bluuebunny/crossref_metadata_2025 huggingface dataset:
Depth and Distance Perception of Dentists and Dental Students
Authors: Dimitrijevic T , Kahler B , Evans G , Collins M , Moule A
Published: August 2011

The quality of work carried out by dentists is dependent, among other things, on experience, training, and manual dexterity. Historical focus on the latter as a predictor of dental performance has failed to recognize that dental competence also requires good perceptual and visual skills, not only for gathering information but also for judging positions, distances, and the size of objects and shapes. Most predictive tests ignore visual and interpretative deficiencies that could make individual acquisition of skills and interpretation of instructions difficult. Ability to estimate depth and distance, the manner in which students learn this ability, whether and how it can be taught, or whether there is an association among ability, stereopsis, and dental performance has not been thoroughly examined; nor has the perception that dental students fully understand verbal and written instruction relating to depth and distance. This study investigated the ability of dentists and dental students to estimate and reproduce small depths and distances and the relationship of this ability to stereopsis, dental experience, and student performance. A total of 163 undergraduate dental students from three year groups and 20 experienced dentists and specialists performed three tasks. A depth-perception task involved estimation of the depth of two sets (2-mm or 4-mm wide) of nine computer milled slots ranging in depth from 0.5 to 4.0 mm. A distance task involved estimation of the width of specially prepared printed square blocks. In a writing task, participants recorded distances across a printed line on separate sheets of paper. All tasks were conducted at set positions in custom-made transportable light boxes. Stereopsis and visual acuity were also measured. Ability to perform perceptual tasks varied enormously, with the level of accuracy dependent on the type of task and dental experience. Many students had considerable difficulty in estimating depth. Inexperienced students performed poorly. Most participants overestimated depth and distance estimation tasks, but underestimated when required to draw distances. Smaller depths and distances were easier to estimate than larger ones. All groups overestimated depth more in 4-mm-wide blocks than in 2-mm-wide blocks. There was no correlation found between depth and distance estimation and stereopsis scores or with the overall grades tested. This study highlights that some dentists and many dental students, particularly early in their course, have great difficulty in accurately gauging depths and distances. It is proposed that that this could impact significantly on a student's ability to interpret verbal and written preclinical instruction and could make the acquisition of manual skills and interpretation of clinical instruction difficult. Routine testing of all undergraduate dental students for perceptual and visual difficulties is recommended, so that those with difficulties can be identified and problems remedied, if possible, early in their course.
Adhesion of Resin Composite to Hydrofluoric Acid-exposed Enamel and Dentin in Repair Protocols
Authors: Saracoglu A , Özcan M , Kumbuloglu O , Turkun M
Published: August 2011

Intraoral repairs of ceramic fixed-dental-prostheses (FDP) often include cervical recessions that require pretreatment of the exposed tooth surfaces either before or after the ceramic is conditioned with hydrofluoric (HF) acid gel. The sequence of repair protocol may cross-contaminate the exposed etched enamel or dentin surfaces during the application or rinsing process and thereby affect the adhesion. This study evaluated the influence of HF acid gel with two concentrations on bond strengths of composite to enamel and dentin. Human third molars (N=100, n=10 per group) with similar sizes were selected and randomly divided into 10 groups. Flat surfaces of enamel and dentin were created by wet ground finishing. Before or after the enamel (E) or dentin (D) was conditioned with phosphoric acid (P), substrate surfaces were conditioned with either 9.5% HF (HF9.5) or 5% HF (HF5). Subsequently, a bonding agent (B) was applied. The experimental groups by conditioning sequence were as follows where the first letter of the group abbreviation represents the substrate (E or D) followed by the acid type and concentration: group 1 (EPHF9.5), group 2 (EPHF5), group 3 (EHF9.5P), group 4 (EHF5P), group 5 (DPHF9.5), group 6 (DPHF5), group 7 (DHF9.5P), and group 8 (DHF5P). Group 9 (EPB) and group 10 (DPB) acted as the control groups. Repair resin was adhered incrementally onto the conditioned enamel and dentin in polyethylene molds. Each layer was photo-polymerized for 40 seconds. All specimens were thermocycled (×1000, 5°-55°C) and subjected to shear test (universal testing machine, 1 mm/min). Specimens that debonded during thermocycling were considered as 0 MPa. The bond strength data were analyzed using Kruskal-Wallis test and failure types using the chi-square test (α=0.05). Overall, the bond results (MPa) were lower on dentin than on enamel (p<0.01). EPB (25.6 ± 6.6) and DPB (20.2 ± 4.9) control groups showed significantly higher results than those of other groups (p<0.05). While higher mean bond strengths were obtained in group 1 (EPHF9.5) (11.5 ± 2.1) and group 2 (EPHF5) (7.3 ± 0.6), lower results were obtained when HF acid gels were applied prior to phosphoric acid (EHF9.5P: 5.0 ± 1.1, EHF5P: 3.6 ± 0.1) (p<0.05). On dentin, the results were the lowest in group 8 (DHF5P: 1.5 ± 1.6), being significantly lower than those of group 5 (DPHF9.5) (p<0.05). Scanning electron microscope (SEM) images revealed predominantly mixed failures with less than half of the composite left on both enamel and dentin surfaces (64 out of 80) (p<0.05), indicating that in general, adhesion was not ideal. Contamination of the enamel or dentin surfaces with HF acid gel impairs the bond strength of composites. Considering both the bond strength results and failure types, when dental tissues are to be repaired next to ceramic, application of phosphoric acid before HF acid gel application can be recommended. HF acid gel concentration did not influence the results except on enamel.
Factors Affecting the Detection and Treatment of Occlusal Caries Using the International Caries Detection and Assessment System
Authors: Al-Khatrash AA , Badran YM , Alomari QD
Published: August 2011

Clinical Relevance

Occlusal caries is the predominant form of dental caries at the present time. This study documents the variability in detection and treatment of occlusal caries among dentists graduating from different dental schools around the world and practicing in Kuwait. Furthermore, it shows that dentists tend to overtreat occlusal caries.
Effects of pH Values of Hydrogen Peroxide Bleaching Agents on Enamel Surface Properties
Authors: Xu B , Li Q , Wang Y
Published: August 2011

This study investigated the influence of pH values of bleaching agents on the properties of the enamel surface. Sixty freshly extracted premolars were embedded in epoxy resin and mesiodistally sectioned through the buccal aspect into two parts. The sectioned slabs were distributed among six groups (n=10) and treated using different solutions. Group HCl was treated with HCl solution (pH=3.0) and served as a positive control. Group DW, stored in distilled water (pH=7.0), served as a negative control. Four treatment groups were treated using 30% hydrogen peroxide solutions with different pH values: group HP3 (pH=3.0), group HP5 (pH=5.0), group HP7 (pH=7.0), and group HP8 (pH=8.0). The buccal slabs were subjected to spectrophotometric evaluations. Scanning electron microscopy investigation and Micro-Raman spectroscopy were used to evaluate enamel surface morphological and chemical composition alterations. pH value has a significant influence on the color changes after bleaching (p<0.001). Tukey's multiple comparisons revealed that the order of color changes was HP8, HP7>HP5, HP3>HCl>DW. No obvious morphological alterations were detected on the enamel surface in groups DW, HP7, and HP8. The enamel surface of groups HCl and HP3 showed significant alterations with an erosion appearance. No obvious chemical composition changes were detected with respect to Micro-Raman analysis. Within the limitations of this study, it was concluded that no obvious morphological or chemical composition alterations of enamel surface were detected in the neutral or alkaline bleaching solutions. Bleaching solutions with lower pH values could result in more significant erosion of enamel, which represented a slight whitening effect.
Trauma-Related Dreams of Australian Veterans with PTSD: Content, Affect and Phenomenology
Authors: Phelps Andrea J. , Forbes David , Hopwood Malcolm , Creamer Mark
Published: August 2011

Objective: Consensus on the parameters of trauma-related dreams required to meet criteria for post-traumatic stress disorder (PTSD) is critical when: (i) the diagnosis requires a single re-experiencing symptom; and (ii) trauma dreams are prevalent in survivors without PTSD.

Method: This study investigated the phenomenology of PTSD dreams in 40 veterans, using structured interview and self-report measures.

Results: Dream content varied between replay, non-replay, and mixed, but affect was largely the same as that experienced at the time of trauma across all dream types. ANOVA indicated no difference between dream types on PTSD severity or nightmare distress.

Conclusions: The findings provide preliminary support for non-replay dreams to satisfy the DSM B2 diagnostic criterion when the affect associated with those dreams is the same as that experienced at the time of the traumatic event.
Biliary Ascariasis with hepatic abscess in a young boy of 2.5 years of age
Authors: Rahman Mohibur , Amin Mohammad Robed , Hossain Tanvir , Rahman Kazi Arifur , Sharmin Hazera , Habib Ahmed Ahsan
Published: August 2011

Ascariasis is the most widespread helminthiasis worldwide. In endemic areas, Ascaris lumbricoides infestation is a very widespread cause of biliopancreatic disease and one of common cause of pancreatitis. Liver abscess as a part of complication of biliary ascariais is possible but not common. Endoscopic management of biliopancreatic ascariasis is feasible, with a very low morbidity and a high rate of success. We experienced a paediatric patient of biliary ascariasis who developed liver abscess as part of complication and initial presentation. Keyword : Helminthiasis, Ascariasis, Hepatic, Abscess DOI: http://dx.doi.org/10.3329/jom.v12i2.6735 JOM 2011; 12(2): 170-173
Retained Foreign Body in the Pleura
Authors: Jana Pulak Kumar , Das Sibes Kumar , Bandyopadhyay Rajat , Bairagya Tapan Das
Published: August 2011

DOI: http://dx.doi.org/10.3329/jom.v12i2.6972 JOM 2011; 12(2): 191
Disseminated histoplasmosis in a renal transplant recipient  a fatal case report
Authors: Araújo Tânia Mara L.B. , Silva Junior Geraldo B. , Barbosa Orivaldo A. , Lima Rafael S.A. , Daher Elizabeth F.
Published: August 2011

Histoplasmosis is an infectious disease caused by the dimorphic fungus Histoplasma capsulatum.. The disseminated form is usually found in immunocompromised patients. A 53 year-old man, renal transplant recipient, was admitted with fever, dyspnea, productive cough, adynamia and weight loss. He was septic, but hemodynamically stable. The tracheal aspirate found intracellular fungi and the peripheral blood exam was compatible with histoplasmosis. The patient presented a progressive worsening of respiratory pattern and needed mechanical ventilation, vasoactive drugs and hemodialysis. A large spectrum antimicrobial therapy was started, including amphotericin B, but the patient died. Keyword: Disseminated histoplasmosis. Kidney transplantation. Immunosuppression DOI: http://dx.doi.org/10.3329/jom.v12i2.7125 JOM 2011; 12(2): 163-165
National Guideline of Rabies Prophylaxis-2010
Authors: Amin Mohammad Robed
Published: August 2011

Background: Rabies has been the subject of fear ever since the disease was recognized. Worldwide the number of deaths annually, due to rabies, is estimated to be between 35,000 to 50,000 approximately Rabies continues to be a major public health problem in Bangladesh killing an estimated 2000 people annually and 100,000 people receive post-exposure treatment in the country. In this regard the post-exposure treatment of animal bite cases is of prime importance. Materials and Methods: Communicable disease control(CDC) of, Directorate General of Health Services (DGHS) took the noble initiative to establish the national rabies elimination programme 2010 with an comprehensive approach of care for human and control of rabid animal.  An expert group meeting for strategic plan and finalizing the guidelines for prevention and control of rabies cases was held in 2010, under CDC of DGHS to bring out uniformity in post-exposure treatment practices. . The participants in the meeting included practitioners managing anti-rabies clinics, laboratory medicine practitioners, policy makers, public health experts from both public and private sector. The guideline, which emerged out of consensus of expert groups, is summarized in this paper. Results: Until recently the Nervous Tissue Vaccine (NTV) was the mainstay for post-exposure prophylaxis in Bangladesh. As per WHO recommendations, the production and use of this reactogenic vaccine should be gradually phased out from our country. Modern, safe and effective anti-rabies Cell Culture Vaccines (CCVs) will be used for post-exposure prophylaxis in public sectors. The limitation is the high cost of this vaccine and also the cost and unavailability of Anti Rabies Immunoglobulin. WHO recommended the use of intra-dermal (ID) route of application of CCVs. Considering the recommendations of experts, results of clinical trials and international experience, experts of Bangladesh recommends ID regimen phase wise. In first phase, only Dhaka Infectious Disease Hospital will serve as Anti-rabies centre for ID regimen. After its successful implementation, ID regimen will spread out to Division and then to District level hospitals. National experts suggested and recommended the use of cost-effective vaccination schedules such as abbreviated multisite IM Zagreb protocol (4 dose, 3 visits) and updated Thai Red Cross (TRC) intradermal regimen(2-2-2-0-2) to phase out NTV and to make available modern rabies vaccine in public sector. Conclusion: This guideline will be extremely useful for the country to make rational use of modern rabies vaccine and phase out NTV by 2011. The guideline will be of immense use for better management of animal bite cases and availability and affordability of modern rabies vaccine will be of great help for physician to manage appropriately for preventing  the deadly disease rabies. DOI: http://dx.doi.org/10.3329/jom.v12i2.7691 JOM 2011; 12(2): 153-159
Urinary Tract Infections During Early Posttransplant Period in Adult kidney Allograft Recipients
Authors: Islam MD Nazrul , Dutta Pradip Kumar , Akhter Mursheda , Das Gupta Ratan , Uddin Joardder MD Sahab , Salehuddin Firoz , Rahman MD Mustafizur , Rashid Harun UR
Published: August 2011

Background: Urinary tract infections (UTIs) represent the most common cause of bacterial infection in renal allograft recipients. The purpose of this study was to evaluate UTI in renal transplant recipients at earlier post transplant period (first 3 months) and isolation of causative organism. Materials & methods: We studied 31 patients (18 males and 13 females), aged 27 ± 8.8 years. UTIs occurring during the first three months were analyzed. During this period, all episodes of infection, transplant function, graft survival and patient survival were monitored. Results: Twenty two patients had suffered from different types of infection within first 3 months of transplantation, most of the infectious episodes occurred during hospital stay. Most of the infection occurred in urinary tract and most of the episodes of UTI were asymptomatic, presented with bacteriuria. Most of the isolated organisms were Gram negative E.Coli. Out of 51 episodes of bacterial infection, UTIs account for 49 episodes (96%) Patients’ age, sex and acute rejection episodes did not correlate with UTI. Patient who had prolonged urethral catheterization had suffered from significantly more number of UTI in comparison to short period of urethral catheterization (p=0.02).Similar incidence of UTI were observed in ureteric stented and non stented patients but non stented patients had suffered from significant number of urological complication (p<0.02) . Antibiotic sensitivity pattern revealed that, all isolates were sensitive to ciprofloxacin, ceftriaxone and ceftazidime, ranged between, 67 to 100% and highly resistant to ampicillin, cotrimoxazole and cephradine. Conclusion : Short term renal graft function was not found to be affected by UTI occurrence. UTIs are common infectious complications in renal transplant recipients and often relapse and require hospitalization. Keyword: urinary tract infections (UTIs), renal transplantation, acute rejection episodes. DOI: http://dx.doi.org/10.3329/jom.v12i2.8416 JOM 2011; 12(2): 103-108
Profile of Lung Cancer: A One-Year Report
Authors: Akhtar Parveen Shahida , Masud Zafor Mohammad , Alam Mohammad Tarek , Begum Maksuda
Published: August 2011

Background: Lung cancer has been the most common cancer in the world since 1985 and the leading cause of cancer death. Worldwide it is by far the most common cancer of men and increasingly being recognized in Bangladesh. Objective: To observe the profile of lung cancer patients and the outcome of chemotherapy. Method: In one year (1st January’08 to 31st December’08) the lung cancer patients who attended the dept. of Medical Oncology were included in this study. The patient’s history, clinical evaluation, previous treatment record (surgical intervention, chemotherapy and radiotherapy), histopathology and other investigation reports were documented. Chemotherapy and or supportive and symptomatic treatment carried out in the department were noted and response of the treatment were observed and documented. Result: Total number of patients was 701.Of them, 608 males and 93 females; male female ratio: 6.53:1. Common occurrence (> 85%) at and above 50 years of old; age range 25 years to 95 years and mean age 62 years; 44% was illiterate and 40% had primary school education; more than 82% belonged to poor and bellow average socioeconomic status. Previous records showed 524 patients (about 75%) attended after diagnosis and 177 cases (25%) had had prior treatment (6 by surgery, 22 by radiotherapy and 147 by chemotherapy). On clinical evaluation, almost all patients were symptomatic with WHO Grade-2 (44.51%) and Grade -3 (26.68%) performance status. Right lung was affected more (55%). Pathologically non-small cell carcinoma was 81.45% and small cell carcinoma 18.55%. But histopathology differed by sex; squamous cell carcinoma (43.42%) was most common in male but in female it was adenocarcinoma (55.92%). All most all cases were at inoperable stage (locally advanced/metastatic cancer/ medically unfit). Thirty percent of male patients and 45% of females dropped out after first and second visit. Around 20% patients got only supportive symptomatic management in both sexes and 326 patients (296 male and 30 female) were treated by chemotherapy. Within three to six months of treatment, 10% of the patients showed complete symptomatic relief, weight gaining and radiological disappearance of tumor and all most all patients benefited of some sorts of symptoms relief. Conclusion: The lung cancer patients were at inoperable stages with WHO Grade 2 and Grade 3 performance status in most of the cases; needed much more supportive and symptomatic treatment. Chemotherapy was effective; complete clinical and radiological response in 10% of cases and others got benefit with some sorts of symptoms relief and radiological improvement. Keyword: Lung cancer, Bangladesh, squamous cell carcinoma, adenocarcinoma metastatic cancer, Chemotherapy, Bangladesh. DOI: http://dx.doi.org/10.3329/jom.v12i2.8417 JOM 2011; 12(2): 115-119
Role of Muscle Strengthening Exercise on Osteoarthritis of the Knee Joint
Authors: Azad Abul Kalam , Nabi Golam , Shakoor MA , Moyeenuzzaman MD
Published: August 2011

A total of 106 patients of osteoarthritis of knee were selected for the study. Out of 106 patients 26.41% were male and 73.58% were female. The female and male ratio is 2.78: 1. Mean age was 49.68 ± 9.16 years and house wives were maximum in number 75 (70.8%). They were divided into two groups, 52 patients in group–A, were treated with NSAID plus Exercise and another 54 patients in group-B, were treated with NSAID only. In both group patients were treated for six weeks duration. The improvement was assessed with WOMAC scoring system. Student’s‘t’ test was to see the level of significance. In present study, the patients groups those who received NSAID plus Exercise, improved more significantly (p= 0.001) than those who received NSAID only. So it can be concluded that quadriceps muscle strengthening exercise is effective in the patients with OA knee. Keyword: Osteoarthritis, Knee, Exercise. DOI: http://dx.doi.org/10.3329/jom.v12i2.8418 JOM 2011; 12(2): 120-124
Prevalence and Risk Factors of Type 2 Diabetes Mellitus Among Secretariat Employees of Bangladesh
Authors: Ahasan HAM Nazmul , Islam MD Ziaul , Alam MD Billal , Miah MD Titu , Nur Zannatun , Mohammed Fazle Rabbi , Imran Khan Mohammad Ashik , Hossain Homayra Tahseen , Mahbub MD Shahriar
Published: August 2011

Context: The pandemic of diabetes is more explosive in developing countries and Bangladesh is one of the top 10 countries estimated to have the highest numbers of people with diabetes in 2000 and 2030. Aims: The aim of this study was to quantify the prevalence and risk factors of diabetes among secretariat employees of Bangladesh. Settings and Design: A random sample of 1000 employees of Bangladesh Secretariat was included in this cross sectional study. Methods and Material: Blood glucose levels, both Fasting (FPG) and 2-hours after 75gm load, total cholesterol, triglycerides were measured in each case. Body mass index (BMI), blood pressure, was measured as well as collection of information regarding risk factors and socio-demographic variables. Statistical analysis used: Univariate analysis of all variables was done. Cohen’s Kappa was used to find agreement and odds ratios were calculated to assess risk factors. Results: The prevalence of diabetes was 12.3% and 7.5% according to FBG and 2-hours after 75gm glucose, respectively. Age of study population was e”20 years and male, female ratio was 4.75:1. The prevalence was almost similar among men (12.35%) and women (12.05%) considering FBG. While a higher prevalence among women (9.8%) was noticed than men (7%) after 75gm glucose. Pre-diabetic employees were 13.7 %( impaired glucose tolerance) and 31.8% (impaired Fasting glucose). Moderate agreement was observed between FBG and 2-hours after 75gm glucose (kappa 0.6). Increasing age, sedentary lifestyle (OR 1.5), diabetes among first degree relatives (OR 1.7), BMI >30 (OR 1.5), systolic blood pressure >130 (OR 1.2), total cholesterol >200 (OR 1.6), triglycerides >150 (OR 1.4) were found significantly related to diabetes. Conclusion: Increased prevalence of diabetes, IFG and IGT forecasts the upcoming diabetes explosion and calls for urgent steps towards the primary prevention in developing countries. Keyword: Type 2 diabetes, prevalence, risk-factors, BMI, sedentary lifestyle DOI: http://dx.doi.org/10.3329/jom.v12i2.8419 JOM 2011; 12(2): 125-130
Acute Promyelocytic Leukaemia: An Experience with 6 Cases
Authors: Kabir MD Alamgir , Rahman MD Mujibur , Mogni Mowla Syed Ghulam , Moniruzzaman MD , Rahim Abdur , Jahan Sharmin , Ahsan HM Nazmul
Published: August 2011

Background and objective: Acute promyelocytic leukaemia (APL) is considered a distinct entity among the acute myeloid leukemias (AML). Our purpose is to see its clinical presentations and outcome with ATRA (all- trans retinoic acid). Materials and methods: It is a retrospective descriptive study of 6 patients diagnosed by cytologic criteria between November 2008 and February 2011 in two tertiary care hospitals in Dhaka, Bangladesh. All specific information were recorded in standardized data sheet and analyzed manually. Results: Mean (SD) age of patients was 28.6 (±7.84) years with equal gender distribution. Fever >101°F, weakness, easy fatigability, and bleeding manifestations were common presentations (100%). The other manifestations were bony tenderness, purpuric spots or DIC, but no lymphadenopathy and organomegaly were seen. Mean (±SD) Hb was 9.03 (±1.06) gm/dl, in 66% ESR was >50mm in 1st hr with 50% leukocytosis and 50% leucopenia but 100% thrombocytopenia.In the peripheral blood 40%-85% of the leukocytes were blast cells. Bone marrow was done in all cases which suggested AML-M3 (Acute promyelocytic leukemia) and cytogenetic diagnosis were done in 3 cases, which showed t(15;17)PML-RARA fusion protein positive. ATRA (all-trans retinoic acid) plus chemotherapy (daunorubicin ± cytarabine) achieved complete remission in 5 (80%) patients. Conclusion: Modern treatment is highly effective if administered early. Keyword: Acute promyelocytic leukaemia, PML/RARA fusion protein, All- trans retinoic acid (ATRA). DOI: http://dx.doi.org/10.3329/jom.v12i2.8420 JOM 2011; 12(2): 139-141
Plagiarism in Medical Science - The Forbidden Fruit
Authors: Miah MD Titu , Imran Khan Mohammad Ashik , Ahasan HAM Nazmul , Das Gupta Ratan , Alam MD Billal
Published: August 2011

DOI: http://dx.doi.org/10.3329/jom.v12i2.8422JOM 2011; 12(2): 160-162
Accessory Thyroid Gland In A Patient with Hypothyroid State
Authors: Mannan MA , Begum Rubina , Rahman Muhammad Hafizur , Hassan Khaled , Hoque Mirza Azizul
Published: August 2011

A 40 yrs female muslim housewife attended Endocrinology department of Dhaka Medical College Hospital with the complaints of swelling in front of neck, alone with dryness of the skin, cold intolerance, constipation and menorrhagia. Physical examination and laboratory investigations substantiated the diagnosis of accessory thyroid gland in front of neck above the isthmus of the thyroid gland. RAIU and scanning showed normally present thyroid gland with accessory thyroidal nodular swelling in the midline in the upper part of front of neck .USG of the thyroid gland showed normal size of thyroid gland with coarse echo texture. A hypo echoic solid thyroid nodule was also seen above the isthmus of the thyroid gland, measuring about 2.4 cm×2.2cm. Thyroid function tests revealed hypothyroidism. She is on thyroid hormone replacement therapy. This rare presentation of accessory thyroid gland with hypothyroid state led us to report the case. Keywords: Accessory thyroid gland, Hypothyroidsm, Ectopic, Bangladesh DOI: http://dx.doi.org/10.3329/jom.v12i2.8426 JOM 2011; 12(2): 180-182
A Young Male with Progressive Pallor
Authors: Das Aparna , Badiuzzaman MD , Hoque AKM Aminul , Das Gupta Ratan , Afroza MD , Mohiuddin MD , Hossain Zayed
Published: August 2011

Dyserythropoiesis occurs in a variety of congenital and acquired haematological disorders. The term congenital dyserythropoictic anaemia was first used by Crookston et al. CDA comprises a group of rare hereditary disorders of erythropoiesis which are characterized by distinct morphological abnormalities of erythroblasts in the bone morrow. CDA is classified into three classical types (type I, II and III).Most cases of CDA are diagnosed early in life. Our patient was diagnosed at the age of 22 years with clinical presentation of anaemia, hepatomegaly and bone marrow morphology compatible with CDA type III. We report this case for rarity. Keyword: Dyserythropoiesis, Congenital Dyserythropoictic Anaemia (CDA), Bone morrow DOI: http://dx.doi.org/10.3329/jom.v12i2.8427 JOM 2011; 12(2): 183-184
Pancreatic Lipomatosis Picked Up on Imaging
Authors: Gupta Gaurav , Nijhawan Sandeep , Virani Rahul , Nepalia Subhash
Published: August 2011

DOI: http://dx.doi.org/10.3329/jom.v12i2.8431 JOM 2011; 12(2): 193
Constructing Pedagogical Models For E-learning
Authors: Behar Patricia Alejandra
Published: August 2011

This article brings forth an overview of the paradigmatic crisis and the introduction of new pedagogical practices. It also discusses the relationship between paradigm and pedagogical model, presenting a theoretical discussion on the concepts of pedagogical model for E-learning and its pedagogical architecture. To do so, the elements that are part of it such as organizational aspects, content, methodological and technological aspects are discussed. This theoretical discussion underlies the construction of a new pedagogical model for E-learning taking into account the grounds over which today´s net society is based on: time and space. Examples of E-learning pedagogical models are presented.
World Cup 2014 – Professional Training Program for Brazilian Hotels
Authors: Assis Silvone Alves , Pfitscher Gerson Henrique , Abdalla Humberto
Published: August 2011

This paper presents an experience of implementing a professional training program for the Brazilian hospitality industry in the 12 cities that will be the headquarters of the World Cup in 2014. This project was developed in the context of the program â??Welcoming Cup
Professional Partnerships: Supporting the Preparation of Pre-Service Teachers Through a Tiered Online Mentoring System
Authors: Schwartz-Bechet Barbara , Gogos Arhonda
Published: August 2011

The University of Maryland University Collegeâ??s (UMUC) Department of Education developed a program to increase achievement of secondary school students and increase retention of Master of Arts in Teaching Program (MAT) pre-service teacher candidates entitled, â??Professional Partnerships
Collaborative and Social Learning using Virtual Worlds: Preparing Students for Virtually Anything
Authors: Erenli Kai , Ortner Gerhard
Published: August 2011

"Teams, increasingly more than individuals, are charged with the most challenging and mission-critical projects. Leaders need to evaluate and motivate from a distance. And the makeup of teams is increasingly complex â?? they´re bigger, more diverse, more geographically distributed, composed more of specialists than generalists, and much more dependent on technology than in the past. And difficult economic times only accent these challenges." This statement made by Reeves and Read in their Book â??Total Engagement
E-Learning and School Development - Strengths and Challenges of Capacity Building in School Development Projects
Authors: Skov Hansen Line , Sunnevåg Anne-Karin , Kostøl Anne
Published: August 2011

Abstract - This paper intends to focus on the strengths and challenges of capacity building in school development projects. The paper is based on practical experiences with three different projects CLL (Classroom Management, Learning and Teaching Authority) in Norway, the implementation of the LP- (learning environment and pedagogical analysis) model in Denmark as well as professional development of school administrators in a Danish municipality. The total number of participants in these projects is approximately 500 schools and 24 000 teachers and school administrators. One of the challenges about school improvement in general, is linked to the development of competences and training of employees. Training of teachers and school administrators is often costly in terms of time, finances and organization. In accordance with these challenges, Centre of the Study of Educational Practice (SePU), Norway and Centre for Knowledge-Based Educational Practice (CVIPP), Denmark have designed projects for developing competences and training based on â??blended learning
Correlation between Awareness of Blended Learning Techniques and Participation Rate in E-learning: a Case Study
Authors: Antoniadis Nikolaos , Konetas Dimitrios
Published: August 2011

The use of information and communication technologies both in higher education and in business environments has been dramatically increasing in the past two decades. Blended learning (either synchronous or asynchronous) has been gaining ground and becoming a major alternative to standard teaching. In Greece, higher education institutions provide a substantial part of their curricula in electronic form and instructors are urged to use the e-learning tools more. However, students are not always willing to explore and take full advantage of the enhanced possibilities and often are not involved at all. Various modules of on-line education attract students in different ways, thus leading to a natural tendency to use different tools to fulfill their needs. This study aims at exploring the correlation between studentsâ?? awareness for this learning model, their level of participation in such learning formats and their final performance. Comparative results for participation and performance are presented for a variety of relevant interactive tools employed by the Learning Management System (LMS) of TEI of Epirus, a higher education institution in Greece.
The Facultative Intracellular Pathogen Candida glabrata Subverts Macrophage Cytokine Production and Phagolysosome Maturation
Authors: Seider Katja , Brunke Sascha , Schild Lydia , Jablonowski Nadja , Wilson Duncan , Majer Olivia , Barz Dagmar , Haas Albert , Kuchler Karl , Schaller Martin , Hube Bernhard
Published: August 2011

Although Candida glabrata is an important human pathogenic yeast, its pathogenicity mechanisms are largely unknown. Immune evasion strategies seem to play key roles during infection, since very little inflammation is observed in mouse models. Furthermore, C. glabrata multiplies intracellularly after engulfment by macrophages. In this study, we sought to identify the strategies that enable C. glabrata to survive phagosome biogenesis and antimicrobial activities within human monocyte-derived macrophages. We show that, despite significant intracellular proliferation, macrophage damage or apoptosis was not apparent, and production of reactive oxygen species was inhibited. Additionally, with the exception of GM-CSF, levels of pro- and anti-inflammatory cytokines were only marginally increased. We demonstrate that adhesion to and internalization by macrophages occur within minutes, and recruitment of endosomal early endosomal Ag 1 and lysosomal-associated membrane protein 1 indicates phagosome maturation. However, phagosomes containing viable C. glabrata, but not heat-killed yeasts, failed to recruit cathepsin D and were only weakly acidified. This inhibition of acidification did not require fungal viability, but it had a heat-sensitive surface attribute. Therefore, C. glabrata modifies the phagosome into a nonacidified environment and multiplies until the host cells finally lyse and release the fungi. Our results suggest persistence of C. glabrata within macrophages as a possible immune evasion strategy.
The Transport and Inactivation Kinetics of Bacterial Lipopolysaccharide Influence Its Immunological Potency In Vivo
Authors: Lu Mingfang , Munford Robert S.
Published: August 2011

The extraordinary potency and pathological relevance of Gram-negative bacterial LPSs have made them very popular experimental agonists, yet little is known about what happens to these stimulatory molecules within animal tissues. We tracked fluorescent and radiolabeled LPS from a s.c. inoculation site to its draining lymph nodes (DLN), blood, and liver. Although we found FITC-labeled LPS in DLN within minutes of injection, drainage of radiolabeled LPS continued for >6 wk. Within the DLN, most of the LPS was found in the subcapsular sinus or medulla, near or within lymphatic endothelial cells and CD169+ macrophages. Whereas most of the LPS seemed to pass through the DLN without entering B cell follicles, by 24 h after injection a small amount of LPS was found in the paracortex. In wild-type mice, ≥70% of the injected radiolabeled LPS underwent inactivation by deacylation before it left the footpad; in animals that lacked acyloxyacyl hydrolase, the LPS-deacylating enzyme, prolonged drainage of fully acylated (active) LPS boosted polyclonal IgM and IgG3 Ab titers. LPS egress from a s.c. injection site thus occurred during many weeks and was mainly via lymphatic channels. Its immunological potency, as measured by its ability to stimulate polyclonal Ab production, was greatly influenced by the kinetics of both lymphatic drainage and enzymatic inactivation.
The CD6 Multiple Sclerosis Susceptibility Allele Is Associated with Alterations in CD4+ T Cell Proliferation
Authors: Kofler David M. , Severson Christopher A. , Mousissian Narine , De Jager Philip L. , Hafler David A.
Published: August 2011

Genome-wide association studies have revealed a large number of genetic associations with autoimmune diseases. Despite this progress, the mechanisms underlying the contribution of allelic variants to the onset of immune-related diseases remain mostly unknown. Our recent meta-analysis of genome-wide association studies of multiple sclerosis (MS) identified a new susceptibility locus tagged by a single nucleotide polymorphism, rs17824933 (p = 3.8 × 10−9), that is found in a block of linkage disequilibrium containing the CD6 gene. Because CD6 plays an important role in maintenance of T cell activation and proliferation, we examined the biologic phenotypes of the risk-associated allele. In this article, we report that the MS susceptibility allele in CD6 is associated with decreased expression of full-length CD6 in CD4+ and CD8+ T cells. As a consequence, proliferation is diminished during long-term activation of CD4+ T cells from subjects with the risk allele. Selective knockdown of full-length CD6 using exon 5-specific small interfering RNA induces a similar proliferation defect of CD4+ T cells from subjects homozygous for the protective allele. Exon 5 encodes for the extracellular binding site of the CD6 ligand ALCAM, which is required for CD6 stimulation. In CD4+ T cells from subjects with the risk allele, exon 5 is consistently underexpressed, thereby providing a mechanism by which the allele affects proliferation of CD4+ T cells. These findings indicate that the MS risk allele in the CD6 locus is associated with altered proliferation of CD4+ T cells and demonstrate the influence of a disease-related allelic variant on important immunological characteristics.
Membrane-Associated CD93 Regulates Leukocyte Migration and C1q-Hemolytic Activity during Murine Peritonitis
Authors: Greenlee-Wacker Mallary C. , Briseño Carlos , Galvan Manuel , Moriel Gabriela , Velázquez Peter , Bohlson Suzanne S.
Published: August 2011

CD93 is emerging as a novel regulator of inflammation; however, its molecular function is unknown. CD93 exists as a membrane-associated glycoprotein on the surface of cells involved in the inflammatory cascade, including endothelial and myeloid cells. A soluble form (sCD93) is detectable in blood and is elevated with inflammation. In this study, we demonstrate heightened susceptibility to thioglycollate-induced peritonitis in CD93−/− mice. CD93−/− mice showed a 1.6–1.8-fold increase in leukocyte infiltration during thioglycollate-induced peritonitis between 3 and 24 h that returned to wild type levels by 96 h. Impaired vascular integrity in CD93−/− mice during peritonitis was demonstrated using fluorescence multiphoton intravital microscopy; however, no differences in cytokine or chemokine levels were detected with Luminex Multiplex or ELISA analysis. C1q-hemolytic activity in CD93−/− mice was decreased by 22% at time zero and by 46% 3 h after thioglycollate injection, suggesting a defect in the classical complement pathway. Leukocyte recruitment and C1q-hemolytic activity was restored to wild type levels when CD93 was expressed on either hematopoietic cells or nonhematopoietic cells in bone marrow chimeric mice. However, elevated levels of sCD93 in inflammatory fluid were observed only when CD93 was expressed on nonhematopoietic cells. Because cell-associated CD93 was sufficient to restore a normal inflammatory response, these data suggest that cell-associated CD93, and not sCD93, regulates leukocyte recruitment and complement activation during murine peritonitis.
IL-10 Restricts Activation-Induced Death of NK Cells during Acute Murine Cytomegalovirus Infection
Authors: Stacey Maria A. , Marsden Morgan , Wang Eddie C. Y. , Wilkinson Gavin W. G. , Humphreys Ian R.
Published: August 2011

IL-10 is an immunomodulatory cytokine that acts to antagonize T cell responses elicited during acute and chronic infections. Thus, the IL-10R signaling pathway provides a potential therapeutic target in strategies aimed at combating infectious diseases. In this study, we set out to investigate whether IL-10 expression had an effect on NK cells. Murine CMV infection provides the best characterized in vivo system to evaluate the NK cell response, with NK cells being critical in the early control of acute infection. Blockade of IL-10R during acute murine CMV infection markedly reduced the accumulation of cytotoxic NK cells in the spleen and lung, a phenotype associated with a transient elevation of virus DNA load. Impaired NK cell responsiveness after IL-10R blockade was attributed to elevated levels of apoptosis observed in NK cells exhibiting an activated phenotype. Therefore, we conclude that IL-10 contributes to antiviral innate immunity during acute infection by restricting activation-induced death in NK cells.
MicroRNA-21 Limits In Vivo Immune Response-Mediated Activation of the IL-12/IFN-γ Pathway, Th1 Polarization, and the Severity of Delayed-Type Hypersensitivity
Authors: Lu Thomas X. , Hartner Jochen , Lim Eun-Jin , Fabry Victoria , Mingler Melissa K. , Cole Eric T. , Orkin Stuart H. , Aronow Bruce J. , Rothenberg Marc E.
Published: August 2011

An altered balance between Th1 and Th2 cytokines is responsible for a variety of immunoinflammatory disorders such as asthma, yet the role of posttranscriptional mechanisms, such as those mediated by microRNAs (miRs), in adjusting the relative magnitude and balance of Th cytokine expression have been largely unexplored. In this study, we show that miR-21 has a central role in setting a balance between Th1 and Th2 responses to Ags. Targeted ablation of miR-21 in mice led to reduced lung eosinophilia after allergen challenge, with a broadly reprogrammed immunoactivation transcriptome and significantly increased levels of the Th1 cytokine IFN-γ. Biological network-based transcriptome analysis of OVA-challenged miR-21−/− mice identified an unexpected prominent dysregulation of IL-12/IFN-γ pathways as the most significantly affected in the lungs, with a key role for miR-21 in IFN-γ signaling and T cell polarization, consistent with a functional miR-21 binding site in IL-12p35. In support of these hypotheses, miR-21 deficiency led dendritic cells to produce more IL-12 after LPS stimulation and OVA-challenged CD4+ T lymphocytes to produce increased IFN-γ and decreased IL-4. Further, loss of miR-21 significantly enhanced the Th1-associated delayed-type hypersensitivity cutaneous responses. Thus, our results define miR-21 as a major regulator of Th1 versus Th2 responses, defining a new mechanism for regulating polarized immunoinflammatory responses.
Recognition and Killing of Human and Murine Pancreatic β Cells by the NK Receptor NKp46
Authors: Gur Chamutal , Enk Jonatan , Kassem Sameer A. , Suissa Yaron , Magenheim Judith , Stolovich-Rain Miri , Nir Tomer , Achdout Hagit , Glaser Benjamin , Shapiro James , Naparstek Yaakov , Porgador Angel , Dor Yuval , Mandelboim Ofer
Published: August 2011

Type 1 diabetes is an incurable disease that is currently treated by insulin injections or in rare cases by islet transplantation. We have recently shown that NKp46, a major killer receptor expressed by NK cells, recognizes an unknown ligand expressed by β cells and that in the absence of NKp46, or when its activity is blocked, diabetes development is inhibited. In this study, we investigate whether NKp46 is involved in the killing of human β cells that are intended to be used for transplantation, and we also thoroughly characterize the interaction between NKp46 and its human and mouse β cell ligands. We show that human β cells express an unknown ligand for NKp46 and are killed in an NKp46-dependent manner. We further demonstrate that the expression of the NKp46 ligand is detected on human β cells already at the embryonic stage and that it appears on murine β cells only following birth. Because the NKp46 ligand is detected on healthy β cells, we wondered why type 1 diabetes does not develop in all individuals and show that NK cells are absent from the vicinity of islets of healthy mice and are detected in situ in proximity with β cells in NOD mice. We also investigate the molecular mechanisms controlling NKp46 interactions with its β cell ligand and demonstrate that the recognition is confined to the membrane proximal domain and stalk region of NKp46 and that two glycosylated residues of NKp46, Thr125 and Asn216, are critical for this recognition.
Hierarchical IL-5 Expression Defines a Subpopulation of Highly Differentiated Human Th2 Cells
Authors: Upadhyaya Bhaskar , Yin Yuzhi , Hill Brenna J. , Douek Daniel C. , Prussin Calman
Published: August 2011

Each of the three Th2 cytokine genes, IL-4, IL-5, and IL-13, has different functions. We hypothesized that Th2 heterogeneity could yield Th2 subpopulations with different cytokine expression and effector functions. Using multiple approaches, we demonstrate that human Th2 cells are composed of two major subpopulations: a minority IL-5+ (IL-5+, IL-4+, IL-13+) and majority IL-5− Th2 (IL-5−, IL-4+, IL-13+) population. IL-5+ Th2 cells comprised only 20% of all Th2 cells. Serial rounds of in vitro differentiation initially yielded IL-5− Th2, but required multiple rounds of differentiation to generate IL-5+ Th2 cells. IL-5+ Th2 cells expressed less CD27 and greater programmed cell death-1 than IL-5− Th2 cells, consistent with their being more highly differentiated, Ag-exposed memory cells. IL-5+ Th2 cells expressed greater IL-4, IL-13, and GATA-3 relative to IL-5− Th2 cells. GATA-3 and H3K4me3 binding to the IL5 promoter (IL5p) was greater in IL-5+ relative to IL-5− Th2 cells, whereas there was no difference in their binding to the IL4p and IL13p. Conversely, H3K27me3 binding to the IL5p was greater in IL-5− Th2 cells. These findings demonstrate Th2 lineage heterogeneity, in which the IL5 gene is regulated in a hierarchical manner relative to other Th2 genes. IL-5+ Th2 cells are phenotypically distinct and have epigenetic changes consistent with greater IL5p accessibility. Recurrent antigenic exposure preferentially drives the differentiation of IL-5+ Th2 cells. These results demonstrate that IL-5+ and IL-5− Th2 cells, respectively, represent more and less highly differentiated Th2 cell subpopulations. Such Th2 subpopulations may differentially contribute to Th2-driven pathology.
Caveolin-1 Orchestrates TCR Synaptic Polarity, Signal Specificity, and Function in CD8 T Cells
Authors: Tomassian Tamar , Humphries Lisa A. , Liu Scot D. , Silva Oscar , Brooks David G. , Miceli M. Carrie
Published: August 2011

TCR engagement triggers the polarized recruitment of membrane, actin, and transducer assemblies within the T cell–APC contact that amplify and specify signaling cascades and T effector activity. We report that caveolin-1, a scaffold that regulates polarity and signaling in nonlymphoid cells, is required for optimal TCR-induced actin polymerization, synaptic membrane raft polarity, and function in CD8, but not CD4, T cells. In CD8+ T cells, caveolin-1 ablation selectively impaired TCR-induced NFAT-dependent NFATc1 and cytokine gene expression, whereas caveolin-1 re-expression promoted NFATc1 gene expression. Alternatively, caveolin-1 ablation did not affect TCR-induced NF-κB–dependent Iκbα expression. Cav-1−/− mice did not efficiently promote CD8 immunity to lymphocytic choriomeningitis virus, nor did cav-1−/− OT-1+ CD8+ T cells efficiently respond to Listeria monocytogenes-OVA after transfer into wild-type hosts. Therefore, caveolin-1 is a T cell-intrinsic orchestrator of TCR-mediated membrane polarity and signal specificity selectively employed by CD8 T cells to customize TCR responsiveness.