bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of (R,S)‐ornidazole on the fertility of male mice and the excretion and metabolism of 36Cl‐(R,S)‐ornidazole and 36Cl‐(R,S)‐α‐chlorohydrin in male mice and rats
Authors: Bone W. , Jones A. R , Cooper T. G.
Published: March 2003

(R,S)‐Ornidazole, an effective antifertility agent for male rats at 400 mg/kg/day, was ineffective at this dose in male mice and at 1000 mg/kg/day caused neural effects. The compound was not excreted unchanged and more polar metabolites and Cl– were detected in 0–8 h urine following a single injection (400 mg/kg). In 8–24 h urine even these metabolites and most Cl ion were absent, indicating rapid metabolism of ornidazole. There was no organ specific accumulation of 36Cl‐(R,S)‐ornidazole in murine tissues. After injection of 36Cl‐(R,S)‐α‐chlorohydrin, another antifertility agent in the rat but not the mouse, there was also no tissue‐specific accumulation of radioactivity in the reproductive tract of either species. Urinary excretion rates of α‐chlorohydrin were twice as rapid in mice as in rats. In mice, α‐chlorohydrin was the major urinary metabolite, but in the rat metabolites included Cl–, 3‐chlorolactate (BCLA) at 5 and 10 h and BCLA only at 24 h. BCLA was the major metabolite detected in most tissues at 10 and 24 h. In the rat cauda (but not caput) epididymidis the glycolytic inhibitor 3‐chlorolactaldehyde was present at 5 h (but not 10 h), indicative of early metabolism. These results demonstrate a greater metabolism and excretion of putative antifertility agents in the mouse than the rat, lowering the amount of effective inhibitor circulating in the animal, which may explain why (R,S)‐α‐chlorohydrin and (R,S)‐ornidazole are ineffective in this species at the dosages and injection times used, despite their spermatozoa being sensitive to inhibition by (R,S)‐α‐chlorohydrin in vitro.
Lack of antifertility properties of novel halogenated glycolytic inhibitors and the urinary excretion and metabolism of 1,6‐dichloro‐1,6‐dideoxy‐D‐fructofuranose in the male rat
Authors: Jones A. R. , Morin C. , Bone W. , Cooper T. G.
Published: March 2003

The antifertility action of (R,S)‐α‐chlorohydrin administered orally to male rats was compared with that of several novel chlorinated compounds known to inhibit glycolysis and the kinematics of rat sperm in vitro. Oral gavage of 1,6‐dichloro‐1,6‐dideoxy‐D‐fructofuranose (dichlorodideoxyfructose, DCF), 1‐chloro‐3‐hydroxypropanone, its dimethylketal and bromopyruvate did not reduce the fertility of male rats below that of controls at the equivalent antifertility dose of (R,S)‐α‐chlorohydrin (5 mg/kg/day) or higher. As anticipated for a compound cleaved to products of (S)‐chirality even high doses of DCF (200 mg/kg) showed no effect on renal function. 36Cl‐Labelled DCF administered orally to male rats was eliminated only slowly in the urine (16% of the ingested dose excreted in 96 h). In the first 8 h, approximately 50% of DCF was excreted unchanged, 30% was excreted as 3‐chlorolactate (BCLA), the oxidation product 3‐chlorolactaldehyde and 25% as Cl–. By 24 h little DCF remained and the major metabolite (70%) was BCLA and 20% Cl–. The high rate of dechlorination is most likely responsible for the low antifertility action of DCF.
Tissue inhibitors of metalloproteinases 1 and 2 in human seminal plasma and their association with spermatozoa
Authors: BAUMGART E. , LENK S. V. , LOENING S. A. , JUNG K.
Published: March 2003

A 24‐kDa heparin binding protein recently identified as tissue inhibitor of matrix metalloproteinases 2 (TIMP‐2) in bovine seminal fluid was suggested to play an important role in bull fertility. As no data are present for men, the concentrations of tissue inhibitors of metalloproteinases 1 (TIMP‐1) and TIMP‐2 were quantified in human seminal plasma of normozoospermic and azoospermic men using enzyme‐linked immunosorbent assay methods. TIMP‐1 and 2 were not significantly different in both groups and there were no relationships between the concentrations of both TIMPs and other sperm characteristics. It is assumed that TIMPs are released from accessory sex glands.
Collagen biosynthesis by neointimal smooth muscle cells cultured from rabbit aortic explants 15 weeks after de‐endothelialization
Authors: WANG HE , LI ZHIHE , MOORE SEAN , ALAVI MISBAHUDDIN ZAFAR
Published: March 2003

Extracellular matrix (ECM) accumulation in arterial neointima, developed in response to de‐endothelialization, is a prolonged process. In this study, we examined the relationship between increased collagen accumulation and synthetic activity of neointimal smooth muscle cells (SMCs) derived from aortic explants fifteen weeks after balloon catheter injury. Freshly confluent SMCs, derived either from normal aorta or from aortic neointima, were used in this study. The newly synthesized collagen was analysed by measuring [3H]‐proline incorporation; and the mRNA expression for two major types of collagen, collagen type I and type III, was studied by Northern blot analysis. Our results indicated a three fold increase in protein (collagen) synthesis by neointimal SMCs. At the same time, the steady‐state mRNA for procollagen I and procollagen III was elevated five and three times, respectively. These data indicate that persistent synthesis contributes to collagen accumulation in the arterial neointima and both transcriptional and post‐transcriptional regulation take part in this process.
Encephalomyocarditis (EMC) virus infection in PC12 and C6 cells
Authors: Su Weiping , Ueno‐Yamanouchi Aito , Nakayama Hiroyuki , Doi Kunio
Published: March 2003

PC12 cells derived from rat pheochromocytoma and C6 cells derived from rat glioma were infected with 0.3 plaque forming units (PFU)/cell of the D variant of encephalomyocarditis virus (EMC‐D), after pretreatment with or without nerve growth factor (NGF). The virus titres in medium and cells were investigated at 6, 12, 24, 48 and 72 h post infection (HPI), and histopathology and viral antigens in cells were examined at 24 and 48 HPI, respectively. As a result, neither viral replication nor light and electron microscopic changes were observed in PC12 cell cultures without NGF‐pretreatment. On the contrary, in PC12 cell cultures with NGF‐pretreatment, the virus titre prominently increased at 12 HPI, and peaked at 48 HPI. In addition, distinct histological and ultrastructural changes with viral antigens in cells were observed. C6 cells showed similar morphology and susceptibility to EMC‐ D‐infection irrespective of NGF‐pretreatment. Namely, the virus titres in C6 cell cultures increased slightly and viral antigens were found in a small number of C6 cells, but there were no evident histological and ultrastructural changes. These results suggest that PC12 cells pretreated with NGF and C6 cells are susceptible to EMC‐D infection in vitro.
Targetting VEGF in anti‐angiogenic and anti‐tumour therapy: Where are we now?
Authors: Leenders William P. J.
Published: March 2003

Since the recognition of the importance of the vascular bed for growth and metastasis of solid tumours, many researchers have investigated the approach of attacking the tumour vascular bed instead of the tumour cells themselves in anti‐cancer therapy. Such approaches have become possible with the increasing knowledge of the angiogenic process and the factors that regulate it. Especially the potent angiogenic factor VEGF has been the subject of extensive study in this regard. A number of studies showed that inactivation of this factor or its receptors led to a profound negative effect on the development of experimental tumours. However, despite the encouraging results obtained in animal studies, it remains to be established whether human tumours, which might be in a state of relative quiescence, are as sensitive to anti‐VEGF treatment as the fast‐growing tumours that are generally used in animal studies. If so, anti‐VEGF treatment might certainly represent a powerful tool in anti‐cancer therapy, either or not in combination with other blockers of angiogenesis.
Therapeutic potential of the anti‐angiogenesis drug TNP‐470
Authors: Gervaz  , Fontolliet
Published: March 2003

Neovessel formation is a pre‐requisite for tumour growth and dissemination. Inhibition of angiogenesis is a promising approach for the treatment of neoplasms. In recent years, antiangiogenic drugs, such as TNP‐470, have entered clinical trials. In this paper, we review the key experimental and clinical data on the role of TNP‐470 in anti‐tumour treatment.
Differentiation of a colon cancer cell line on a reconstituted basement membrane in vitro
Authors: Kim Hee Sung , Lee Byung Lan , Bae Soo In , Kim Yong Il , Park Jae‐Gahb , Kleinman Hynda K. , Kim Woo Ho
Published: March 2003

Basement membrane, a thin extracellular matrix, functions as a tissue stabilizer that promotes tissue integrity and differentiated phenotype. We studied a human colon cancer cell line, SNU 61, to evaluate its ability to differentiate on basement membrane. Cells were cultured on plastic, reconstituted basement membrane (Matrigel) or polyhydroxyethyl methacrylate (poly HEMA) for 72 h and evaluated by light and electron microscopy. On Matrigel, the cells showed gland formation with highly polarized cells containing basal nuclei and well developed brush border microvilli on the luminal surface. Apoptosis was noted mainly at the luminal side. On electron microscopic examination, numerous long microvilli, abundant cytoplasmic organelles and intercellular junctions were noted in the Matrigel‐cultured cells. Intermediate cytoskeletons were scattered in the cytoplasm and existed on the axes of microvilli. Junctional complexes and desmosomes were frequently formed along intercellular spaces. The cells cultured on poly HEMA, on the other hand, were poorly differentiated and contained a few glandular structures with small lumens. Brush border microvilli, characteristic of enterocytic differentiation, were few in number and were developed on the basal surface. Intermediate filaments and microtubules were fewer than in the Matrigel‐cultured cells. Carcinoembryonic antigen was expressed on the luminal surface of the Matrigel‐cultured cells and in the cytoplasm of the poly HEMA cultured cells. CD44 stained the basolateral surface in the Matrigel‐cultured cells, but the basal side was not stained in the poly HEMA cultured cells. These results are consistent with the different localization of microvilli in the Matrigel and in the poly HEMA cultured cells. Our observations suggest that human colon cancer cells on basement membrane can undergo glandular differentiation and that extracellular matrix is an important factor in morphogenesis.
Tissue distribution of rat macroglobulins in tumour‐bearing rats
Authors: Maltseva  , Zorina  , Mingaljev  , Krajushkina  , Chirikova  , Zorin
Published: March 2003

Rat macroglobulins were determined in blood sera and extracts of tissues of intact rats and rats with Walker carcinoma by rocket immunoelectrophoresis. The serum levels of α1‐macroglobulin (α1MG) α2‐macroglobulin (α2MG) and pregnancy‐associated α1‐glycoprotein (α1PAG) were 1.86 ± 0.07 mg/ml, 0.12 ± 0.02 mg/ml and 18.32 ± 4.07 AU/ml respectively in control rats. Maximum concentrations of α1MG were found in heart, lung and spleen and lesser quantities were in liver and thymus, while α2MG and α1PAG were not found at all in tissue extracts from control rats.

Serum α2MG and α1PAG concentrations increased more than 30‐fold in tumour‐bearing rats compared to control animals, while α1MG serum concentration was little changed. Increases in all three macroglobulins occurred in the tissues of tumour‐bearing rats, particularly α1PAG. The tissue concentrations of α1MG and α2MG were similar and the tissue distribution was also similar with highest concentrations in heart and lung. Considerable quantities of the proteins were found in the tumour and part of peritoneum which made contact with the tumour. Changes in the protein concentrations in serum and tissue extracts of tumour‐bearing rats suggest that all members of rat macroglobulin family are disturbed during the development of the Walker carcinoma, though only α2MG and α1PAG were substantially elevated.
Early vasculitis in the mercuric chloride induced Brown Norway rat model is neutrophil independent
Authors: Harris Fiona E. , Turner David R. , Oliveira David B.G.
Published: March 2003

In the Brown Norway rat, mercuric chloride (HgCl2) induces an autoimmune syndrome characterized by necrotizing vasculitis, predominantly affecting the caecum, and a polyclonal B‐cell response. The time course of vasculitis is biphasic, with an αβ T‐cell independent phase occurring within 24 h, and a T‐cell and neutrophil dependent phase, maximal at two weeks. The pathogenesis of the early phase of vasculitis is unclear, and this study aims to examine the role of neutrophils.

Rat neutrophils were depleted using cyclophosphamide. RP3, an antirat neutrophil monoclonal antibody, inhibited neutrophil leucocytosis but did not deplete neutrophils. Vasculitis was induced by subcutaneous HgCl2 injection. Serial measurements of peripheral blood leucocyte count were made. Rats were killed after 24 or 72 h. The macroscopic appearance of the caecum was scored by an experienced observer, and samples taken for histological examination. Caecums were excised and myeloperoxidase, a marker enzyme for neutrophil infiltration, assayed.

Cyclophosphamide induced marked neutropaenia whereas RP3 inhibited the neutrophilia observed after HgCl2 injection. Vasculitis was present in both treated and control animals, with no significant differences in macroscopic or microscopic scores between the groups. Tissue myeloperoxidase activity was low in all animals and did not differ significantly between groups.

The data do not support a role for neutrophils in the initial pathogenesis of vasculitis in this model.
Accumulation of amyloid‐β protein in exocrine glands of transgenic mice overexpressing a carboxyl terminal portion of amyloid protein precursor
Authors: Fukuchi Ken‐Ichiro , Li Ling , Hart Michael , Lindsey J. Russell
Published: March 2003

Amyloid‐β protein (Aβ) and its precursor (βPP) play important roles in the pathogenesis of Alzheimer disease and inclusion‐body myositis. In humans, Aβ deposits are found in brain, skeletal muscle, and skin. Therefore, we have investigated possible Aβ deposits in multiple tissues of two transgenic mouse lines overexpressing the signal plus Aβ‐bearing 99‐amino acid carboxyl terminal sequences of βPP under the control of a cytomegalovirus enhancer/β‐actin promoter. One of the lines developed Aβ‐immunoreactive intracellular deposits consistently in the pancreas and lacrimal gland, and occasionally in gastric, DeSteno's, and lingual glands. Although the Aβ deposits increased during ageing and degenerative changes of the tissues were observed, little or no extracellular Aβ deposits were observed up to the age of 25 months. These lines of transgenic mice are useful for studying the molecular mechanisms of development and clearance of intracellular Aβ deposits.
The dental problems and management of a patient suffering from congenital insensitivity to pain
Authors: Littlewood  , Mitchell
Published: March 2003

Congenital insensitivity to pain is a rare condition usually manifested in childhood by a history of unrecognized trauma, indifference to painful stimuli or self‐mutilation. This paper describes the management of a 13‐month‐old male who had severely lacerated his tongue by habitually chewing it, using soft polyvinyl mouthguards retained with a minimal amount of denture fixative.
Implant‐supported prosthesis in a child with hereditary mandibular anodontia: the use of ball attachments
Authors: Mcmillan  , Nunn  , Postlethwaite
Published: March 2003

This report describes the provision of an implant‐supported hybrid overdenture in an 8‐year‐old child with mandibular anodontia. An interdisciplinary approach to treatment planning was employed. Two implant fixtures were placed in the canine regions and ball attachments connected to provide support and retention for the prosthesis. There was only one implant‐related complication during the first follow‐up year. Close follow‐up during the child’s growing years is essential for the maintenance of the peri‐implant tissues and to replace the prosthesis as mandibular growth occurs.
Traumatic injuries to the chin: a survey in a paediatric dental practice
Authors: Holan
Published: March 2003

Objective. The aim of the study was to provide data on the prevalence of clinical signs of traumatic injuries to the chin and of parental report of such injuries in a group of children visiting a private paediatric dental practice.

Sample and methods. The study group comprised 303 children (151 boys and 152 girls) whose dental age was within the limits in which all primary molars are present. The children visited the author’s private practice for purposes other than chin injury and its dental implications. Data collected included age, gender, presence and location of fractures in primary molars, presence of a scar on the child’s chin, and parental report of previous chin injuries.

Results. Fractured primary molars were detected in 96 (31·7%) children. 79 (26%) children had a scar on the chin and previous chin injuries were reported for 110 (36·3%) children. Boys presented a higher prevalence of evidence of chin injuries than girls. The male/female ratios for fractured molars, scar on the chin and previous trauma were 1·5:1, 1·8:1 and 1·5:1 respectively. These differences were statistically significant (χ2, P= 0.012, P= 0.002 and P= 0.008 respectively).

Conclusions. It is concluded from this survey that traumatic injuries to the chin are not infrequent and the incidence of injuries to the chin is higher in boys than in girls
A repeated criterion‐based audit of radiographic usage by a paediatric dentistry unit
Authors: Shockledge R.R. , Hill F.J.
Published: March 2003

Aims. To report a simple clinical audit which was conducted within a single hospital paediatric dental unit and to demonstrate the potential value of such small‐scale projects.

Design. A criterion‐based audit of radiographic practice which was repeated after 3 years in order to evaluate changes.

Setting. Six 1 hour meetings of an audit group consisting of the staff and postgraduate students of the Unit.

Sample and Methods. Various aspects of radiographic usage were quantitatively assessed using a sample of patient records and a pre‐planned check list to assess the extent to which agreed good‐practice criteria were being met. The initial audit identified areas for improvement which were addressed before repeating the exercise 3 years later.

Results. Clinical note‐keeping to accompany radiographic examinations was found to be the least satisfactory area of practice. When the exercise was repeated, encouraging improvements were demonstrated.

Conclusions. The audit was worthwhile because it appeared to produce improvements in standards of patient care.
Arresting dentine caries in Chinese preschool children
Authors: Lo E.C.M. , Schwarz E. , Wong M.C.M.
Published: March 2003

Objectives. To investigate the incidence of rehardening of caries lesions in children in Southern China taking part in a preventive programme.

Design. Longitudinal study.

Sample and methods. A prevention programme was established for 168 3–6‐year‐old children in a kindergarten (KG1), which included regular oral health education sessions and a daily toothbrushing exercise using fluoridated toothpaste (1000 ppm F). A group of 121 children studying in two other kindergartens without a preventive programme formed the controls. Due to lack of resources and dental personnel, restorative and other curative treatments were not provided.

Results. Rehardening of dentine caries (arrested caries) was found in children in both test and control groups. At the third annual examination, 45% of the caries lesions on the proximal surfaces of primary anterior teeth in KG1 children found at the baseline and previous annual examinations had become arrested. A multiple linear regression analysis indicated that baseline ds score and its interactions with the prevention programme, gender and the child’s oral hygiene all had significant effect on the number of tooth surfaces with arrested caries at the third annual examination.

Conclusion. Results from this study support the use of simple prevention programmes to stabilize the caries situation in communities where intensive use of trained dental personnel is not feasible.
On the pulpal nerve supply in primary human teeth: evidence for the innervation of primary dentine*
Authors: Egan C.A. , Hector M.P. , Bishop M.A.
Published: March 2003

The presence of nerves in human tooth pulp has been recognized for over a hundred years, and the innervation of dentine for about 40 years. These observations have been made in permanent teeth. Very few studies have reported on the innervation of the primary pulp and dentine. The purpose of this study was to describe the innervation of the primary tooth pulp–dentine complex. Ten mature primary teeth (one incisor, six canines and three molars) were used. Immediately following extraction they were divided into three sections using a diamond disc and saline coolant. They were then immersion fixed in a solution of formaldehyde and picric acid dissolved in a phosphate buffer pH 7·4). The teeth were then demineralized for 1–3 weeks in formic acid. Following complete demineralization, 30 μm sections were cut on a freezing microtome. Neural tissue was stained using a specific antibody to calcitonin gene related peptide (CGRP). Sections were mounted on glass slides and examined using light microscopy. No individual nerve fibres were seen in the control sections, suggesting that the method used was specific for CGRP‐containing nerve fibres. The primary teeth appeared to be well innervated. Myelinated and unmyelinated nerves were seen. There was a dense but variable subodontoblastic plexus of nerves (plexus of Raschkow) and nerve fibres were seen to leave this to travel towards the odontoblast layer. Most terminated here, but a few penetrated the odontoblast layer to enter predentine and the dentine tubules. The maximum penetration was 125 μm but most terminated within 30 μm of the dentinopulpal junction. The coronal region was more densely innervated than the root. Within the crown the cervical third was the most densely innervated region, followed by the pulp horn and the middle third. In conclusion, this study has demonstrated that mature primary tooth contains a pulp which is well innervated and has many nerve endings terminating in or near the odontoblast layer, with a small number penetrating into dentine.
Denture satisfaction and clinical performance in a paediatric population
Authors: Rodd H.D. , Atkin J.M.
Published: March 2003

Objectives. The objectives of this study were to investigate the clinical performance of partial upper dentures in children and to assess reported denture satisfaction in this young population.

Design. This was a retrospective study using patients’ dental records in conjunction with a postal questionnaire.

Setting. The Paediatric Dentistry Clinic, School of Clinical Dentistry, Sheffield.

Sample and methods. Fifty‐eight children (aged 7–17 years) who had been provided with a partial upper denture to replace one or more missing permanent incisors were included in the study. The patients’ dental records were examined for the following details: tooth type missing, presence of retained incisor roots, aetiology of tooth absence, age at which the denture was first provided, total time period dentures had been worn, and frequency and type of any denture repairs or replacements. Next a short questionnaire was sent to each child, which sought an evaluation of several parameters of denture satisfaction including: overall attitude towards wearing a denture, denture appearance, ease of eating, comfort and perceived degree of teasing from peers. Visual analogue scales (VAS) were employed to provide a graded response.

Results. 70·7% of subjects had a single missing incisor and trauma was the most common cause of tooth loss (77·3%). The mean age at which patients started wearing a denture was 11·6 years and the mean length of time dentures had been worn, at the time of the investigation, was 2·1 years. A ‘T‐shaped’ denture was most commonly employed (77·5% of dentures). Overall, 36·2% of subjects had required at least one denture repair, 28·2% presenting within a year of denture provision. One or more denture replacements had been received by 60·3% of the patients, and 43·6% had required this within a year. Component failure was highest for the denture tooth (40% of repairs) and a change in the patient’s dentition necessitated a denture remake in 66% of cases. VAS scores for parameters of denture satisfaction indicated an overall positive evaluation of the dentures, with the most positive response relating to ease of eating. However, the reported degree of teasing was high and increased with time. The only significant difference for denture satisfaction according to gender was for mastication: girls reportedly found eating easier than did boys.

Conclusion. Children are generally accepting of upper partial dentures, but their poor clinical performance is of concern and there is need for improvement.
The trouble with teething – misdiagnosis and misuse of a topical medicament
Authors: Wilson P. H. R. , Mason C.
Published: March 2003

Summary. For many clinicians and parents ‘teething’ remains a convenient diagnosis to explain all manner of local and systemic upset in the young child. Many therapies are on the market to help alleviate the symptoms of primary tooth eruption. In this article we highlight the problems of ‘teething’ as a diagnosis by presenting a case where an initial misdiagnosis of teething compromised a patient’s life. The same patient then suffered from topical analgesic misuse during the recovery period.
General anaesthesia for exodontia in children: experience of a dental teaching hospital in relation to changes in national guidance
Authors: Hunter M. L. , Hunter B. , Dhir A. P. , Shah B.
Published: March 2003

Summary. Objectives. To examine, in relation to changes in national guidance, trends in the provision of general anaesthesia for exodontia in children.

Design. Retrospective analysis of hospital records.

Setting. University Dental Hospital, Cardiff, UK.

Methods. Data were drawn from records of services provided in each of four index months during 1989, 1991, 1997 and 1999 (the years immediately preceding/following the Poswillo Report of 1990 and the General Dental Council's revised guidance of 1998).

Results. In the first year after publication of the Poswillo report, there was a 19·6% increase in use of ‘chair case’ general anaesthesia over the four index months. Subsequently, upon the emergence of additional providers, patient flow in 1997 had fallen to 65·8% of that seen at baseline. Following the General Dental Council's revised guidance of 1998, there was a further reduction in the provision of ‘chair case’ general anaesthesia (to 40·8% of that seen at baseline).

Conclusions. In this unit, throughput of children receiving general anaesthesia for exodontia has fluctuated in periods marked by changing national guidance. However, it is not possible to attribute such fluctuations in patient flow solely to this factor.
Unusual presentation of talon cusp: two case reports
Authors: Nadkarni U. M. , Munshi A. , Damle S. G.
Published: March 2003

Summary. Talon cusp is an uncommon odontogenic anomaly comprising of an accessory cusp‐like structure, usually observed on the palatal surfaces of maxillary incisors. Two uncommon presentations of talon cusp, occurring on a mandibular incisor and on a supernumerary tooth in the maxilla, are reported.
Impacted supernumerary tooth developed under palatal polyp
Authors: Noguchi M. , Tomizawa M. , Suzuki M. , Noda T.
Published: March 2003

Summary. We present a rare case of an infant's palatal polyp associated with an impacted supernumerary tooth. We have previously reported three cases of palatal polyps in infants [1]. In one case, after surgical removal of the palatal polyp at the age of 1 year and 8 months, the lesion subsequently began swelling. A periapical radiograph at the age of 2 years and 9 months revealed a small calcified mass in the maxillary left incisor region. The swelling was kept under observation, the calcified mass developed gradually and was removed surgically at the age of 5 years and 5 months. The removed calcified mass was clinically diagnosed as an impacted supernumerary tooth and this was confirmed histologically. Histological findings did not indicate any relationship between the palatal polyp and the impacted supernumerary tooth.
Oral submucous fibrosis in a 12‐year‐old Bangladeshi boy: a case report and review of literature
Authors: Yusuf H. , Yong S. L.
Published: March 2003

Summary.  Oral submucous fibrosis is commonly seen in the adult population of the ethnic minorities in the UK, although its presentation in a child is rare. Whilst the condition is considered multifactorial and irreversible, we present a case of oral submucous fibrosis in a 12‐year‐old Bangladeshi boy whose cessation of habitual betel nut chewing and forcible mouth chewing exercises led to an improvement in his mouth opening, although his ability to protrude his tongue remained unaltered. The clinical features, pathogenesis and management of submucous fibrosis are described. The widespread use of betel quid among Asians in the UK is summarized and the importance of its recognition as a precancerous condition is emphasized.
Specialism in nursing: the case of nursing care for elderly people
Authors: Cheah Yeow Leng , Moon Graham M
Published: March 2003

Is elderly care nursing a speciality? This paper reports results from an interview‐based study which aims to uncover the distinctive elements of nursing work with elderly people Within the context of sociological literature on specialism it is concluded that a case for seeing elderly care nursing as a speciality area can be made However, that case has implications for the continued marginalization of elderly people in society
The effects of student nurse community mental health placements on sufferers of mental health problems in the community
Authors: Richards Robin M
Published: March 2003

The effects which student nurses have on the care of clients with mental health problems in the community is an area which has seldom been studied With the closure of large psychiatric hospitals and the rise in community placements as part of Project 2000, an increasing number of students are being placed in the community The study gathers data from clients attending five self‐help/support groups in the North Derbyshire area of England Analysis of the data challenges assumptions generally held by community psychiatric nurses (CPNs) that the presence of a third person, e g student/visitor, during a CPN home visit to the client is detrimental to the therapeutic interaction between the CPN and the client The findings are inconclusive but suggest that some client groups (possibly those with long‐term mental health problems) may find the presence of a student during a CPN visit facilitative The study raises the issue of the student nurse/patient power relationship within a support group Findings suggest that membership of a support group is empowering to the client and illustrates that clients in the community have greater control over the involvement of student nurses in their care than patients in hospital Groups within the sample expressed a unanimous view that student nurse placements should be long enough to allow therapeutic nurse/client relationships to develop This is in direct contrast to the current Project 2000 Common Foundation Programme approach of short observational non‐institutional placements
The role of the health visitor in identifying and working with vulnerable families in relation to child protection: a review of the literature
Authors: Appleton Jane V
Published: March 2003

This paper presents an overview of the research surrounding the role of the health visitor in identifying and working with vulnerable families in relation to child protection Only a limited number of empirical studies have been completed within the field of health visiting, so this review draws on most of the literature published over the last 15 years, which is mainly British in origin No previous reviews have focused on this specific area of health visiting Clearly with the recent increase in public and official recognition of child protection issues and the continuing debate of health visitor involvement within this area, this review takes a significant step forward in drawing together relevant research The review focuses on research within three main areas Firstly, the health visitor's role in working with vulnerable families in relation to child protection is explored The clients’perceptions of this role are also explored Secondly, the identification of vulnerable families by health visitors and non‐health visitors is explored Within this area a number of studies by non‐health visitors investigating screening approaches to child abuse have been reviewed, because they play such a major role in the literature and appear to have influenced subsequent health visitor research Thirdly, a review of health visitors’preventive work with vulnerable families is completed
What changes in health behaviour might nurses logically expect from their health education work?
Authors: Dines Alison
Published: March 2003

This paper examines nurses' health education work from a philosophical perspective Two key concepts, choice and autonomy, are explored by analysing examples of the health education work of the practice nurse and the health visitor As a result, the question,‘what changes in health behaviour might nurses logically expect from their health education work?’is considered The individualistic assumption within nurses' health education work, that individual patients and clients face certain choices and are able to exert some control over their health status, is reviewed Choices related to healthy eating, for example, are recognized to be constrained by issues such as finance, time and social circumstances The choice not to smoke is similarly constrained, for example, by social deprivation, cultural patterns and advertising The paper both rejects an overly determined conception of patients and clients where they are viewed as unable to make any choices, but also cautions against the danger of victim‐blaming Constraints on patients' and clients' autonomy in health education by nurses are also considered These limitations on health education work include, for example, a lack of scientific knowledge related to an individual's propensity to develop disease In contrast, health education work within nursing may also be seen as enabling people to be more autonomous in relation to their health by imparting knowledge about health risks Health education work by nurses thus emerges from the analysis as a constrained but valuable activity
Nurses'notes on sleep patterns in patients undergoing coronary artery bypass surgery: a retrospective evaluation of patient records
Authors: Edéll‐Gustafsson Ulla , Arén Claes , Hamrin Elisabeth , Hetta Jerker
Published: March 2003

In this study, patient records from 80 male patients, aged 43–76, undergoing first‐time coronary artery bypass surgery were evaluated with regard to nurses' documentation on sleep during the first four postoperative days This documentation was classified into descriptions of quality and quantity of sleep Notations on sleep were found in 69–86% of patient records each night, and was most common the second night Descriptions of both quality and quantity of sleep occurred in only 12 out of 320 patient‐nights Notes regarding duration of sleep were found for 146 patient‐nights (45 6%), of which 103 (32 2%) contained sleep disturbances Information on quality of sleep was given for 116 patient‐nights (36 3%), with only 38 patient‐nights (11 9%) of sleep disturbances For 72 patient‐nights, documentation of the patients' sleep was lacking Frequent awakening was the most common sleep disturbance noted during all but the first night, when continuous awakening dominated We conclude that the nurses' documentation regarding sleep and sleep disturbances varied over a wide range, with a mixture of quantitative and qualitative information, and that more structured descriptions are needed
Staff nurses' work satisfaction in psychogeriatric wards
Authors: Gilloran Alan , McKinley Andrew , McGlew Tom , McKee Kevin , Robertson Alex
Published: March 2003

This paper begins by reviewing the small number of studies of staff nurses’ work satisfaction Subsequently, an examination is made of the differences in work satisfaction between staff nurses and other grades of nursing staff in psychogeriatric wards in National Health Service hospitals in Scotland These data are part of a larger study into work satisfaction and the quality of care in these settings Significant differences in satisfaction at work are identified between the staff nurse group and the other grades taken as a whole Analysis of the components of job satisfaction suggests that these differences arise from first, the experience of the work itself, second, the quality of the supervision which takes place, and third, the assessment of hospital policies, such as the transfer of staff to other wards
Perceived functions and usefulness of health service support workers
Authors: Chang Anne M
Published: March 2003

Support workers have been advocated as a means of overcoming a shortage of professional nursing practice, whether this shortage is derived from a decrease in budgeted positions or from a lack of persons to fill positions The demand for nursing practice has increased because of a rise in the intensity and complexity of patient care The purpose of this study was to examine professional nurses' views on the non‐nursing duties they were currently performing and the possible use of support personnel to assist them in their role of providing patient care Group interviews of qualified nurses were used to develop a questionnaire comprising 40 items concerning support worker duties, 26 non‐nursing duties and one item requesting respondents to indicate if a support worker would be useful 408 (60%) nurses completed the questionnaire and 71% agreed that a support worker would be useful Twenty‐three support worker activities were statistically significant (P<0 01) in the level of agreement and variation from the undecided position The significant groups of support worker activities determined by principal component analysis using a single factor were clerical, cleaning and stocking and direct patient care, while the indirect patient care group of activities was not significant Forty‐six per cent of the non‐nursing duties were agreed to, while 50% were seen to be the role of the nurse There were areas of support worker activity which were related to agreed non‐nursing duties and other areas where there was an overlap, with the duties being seen as both nursing and suitable for the support worker
The implementation of Project 2000 in the community: a new perspective on the community nurse's role
Authors: Hallett Christine E , Williams Anne , Orr Jean , Butterworth Tony , Collister Blair
Published: March 2003

This paper considers some of the initiatives taken by community nurses in England in implementing Project 2000 placements The data were obtained during an English National Board funded study in two phases The first phase involved a series of exploratory interviews, a postal questionnaire survey, and semi‐structured interviews with 15 managers In phase two, one Project 2000 demonstration district was studied in depth by means of interviews complemented by small‐scale questionnaire studies Community nurses had confronted a number of difficulties in implementing Project 2000 Among the most serious of these were shortage of time, poor communication with the colleges of nursing and lack of preparation As a consequence, community nurses took what they saw as independent approaches to students’ placements Many set their own aims and objectives for placements and produced written guidelines and teaching plans for students Many also asserted the importance of their role in the assessment of students’ practical work
The changing profile of acute childhood illness: a need for the development of family nursing knowledge
Authors: Rennick Janet E
Published: March 2003

The profile of the acutely ill child and family has undergone dramatic changes in recent years Advances in medical technology have substantially altered the life‐death trajectory for ill children and their families, however, they have also left families to endure increasingly difficult situations with uncertain outcomes for prolonged periods of time Nurses are interested in understanding how families manage in the face of serious illness, yet a review of the literature has revealed little progress in this area While the importance of the family has been repeatedly documented, theoretical developments regarding family process during acute illness have been limited This paper analyses those factors that have limited nursing knowledge development and, as a result, contributed to gaps in current thinking regarding the acutely ill child They include (a) a history of theoretical nursing models which, until recently, focused on the individual, (b) research that has focused on the individual parent or child while virtually ignoring family variables, (c) an outdated definition of acute illness which does not reflect the current population of hospitalized children, (d) limited use of theoretical frameworks borrowed from other disciplines, and (e) unresolved methodological issues related to the study of families in nursing
Implementing change in nurses’ professional behaviours: limitations of the cognitive approach
Authors: Lima‐Basto Marta
Published: March 2003

This paper reports on a study of the effects of an intervention on a group of nurses’ professional behaviours and on the process of behaviour change, according to the cognitive approach The quasi‐experimental design followed in the study resembles the time‐series design The study took place in a general state hospital in Lisboa and centred on the cardiology unit Subjects were all nurses giving direct patient care (n= 17) The study extended over a period of 13 months Results showed that the effects of the intervention were the adoption of some of the expected behaviours Several questions were raised by the study, and the discussion points out some of the limitations of a cognitive approach to the understanding of the process of change of nurses’ professional behaviours
A comparison study of children with sickle cell disease and their non‐diseases siblings on hopelessness, depression, and perceived competence
Authors: Juanita Lee E. , Phoenix David , Brown Woodrow , Jackson Brenda S.
Published: March 2003

The purpose of this comparison study was to explore the extent to which hopelessness and self‐perception of competence are associated with depression in a community population of children with sickle cell disease compared to their non‐diseases siblings. Subjects were African‐American children drawn randomly from the case management programme at the L.D. Barksdale Sickle Cell Anemia Foundation. Depression scores were higher for the non‐diseased siblings. The children with sickle cell disease scored lower on the perceived physical competence scale. Recommendations for practice include increasing hope, improving relationships, monitoring depression in patients and their siblings, and monitoring perceptions of cognitive, social, physical, and general self‐worth.
Science, abduction and the fuzzy nurse: an exploration of expertise
Authors: Rolfe Gary
Published: March 2003

Benner's work on expertise in nursing drew heavily on the writing of Dreyfus and Dreyfus in the field of computing. Dreyfus and Dreyfus argued that the continued failure of computer programmers to create an ‘expert system’, a program which could replicate the way that a human expert thinks, implied that experts do not think in a rational, analytic way. Dreyfus and Dreyfus therefore concluded that expertise is an intuitive process, and that ‘the expert is simply not following any rules! He is … recognising thousands of special cases’. Applied to nursing, this model of expertise has a number of profound implications for practice and education, and has been criticised for being elitist and deliberately obscure. This paper examines some recent innovations in computer logic, and arues that nursing can learn from a new breed of ‘fuzzy’ compurter programmes which appear to be able not only to perform better than experts, but to verbalize their decision‐making processes. By beginning to understand how experts think, it might be possible to dvelop expertise in a more controlled and logical way, thereby improving the practice of nursing.
Death, portry, psychotherapy and clinical supervision (the contribution of psychodynamic psychotherapy to palliative care nursing)*
Authors: Jones Alun
Published: March 2003

This paper explores one facet of a therapeutic relationship with a woman suffering from inoperable cervical cancer. The psychotherapy sessions were conducted in both hospital and the family home and continued on a weekly basis until final termaination immediately prior to the woman's death. Through a ‘suspense structure’ case study narrative, the writer, a nurse psychotherapist, describes the way in which the humanities art and poetry can provide a means through which to understand seemingly incomprehensible feelings related to reviewing past events as a preparation for death.

While no explict critique is made of the twin psychoanalytical concept of transference and countertransference, the occurrence is woven into the text. The essential nature of clinical supervision is illustrated in context. The author proposes that engagement in a therapeutic relationship with a dying person presents the worker with parallel struggles manifesting in elementary feelings which require discernment. The central recommendation of this paper is that the rich symbolic language and metaphors, redolent in art and poetry, be harnessed as a potent therapeutic and metaphors, redolent in art and poetry, be harnessed as a potent therapeutic tool. Throughout the discussion, the terms counseling and psychotherapy are used interchangeably.
Nurse teachers' perceptions of information technology: a study of nurse teachers in Northern Ireland
Authors: Sinclair Marlene , Gardner John
Published: March 2003

This paper presents the results of a brief study of Northern Ireland nurse educators' perceptions of information technology (IT) in nurse education. The study focuses on training, computer use, student assessment, and future trends. The results indicate that although there remain tutors who have not received any formal training in computer use, the majority want to use computers and recognize their need for competence. While training would pear to have a positive effect on their perceived level of competence and computer knowledge, the study identifies factors which contributes to the restricted use of computers assisted learning (CAL). Student assessment varies across the province and findings of the study indicate that although many changes have taken place, staff expect more in the futures. They identify a need for policies that include training programmes, competences assessment, appropriates technology, and networking.