
Published: March 2003

Summary. Two rare cases of congenital mucoceles in newborn babies are reported. The patients presented with nodular swellings on their lower lips at birth with no obvious local aetiology. In both cases the mucoceles interfered with normal feeding. The lesions were excised by surgical approach under general anaesthesia and histopathological examination confirmed the lesions to be extravasation‐type mucoceles. The article includes a brief discussion of the epidemiology and ethiopathogeny of mucoceles.
Eruption disturbances of mandibular permanent canines in Japanese children
Authors: Taguchi Y. , Kurol J. , Kobayashi H. , Noda T.
Published: March 2003

Objectives. The purpose of this study was to clarify the cause and prognosis of eruption disturbance of mandibular permanent canines.

Sample and Methods. Fifteen Japanese children who visited Niigata University Dental Hospital between 1979 and 1997 with unerupted and/or impacted mandibular permanent canines were examined.

Results. All cases showed unilateral disturbances. The eruption disturbance of 6 mandibular canines was associated with a calcified obstacle such as an odontoma (5 cases) or a supernumerary tooth (1 case). After removal of the obstacle, 5 canines were aligned within the dentition. Out of 10 cases, where the permanent canine germ showed malpositioning or aberrant eruption path, 5 primary predecessors had undergone endodontic treatment. In these 10 cases, 6 canines erupted after treatment, two were extracted and the remaining two were left in their impacted position.

Conclusions. The present results suggest that it is relatively easy for the position of unerupted mandibular canines associated with calcified obstacles to be improved by removal of the obstacle, but that it is more difficult for teeth showing anomaly in the position of the canine germ to be aligned within the dentition.
The relationship between sweetness preference, levels of salivary mutans streptococci and caries experience in Brazilian pre‐school children
Authors: Maciel S.M. , Marcenes W. , Sheiham A.
Published: March 2003

Aim. To analyse the relationship between preference for sweetness, levels of salivary mutans streptococci and levels of caries in low socio‐economic 4–5‐year‐old Brazilian children.

Design. A cross‐sectional survey.

Subjects and methods. 298 children of both sexes, who, in 1998, were regularly attending public nurseries were randomly selected. Caries experience was assessed according to WHO guidelines. Saliva samples were analysed for mutans streptococci using the spatula method. Children’s preference for sugar was measured using the ‘Sweet Preference Inventory’. Personal interviews with the mothers were conducted.

Results. 255 children completed all aspects of the research, a response rate of 85·6%. 34·9% of them were caries‐free. The mean dmf‐s was 4·25 (SD 6·16), the decayed component being 3·56 (SD 5·82) and the filled surfaces, 0·69 (SD 1·85). For these pre‐school children; male sex (P < 0·01), single parent (P < 0·01), habit of eating or drinking items that contained non‐milk extrinsic sugar between meal times (P < 0·05) and high levels of salivary mutans streptococci (P < 0·001) were significantly associated with higher dmfs scores. There was no statistical relationship between sweetness preference and dental caries and with mutans streptococci levels.

Conclusion. Levels of salivary mutans streptococci but not sweetness preference were potential good predictors of caries experience among 4–5 years‐old‐children living in urban area of Brazil.
Is there a relationship between asthma and dental erosion? A case control study
Authors: Al‐Dlaigan Y. H. , Shaw L. , Smith A. J.
Published: March 2003

Summary. Objectives. The aims of this study were firstly to assess and compare the prevalence of dental erosion and dietary intake between three groups of children; children with asthma, those with significant tooth erosion but with no history of asthma, and children with no history of asthma or other medical problems. Secondly, to discover whether there was a relationship between medical history and dietary practises of these children and the levels of dental erosion. Thirdly, to measure and compare their salivary flow rates, pH and buffering capacity.

Methods. The study consisted of 3 groups of children aged 11–18 years attending Birmingham Dental Hospital: 20 children with asthma requiring long‐term medication, 20 children referred with dental erosion, and 20 children in the age and sex matched control group. Tooth wear was recorded using a modification of the tooth wear index (TWI) of Smith and Knight. Data on the medical and dietary history were obtained from a self‐reported questionnaire supplemented by a structured interview. The salivary samples were collected under standard methods for measurements.

Results. Fifty percent of the children in the control group had low erosion and 50% moderate erosion. However, high levels were recorded in 35% of children in the asthma group and 65% in the erosion group. There appeared to be no overall differences in diet between the groups. There was an association between dental erosion and the consumption of soft drinks, carbonated beverages and fresh fruits in all the three groups. More variables related to erosion were found in the erosion and asthma groups. A comparison between the three groups showed no significant differences in unstimulated and stimulated salivary flow rates, or pH and buffering capacity.

Conclusion. There were significant differences in the prevalence of erosion between the three groups, children with asthma having a higher prevalence than the control group. Although there was a relationship between the levels of erosion and some medical history and acidic dietary components, these did not explain the higher levels in asthmatic children. Further investigation is required into the factors affecting the increased prevalence of erosion in children with asthma.
The British Society of Paediatric Dentistry: 50 years of achievement
Authors: Gelbier S.
Published: March 2003

Summary. This paper describes the origins of organizations for children's dentists in the UK, starting 50 years ago and culminating in the foundation of the British Society of Paediatric Dentistry. It focuses on some of the people who were instrumental in these developments and their relations with children's dentists worldwide.
The success of inhalation sedation for comprehensive dental care within the Community Dental Service
Authors: Bryan R. A. E.
Published: March 2003

Summary.  Objectives. To assess the outcomes of treatment with nitrous oxide/oxygen inhalation sedation (IS). To relate these to the age and previous dental experience of the child and the experience of the operator. To provide base‐line information and identify training needs.

Methods. A retrospective examination of the clinical records of all children treated with IS within the Community Dental Service of Harrow and Hillingdon NHS Trust (HHHT) over a 3‐month period was made. Personal details and previous dental experience were recorded. The outcome of the planned treatment was identified.

Results. Two hundred and eleven sets of records were reviewed from eight clinicians. The average age of the children was 7·2 years. Treatment plans were successfully completed in 83·9% of cases. Records showed that 18·5% of the children had previously had general anaesthesia (GA) for dental treatment, 27·5% had received IS and 5·2% had no previous dental experience. Of the ‘failed’ treatments, 50% were under 7 years of age and 31·3% were referred for GA. There was no difference in the proportion of failures in relation to the experience of the operator.

Conclusion. This review shows that inhalation sedation with nitrous oxide/oxygen is a very successful adjunct to the clinical management of children within the Community Dental Service.
The cause of drooling in children with cerebral palsy – hypersalivation or swallowing defect?
Authors: Tahmassebi J. F. , Curzon M. E. J.
Published: March 2003

Summary. Objective. To determine whether or not drooling in children with cerebral palsy is due to hypersalivation.

Population and methods. The study population consisted of 10 children with cerebral palsy who were identified as having severe drooling, and a matched control group composed of 10 unaffected children who had no known physical or mental disabilities. Salivary flow rate was compared between the cerebral palsied children and the control group using the chin‐cup collection drool quantification method described by Sochanjwskyj. Components of the system included a cup‐like collection device, a vacuum pump, plastic tubing, an airtight collection chamber, and calibrated test tubes held against the subject's chin with elastic straps attached to an orthodontic head bonnet. Statistical analysis was completed using the Student's t‐test and Fisher's Exact Probability test.

Results. The ages of the population ranged from 5·2 to 15·6 years, mean age (± SE) of 10·56 ± 1·13 years. There was no statistically significant difference in the rate of salivary flow rate between the two groups’ mean ± SE: cerebral palsy group 0·220 ± 0·018; control group 0·334 ± 0·052 (P = 0·053). The results were further confirmed by comparing the buffering capacity (P = 1·00) and concentrations of the sodium (P = 0·065) and potassium ions (P = 0·058) in the saliva of the study groups.

Conclusions. Children with cerebral palsy who drool do not appear to produce excess saliva. Their salivation is similar to the control children.
Learning disability nursing: from normalization to materialism — towards a new paradigm
Authors: Gilbert Tony
Published: March 2003

For almost 2 decades the ‘normalization principle’ has provided the dominant paradigm for the planning and evaluation of nursing services to people with a learning disability within the United Kingdom This has reflected the international influence of this philosophy in services to a wide range of disadvantaged and marginalized groups However, this paper will argue that nurses working with this client group are facing a range of social and political changes which expose the weaknesses in this paradigm This calls for a new approach to the way the relationship between practitioners and their clients is conceptualized Here it is argued that a materialist paradigm provides a more realistic framework upon which to base future nursing practice
The influence of educational theory on the development of nurse training to education in the United Kingdom
Authors: Crotty Margaret
Published: March 2003

This paper discusses the development of nurse training to education from its historical apprenticeship‐style approach to the current position of professional education through diploma‐level programmes The influence of education theory on nurse training over the years is explored The slowness of the transition from training to education is shown to have been dependent on the view of what is considered as appropriate preparation for the role Historically, one can see that it was expedient that preparation for the role began as training, and the development to education was thwarted by the lack of resources, the shortage of nurses, and the medical and political ideologies of the day The implementation of Project 2000, with students being supernumerary to the workforce, and the programme being educationally led, created the need for the development of professional education from the traditional training model
Boundary work in the nursing curriculum: the case of sociology
Authors: Cooke Hannah
Published: March 2003

A discussion of the boundaries between nursing and sociology is contained in this paper The creation of nursing as an academic subject is discussed and compared with the creation of academic geography The creation of academic subject involves ‘boundary work’ in which power and legitimacy are conferred on some forms of knowledge and not others Boundary work enables a discipline to stake out a claim to its legitimate territory and the resources that go with it In a practice discipline such as nursing, the boundaries between nursing and supporting subjects, such as sociology and physiology, create problems of transfer of learning This has implications for curriculum design Bernstein's work on educational transmissions offers useful insights He suggests a distinction between educational knowledge codes ‘Collection’ codes involve strong boundaries between subjects,‘integrated’ codes imply weak boundaries The implications of the move to an integrated code in nursing are discussed The existence of an integrated code implies a ‘strong ideological consensus’ within a discipline In nursing this entails a belief in the ‘individualized care’ of the patients This is incompatible with the sociological understanding of nursing
Patient‐controlled analgesia (PCA): does time saved by PCA improve patient satisfaction with nursing care?
Authors: Koh Paulin , Thomas Veronica J
Published: March 2003

This quasi‐experimental study compared the degree of satisfaction with nursing care among patients receiving post‐operative pain relief via patient‐controlled analgesia (PCA) and those receiving traditional intramuscular injection (IMI) regimes This study, which involved a total of 79 adult patients (mainly female) undergoing major abdominal surgery, was comprised of two main parts First, the amount of time taken by nurses to carry out pain control procedures on 11 matched pairs of PCA and traditional patients was recorded Second, all patients were asked to fill in a questionnaire regarding their satisfaction with the quality of nursing care they had received on their third post‐operative day The findings indicated that PCA did save time and this time saving could improve the nursing care quality of the whole ward, though not necessarily resulting in higher satisfaction amongst those patients who used PCA Interestingly, younger and the more highly educated patients were found to be especially critical and be less satisfied with care The implications for nursing practice and management are addressed, with special emphasis placed on the notion that time saved with PCA should be used to increase patient‐nurse contact and should not be used to compensate for a reduction in nursing staff