bluuebunny/crossref_metadata_2025 huggingface dataset:
Prolactin and Leydig cells: biphasic effects of prolactin on LH‐, T3‐ and GH‐induced testosterone/oestradiol secretion by Leydig cells in pubertal rats
Authors: Maran R. R. M. , Arunakaran J. , Aruldhas M. M.
Published: March 2003

The effect of rat prolactin (rPRL) on basal and LH‐, GH‐ and T3‐mediated testosterone and oestradiol secretion was studied in pubertal rat Leydig cells. Purified Leydig cells were cultured for 24 h at 37 °C in a medium containing 4% foetal calf serum (FCS). The medium was then replaced with fresh medium containing different concentrations of rPRL (5–400 ng/mL) for 48 h at 34 °C without FCS. rPRL increased testosterone secretion by Leydig cells at doses of 50–400 ng and maximum stimulation was observed at a dose of 200 ng. Oestradiol secretion was parallel to that of testosterone except at low doses (5–50 ng/mL). To assess the modulatory effect of rPRL on LH‐, GH‐ and T3‐induced Leydig cell testosterone and oestradiol secretion, minimum (50 ng) and maximum (200 ng) effective doses of rPRL were co‐administered with LH (25/100 ng), GH (10/50 ng) and T3 (25/50 ng). Co‐administration of rPRL (50/100 ng) with T3 (25/50 ng) decreased testosterone secretion. While co‐administration of T3 (25 ng) decreased rPRL‐induced oestradiol secretion, the latter was unaltered at a dose of 50 ng T3. A minimum effective dose of rPRL (50 ng) plus LH (25 ng) stimulated both testosterone and oestradiol secretion. While a maximum effective dose of rPRL (200 ng) did not alter LH (25 ng)‐induced testosterone and oestradiol secretion, it inhibited testosterone secretion induced by 100 ng LH and increased oestradiol secretion. Both doses of rPRL (50, 200 ng) plus GH (10/50 ng) inhibited testosterone secretion when compared with testosterone secretion induced by either GH or PRL alone and stimulated oestradiol secretion. The present in vitro study indicates that rPRL stimulates both testosterone and oestradiol secretion by Leydig cells and that this effect can be modulated by LH, GH and T3.
Rabbit sex hormone‐binding globulin: expression in the liver and testis during postnatal development and structural characterization by truncated proteins
Authors: Wong Alice S. T. , Lui Wing‐Yee , Hui Irene T. C. , Lee Will M.
Published: March 2003

Although sex hormone binding globulin (SHBG) is found in the blood plasma of adult humans and rabbits and the gene is expressed in their livers, it is not detected in the plasma of adult rodents nor is it expressed in adult rodent livers. Thus the rabbit represents a good model to study the metabolism and function of SHBG in the blood. We have used a cloned rabbit SHBG cDNA to detect mRNA expression in rabbits during the postnatal period, and to construct truncated SHBG proteins for structure/function analysis. The SHBG mRNA appeared in the testis as early as 3 days after birth. The level increased gradually in abundance throughout postnatal development, and attained a maximum at 12 weeks of age when the gonads were fully matured. In contrast, SHBG mRNA in the livers of male and female animals increased to a maximum by 4 weeks of age, and were maintained at this level until 12 weeks before subsiding to the initial levels. The increase and decrease in SHBG mRNA levels in the liver were accompanied by similar changes in serum SHBG. This suggests that SHBG in the blood circulation comes from the liver and this might also provide a source of SHBG for the male reproductive tract before formation of the blood–testis barrier. To elucidate the minimal sequence of rabbit SHBG responsible for steroid‐binding, a panel of 13 truncated SHBG proteins was constructed, expressed inEscherichia coli, and biochemically purified for study. It was shown that the complete protein sequence of rabbit SHBG was important for maintaining a stable steroid–protein complex. Unlike human SHBG for which a truncated protein of the first 206 residues of the 373 amino acid protein can still bind steroid, removal of 43 or more residues from the C‐terminus of rabbit SHBG completely abolished steroid‐binding.
Reassessment of sperm morphology of archival semen smears from the period 1980–1994
Authors: Horte A. , Vierula M. , Toppari J. , Suominen J.
Published: March 2003

Several reports have suggested that sperm counts of normal men have declined in many geographical regions during the last decades. Deterioration of sperm morphology has also been reported in some studies covering long sample collecting periods. The original semen analysis data of our semen laboratory from the period 1980–1994 showed a significant decline in the proportion of spermatozoa with normal morphology. The finding was, however, questioned because of changes in sperm morphology assessment criteria during the study period. In the present study 1745 smears were re‐analysed to cover evenly the whole study period. The samples were examined in random order by using strict assessment criteria. Multiple linear regression analysis of the re‐analysed data showed no effect of the year of sample delivery on sperm morphology between the years 1980 and 1994. However, there was a significant decline in the proportion of normal spermatozoa with later year of men’s birth.
Circannual variation in human semen parameters
Authors: Andolz Pablo , Angeles Bielsa M. , Andolz Ana
Published: March 2003

The aim of the present study was to determine whether there were significant monthly variations in the semen parameters (i.e. volume, sperm count, total sperm count, motile and normal sperm count) of men living in a Mediterranean climate area. A total of 10 877 semen analysis results were included. Semen samples were obtained as a part of an initial screening of male partners from couples with infertility problems who were attending our laboratory from 1970 to 2000. Log transformation and cubic root transformation were used to test the sample distribution. Statistical significance was adjusted by year of examination, patient’s age and sexual abstinence period by performing covariance analyses. Differences between months were assessed with the Bonferroni post‐hoc test. There was an increase in March and a decrease in September in the adjusted mean sperm count (p < 0.0005), total sperm count (p < 0.0005), motile sperm count (p=0.01) and normal sperm count (p=0.002). There were no variations in semen volume in the study period. Monthly changes in semen quality are confirmed in this population.
Sperm disposal system in spermatic granuloma: a link with superoxide radicals
Authors: Chatterjee Suvro , Rahman Mohammad Masihur , Laloraya Malini , Pradeep Kumar G.
Published: March 2003

Spermatic granulomas are believed to maintain ‘physiological harmony’ in the male reproductive tract by maintaining a balance of hydrostatic pressure post‐vasectomy. The mechanism for the disposal of deposited spermatozoa in the granuloma core is not clear. A fourfold rise in the production of superoxide along with ascorbyl and dienyl radicals and a 50% drop in the production of nitric oxide (NO) radicals by granuloma tissue hints that a reaction between NO and superoxide radicals could lead to the formation of peroxynitrite species which may contribute to the disposal of spermatozoa in the granuloma core. A higher protease activity and low hypoxanthine content in the granuloma indicates that a free radical driven sperm disposal system is active in granulomas.
Comparison of the Sperm Quality Analyzer IIC variables with the computer‐aided sperm analysis estimates
Authors: Suzuki Tatsuya , Shibahara Hiroaki , Tsunoda Hiromichi , Hirano Yuki , Taneichi Akiyo , Obara Hiromi , Takamizawa Satoru , Sato Ikuo
Published: March 2003

Sperm Quality Analyzer (SQA) IIC, an upgrade version, is an inexpensive device and provides a quantitative estimation of sperm motility, whereas the use of computer‐aided sperm analysis (CASA) provides high precision and provision of quantitative data on sperm kinetics. The aim of the present study was to evaluate if the SQA IIC variables correlated with the CASA estimates. Semen quality analysis of 71 fresh semen samples was performed using SQA IIC and CASA. Total sperm concentration, percentage of progressively motile sperm, percentage of normal morphology, motile sperm concentration, sperm motility index (SMI) and functional sperm count (FSC) determinations were performed using SQA IIC. Sperm concentration, sperm motility, and sperm motion variables including amplitude of lateral head displacement (ALH), beat cross frequency (BCF), curvilinear velocity (VCL), straight line velocity (VSL), average path velocity (VAP), linearity (LIN=VSL/VCL), and straightness (STR=VSL/VAP) were evaluated simultaneously on the same semen samples using CASA. The sperm characteristics were compared between SQA IIC and CASA. There were significant correlations of sperm concentration (r=0.634,p < 0.0001), sperm motility (r=0.697,p < 0.0001), and motile sperm concentration (r=0.757,p < 0.0001) between the two devices. Both SMI and FSC significantly correlated with eight CASA estimates, including sperm concentration, sperm motility, motile sperm concentration, ALH, VCL, VSL, VAP, and Rapid. SQA IIC is simple and easy to use. Moreover, the SQA IIC variables well correlated with the CASA estimates. As a screening test for semen quality, SQA IIC is considered as useful in the management of male infertility.
Administration of acetylcholine to the spermatic nerve plexus inhibits testosterone secretion in an in vitro isolated rat testis–nerve plexus system
Authors: Zhu C. , Palmada M. N. , Aguado L. I. , Cavicchia Juan Carlos
Published: March 2003

Strong evidence indicated that spermatic nerves are involved in the regulation of testosterone secretion. Our previous work showed that the inferior spermatic nerves play a more significant role than the superior ones in the regulation of testosterone secretion. However, it is unknown whether traditional neurotransmitters are involved in this regulation. In order to evaluate this point, the present experiments were carried out in an in vitro system where an isolated testis–spermatic nerve plexus preparation was incubated in two separate containers, one for the testis and the other for the nerve plexus and both interconnected by the inferior spermatic nerves. Both tissues were maintained in the same environmental conditions except for the neurotransmitter treatment, applied only to the nerve plexus. Acetylcholine can significantly inhibit the secretion of testosterone until the end of incubation. The present experiments suggest that the secretion of testosterone could be regulated, at least in part, by acetylcholine through the inferior spermatic nerves.
Dietary fatty acid composition affects aminopeptidase activities in the testes of mice
Authors: Arechaga Garbiñe , Prieto Isabel , Segarra Ana B. , Alba Francisco , Ruiz‐Larrea María B. , Ruiz‐Sanz José I. , De Gasparo Marc , Ramirez Manuel
Published: March 2003

The autocrine/paracrine control mechanisms of local factors, such as the renin–angiotensin system and the thyrotropin‐releasing hormone (TRH), seem to play a relevant role in testicular physiology. It has been proposed that dietary fat composition influences male reproductive function modifying the cholesterol–phospholipid composition of testicular plasma membranes. Modifications in the composition and physical properties of the membranes may lead to alterations in the activities of membrane‐bound (M‐B) enzymes. We have previously demonstrated that cholesterol and steroid hormones affect aminopeptidase (AP) activities. Dietary fatty acids with different degrees of saturation modified AP activities in the serum of mice and an olive oil supplemented diet influenced the AP activities in the testes of mice. We hypothesized that the modification of dietary fat composition may affect angiotensin‐ [glutamyl‐AP (GluAP), aspartyl‐AP (AspAP)] and TRH‐ [pyroglutamyl‐AP (pGluAP)] degrading activities in the testis. In this study, we investigated the effect of diets supplemented with sunflower oil (SFO), fish oil (FO), olive oil (OO), lard (L) or coconut oil (CO) on soluble (Sol) and M‐B GluAP, AspAP and pGluAP in mice testis, using arylamides as substrates. Sol GluAP activity did not show differences among groups. However, Sol AspAP and Sol pGluAP progressively decreased with the degree of saturation of the fatty acid used in the diet. In contrast, M‐B GluAP progressively increased with the degree of saturation of the fatty acid used in the diet. For M‐B AspAP activity, mice fed diets containing FO showed significantly higher levels than those fed diets containing SFO, OO and L but not those containing CO. For M‐B pGluAP activity, the highest levels were observed for mice fed diets containing FO and OO. The present data suggest that the type of fat used in the diet may influence the autocrine/paracrine functions of locally synthesized angiotensin peptides and TRH in the testis, and consequently may be important in male reproductive functions.
Cardiotrophin‐1 (CT‐1): a novel hypertrophic and cardioprotective agent
Authors: Latchman David S.
Published: March 2003

Cardiotrophin‐1 (CT‐1) is a member of the IL‐6 family of cytokines which was originally discovered as a factor which can induce hypertrophy of cardiac myocytes both in vitro and in vivo. Subsequently, CT‐1 has been shown to have a wide variety of different effects on cardiac and non cardiac cells including the ability to stimulate the survival of both cardiac and neuronal cells. Interestingly, whilst activation of the p42/p44 MAP kinase pathway is necessary for the survival promoting effects of CT‐1 in cardiac cells, it is not required for its hypertrophic effect which is likely to involve activation of the Jak/STAT‐3 pathway. CT‐1 may therefore be of use as a novel cardio‐protective agent, particularly if its hypertrophic effect can be specifically inhibited.
New vessels, new approaches: angiogenesis as a therapeutic target in musculoskeletal disorders
Authors: Ballara Sundeept C. , Miotla Jadwiga M. , Paleolog Ewa M.
Published: March 2003

Musculoskeletal disorders such as rheumatoid arthritis (RA) and osteoarthritis are a common cause of pain and disability. The vasculature is an important component of the musculoskeletal system, and vascularization is a key event in the development of normal cartilage and bone. By promoting the delivery of nutrients, oxygen and cells, blood vessels help maintain the structural and functional integrity of joints and soft tissue and may facilitate tissue repair and healing. The identification of pro‐angiogenic mediators such as vascular endothelial growth factor (VEGF) has led to the development of antiangiogenic therapies for the treatment of neoplastic diseases. The important role of angiogenesis, and especially VEGF, in the pathogenesis of joint disorders such as RA suggests that antiangiogenic therapy may be a useful adjunct to existing approaches in RA.
Metabolic cardiomyopathies
Authors: Guertl Barbara , Noehammer Christa , Hoefler Gerald
Published: March 2003

The energy needed by cardiac muscle to maintain proper function is supplied by adenosine Ariphosphate primarily (ATP) production through breakdown of fatty acids. Metabolic cardiomyopathies can be caused by disturbances in metabolism, for example diabetes mellitus, hypertrophy and heart failure or alcoholic cardiomyopathy. Deficiency in enzymes of the mitochondrial β‐oxidation show a varying degree of cardiac manifestation. Aberrations of mitochondrial DNA lead to a wide variety of cardiac disorders, without any obvious correlation between genotype and phenotype. A completely different pathogenetic model comprises cardiac manifestation of systemic metabolic diseases caused by deficiencies of various enzymes in a variety of metabolic pathways. Examples of these disorders are glycogen storage diseases (e.g. glycogenosis type II and III), lysosomal storage diseases (e.g. Niemann‐Pick disease, Gaucher disease, I‐cell disease, various types of mucopolysaccharidoses, GM1 gangliosidosis, galactosialidosis, carbohydrate–deficient glycoprotein syndromes and Sandhoff's disease). There are some systemic diseases which can also affect the heart, for example triosephosphate isomerase deficiency, hereditary haemochromatosis, CD 36 defect or propionic acidaemia.
Skeletal muscle necrosis and regeneration after injection of Thalassophryne nattereri (niquim) fish venom in mice
Authors: Lopes‐Ferreira Monica , Núñez Javier , Rucavado Alexandra , Farsky Sandra H.P. , Lomonte Bruno , Angulo Yamileth , Da Silva Ana M. moura , Gutiérrez José María
Published: March 2003

Stings by Thalassophryne nattereri are responsible for envenomation of fishermen in north‐eastern Brazil. Its venom induces prominent local tissue damage, characterized by pain, oedema and necrosis. The pathogenesis of acute muscle damage induced by T. nattereri venom was studied in mice. Intramuscular injection induced myonecrosis within the first hours. Some muscle cells presented a hypercontracted morphology, but most necrotic fibres were not hypercontracted, being instead characterized by a disorganization of myofibrils, with Z line loss, mitochondrial swelling and sarcolemmal disruption. In addition, thrombosis was observed histologically in venules and veins, together with vascular congestion and stasis, evidenced by intravital microscopy. Venom induced a rapid increment in serum creatine kinase (CK) levels, concomitant with a reduction in gastrocnemius muscle CK activity, whereas no increments in muscle lactic acid were detected. A rapid cytolytic effect was induced by the venom on C2C12 murine myoblasts in culture. The inflammatory reaction in affected muscle was characterized by oedema and scarce cellular infiltrate of polymorphonuclear leucocytes and macrophages, with a consequent delay in the removal of necrotic material. Skeletal muscle regeneration was partially impaired, as evidenced by the presence of regenerating fibres of variable size and by the increase of fibrotic tissue in endomysium and perimysium. It is suggested that T. nattereri venom affects muscle fibres by a direct cytotoxic effect, and that the vascular alterations described preclude a successful regenerative process.
The mRNA expression of inducible nitric oxide synthase in DMBA‐induced hamster buccal‐pouch carcinomas: an in situ RT‐PCR study
Authors: Yuk‐Kwan Chen , Shui‐Sang Hsue , Li‐Min Lin
Published: March 2003

Three isoforms of nitric oxide synthase (NOS) have been identified: endothelial NOS, neuronal NOS, and inducible NOS (iNOS). The enhanced expression of iNOS at the protein level using immunohistochemical technique has been reported previously in chemically induced oral carcinomas in hamster buccal‐pouch mucosa. However, the corresponding expression of iNOS at the mRNA level has not yet been demonstrated using in situ reverse transcription‐polymerase chain reaction (IS RT‐PCR). The purpose of the present study is to assess the iNOS mRNA expression level in 7,12‐dimethylbenz[a]anthracene (DMBA)‐induced hamster buccal‐pouch carcinomas using IS RT‐PCR. Thirty outbred, young (6‐weeks old), male, Syrian golden hamsters (Mesocricatus auratus) were randomly divided into one experimental group (10 animals), and two control groups (10 animals each). The pouches of a group of 10 animals of the experimental group were painted bilaterally with a 0.5% DMBA solution three times a week for 15 weeks. Each animal of one of the control groups was similarly treated with only mineral oil. Another control group of 10 animals remained untreated throughout the experiment. Invasive squamous‐cell carcinomas with a 100% tumour incidence developed in all of the DMBA‐treated buccal pouches. The mineral oil‐treated and untreated pouches revealed no obvious changes. Inducible NOS mRNA was demonstrated amongst all the 15‐week DMBA‐treated hamster buccal‐pouch mucosa animals, but not in the untreated animals and not in the animals for which the buccal‐pouch was treated with mineral oil. Further study is necessary to evaluate the mechanism(s) which contribute to the increased iNOS mRNA expression for experimentally induced oral carcinogenesis.
Tooth size and morphology in hemifacial microsomia
Authors: Farias  , Vargervik
Published: March 2003

Aims. To determine whether tooth size and morphology are affected in HFM.Design. The mesiodistal diameter of each tooth of 40 patients with varying severity of HFM was measured with a vernier gauge calibrated to 0·1 mm. Data obtained from teeth on the affected side were compared with data from corresponding teeth on the contralateral side. Setting. Center for Craniofacial Anomalies, School of Dentistry, University of California, San Francisco, USA. Results. Subjects with HFM have smaller teeth on the affected side than on the contralateral side. The more severely affected subjects have the highest degree of tooth size asymmetry. Tooth morphology is also affected in individuals with HFM.
Pharmacists’ knowledge, attitudes and practices concerning sugar‐free medicines
Authors: McVeigh N. , Kinirons M.J.
Published: March 2003

Aims. To examine the attitudes of pharmacists to sugar in medicine and sugar‐free preparations and their levels of knowledge concerning sugar‐free preparations and the implications for dental health.

Design. A questionnaire was designed with a mixture of closed and open‐ended questions.

Setting. Pharmacists practising in the Greater Belfast area of Northern Ireland.

Method. Seventy pharmacists were randomly chosen from the list of pharmacists practising in the area and were asked to participate in the study.

Results. Responses were obtained from 52 of the 70 selected pharmacists, representing a response rate of 74%. Seventy‐five per cent of the pharmacists stated that they had not received formal education concerning sugar in medication and it’s effect on dental health. Their main source of information on the subject was dental health literature. Eighty‐seven per cent felt that all medication should be available in sugar‐free form. Forty‐six per cent stated that sugar in medication was definitely an important cause of dental caries in children and 44% felt that it was a possible factor. The major factors influencing the provision of sugar‐free medicines were parental request, health promotion literature, reports and media advertising. Thirty‐nine per cent of the pharmacists always offered a sugar‐free preparation for over‐the‐counter medication (provided that a sugar‐free alternative was available), and 56% sometimes did so. Fifty per cent always offered a sugar‐free form for prescribed items wherever possible, the remainder depended on it being specified by the prescriber.

Conclusion. There is a high level of interest in this issue among pharmacists, but there is a need for an increased educational input on a continuous basis.
A nasopalatine cyst in an 8‐year‐old child
Authors: Velasquez‐Smith M.T. , Mason C. , Coonar H. , Bennett J.
Published: March 2003

The nasopalatine cyst (NPC) was first described in 1914 and it is considered the most common non‐odontogenic cyst. Most studies show a higher incidence of NPC among males than females, with a male/female ratio of 1·7:1. The majority of the cases described in people in their fifth decade involve Afro‐Caribbeans, while those in their sixth decade are mainly caucasians. These cysts are normally asymptomatic, unless they are infected. The most commonly reported clinical symptom is swelling in the anterior part of the palate. The treatment of choice is enucleation.

 Even though it has been stated that NPCs may occur at any age no reports have been made on children less than 9 years old. Some reports support a predisposition in young Afro‐Caribbeans, where NPCs appear to be more aggressive, larger and symptomatic. We present a case of a NPC in an 8‐year‐old caucasian female.
Community dental officers’ use and knowledge of restorative techniques for primary molars: an audit of two Trusts in Wales
Authors: Maggs‐Rapport  , Treasure  , Chadwick
Published: March 2003

Objective. A baseline audit of current levels of knowledge about, and use of, restorative techniques in children’s primary molars.

Design. A survey of community dental officers.

Setting. Two large Trusts in Wales.

Sample. Eighteen dental officers (five from Trust A and 13 from Trust B) from a total of 23 (six from Trust A and 17 from Trust B).

Outcome measures. Dental officers’ use of restorative materials in primary molars. Dental officers’ participation in postgraduate training for restorative techniques. Dental officers’ consideration of the research literature on ‘best practice’ in restorative techniques.

Results. Dental officers in these two Trusts were not using stainless steel crowns (SSCs) for restoring primary molars. All 18 dental officers reported using glass ionomer cement (GIC) and amalgam as restorative materials, whilst six reported using GIC exclusively. Only 11 dentists mentioned using stainless steel crowns and this was in conjunction with carrying out a pulpotomy. Fewer dentists had been taught to use GIC than either SSCs or amalgam for restoring primary teeth during undergraduate training. A hands‐on, user‐friendly, postgraduate training course is considered the most effective way of teaching dentists about restorative techniques. The research evidence on SSCs did not appear to influence these dental officers in their use of restorative materials.

Conclusions. This study offers important baseline data about the acceptability of differing restorative techniques and about the type of intervention that could bring about change in pattern of use by community dental officers in two large Trusts in Wales. If a postgraduate course in the use of stainless steel crowns is to meet dental officers’ needs, it should address their concerns about the use of crowns.
Degloving injury to mental protuberance: a case report
Authors: McLaughlin P.P.
Published: March 2003

Sporting injuries are increasing in frequency with the increase in leisure time. This report describes a case of degloving of the mental protuberance. Ideally this injury should be treated as soon as possible by repositioning the displaced tissue and closure. Immediate assistance was not sought until superimposed infection caused pain and swelling. Because the wound was infected, treatment was aimed at obtaining healing by secondary intention.
Caries experience and streptococci and lactobacilli salivary levels in 6–8‐year‐old Sardinians
Authors: Campus G. , Lumbau A. , Bachisio S.L.
Published: March 2003

Objectives. The aim of this investigation was to compare clinical data regarding oral status (DMFT/DMFS indices) and streptococci or lactobacilli counts in stimulated whole saliva in two groups of children, aged 6 and 8 years.

Methods. Seventy‐nine boys and 93 girls aged 6 (84 subjects) and 8 (88 subjects) years old were selected. DMFT/dmft, DMFS/dmfs and OHI‐S indices were recorded. Mutans streptococci (Sm) and lactobacilli (Lb) salivary levels were assessed using commercially available strip tests and were rated from 0 to 3 and from 0 to 4 in the group as a whole.

Results. Mean dmfs was 9·06 ± 10·80, made up of ds = 7·28 ± 9·54, fs = 1·19 ± 3·64 and ms = 0·59 ± 3·47. Mean DMFS was 0·73 ± 1·91, made of DS = 0·54 ± 1·29, FS = 0·08 ± 0·56 and MS = 0·11 ± 0·56. Statistically significant differences were found for both Sm and Lb scores between those with and without caries in the primary teeth (P < 0·05). The different Lb scores were also significant in relation to caries in permanent teeth in older children.

Conclusion. A high proportion of children had some caries experience, and were in need of treatment.
Dens invaginatus: a retrospective study of prophylactic invagination treatment
Authors: Ridell K. , Mejàre I. , Matsson L.
Published: March 2003

Aim. To evaluate the prognosis for pulp survival in teeth with dens invaginatus (DI) subjected to prophylactic invagination treatment.

Design. A retrospective study by examination of dental records and radiographs.

Sample and methods. The dental records of all patients referred to the Eastman Dental Institute, Stockholm, Sweden, with the diagnosis dens invaginatus between the years 1969–1997 were reviewed. Clinical data was collected from the dental records and the diagnosis DI was confirmed on the radiographs from the time of referral. 95 teeth in 66 patients had been subjected to prophylactic invagination treatment. The retrospective evaluation was based on an examination of the radiographs available from the follow‐ups.

Results. 11·3% of the teeth that were followed for 6 months or longer (n = 80) were judged as failures, All failures were initially classified as Oehlers type 2.

Conclusion. The findings stress the importance of a follow‐up program for teeth subjected to prophylactic invagination treatment in order to avoid serious periradicular complications that could influence the outcome of the endodontic treatment.
Facial features of widespread neuroblastoma: a case report
Authors: Cliff J.F. , Newman L. , Malone M. , Brady G. , Crean St. J.
Published: March 2003

A case report of stage IV neuroblastoma which presented with periorbital swelling and ecchymosis originally misdiagnosed as facial trauma. The child soon developed a sinister pancytopenia, which following extensive investigations was revealed to be due to an underlying neuroblastoma. Periorbital ecchymosis associated with neuroblastoma is termed ‘raccoon eyes’ and is a diagnostic trap for the unwary.
Detection of in vitro demineralization of primary teeth using quantitative light‐induced fluorescence (QLF)
Authors: Pretty I. A. , Edgar W. M. , Higham S. M.
Published: March 2003

Summary. Introduction. With the advent of remineralizing therapies and the new, conservative approach to restoration placement, interest in detecting and monitoring subclinical, precavitated lesions has increased. The increased understanding of clinicians about the processes of primary and secondary prevention and the detection of lesions to which these therapies may be applied, is one of the current goals in caries management. Quantitative light‐induced fluorescence (QLF) is a new method for the detection of very early caries.

Objectives. To determine the ability of QLF to detect and longitudinally monitor in vitro enamel demineralization. To present the device to the paediatric community and present future in vivo uses of the device.

Design. An in vitro study with combined in vivo pilot.

Sample and methods. Twelve previously extracted, caries free, primary molars were selected and prepared. Two teeth were randomly selected as controls. Teeth were prepared by gentle pumicing and coating in an acid‐resistant nail‐varnish, except for an exposed window on the buccal surface. QLF baseline images were taken and the teeth then exposed to a demineralizing solution. Teeth were removed at regular intervals (24, 48, 72, 96, 120, and 144 h), air‐dried and QLF images taken. QLF images were analysed by a single, blinded examiner (to control, to length of exposure). Mineral loss, as measured by ΔQ, was recorded.

Results. Demineralization was noted in all experimental teeth by 48 h, and within 24 h in six teeth. The QLF successfully monitored the increase in mineral loss over time (P < 0·05). The detected lesions were not visible clinically until 144 h and then in only the most severe lesions. No demineralization was detected by QLF in control teeth. The device was user‐ and patient‐friendly in vivo, detecting subclinical lesions.

Conclusion. Detection of very early mineral loss and subsequent monitoring of this loss is possible in primary teeth using QLF. The device is well suited to use in paediatric dentistry and offers applications for both clinicians and researchers. The determination of the status of carious lesions (active/inactive) will be possible with readings taken at recall appointments.
Evidence for reversal of the caries decline among Norwegian children
Authors: Haugejorden O. , Birkeland J. M.
Published: March 2003

Summary. Objective. The purpose of the present study was to report on caries status and to explore possible reasons for changes in caries experience among 5‐ and 12‐year‐old Norwegian children.

Design. National cross‐sectional and time trend study.

Methods. Aggregated data from the Public Dental Services and from official statistics were used. Information was available on the total number of children, the proportion receiving treatment, sale of fluoride tablets, socio‐economic background, caries prevalence and dmft/DMFT scores.

Results. The prevalence of caries among 5‐year‐olds reached a low of 30·4% in 1997 and increased to 38·9% in 2000. The mean dmft scores increased from 1·1 to 1·5. Conversely, the prevalence of caries among 12‐year‐olds decreased from 55·4% in 1997 to 52·2% in 2000 and the mean DMFT score from 1·7 to 1·5. Bivariate analyses at county level revealed significant associations, which for the most part disappeared in multivariate analyses. The sale of fluoride tablets had a significant effect on caries prevalence among 5‐year‐olds in 1998, in 1999 and in 2000. Infant mortality was associated with the dmft score in 1999. The only consistently significant predictor of caries experience at 12 years of age was caries prevalence at age 5.

Conclusions. There has been a highly significant increase in caries experience among 5‐year‐olds (P < 0·001) and a levelling off among 12‐year‐olds over the past 3 years. Considering the association between caries prevalence at age 5 and caries experience at 12 years of age, there is a need for reassessment of the caries preventive programmes for children in Norway.
A case of bilateral supplemental maxillary central incisors
Authors: Camilleri S.
Published: March 2003

Summary. A case of bilateral supplemental maxillary central incisors is presented. Treatment comprised of extraction of one supplemental and two lateral incisors, preservation of one supplemental incisor, finishing with a ‘Cyclops’ arrangement of the teeth. The handling of supernumerary teeth in general is discussed.
Interpretation of pressure‐sore prevalence
Authors: Allcock Nick , Wharrad Heather , Nicolson A
Published: March 2003

Pressure sores result in patient morbidity and mortality as well as commanding considerable resources within the British National Health Service To assess the impact of preventive measures, accurate and reliable rates of prevalence and incidence are required This information is likely to be used as a measure of quality of care as well being included in future purchaser/provider contracting A number of prevalence studies have been carried out in the United Kingdom using a variety of populations and different methods The methods employed in these studies need to be considered before any meaningful comparisons can be drawn In particular, there are variations in the reported rates possibly related to the under‐reporting of pressure sore prevalence This paper describes a recent point prevalence study which suggested that this may be the case The need for caution when comparing crude ratesis highlighted and the importance of standardizing the methods used for determining prevalence rates is discussed
Likert or Rasch? Nothing is more applicable than good theory
Authors: van Alphen Arnold , Halfens Ruud , Hasman Arie , Imbos Tjaart
Published: March 2003

In nursing research many concepts are measured by questionnaires Respondents are asked to respond to a set of related statements or questions In unidimensional scaling these statements or questions are indicants of the same concept Scaling means to assign numbers to respondents, according to their position on the continuum underlying the concept It is very common to use the summative Likert scaling procedure The sumscore of the responses to the items is the estimator of the position of the patient on the continuum The rationale behind this procedure is classical test theory The main assumption in this theory is that all items are parallel instruments The Rasch model offers an alternative scaling procedure With Rasch both respondents and items are scaled on the same continuum Whereas in Likert scaling all items have the same weight in the summating procedure, in the Rasch model items are differentiated from each other by‘difficulty’The model holds that the probability of a positive response to an item is dependent on the difference between the difficulty of the item and the value of the person on the latent trait The rationale behind this procedure is item response theory In this paper both scaling procedures and their rationales are discussed
Recovery from liver transplantation: a literature review
Authors: Wainwright Steven P
Published: March 2003

Liver transplantation is now the treatment of choice for patients with end stage chronic liver disease However, there appears to be no review of the literature on patient recovery from liver transplantation This comprehensive review presents a picture of the state of the art in liver transplantation, and considers literature on psychiatric, functional status, and quality of life aspects of patient recovery Numerous suggestions for further research are made
Patient autonomy and the politics of professional relationships
Authors: May Carl
Published: March 2003

Debate in the health care professions about the politics of interpersonal relationships between professionals and their patients or clients is increasingly organized around proxy measures of the quality of professional services such as patient satisfaction, or the extent to which the provision of care avoids routines and is genuinely individualized This paper explores some of the problems which arise from this in relation to patients' autonomy and nurses' authority
Health and memory in people over 50: a survey of a single‐GP practice in England
Authors: Neadley Alwyn W , Kendrick Don C , Brown Ron
Published: March 2003

One hundred and forty people over the age of 50 randomly sampled from a single‐handed British general practice were screened for dementia using the Kendrick Cognitive Tests for the Elderly The tests results were compared with actuarial data concerning health and health services provision The results indicate that there are clear interrelations between low but non‐dementing scores in memory and speed performance with the use of services, mobility levels and chronic disorders
Managerial strategy and nursing commitment in Australian hospitals
Authors: Brewer Ann M , Lok Peter
Published: March 2003

This study examined the relationship of managerial strategy and nursing commitment in Australian hospitals The general principles of managerial strategy and employee response were illustrated and the meaning of commitment and resistance were defined Data were collected by questionnaire survey and interviews The result demonstrated that the middle manager/nurse unit manager played an important role in generating nursing commitment in the workplace Trust and identification were the most relevant components of nursing commitment However, the study also found that there was still a high degree of distrust between senior management and nurses Change strategies which nurse managers could apply to promote greater organizational commitment in nursing are discussed
Neuroleptic malignant syndrome: do we know enough?
Authors: de la Cour Jane
Published: March 2003

This study aimed to examine health care professionals' knowledge of neuroleptic malignant syndrome (NMS) A meta‐analysis of 16 pieces of international literature on the subject, published in the decade 1980–1990, identified five areas of knowledge which their authors felt were the most important aspects of the syndrome These included being able to define the condition, knowing what drugs were associated with the onset of NMS, being aware of the common manifestations of the disorder, having knowledge of other conditions which have similar symptoms to NMS, and how the syndrome is treated A multiple‐choice questionnaire was administered to a non‐randomized convenience sample of 40 pharmacists, doctors and nurses in the United Kingdom, and to 30 nurses in six other countries (India, Germany, Holland, Japan, USA and France) Two open‐ended questions were also asked of the participants to ascertain their attitude to having knowledge of NMS Analysis of the responses showed that the majority of health care professionals tested in this way did not know enough about NMS to aid early detection of the syndrome and to prevent loss of life
Control and restraint in contemporary psychiatric nursing: some ethical considerations
Authors: Hopton John
Published: March 2003

This paper begins with an exploration of current attitudes towards the use of physical restraint m psychiatric nursing, and the contributions which the 1985 Ritchie Report and the 1991 Report of the Committee Of Inquiry Into Ashworth Hospital have made to the debate on the use of control and restraint within psychiatric institutions The man focus of the paper, though, is an evaluation of the ethical justifications for and the ethical and political objections to the use of physical restraint techniques as a response to aggressive and self‐injurious behaviour in contemporary mental health nursing practice The author concludes that the number of situations where control and restraint techniques are used might be reduced by the development of new therapeutic approaches Such approaches should allow for more negotiation regarding care between clients and nurses, and acknowledge the potential benefits of clients resisting supposedly therapeutic interventions which they find unhelpful
A review of pressure damage prevention strategies
Authors: Land Lucy
Published: March 2003

The prevention of pressure damage is a fundamental aspect of nursing care Despite this and the amount of literature available, the prevalence and incidence of pressure sores do not appear to be diminishing This review focuses on elements of care that are within the power of nurses to attain and suggests strategies for promoting quality care by simple, economic and effective means
Health‐as‐process: a health visiting perspective
Authors: Cowley Sarah
Published: March 2003

Health visitors are community nurses who define their role specifically in terms of health promotion, although they have often found difficulty in explaining how their seemingly diffuse and unfocused practice achieves this The grounded theory study reported here set out to uncover some of the hidden processes and features embedded within health visiting, so the practice might be more clearly articulated This paper reports one aspect of that study, which suggests that health visitors treat health as a lifelong process, involving the accumulation and use of ‘resources for health’ The relevance of approaches which appeared both caring and educational will be set in the context of therapeutic nursing and adult education theories Historically, health visitors have links with both nursing and health education, the analysis presented here helps to clarify the relationships between these different areas of work The paper will explain how treating health as a process allows multiple competing views and ideas about health and health promotion to be integrated into a manageable form, thus allowing positive health to be promoted within a broad, acceptable socio‐cultural context However, the analysis also highlighted various points at which treating health as a process contradicts the firmly measurable requirements of the market‐orientated health service Nevertheless, where health visitors are sufficiently skilled, and are permitted by their employing authorities to use this approach, it may serve to protect clients from intrusive and accusing interventions, made in the name of health promotion
Health care rationing: nursing perspectives
Authors: Wells John S G
Published: March 2003

Ideas currently postulated around the way health care should be delivered and costs controlled, often referred to as health care rationing, are increasingly coming to dominate the agenda of health care in the 1990s British nursing has yet to take a noticeably visible role in this debate, despite the fact that it poses a serious dilemma for a profession whose cultural ethos has been shaped by the concepts of universal access and comprehensiveness of care and is wedded to the idea of holism In the USA debate amongst nurses is further advanced and whilst this discourse may be of limited value to British nursing, owing to a differing historical and cultural attitude to health care, recent changes to the organizational values in the NHS are leading to similar issues arising already faced by American nurses This paper considers the broad parameters of the debate on health care rationing and examines how these parameters have been reflected within relevant North American and British nursing literature, pointing both to similar and differentiating factors between the two countries
The professional imagination: narrative and the symbolic boundaries between medicine and nursing
Authors: May Carl , Fleming Christine
Published: March 2003

The socilogy of nursing, despite despite decisive interventions by recent commentators, continues to take as its main focus the subordination of nursing to biomedicine. This view reflects analytic stability, as well as institutional inertia. Far less attention has been paid by sociologists to the ways in which nursing is constructing itsdifferencefrom medicine, and the exercise of the professional imagination that this involves. This paper suggests a strategy by which this might be remedied, which would focus on professional narratives.
Men in nursing: issues of gender segregation and hidden advantage
Authors: Evans Joan
Published: March 2003

The small but growing number of men in the nursing profession does not herald a progressive integration of masculine and feminine sex roles. The evidence presented in this paper suggests that even in female‐dominated occupations such as nursing, patriarchal gender relations which reflect a high valuation of all that is male and masculine, play a significant role in situating a disproportionate number of men in administrative and elite specialty positions. At the heart of this gender dynamic is the need to separate the masculine from the lesser valued feminine. Male nurses do this by employing strategies that allow them to distance themselves from female colleagues and the quintessential feminine image of nursing itself, as a prerequisite to elevating their own prestige and power. They are aided in this task by patriarchal cultural institutions that create and perpetuate male advantage, as well as by women nurses themselves who, consciously or unconsciously, nurture the careers of men colleagues.
The use of a customized training needs analysis tool for nurse practitioner development
Authors: Hicks Carolyn , Hennessy Deborah
Published: March 2003

The role and professional boundaries of the nurse practitioner (NP) in the UK have not yet been unequivocally defined. This confusion has served to limit the expansion of the NP in both the acute and primary care sectors, despite a mounting body of evidence that attests to their value. This lack of coherence has necessarily impacted upon the educational provision currently available for NP development, with a range of courses of variable nature and standards being provided. The lack of nationally agreed educational criteria and the importance of taking account of local needs, together suggest that a formal training needs analysis might be valuable in systematizing and unifying the present position. Such a survey would have the function of informing both the definition and regional training requirements of NPs, provided the data were obtained through the use of a reliable assessment instrument. To this end a total population survey of all nurses employed in general practice within a large regional health authority was undertaken, using a psychometrically valid and reliable training needs analysis questionnaire. The information obtained provided a preliminary definition of the NP role and a clear index of the content and level of prospective educational provision. In addition, the survey offered an estimate of the numbers of potential participants on NP courses, by FHSA and preferred educational institution. In this way, the use of a scientifically constructed and specifically customized training needs analysis tool may have the potential to inform precise educational commissioning, thereby rationalizing resources and enhancing the quality of both training and ultimate care provision.