bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical incident technique: a user’s guide for nurse researchers
Authors: Schluter Jessica , Seaton Philippa , Chaboyer Wendy
Published: August 2010

Title.  Critical incident technique: a user’s guide for nurse researchers

Aim.  This paper is a description of the development and processes of the critical incident technique and its applicability to nursing research, using a recently‐conducted study of the Australian nursing workforce as an exemplar. Issues are raised for consideration prior to the technique being put into practice.

Background.  Since 1954, the critical incident technique has been used to study people’s activities in a variety of professions. This five‐step technique can be modified for specific settings and research questions. The fruitfulness of a study using the technique relies on gaining three important pieces of information. First, participants’ complete and rich descriptions of the situation or event to be explored; secondly, the specific actions of the person/s involved in the event to aid understanding of why certain decisions were made; thirdly, the outcome of the event, to ascertain the effectiveness of the behaviour. As in other qualitative methodologies, an inductive analysis process can be used with the critical incident technique.

Findings.  Rich contextual information can be obtained using this technique. It generates information and uncovers tacit knowledge through assisting participants to describe their thought processes and actions during the event. Use of probing questions that determine how participants take part in certain events, or act in the ways they do, greatly enhances the outcome. A full interpretation of the event can only occur when all its aspects are provided.

Conclusion.  The critical incident technique is a practical method that allows researchers to understand complexities of the nursing role and function, and the interactions between nurses and other clinicians.
Waiting for healthcare: a concept analysis
Authors: Fogarty Caroline , Cronin Patricia
Published: August 2010

Title.  Waiting for healthcare: a concept analysis

Aim.  This paper is a report of an analysis of the concept of waiting for health care from the client’s perspective.

Background.  Waiting is commonplace in many areas of health care and has become a topical and politically important issue in the provision of healthcare services. Whilst managers and governments search for solutions to this problem, it is important that this aspect of clients’ healthcare experience is examined to evaluate its impact and implications for nursing practice.

Methods.  The PubMed and CINAHL databases (dating from 1950 and 1982 to 2007 respectively) were searched using the keywords ‘health care’ and ‘waiting’. The reference lists of papers identified were also checked and this revealed literature from a number of other disciplines related to the concept.

Results.  Waiting for health care is identified as an unspecified yet measurable period of time between identification of a healthcare problem and its diagnosis and treatment, when clients experience uncertainty and powerlessness whilst anticipating a disease outcome. The critical attributes of waiting for health care are: a period of measured time, subjective interpretation of the perceived significance of the measured time, feeling uncertain and powerless and anticipation of a response to the healthcare need.

Conclusion.  Strategies that facilitate contact with clients through pre‐assessment clinics and giving written information and a contact point may seem obvious but are currently overlooked in busy healthcare environments. This is an area where nurses can lead in the delivery of person‐centred care and could potentially increase satisfaction with how waiting is managed.
Time to establishment success for introduced signal crayfish in Sweden – a statistical evaluation when success is partially known
Authors: Sahlin Ullrika , Smith Henrik G. , Edsman Lennart , Bengtsson Göran
Published: August 2010

1. The signal crayfish Pacifastacus leniusculus is an invasive species in Sweden, threatening the red‐listed nobel crayfish Astacus astacus through spreading the crayfish plague. Time‐to‐event models can handle censored data on such introduced populations for which the state (successful or not) is only partially known at the last observation, but even though data on introduced populations most often are censored, this type of model is usually not used for likelihood‐based inference and predictions of the dynamics of establishing populations.

2. We specified and fitted a probabilistic time‐to‐event model to be used to predict the time to successful establishment of signal crayfish populations introduced into Sweden. Important covariates of establishment success were found by the methods of ‘model averaging’ and ‘hierarchical partitioning’, considering model uncertainty and multi‐colinearity, respectively.

3. The hazard function that received the highest evidence based on the empirical data showed that the chances of establishment were highest in the time periods immediately following the first introduction. The model predicts establishment success to be <50% within 5 years after first introduction over the current distributional range of signal crayfish in Sweden today.

4. Among covariates related to temperature, fish species and physical properties of the habitat, the length of the growing season was the most important and consistent covariate of establishment success. We found that establishment success of signal crayfish is expected to increase with the number of days when growth is possible, and decrease with the number of days with extremely high temperatures, which can be seen to approximate conditions of stress.

5. Synthesis and applications. The results demonstrate lower establishment success of signal crayfish further north in Sweden, which may decrease the incentives of additional illegal introductions that may threaten the red‐listed noble crayfish Astacus astacus. We provide a fully probabilistic statistical evaluation that quantifies uncertainty in the duration of the establishment stage that is useful for management decisions of invasive species. The combination of model averaging and hierarchical partitioning provides a comprehensive method to address multi‐colinearity common to retrospective data on establishment success of invasive species.
Motivational correlates of physical activity in persons with an intellectual disability: a systematic literature review
Authors: Hutzler Y. , Korsensky O.
Published: August 2010

Background  The purpose of this study is to systematically retrieve, examine and discuss scientific studies focusing on motivational correlates that both contribute to, and can be assumed to be effects of, participation in sport, recreation, or health‐related physical activities in persons with intellectual disability (ID).

Methods  A systematic analysis of the literature retrieved through electronic databases and other resources was performed, covering articles published from 1980 through 2009. Inclusion criteria were based on terms referring to the participants, the psychosocial correlates and the type of activity.

Results  Twenty‐three articles satisfied the inclusion criteria, and were divided into four categories of studies: (1) cross‐sectional designs, (2) experimental prospective one‐group designs, (3) longitudinal comparative intervention designs, and (4) qualitative designs. The level of quality regarding the intervention studies was assessed using four different scales, and on average they depicted a moderate level of evidence.

Conclusions  Both exercise and sport‐related activities seem to contribute to well‐being. Improved physical fitness and elevated skill level gained during exercise and sport activities appear to serve as mediators for increased perceptions of self‐efficacy and social competence. Peer modelling, as well as video and audio reinforcement, appear to be important modalities in maintaining compliance to exercise programmes.
Expression and Translocation of Aquaporin‐2 in the Endolymphatic Sac in Patients with Meniere’s Disease
Authors: Maekawa C. , Kitahara T. , Kizawa K. , Okazaki S. , Kamakura T. , Horii A. , Imai T. , Doi K. , Inohara H. , Kiyama H.
Published: August 2010

Meniere’s disease, characterised by episodic vertigo, fluctuating hearing loss and tinnitus, can occur under conditions of stress. Its pathology was first revealed to be inner ear hydrops through temporal bone studies in 1938. Although its pathogenesis has been proposed to be a disorder of water transport in the inner ear, subsequently, it remains unsolved, until now. A recent study revealed that both plasma stress hormone, vasopressin (pAVP) and its receptor, V2 (V2R) expression in the inner ear endolymphatic sac were significantly higher in Meniere’s patients. In the present study, to link V2R‐related molecules and inner ear hydrops, we examined V2R‐linked water channel molecule, aquaporin‐2 (AQP2) expression and translocation in human endolymphatic sac. AQP2 mRNA expression in the endolymphatic sac was significantly higher in Meniere’s patients by using real‐time polymerase chain reaction, as further confirmed by western blotting. AQP2‐like immunoreactivity (‐LIR) was translocated from luminal to basolateral side with endosomal trapping in the endolymphatic sac at the time of AVP exposure in human endolymphatic sac tissue culture. The similar AQP2‐LIR translocation was also demonstrated by forskolin and blocked by vasopressin/V2R specific antagonist, OPC31260 and protein kinase A (PKA) specific antagonists, H‐89 and KT‐5720. We concluded that in the pathogenesis of inner ear hydrops resulting in Meniere’s attacks, pAVP elevation as a result of stress and subsequent V2R‐cAMP‐PKA‐AQP2 activation and endosomal trapping of AQP2 in the endolymphatic sac, might be important as a basis of this disease. Further experimental and clinical studies are needed to better clarify the neuroscientific relationship between stress and Meniere’s disease.
Nocturnal bruxing events: a report of normative data and cardiovascular response
Authors: OKESON J.P. , PHILLIPS B.A. , BERRY D.T.R. , BALDWIN R.M.
Published: August 2010

Twenty subjects referred to a sleep laboratory for evaluation of sleep apnoea and found not to have any sleep disordered breathing problems were evaluated in this study. Bruxing events were recorded for frequency, duration, association with sleep stage and sleep position. The possible association between leg movements and bruxing events was also evaluated, but did not reveal any common mechanism. This study revealed that heart rate during bruxing events increased on average by 16.6%.
Condylar asymmetry and its relation to age in a group of patients with a craniomandibular disorder of myogenous origin
Authors: MILLER V.J. , MYERS S.L. , YOELI Z. , ZELTSER C.
Published: August 2010

A group of patients with a myogenous origin of craniomandibular disorders was found to show a variation of condylar asymmetry with age. The curve obtained by plotting patient age against their asymmetry index was parabolic in nature. This differed from a group of patients with an arthrogenous origin of pain, where a linear correlation with age, with a negative slope, had previously been found. The mean asymmetry index for this group of patients was found to be 23.77%. This is higher than that reported for a group of patients with a craniomandibular disorder of arthrogenous origin, namely 18.76%. It appears that these two groups differ in the variation of condylar asymmetry with age.
The acquisition and validation of removable partial denture design knowledge. II. Design rules and expert reaction
Authors: DAVENPORT J.C. , HAMMOND P. , DE MATTOS M.G.
Published: August 2010

summary
Details are presented of the reaction of multiple prosthetic experts in 17 dental schools in the U.K. to 125 design rules for removable partial dentures. Those rules receiving support from 50% of the schools are candidates for inclusion in RaPiD, a knowledge‐based assistant for the design of removable partial dentures.
Effect of continuous pressure on histopathological changes in denture‐supporting tissues
Authors: MORI S. , SATO T. , HARA T. , NAKASHIMA K. , MINAGI S.
Published: August 2010

summary
The histopathological changes in denture‐supporting tissues were studied in relation to continuous pressure exerted through an experimental denture base. The experimental dentures were designed to load continuous pressures (1.5, 3.4 or 4.9 kPa) to the palate of molar region of rat. Histopathological changes caused by the continuous pressure were observed, and the intensity of the pressure was also estimated. A high correlation was observed between the histopathological changes under the denture base and the intensity of the continuous pressure. In groups exposed to 4.9 and 34 kPa, the continuous mechanical pressure caused bone resorption; in 1.5 kPa group, no evidence of bone resorption was observed. The epithelium and lamina propria mucosa under the denture base, which were compressed by the continuous pressure, recovered histopathologically depending on the decrease of the pressure caused by bone resorption; no quantitative recovery of the absorbed bone tissue was observed. No inflammatory change was induced by the continuous pressure. From the histopathological results observed in this study, the possibility of the existence of a threshold for bone resorption induced by continuous pressure was suggested.
Outcome of therapy in the conservative management of temporomandibular pain dysfunction disorder
Authors: SUVINEN T.I. , HANES K. R. , READE P. C.
Published: August 2010

summary
The present study considered predictors of the outcome of treatment for temporomandibular pain dysfunction disorder (TMPD). Thirty‐seven patients were assessed with objective and self‐report measures of physiological and psychosocial aspects of this disorder at initial assessment and at 6‐month follow‐up subsequent to conservative physical therapy. Patients were subdivided into slow and rapid responders to conservative physical therapy based on self‐reported level of improvement. Measures employed included the Temporomandibular Pain Dysfunction Disorder Questionnaire and the Temporomandibular Pain Dysfunction Disorder Clinical Form. Eighty‐one per cent of patients showed a 50% or greater improvement in pain severity at follow‐up, with minimal differential changes across the two groups found in the physiological symptoms, while the rapid responding group showed greater improvement in terms of psychosocial factors. These findings indicated that psychosocial factors, particularly coping strategies and illness behaviour, cannot be ignored in the management of TMPD.
Comparative evaluation of polishing systems on the surface of three aesthetic materials
Authors: BOUVIER D. , DUPREZ J.‐P. , LISSAC M.
Published: August 2010

summary
This Study compared the efficacy of three different polishing methods on a resin composite, a glass ionomer cement (GIC) and a compomer. Thirty samples of each material were prepared. Ten of them were randomly assigned to one of the three polishing methods. The surface roughness (Ra) of the samples were measured before and after the polishing procedure with a profilometer. There was no statistical difference between the composite and the compomer prior to polishing but statistical difference was found between the GIC and the two other materials. After polishing, the smoothest surfaces were obtained using SofLex discs for the three materials, and the roughest surface, with tungsten carbide burs for the composite and the compomer, and with Enhance kit for the GIC. The composite gave the smoothest surface with the three methods.
Oral regurgitation after reflux provoking meals: a possible cause of dental erosion?
Authors: BARTLETT D.W. , EVANS D.F. , SMITH B.G.N.
Published: August 2010

summary
Certain foods and drinks such as alcohol, heavily spiced or fatty meals are known to provoke gastro‐oesophageal reflux (GOR). This may give rise to symptoms of heartburn, epigastric pain and occasionally oral regurgitation of the gastric contents. Oral regurgitation of gastric juice is important in dentistry because of its association with dental erosion. This study measured oesophageal and oral reflux in 12 healthy subjects after a curry meal taken with alcohol 2 h before sleep. Each subject repeated the test with a bland non‐reflux provoking control meal. GOR was measured by recording distal and proximal oesophageal pH on a dual channel, portable pH monitor. Oral pH was measured with a pH sensitive radio‐telemetry capsule (RTC) held on the palate in a vacuum formed splint. Signals from the RTC were received by an aerial worn around the head. The pH change produced by GOR was estimated as the percentage time that pH (PTpH) was less than 4 in the distal oesophageus. Similarly, the PTpH was estimated <4 and <5 in the proximal oesophagus and <5.5 and <6 in the mouth over a period of 16 h. All subjects tolerated the monitors overnight with little loss of data and data were collected from all studies. The curry meal provoked GOR in all subjects, but only in six subjects to pathological levels according to international guidelines. The results show that GOR measured as the PTpH <4 was significantly higher in the distal oesophageus whilst subjects were supine after the curry meal than with the control meal (P= 0.0006) and in the proximal oesophagus in the upright position (P = 0.006). There was a significant difference in the oral PTpH <5.5 between the two meals for the total study period (P = 0.005). The bland meal provoked pathological levels of reflux in only two subjects. In one of these subjects the bland meal provoked oral regurgitation with a PTpH <5.5 of 13.5%. In the remaining subjects little oral regurgitation occurred.
Curing of a silane coupling agent and its effect on the transverse strength of autopolymerizing polymethylmethacrylate—glass fibre composite
Authors: VALLITTU P. K.
Published: August 2010

summary
The aim of this study was to determine how curing γ‐methacryloxypropyltrimethoxysilane (γ‐MPS) to the surface of E‐glass fibre affects the transverse strength of autopolymerizing polymethylmethacrylate–glass fibre composite (PMMA‐GF). For this purpose, unidirectional glass fibres treated with γ‐MPS solution and cured for various lengths of time at different temperatures (+50°C, +1OO°C and +150°C) were used as a strengthener of PMMA test specimens (n = 10 per group). The mean concentration of glass fibres in the test specimens was 17 wt%. The unreinforced test specimens and the test specimens reinforced with unsilanized fibres were compared, but no statistical difference in their transverse strengths was found (p = 0.568). The results also revealed that when the curing temperatures of the γ‐MPS were compared, the highest transverse strength (152 MPa) for the PMMA‐GF composite was obtained by curing the MPS for 120 min at +100°C; the lowest strength (91 MPa) was obtained by polymerizing the MPS at +150°C (P<0.001). However, SEM photomicrographs taken from the interface of the glass fibre and PMMA showed that the fibre adhered equally well to the PMMA treated at +100°C or at +150°C. This suggests that reduction in transverse strength of composite test specimens is caused by other factors, for example, by improper impregnation of PMMA into the fibre bundle, rather than by inadequate adhesion.
Study of occlusal contact variability within individuals in a position of maximum intercuspation using the T‐SCAN system
Authors: GONZÁLEZ SEQUEROS O. , GARCÍA V. C. GARRIDO , CARTAGENA A. GARCÍA
Published: August 2010

summary
Views on the reliability of the T‐SCAN system as a method for occlusal contact registration are contradictory. In this paper the tooth contacts of various patients in maximum intercuspation are analysed and their different bites compared using the time analysis mode of the T‐SCAN. The findings show that within the same individual, no significant differences exist between the number of contacts on each tooth after four bites were performed in an MI position, except for teeth numbers 46, 44 and 41.
Amalgam marginal quality assessment: a comparison of seven methods
Authors: GROSSMAN E. S. , MATEJKA J. M.
Published: August 2010

summary
Black's class I classic cavities were cut in 120 sound extracted human premolars and restored with one of two silver amalgams, six different base combinations, with or without cavity varnish and then aged for 3 months or 1 year. Thereafter, the restored teeth were subjected to a bacterial or acid broth in vitro carious challenge for 36 days. Resin cast impressions were made of the restoration margin of each specimen before and after the carious challenge giving a total of 240 replicas. The replicas were examined in a scanning electron microscope (SEM) and the margins subjected to seven marginal assessment procedures: (i) ranking using micrographs of the margin; (ii) percentage length of marginal discrepancy; (iii) Mjör assessment using six groups; (iv) number of margin segments showing a discrepancy; (v) greatest gap size; (vi) ranking based firstly on gap size and then number of margin segments showing a discrepancy; and (vii) ranking based firstly on gap size and then percentage length of marginal discrepancy. The data from procedures (i), (ii), (vi) and (vii) were examined using one‐way ANOVA; a linear logistic statistical analysis examined data from procedures (iii)–(v). Statistical significance was chosen at P<0.05. It was found that procedure (vii) was able to discriminate between variables to a greater degree than all other procedures. It is recommended that a ranking system based on greatest gap size and percentage length of marginal discrepancy be used to assess marginal quality of amalgam restorations.
Morphological differences in individuals with lip competence and incompetence based on electromyographic diagnosis
Authors: Yamaguchi K. , Morimoto Y. , Nanda R. S. , Ghosh J. , Tanne K.
Published: August 2010

The study group consisted of 19 subjects with positive overjet and overbite, and 17 subjects with skeletal open bite. Two bipolar surface electrodes were attached to the skin of the upper and lower lips. The mean integrated amplitude of the electromyographic (EMG) activity was obtained at the mandibular rest position with the lips in contact and with the lips apart. Subjects were divided into two groups based on positive or negative values of the difference in integrated EMG activity of the mentalis muscle between the two lip positions. Subjects displaying a negative value were classified as having competent lips and those displaying a positive value were classified as having incompetent lips. The EMG activity of the mentalis muscle was found to be more indicative of lip sealing as compared with the EMG activity of the depressor of the lower and the upper lips. The activities of the mentalis muscle at the mandibular rest position with the lips in contact and with the lips apart appear to offer an objective criterion for the evaluation of lip incompetence. In addition, the vertical dimension of the face, as well as the proclination of the incisors, appear to affect lower lip function.
Clinical evaluation of an urethane tetramethacrylate‐based composite material as a prosthetic veneering agent
Authors: Matsumura H. , Nakamura M. , Tanoue N. , Atsuta M.
Published: August 2010

The purpose of the current study was to evaluate the clinical performance of a hybrid composite material used as a prosthetic veneering agent after servicing for more than 4 years. A photo‐curable composite material (Cesead®) was selected as the veneering agent. Composite resin veneered restorations made with the composite and a noble metal alloy were inserted into 110 teeth of 40 patients. Modified United States Public Health Service (USPHS) criteria were used for direct evaluation of colour matching ability, veneer–metal interfacial staining, veneer surface texture, staining of the metal casting, and wear of the veneer–metal interface. After an average observation period of 5 years and 3 months, the rate of restorations considered to be clinically ideal (Alfa) was 75·5% for colour match, 93·6% for veneer–metal interfacial staining, 82·7% for veneer surface texture, 97·3% for staining of the metal casting, and 95·5% for wear. The restorations judged as clinically unacceptable (Charlie) consisted of only one case for colour match and three cases for veneer surface texture. Although the Alfa rate decreased with increasing length of service, the Cesead® composite is considered to be a clinically reliable material as a prosthetic veneering agent.
Effects of surface treatments on bond strength of glass‐infiltrated ceramic
Authors: Lu Y.‐C. , Tseng H. , Shih Y.‐H. , Lee S.‐Y.
Published: August 2010

The purpose of this study was to evaluate the effects of various surface treatments on the bond strength at the In‐Ceram/resin composite interface. Ninety‐eight In‐Ceram specimens were divided into seven groups and exposed to various surface treatments as follows: (A) control (B) saliva contamination (C) saliva contamination plus aluminum oxide sandblasting (D) glove powder contamination (E) glove powder contamination plus aluminum oxide sandblasting (F) rough aluminum oxide sandblasting and (G) excess glass infiltration. A resin composite cylinder was cemented to each In‐Ceram specimen with Panavia 21 resin luting cement. Half of the cemented specimens in each group were stored in water for 24 h, and the other half were stored in water for 2 weeks and then were thermo‐cycled for 2000 cycles. Shear bond strengths (SBS) of seven specimens in each subgroup were determined and analysed using analysis of variance (ANOVA) and Tukey HSD test as well as Student‘s t‐test. Scanning electronic microscopy was used to identify the type of bond failure. Shear bond strength was significantly decreased by saliva and glove powder contaminations (P < 0·05). Sandblasting treatment did not improve the saliva‐contaminated specimens. However, the glove powder plus sandblasting group showed no significant difference in SBS compared with the control group. There was no significant difference in SBS between the excess glass‐infiltrating group and the control group. The SBS was significantly decreased by rough aluminum oxide sandblasting (P < 0·05). The SBS values of groups without thermocycling were significantly greater than those of groups with thermocycling (P < 0·05). There were no significant differences among SBS values of the seven groups with thermocycling. Combined cohesive and adhesive bond failures were seen in every group. Various surface treatments or contaminants may significantly influence the bond strength of In‐Ceram restorative in clinical use.
Activity of jaw‐opening and jaw‐closing muscles and their influence on dentofacial morphological features in normal adults
Authors: Watanabe K. , Watanabe M.
Published: August 2010

The purpose of this study was to determine the relationship between the dentofacial morphology and the function of masticatory muscles estimated by kinesiological measurements during isotonic jaw‐opening (O) and closing (C) muscle contractions. We examined 26 male adult subjects who had no history of masticatory dysfunction. Three kinesiological parameters, the maximum force (Fmax), maximum velocity (Vmax) and maximum power (Pmax) were measured in both O and C muscles. Correlation analysis was performed between these parameters and dentofacial morphological features determined on lateral roentgenographic cephalograms. The Fmax (C), Vmax (O), log O/C of Vmax, and Pmax (O) significantly correlated with anterior overbite. Pmax (C) significantly and negatively correlated with SN‐ArG. Furthermore, log O/C of Pmax significantly and negatively correlated with SNA, SNB and ArG/GMe, and positively with SN‐ArG. These results, combined with our previous findings that electromyographic muscle activity during isometric contraction correlated significantly with mandibular morphology, indicate that the dentofacial morphology is influenced by the function of both O and C muscles.
Colour reproducibility of a photo‐activated prosthetic composite with different thicknesses
Authors: Koishi Y. , Tanoue N. , Matsumura H. , Atsuta M.
Published: August 2010

This study determined the colour accuracy of a photo‐activated prosthetic composite with various thicknesses and shades for the purpose of evaluating the relationship between material thickness variation and colour reproducibility. Four light shades (A1, B1, C1 and D2) and four dark shades (A4, B4, C4 and D4) of a representative photo‐activated prosthetic composite (Artglass) for body paste were assessed. The specimens were prepared with thicknesses of 0·5, 1·0, 1·5, 2·0, 2·5 and 3·0 mm. The L*a*b* colour parameter of each shade was measured using a dental colorimeter (ShadeEye) connected to a computer. The overall colour accuracy of groups of five specimens was compared by means of analysis of variance (ANOVA) and Scheffe’s S multiple range test (P=0˙05). In addition, L*a*b* colour difference (ΔE*) values between the 3·0 mm thickness and the other thicknesses were calculated. Three‐factor ANOVA revealed that all colour parameters were influenced by the thickness as well as by the shade letter and shade tab (P < 0·05). The L* value consistently decreased for all shades as thickness increased, although there was no obvious correlation between the thickness of the material and either the a* or b* values. Among the ΔE* values, the values between the 2·5 and 3·0 mm thicknesses were the lowest, and values were found to be lower than 2·0 for all shades. The colour accuracy of the photo‐activated prosthetic composite was related to the thickness of the material regardless of the shade. For acceptable colour reproducibility, a composite material thickness of at least 2·5 mm was found to be required.
The effect of pH on the erosion of dentine and enamel by dietary acids in vitro
Authors: West N. X. , Hughes J. A. , Addy M.
Published: August 2010

The reported incidence of tooth erosion caused by acidic soft drinks has been increasingly documented. Citric and phosphoric acids are the two main dietary acids present in these soft drinks. Many variables need to be determined in order to assess risk factors for dental erosion caused by beverage consumption including pH, titratable acidity, pKa, buffering capacity, hence the aim of these in vitro investigations. Methodologies included profiling flat enamel and dentine samples (< ± 0·3 μm profile) from unerupted human third molars. Groups of five specimens were placed in acidic solutions adjusted with alkali over the available pH range; citric, phosphoric and hydrochloric acid were adjusted with sodium hydroxide and citric acid with trisodium citrate. Tissue loss was calculated by profilometry. Results showed that under these conditions citric acid caused far more erosion over the pH range employed than phosphoric acid for both tissue types. Citric acid compared with hydrochloric acid highlighted dissolution and chelation effects. Phosphoric acid caused minimal erosion over pH 3 for enamel and pH 4 for dentine. These factors could be considered in order to reduce the erosivity of acidic soft drinks.
Inhibition of demineralization in vitro around fluoride releasing materials
Authors: Dionysopoulos P. , Kotsanos N. , Koliniotou‐Koubia E. , Tolidis K.
Published: August 2010

summary  Replacement of restorations because of secondary caries is a continuing problem in restorative dentistry. This investigation assessed the capacity of fluoride‐releasing restorative materials to resist caries in vitro when used in roots. Class 5 cavities were prepared in buccal and lingual surfaces of 30 extracted premolars and restored with one of three polyacid modified resin composites (F‐2000, Hytac and Compoglass F), a resin modified glass–ionomer cement (Fuji II LC) a conventional glass ionomer (Ketac‐Fil), and a resin composite (Z‐100). After 5 weeks in an acid gel for caries‐like lesion formation, the teeth were sectioned longitudinally and examined with polarized light. The results showed that restoration of caries with polyacid modified resin composites and resin modified glass ionomer cements may be of great importance in the prevention of secondary caries around the restorations in roots. Clinical Relevance Light cured fluoride‐releasing restorations may inhibit caries‐like lesions. Inhibition of demineralization in vitro around fluoride releasing materials.
Effect of temperature and stress distribution on all‐ceramic restorations by using a three‐dimensional finite element analysis
Authors: Güngör M. A. , Küçük M. , Dündar M. , Karaoğlu Ç. , Artunç C.
Published: August 2010

summary  This study presents the stress analysis of the mandibular first premolar tooth restored with an all‐ceramic crown under thermal loading as a result of hot/cold liquid intake to the mouth using the three‐dimensional (3D) finite element analysis (FEA). In the first step of the study, the temperature changes as a result of hot/cold liquid intake were calculated. The thermal stress distributions because of the temperature changes were then obtained. Thermal loads ranging from 60 to 15 °C were applied on all prepared models. The distribution of temperature and stress were plotted for some critical points which were the transition points of strain to tension or tension to strain when hot or cold liquids were consumed. The changes in oral temperature cause thermal fatigue and the material stability might be negatively affected. According to the thermal tension results in the present study, IPS Empress, Carrara press ceramic and Ceramco FAC all‐ceramic materials exhibited different values while IPS Empress 2 material showed similar properties to that of enamel.
Computer‐assisted morphological analysis of dental casts with maxillary prognathism and reversed occlusion
Authors: Kojima T. , Sohmura T. , Wakabayashi K. , Kinuta S. , Nagao M. , Dei N. , Nakamura T. , Takahashi J.
Published: August 2010

summary  The morphologic characteristics of the dentition with maxillary prognathism and reversed occlusion were examined by a computer‐assisted dental cast analysing system. Dental casts with normal occlusion, maxillary prognathism and reversed occlusion were selected and measured by a 3D shape measuring system. The dental arches and anteroposterior occlusal curves were approximated numerically by the polynomial expression with a fourth order and second order coefficients, respectively. The coefficients were analysed statistically. Maxillary dental arches with mandibular prognathism showed a more acuminate shape (V‐shape) with a significant larger second order coefficient, while arches with reversed occlusion showed more angulate shapes (U‐shape) with significantly smaller second order coefficients compared with arches with normal occlusions. However, a notable difference in the shape of the mandibular dental arches was not observed. The mandibular dental arches with maxillary prognathism were positioned backward relative to maxillary dental arches, while the arches with reversed occlusion were positioned forward. The anteroposterior occlusal curves with maxillary prognathism showed larger curvatures in maxilla and mandible, while the curves with reversed occlusion showed smaller curvatures in mandible comparing with the curves with normal occlusion. These results suggest that the present method could offer a useful and objective examination technique for the diagnosis of malocclusion.
Surface Antigen Changes Accompanying Lymphocyte Activation
Authors: KERBEL R. S.
Published: August 2010

It is here shown that some noncongenic anti‐H‐2 antisera produced by using normal spleen cells as the immunogen can contain cytotoxic antibody activity against activated, but not resting, lymphocytes of unrelated H‐2 haplotype strains. Reactivity was noted against lymphocytes activated in vitro with T‐ or B‐cell mitogens, or in vivo by antigenic stimulation. Analysis of the results indicated that the anti‐activated lymphocyte activity was most likely related to production of anti‐Ala‐1 (‘activated lymphocyte antigen’) alloantibodies. This appears to occur as a result of donor lymphocyte activation during production of the anti‐H‐2 antisera, using Ala‐1‐incompatible donor and recipient combinations, where the donor cells are competent to recognize and react against host H‐2 incompatibilities. These results confirm the finding that lymphocyte activation can be accompanied by the expression of an antigen that is either absent or weakly expressed on resting lymphocytes.
Relationships Between β2‐Microglobulin and Alloantigens Coded for by the Major Histocompatibility Complexes of the Rabbit and the Guinea Pig
Authors: BJÖRCK L. , CIGEN R. , BERGGÅRD B. , LÖW B. , BERGGÅRD I.
Published: August 2010

Treatment of rabbit and guinea pig lymphocytes with Fab’ fragments of anti‐β2‐microglobulin completely inhibited the cytotoxic effects of alloantisera to RLA or GPLA antigens, respectively. Aggregation of β2‐microglobulin on the lymphocyte surface by successive incubations with goat anti‐β2‐microglobulin and F(ab')2 fragments of rabbit anti‐goat IgG also made rabbit lymphocytes resistant to lysis by anti‐RLA, and guinea pig lymphocytes resistant to lysis by anti‐GPLA. The two kinds of pretreatment of guinea pig lymphocytes did not affect the cytotoxicity of antisera directed against guinea pig Ia antigens. These results in conjunction with previous findings in the mouse and in man suggest that β2‐microglobulin on the lymphocyte surface in mammals is generally associated with major serologically defined histocompatibility antigens but not with I‐region‐associated antigens.
T‐Lymphocyte Recognition of Alloantigen In Vitro
Authors: HERTEL‐WULFF B. , RUBIN B.
Published: August 2010

The present report deals with our attempts to characterize the potent stimulator cell(s) that induce Fc receptor (FcR)‐negative T lymphocytes to differentiate into cytotoxic T lymphocytes in vitro. We found two categories of such cells: [1] resting B cells, FcR+ T cells, and macrophages and [2] T cells either activated in 800‐R‐irradiated mice against H‐2 antigens or M‐locus antigens or activated in vitro by concanavalin A. The distinction between potent and weak stimulator cells is discussed in relation to the surface antigenic markers and the immunological function of these cells.
Autologous Mixed Lymphocyte Reaction in Man
Authors: GUPTA S.
Published: August 2010

Peripheral blood from 15 young (20–30 years) and 15 aging (65–80 years) subjects was analysed for the proliferative response of T cells upon stimulation with non‐T cells in the autologous mixed culture reaction (AMLR) and allogeneic MLR, and for the proportion of monoclonal antibody‐defined lymphocyte subsets and monocytes. No significant difference was observed in the AMLR or allogeneic MLR between T and non‐T cells in aging and young subjects. However, when non‐T cells were further fractionated into adherent monocytes and non‐adherent B cells (B cells and null cells), the AMLR between macrophages and T cells was significantly (P < 0.05) higher in young subjects than in simultaneously studied aging subjects. In contrast, the AMLR between T cells and B cells was significantly (P < 0.05) higher in the aging subjects than in the young group. In the T‐T AMLR (using phytohaemagglutin‐stimulated T cells as stimulators), aging subjects had a significantly (P < 0.05) lower proliferative response than simultaneously studied young subjects. In vitro addition of purified interleukin 2 reconstituted the T‐T AMLR to the base‐line T‐T AMLR in young humans. No significant difference was observed in the allogeneic MLR and lymphocyte subsets between the two groups. The significance of these observations is discussed.
Enrichment of Human Epidermal Langerhans Dendritic Cells
Authors: BJERCKE S. , LEA T. , BRAATHEN L. R. , THORSBY E.
Published: August 2010

Langerhans cells (I, C) were enriched from a human epidermal cell (EC) suspension by a rosette‐forming technique. First EC were sensitized with the monoclonal antibody OKT6, and then they were mixed with ox erythrocytes (ORBC) coated with affinity‐purified rabbit IgG anti‐mouse IgG antibodies. Rosette‐forming LC were then separated from non‐rosetting EC by means of Percoll flotation. After hypotonic lysis of the ORBC, the cells obtained had a viability greater than 90%, and 674–98% of the viable cells were OKT6‐positive. In functional studies the enriched cells were strongly stimulatory for allogeneic lymphocytes and were able to function as antigen‐presenting cells for the T‐cell response to the soluble antigen purified protein derivative.
Immune Complex‐Mediated Enhancement of Antibody Responses without Induction of Delayed‐Type Hypersensitivity
Authors: Wernersson S. , Kleinau S. , Heyman B.
Published: August 2010

Immunoglobulin (Ig)G and IgE antibodies enhance the humoral response in vivo to soluble antigens with which they form complexes. In vitro, antigen is targeted to B cells by IgE antibodies and to macrophages and dendritic cells (DCs) by IgG, thus leading to increased antigen presentation to specific T cells. Possibly these mechanisms are also responsible for antibody‐mediated enhancement in vivo. We now address the question of whether IgG‐ and/or IgE‐antigen complexes can prime for delayed‐type hypersensitivity (DTH), a reaction known to require primed T helper (Th)1 cells. Mice were immunized with IgG‐anti‐2,4,6‐trinitrophenyl (TNP)/BSA‐TNP or IgE‐anti‐TNP/BSA‐TNP. Mice given BSA‐TNP alone or BSA‐TNP in complete Freund's adjuvans (CFA) were used as controls. DTH and IgG‐anti‐BSA levels were measured after subsequent challenge with BSA. A potent BSA‐specific antibody response was induced by IgE‐ or IgG‐complexed antigen as well as by CFA/antigen but DTH‐reactions were only observed in mice immunized with CFA/antigen. Both IgE and IgG enhanced the production of BSA‐specific IgG1, IgG2a and IgG2b, although the most pronounced enhancement was seen in the production of IgG1. These findings suggest that Th2 cells rather than Th1 cells are involved in the immune response to IgG‐ and IgE‐immune complexes.
Thalidomide Therapy:An Open Trial
Authors: Naafs B. , Faber W. R.
Published: August 2010

ABSTRACT: In an open trial, 35 patients suffering from a variety of dermatologic conditions were treated with thalidomide. The drug was shown to be a valuable addition to the therapeutic armamentarium; however, the occurrence of a peripheral neuropathy will limit its use just as its teratogenic side effects have done for many years.
Granuloma annulare associated with Hodgkin's disease
Authors: Setoyama Mitsuru , Kerdel Francisco A. , Byrnes Johne J. , Kanzaki Tamotsu
Published: August 2010

A 39‐year‐old man was referred to our institution for treatment of Hodgkin's disease (HD) previously diagnosed at another hospital. On physical examination the patient had bilateral cervical lymphadenopathy (9 cm to 0.5 cm in size), but no clinical hepatosplenomegaly was noted. Examination of his skin showed indurated reddish macules and papules scattered over the trunk and buttocks (Fig. 1).

Laboratory examination showed a hemoglobin of 13.9 g/100 mL, with a leukocyte count of 8600/mm3 with 69% neutrophils, 9% eosinophils, 2% monocytes, 22% lymphocytes, and 2% abnormal lymphocytes. The platelet count was 398 × 103/mm3. The serum IgG was 1877 g/100 mL, the IgA was 572.5 g/100 mL, and the IgM was 55.5 g/100 mL, Serum test for HTLV‐1 antibody was positive, but hepatitis B antigen and hepatitis C antibodies were negative, A 67Ga scintigram showed uptake in the supraclavicular and right retrocervical areas. Computed tomographic scans showed bilateral cervical lymph node and left axillary lymph node enlargement. Bone marrow aspiration was normal.

A lymph node biopsy specimen from the left axillary region showed partially effaced lymph node architecture with a few immature or atypical mononuclear cells and some Reed‐Stemberg cells. Necrosis and fibrosis was not seen (Fig. 2), The diagnosis of HD, lymphocyte predominant subtype, was therefore confirmed and he was staged as HD‐IIA.

Biopsies were also obtained from the skin of his back and abdominal wall which showed perifollicular and perivascular cellular infiltration composed of mature small lymphocytes, epithelioid histiocytes, and multinucleated giant cells. Neither Hodgkin cells nor Reed‐Sternberg cells were recognized in the lesional skin. Collagen bundles lying in the upper dermis and close to the adipose tissue showed focal necrobiotic change particularly in the center of the infiltration (Fig. 3).

Alcian‐blue stain confirmed acid mucopolysuccharide deposition on and between degenerated collagen bundles. Special stains for fungus and mycobacterium were negative.

Immunohistochemically, the epithelioid histiocytes and multinucleated giant cells labelled positive for HLA‐DR in the membrane and were positive for lysozyme and alpha‐1 antichymotrypsin in the cytoplasm. Intermingled with these cells, S100a positive dendritic cells were also present, especially around hair follicle. The lymphocytes were immunoreactive with UCHL‐1 (CD45RO), Leu3 (CD4), and Leu4 (CD3), However, only a few lymphocytes stained with Leu3a (CD8), These findings of the skin lesions were consistent with those of granuloma annulare (GA).

The patient was started on combination chemotherapy ABVD (adriamycin, bleomycin, vinblastin, and DTIC) for the HD, After 10 courses of the chemotherapy, the patient is disease free. The GA lesions also began to disappear following the institution of the chemotherapy and the lesions were mostly gone after a second course of ABVD.
Perforation of large and small bowel in Henoch‐Schonlein purpura
Authors: Bissonnette Robert , Dansereau Alain , D'Amico Patrick , Pateneaude Jean‐Victor , Paradis Jean
Published: August 2010

A 43‐year‐old woman with an unremarkable medical history was admitted with severe polyarthralgia, purpuric papules on her lower legs (Fig. 1), and recent pain with blue discoloration of her third left finger. She was taking no medication. At the time of presentation the abdominal examination was normal. Laboratory evaluation showed normal or negative values of BUN, creatinine, AST, WBC, Hb, VDRL, rheumatoid factor, HBSAg, ANA, ASO, cryoglobulins, cryofibrinogen, anticardiolipins, anti‐Sm, anti‐RNP, anti‐Ro, anti‐La, anti‐SCl70, and anti‐centromere. Hepatitis C titer was not obtained. Sedimentation rate was 61 mm/h and immune circulating complexes were present (14.2 <1.5μg/ml); normal, <1.5 μg/ml). Urine sediment analysis revealed the presence of cellular, hyalin, granular, and erythrocyteic casts. IgA level was 1.98 g/l (normal, 0.5–3.0 g/l). Skin biopsy showed extensive leucocytoclastic vasculitis. Deposits of IgA, IgM, and C3 were observed in the dermal vessels under direct immunofluorescence microscopy.

The patient was put on prednisone 60 mg/day. Three days after admission she complained of acute abdominal pain. Increased abdominal tenderness was noted on examination. An abdominal angiogram was normal. Because of the deteriorating intestinal condition, she received methylprednisolone 1 g IV per day. Despite this treatment she developed acute peritonitis 2 days later. Laparotomy disclosed three perforations on the caecum and ascending colon, and one on the ileum. She underwent sub‐total colectomy with terminal ileostomy. Following surgery she was kept on parenteral methylprednisolone 1 g daily; cyclophosphamide 300 mg daily was started with progressive improvement of her condition.

The histopathologic examination of the colonic segment disclosed vasculitis of the medium‐sized vessels (Fig. 2). Direct immunofluorescence microscopy revealed strong deposits of IgA and C3 in the vessel walls of the large intestine (Fig, 3).