bluuebunny/crossref_metadata_2025 huggingface dataset:
Vasopressin and Oxytocin Decrease Excitatory Amino Acid Release in Adult Rat Supraoptic Nucleus
Authors: Currás‐Collazo M. C. , Gillard E. R. , Jin J. , Pandika J.
Published: March 2003

Oxytocin and vasopressin reduce the amplitude of excitatory postsynaptic responses in magnocellular neuroendocrine cells of the supraoptic nucleus (SON). To test whether synaptic glutamate release is modulated by these neuropeptides, we examined the combined effect of vasopressin and oxytocin on depolarization‐induced glutamate and aspartate release from acutely dissected rat SON or fronto‐parietal cortex punches. Glutamate release was stimulated with 60 mm K+ for 5–10 min and measured using ion exchange chromatography or high‐performance liquid chromatography. During depolarization with high K+, extracellular glutamate levels increased, on average, to 204% of control values. In the presence of vasopressin/oxytocin, K+‐stimulated glutamate and aspartate release were significantly reduced by 34% and 62%, respectively, in the SON. Treatment with the aminopeptidase inhibitor amastatin did not mimic the effects of exogenous vasopressin/oxytocin on glutamate or aspartate release, suggesting that, under the conditions tested here, amastatin treatment may produce more complex effects. The effects of exogenous neuropeptides are likely mediated by oxytocin and/or vasopressin receptors, as the oxytocin‐ and V1a‐receptor antagonist, Manning Compound (10–100 µm), partially reversed the effects of vasopressin/oxytocin on SON glutamate release. In contrast, in cortical punches, glutamate release was enhanced by high K+, but vasopressin/oxytocin did not significantly reduce glutamate/aspartate release, consistent with the relatively sparse distribution of vasopressin/oxytocin receptors in fronto‐parietal cortex. These findings suggest that locally released oxytocin and vasopressin may autoregulate SON magnocellular neuroendocrine cell activity in part by modulating the release of excitatory amino acids from afferent terminals targeting these cells and/or from other cellular sources.
Involvement of the Entorhinal Cortex in the Stress Response to Immobilization, But Not to Insulin‐Induced Hypoglycaemia
Authors: Umegaki H. , Zhu W. , Nakamura A. , Suzuki Y. , Takada M. , Endo H. , Iguchi A.
Published: March 2003

Although the involvement of the limbic system in the neuroendocrine responses to some stressors has been documented, the specific role of the entorhinal cortex has not been elucidated. In this study, we investigated the involvement of the entorhinal cortex in stress responses. Fos immunoreactivity, a widely used marker for neuronal activation, was detected in the entorhinal cortex of rats subjected to immobilization stress, whereas no marked staining was observed in the entorhinal cortex of the control and insulin‐induced hypoglycaemia groups. Lesion of the entorhinal cortex produced by ibotenic acid significantly attenuated the adrenocorticotropic hormone (ACTH) release evoked by immobilization; however, no significant change in ACTH release was observed in insulin‐induced hypoglycaemia. No significant difference between entorhinal‐lesioned rats and control rats was observed in blood glucose concentrations when subjected to either immobilization or to insulin‐induced hypoglycaemia. Together, these results indicate that the entorhinal cortex is closely involved in the stress response to immobilization but not to insulin‐induced hypoglycaemia.
The effect of three different recording materials on the reproducibility of condylar guidance registrations in three semi‐adjustable articulators
Authors: Gross  , Nemcovsky  , Ibian  , Gazit
Published: March 2003

Sagittal condylar guide settings of three semi‐adjustable articulators: WhipMix®, Hanau 158® and Denar Mark II® were compared using registrations of base plate wax, copper wax and self‐curing acrylic resin in two subjects. Four‐way ANOVA showed differences between instruments (P < 0·0001), materials (P < 0·0001), registrations (P < 0·0001), and no difference between operators. Mean differences between materials were 3°and 6° within the range of registration and articulator variability. Denar Mark II® gave the highest values, Hanau 158® the lowest with pantronic values generally lower than articulator settings. Neither acrylic nor copper wax were superior to base plate wax. This and previous studies show low reproducibility and variability between instruments, occlusal records and registration material.
A method for quantifying positional change of the condyle on lateral tomograms by means of digital subtraction
Authors: Sato  , Ohki  , Kitamori
Published: March 2003

A method is described for quantifying the positional change of the condyle on lateral tomograms of the temporomandibular joint (TMJ) by use of digital subtraction. This method permits rotational and translational changes of condylar reference points for easy measurement. Accuracy was evaluated in vitro using both TMJs of two dry human skulls and in vivo with seven volunteers. The average absolute error of the angle of rotation in vitro was 0·67°. For the anterior–posterior element of translation the average absolute error was 0·07 mm, and for the superior–inferior element of translation it was 0·06 mm. From these results, we could conclude that the method provides clinically acceptable measurement accuracy. To verify the usefulness of the method, a clinical application is presented.
Bond strength of photocured composite resin facings: clinical versus laboratory procedures
Authors: Zalkind M. , Slavik J. , Raviv E. , Stern N.
Published: March 2003

The tensile strengths of laboratory versus clinical photocured composite resins have been investigated. Metal surfaces were bonded to photocured composite resin by either retentive beads, Sebond® or Silicoating®. The bond strengths were measured by an Instron machine and the fracture sites observed. Following repair with the adhesives Dentacolor Opaquer®, Fusion® and Cover up 2®, the Instron measurements were repeated. The metal/facing bond strength was the highest in samples fabricated by the Silicoating® technique, the bond strength exceeding the cohesive forces in the composite resin facing. The tensile strengths of metal/facing bonded by Sebond® and retentive beads were similar. Fractures that include the facing and partially reveal the metal are the least resistant to tension after repair. Renewal of the Opaque layer and completion of the facing is superior to any of the repair methods used in this paper. The original fracture point is the weakest after repair. All the repair kits tested were inferior to the original restoration materials.
Evaluation of skin‐ versus teeth‐attached markers in wireless optoelectronic recordings of chewing movements in man
Authors: Häggman‐henrikson B. , Eriksson P. ‐O. , Nordh E. , Zafar H.
Published: March 2003

This study evaluated the applicability of skin‐ and teeth‐attached reflex markers fixed to the mandible and the head for optoelectronic recording of chewing movements. Markers were attached to the upper and lower incisors and to the skin on the forehead, the bridge of the nose, the tip of the nose and the chin in seven subjects. Chewing movements were recorded in three dimensions using a high‐resolution system for wireless optoelectronic recording. Skin markers were systematically displaced due to skin stretch. The largest displacement was observed for the chin marker, whereas minor displacement was found for markers located on the forehead and the bridge of the nose. In repeated recordings, the smallest intra‐individual variation in displacement was found for the marker on the bridge of the nose. In spite of relatively large displacement for the chin marker, the temporal estimates of the mandibular movement were not affected. Teeth markers were found to significantly increase the vertical mouth opening, although the duration of the chewing cycle was unaffected. This indicates an increase in chewing velocity. We suggest that markers located on the bridge of the nose are acceptable for recordings of chewing movements. Skin markers on the chin can be reliably used for temporal analysis. They are also acceptable for spatial analysis if an intra‐individual variability of 2 mm is allowed. Teeth‐attached markers may significantly influence the natural chewing behavior. Thus, both types of marker systems have advantages as well as disadvantages with regard to the accuracy of the chewing movement analysis. Selection of a marker system should be based on the aims of the study.
Determining the accuracy of stock and custom tray impression/casts
Authors: Millstein  , Maya  , Segura
Published: March 2003

SUMMARY A study was conducted to evaluate the accuracy of casts made from stock tray and custom tray impressions using polysiloxane impression material. The results indicate that all casts distort but that impressions made from custom trays were more accurate and consistent in reproduction than were stock tray impressions.
In vitro bacterial adherence onto pellicle‐coated aesthetic restorative materials
Authors: Shahal  , Steinberg  , Hirschfeld  , Bronshteyn  , Kopolovic
Published: March 2003

Adhesion of oral bacteria to teeth and restorative materials plays an important role in the pathogenesis of oral diseases. This study investigated the initial adhesion of Streptococcus mutans to enamel and restorative materials. Three types of composites and two types of glass ionomer cements were used. The specimens were coated with freshly collected human parotid saliva. The salivary coated samples were incubated with cell‐free glucosyltransferase, and further incubated with sucrose solution. Finally, the specimens were incubated with 3H‐thymidine labelled bacteria. Adhesion of the bacteria to the specimens was measured by scintillation counter. SEM observations were performed on each sample. The results showed no significant differences among the materials and the control. These findings can be explained by the pellicle which coated all the specimens. This biofilm, to which the bacteria were adhered and proved to probably masked existing surface properties of the specimens resulting in similar bacterial adhesion.
Experimental study of the damping behaviour of IMZ implants
Authors: Haas R. , Bernhart T. , Dörtbudak O. , Mailath G.
Published: March 2003

Measurements of the damping behaviour of dental implants with the Periotest® device are considered to be an objective means to assess the mobility of implants. The effects of the position of an implant in the maxilla or mandible, the period of time passing between the measurements and implant placement and the height at which the Periotest® measurements are performed on the damping behaviour of implants have been discussed controversially. This experimental study examined the influence of the use of different measuring devices, the measuring height and the embedding depth on the damping behaviour of IMZ implants. The implants were embedded in resin at different depths and damping measurements were carried out at different measuring heights. It was found that the values rose with an increasing measuring height and a decreasing embedding depth. Analysis of variance was used to assess the influence of the embedding depth and revealed that the embedding depth had a significant impact on the measuring values at each measuring height, above 6 mm. Moreover, it was found that the higher the measuring height, the higher the measured values and the greater the differences between the values obtained at the individual depths. The different measuring devices had no influence on the measuring results ( P = 0·79). The results of this study suggest that a longitudinal follow‐up of the peri‐implant residual bone height around individual implants is possible. Single measuring values by themselves do not allow any conclusions about the prognosis of an implant. The assessment of the peri‐implant bone height through Periotest® measurements is conceivable only when a table of damping values taking into account the physical length of the implant, the embedding depth and the measuring height for the examined implant system is available. In cylindrical implants, the head of the available prefabricated measuring post can be recommended as a constant measuring point for further studies, especially when the results are to be compared with those obtained by other study groups.
A survey of U.K. centres on implant failures
Authors: Tinsley D. , Watson C. J. , Ogden A. R.
Published: March 2003

This study investigated the experience of endossoseus implants in the U.K. – how success rates compare with other countries; the common causes of failure; early detection, definition and treatment of the failing implant. Information was gathered by means of a questionnaire sent to 120 centres in the U.K. Thirty‐nine centres responded to the survey, reporting on a total of 5328 implants which had been placed over an average time period of 6·5 years. A mean failure rate of 4·3% was reported in the mandible with 16% in the maxilla. The survey showed that 11 different implant systems were in use and that implants were used to support an overdenture in 56% of cases, and bridgework in 26%. The definition of the failing implant and the causes of failure were unclear, with a wide range of opinions given. A combination of methods were used to treat the failing implant including surgical techniques and chemotherapeutic agents, but the long‐term success of these treatments was uncertain. Failure rates especially in the maxilla at some of the centres appear higher than have been previously suggested in the U.K. or abroad. Universal agreement on the criteria for ‘success’ and ‘failure’ of fixtures is needed along with agreed treatment protocols for the failing implant.
The influence of crossbite on the coordinated electromyographic activity of human masticatory muscles during mastication
Authors: Ferrario V. F. , Sforza C. , Serrao G.
Published: March 2003

The analysis of the masticatory muscle activity in subjects with altered occlusal relationships could provide useful data of the functional impact of morphological discrepancies. Thirty subjects aged 16–18 years, with a sound, full permanent dentition, bilateral angle class I, and an overjet and overbite between 2 and 5 mm, were examined. The control group (10 male, 10 female) had no crossbite, while the crossbite group (four male, six female) had a posterior unilateral crossbite (five on the left side, five on the right side). The electromyographic activity of the left and right masseter and temporalis anterior muscles was recorded during 15 s of unilateral (left and right) chewing of gum, and expressed as a percentage of the maximum voluntary clench on cotton rolls. For each subject, the masticatory frequency, the confidence ellipse of the simultaneous differential left–right masseter and temporal activity (Lissajous figure), and an index of muscular symmetry, were computed to assess muscular coordination. In the crossbite subjects, the four analysed muscles appeared to contract with altered and asymmetric patterns. A large variability was found, and the confidence ellipses calculated for the chewing tests performed on the crossed sides were not significant, while the confidence ellipses of the uncrossed side chewing were different from the ellipses computed in the normal occlusion group. The altered occlusal relationship influenced the coordination of the masticatory muscles during chewing on both sides. The functional alteration was more apparent when the side with the altered morphology was directly involved, i.e. when chewing was performed on the crossbite side.
The effect of curing light intensity and test temperature on the dynamic mechanical properties of two polymer composites
Authors: Harris J. S. , Jacobsen P. H. , O'Doherty D. M.
Published: March 2003

The dynamic modulus of elasticity of two composite materials cured by three light intensities was investigated using a dynamic thermal and mechanical analyser at 37 °C and 60 °C. The lowest light intensity, 180 mW/cm2, was found to be unsatisfactory in that specimens were weak and mostly untestable. The higher intensities, 350 and 700 mW/cm2, cured the materials to slightly different extents with the elevated temperatures of testing leading to post‐cure maturation of the materials. An interesting finding was that one material had a significantly higher modulus when tested at 37 °C in comparison with that found at 60 °C. In one material the higher light intensity resulted in significantly higher modulus values and these values were increased by post‐curing. In the other material the higher light intensity did not result in higher modulus figures at either test temperature, and lower test temperature resulted in better post‐cure maturation. These findings are most likely to be caused by differences in base monomer and activator/initiator concentrations. The results indicate that optimum polymerization may not be achieved in all materials by the same method, in particular, high curing light intensities may not achieve the most desirable results.
Perceptions of dentine hypersensitivity in a general practice population
Authors: Gillam D. G. , Seo H. S. , Bulman J. S. , Newman H. N.
Published: March 2003

Recent studies have attempted to determine the prevalence of dentine hypersensitivity (DH) in both hospital and general practice. Results indicate that DH prevalence is higher in patients referred for specialist treatment than in general practice. The aim of this study was to determine perception and prevalence of DH in general practice. Completed questionnaires from 277 patients (115 males, 162 females, mean age 41·7 years [SD 14·36]) were collected. Self‐reported DH prevalence (52%) was observed between the third and fourth decades, peaking in the third and in good agreement with that previously published (45·2%), and significantly more females complained of DH than males (SND=2·24, 95% CI 0·01734–0·2661). Cold was perceived as the most common cause of DH, in agreement with other studies. Only 12·6% of patients reported periodontal surgery compared to 15·5% previously. Of those who received hygiene therapy (67·9%) only 15·5% reported DH following treatment which mainly did not last ≥5 days. Most patients with DH did not perceive the condition as severe and did not seek treatment (75·1%). Only 23·3% used a desensitizing dentifrice. The results indicated that self‐reporting of DH is lower than reported in a dental hospital population and was not perceived as a major dental problem by most patients in a general dental practice population.
Kinematics of the human mandible for different head postures
Authors: Visscher C. M. , Huddleston Slater J. J. R. , Lobbezoo F. , Naeije M.
Published: March 2003

The influence of head posture on movement paths of the incisal point (IP) and of the mandibular condyles during free open–close movements was studied. Ten persons, without craniomandibular or cervical spine disorders, participated in the study. Open close mandibular movements were recorded with the head in five postures, viz., natural head posture, forward head posture, military posture, and lateroflexion to the right and to the left side, using the Oral Kinesiologic Analysis System (OKAS‐3D). This study showed that in a military head posture, the opening movement path of the incisal point is shifted anteriorly relative to the path in a natural head posture. In a forward head posture, the movement path is shifted posteriorly whereas during lateroflexion, it deviates to the side the head has moved to. Moreover, the intra‐articular distance in the temporomandibular joint during closing is smaller with the head in military posture and greater in forward head posture, as compared to the natural head posture. During lateroflexion, the intra‐articular distance on the ipsilateral side is smaller. The influence of head posture upon the kinematics of the mandible is probably a manifestation of differences in mandibular loading in the different head postures.
Dental rehabilitation using endosseous implants and orthognathic surgery in patients with cleft lip and palate: report of two cases
Authors: Fukuda M. , Takahashi T. , Yamaguchi T. , Kochi S. , Inai T. , Watanabe M. , Echigo S.
Published: March 2003

We describe the use of endosseous implants in the autogenous particulate cancellous bone and marrow grafted alveoli after orthognathic surgery for dental rehabilitation of patients with cleft lip and palate. This procedure has been applied to two patients and produced good results functionally and aesthetically. The results are encouraging and indicate that implant placement after orthognathic surgery is useful for patients both with congenital missing teeth and retrognathic maxillae.
Drooling: review of the literature and proposals for management
Authors: Nunn J. H.
Published: March 2003

The aetiology of drooling is described alongside the alternative treatment strategies for what is a disturbing disorder for many children. The advantages and disadvantages of each treatment modality are discussed. Conditions for optimal management are described.
Comparative study of maxillary complete dentures constructed of metal base and metal structure framework
Authors: Ohkubo C. , Kurtz K.S. , Suzuki Y. , Hanatani S. , Abe M. , Hosoi T.
Published: March 2003

A removable denture designed using a three‐dimensional cast metal framework (hereafter referred to as the ‘structurally designed’ denture) could extend denture longevity because it is unbreakable and easy to adjust. The aim of the present clinical study was to compare two types of maxillary removable dentures: conventional dentures and structurally designed denture. One edentulous and five partially dentate patients were fitted with two maxillary dentures made from the same impression and same occlusal relationship. About 20 days after delivery of the denture, masticatory analysis was conducted chewing phase (open, closed, and occluded); coefficients of variation and average variation were calculated. Denture vibration during tapping was then measured using an accelerometer. The patients were also interviewed about comfort, ease of chewing, speech, stability, aesthetics and preference for regular use. For both masticatory movements and denture vibration, there were no significant differences (P>0·1) between the conventional denture and the structural design denture. In evaluating the dentures according to each criteria, the significant superiority of one denture over the other could not be determined. However, all patients subjectly preferred the structurally designed dentures for regular use. According to these findings, structurally designed dentures do not appear to have any particular physiological problems as compared with the conventional dentures.
Restoration removal with and without the aid of magnification
Authors: Forgie A. H. , Pine C. M. , Pitts N. B.
Published: March 2003

This study aims to quantify any cavity size change following removal of tooth‐coloured restorations in vitro using unaided vision and 2·6× magnification. Occlusal composite restorations were removed under simulated clinical conditions and changes in cavity size were measured, blind to method, using standardized photographs. The outline of the cavity was digitized and its area was used as a surrogate for cavity size. The change in cavity size was determined for unaided vision and 2·6× magnification, with any differences between the techniques investigated. There were significant increases in cavity size using both techniques and although the increase in size was less when magnification was used, the difference was not statistically significant. Cavity size changes significantly during re‐restoration and the use of magnification may be of benefit for some clinicians in reducing the size of the change.
Fracture strength of four different types of anterior 3‐unit bridges after thermo‐mechanical fatigue in the dual‐axis chewing simulator
Authors: Kheradmandan S. , Koutayas S. O. , Bernhard M. , Strub J. R.
Published: March 2003

The purpose of this study was to evaluate the fracture strength of four different types of anterior 3‐unit bridges after thermo‐mechanical fatigue in a dual‐axis chewing simulator. Sixty‐four human maxillary incisors were prepared and 32 bridges fabricated. The four groups of eight bridges each were – (GC): AGC® galvano‐ceramic bridges (CA): Celay® In‐Ceram® Alumina bridges (E2): heat‐pressed lithium disilicate glass‐ceramic bridges and (CM) ceramo‐metal (control). Fracture loads were recorded after a dual‐axis chewing simulator and in a universal testing machine. The survival rate after 5 years for the CM and the GC groups was 100%, for the E2 group 75% and for the CA group 37·5% (Kaplan–Mayer analysis). The mean fracture strengths (N) were 681·52 ± 151·90 (CM); 397·71 ± 59·02 (GC); 292·92 ± 46·45 (E2) and 239·95 ± 33·39 (CA), respectively. The log–rank test showed a significant difference between the CA and the GC or the CA and the CM groups. No significant differences between the E2 and the CA or the E2 and the GC groups were found. The study indicates that heat‐pressed lithium disilicate glass‐ceramic and AGC® galvano‐ceramic bridges are alternatives to ceramo‐metal 3‐unit anterior bridges.
Composite conversion and temperature rise using a conventional, plasma arc, and an experimental blue LED curing unit
Authors: Tarle Z. , Meniga A. , Knežević A. , Šutalo J. , Ristić M. , Pichler G.
Published: March 2003

The objective of this study was to evaluate the degree of conversion and temperature rise in three different composite materials when illuminated by an experimental light source [blue superbright light emitting diodes (LEDs)] and compared with plasma light and traditional photopolymerization unit. The degree of conversion and temperature rise were measured using Fourier transform infrared (FTIR) spectroscopy and digital multimeter, respectively. The results revealed significantly higher degree of conversion values in case of conventional curing than with other two light sources whereas temperature rise was significantly lower when blue LEDs and plasma light were used. There were great differences in light intensities between blue LEDs of only 9 mW cm–2 compared with plasma light of 1370 mW cm–2 and Elipar II of 560 mW cm–2. Better match of LED spectral distribution peak to camphorquinone absorption distribution peak probably explains much lower intensities used for similar photopolymerization effect like in the case of rapid plasma lamp curing.
Associated factors of tooth wear in southern Thailand
Authors: Chuajedong P. , Kedjarune‐Leggat U. , Kertpon D. , Chongsuvivatwong V. , Benjakul P.
Published: March 2003

summary  The purpose of this study was to evaluate the possible risk factors connected with tooth wear. Using the Tooth Wear Index (TWI) and the charting of pre‐disposing factors tooth surface loss was recorded in 506 patients, of the Dental Hospital, Prince of Songkla University. We found that age, sex, number of tooth loss, frequency of alcohol, sour fruit and carbonate intake were significant risk factors. Regarding the tooth position, the first molar showed the greatest degree of wear, while the canine and premolar showed the least, respectively. The occlusal surface showed the greatest wear and the cervical, lingual and buccal surfaces showed the least, respectively.
Do early signs of orofacial dysfunctions and occlusal variables predict development of TMD in adolescence?
Authors: Pahkala R. H. , Laine‐Alava M. T.
Published: March 2003

Summary The aim of the present report was to focus on if early signs of different orofacial dysfunctions, e.g. misarticulations of speech, problems in oral motor skills and TMD, malocclusions or occlusal interferences could predict the development of temporomandibular disorders (TMD) in adolescence. Altogether there were 94 children referred for speech therapy and 93 controls who participated in all three stages of this longitudinal study. In the whole sample the mean age during the first examination was 7·6 years, during the second examination 10·6 years, and during the third one 15·4 years. Multiple logistic regression models showed that subjects with a tendency to open bite tended to have palpatory tenderness of the muscles. Overjet was positively related to hypermobile but negatively to hypomobile jaw movements. Deviation on opening was associated with problems in oral motor skills, and some signs of TMD seemed to be related to each other. In addition, girls had a higher risk of having several signs of TMD than boys did. In conclusion, tendency to open bite, both mesial and distal molar occlusion and increased and decreased overjet were occlusal anomalies associated with TMD. Altogether, among 15‐year‐olds there seems to be both local and central factors in the aetiology of TMD.
Bite force determination in children with primary dentition
Authors: Rentes A. M. , Gavião M. B. D. , Amaral J. R.
Published: March 2003

summary  The aim of this study was to determine the bite force with primary dentition in 30 children with normal occlusion (group I), cross bite (group II) and open bite (group III). The magnitude of the bite force was determined through a pressurized transmitter tube (pressure sensor MPX 5700 Motorola), which was connected to a converse analog/digital electronic circuit. The children bit the tube with maximum force three times successively for 5 s, with a 10 s interval among each bite, and the sign was sent directly to the computer. The highest value of the three, for each patient, was considered. Analysis of variance evaluated difference among the three groups. The means of maximum bite force were 213 17, 249 63 and 241 19 N for the groups, respectively, and there were no significant statistical differences among them (P > 0·05). The analysis of correlation showed that the weight, height and bite force presented weak positive correlation (r=0·24 and 0·23). It was concluded that in the studied groups the type of occlusion did not affect the maximum values of the bite force and body variables had a small influence in this magnitude.
Effect of nitrous oxide on dental patients with cerebral palsy – using an electromyogram (EMG) from orofacial muscles as an index
Authors: Yoshida M. , Nakajima I. , Uchida A. , Yamaguchi T. , Akasaka M.
Published: March 2003

summary  The efficacy of nitrous oxide (N2O) inhalation on the elevated orofacial muscle tonus during dental treatment in patients with cerebral palsy (CP) was studied by measuring the mean frequency of electromyographic (EMG) discharge, blood pressure (BP) and heart rate (HR) taking mentally retarded patients (MR) as a control. At a pre‐treatment stage, the mean frequency of the EMG was higher in the CP patients than in the MR patients. By forcing the jaw open, the mean frequency of the EMG, BP and HR was elevated significantly in both types of patients. The enhanced level of the mean frequency of the EMG was higher in the CP patients than in the MR patients. After inhalation of N2O, the mean frequency was reduced significantly in both types of patients, however, the reduction rate was higher in the CP patients than the MR patients; BP and HR were not affected. These results demonstrate the selective efficacy of N2O in reducing the orofacial muscle tonus in CP patients during dental treatment probably because of the N2O inhibiting the function of the central nervous system. The present study therefore suggests the beneficial properties of N2O induced sedation performed during dental treatment on CP patients.
The concept of interpersonal pattern in Peplau's Theory of Nursing
Authors: Beeber  , Bourbonniere
Published: March 2003

Interpersonal pattern, defined as the category in which separate interpersonal acts are linked by similar, defining characteristics, is a critical, data‐rich concept that is used in the therapeutic nurse‐client relationship. If this concept is studied within the framework of aesthetic knowing in nursing, the processes of deliberate involvement that form the crux of the nurse‐client relationship become illuminated. An illustrative case study brings this concept to life by demonstrating the use of interpersonal pattern as the focus of intervention with a frail, elderly woman. In this case study, the nurse practices aesthetic knowing to assess and respond to the woman, and ultimately assist in her forward movement towards optimum function and health. Linkages of this type of intervention to all of nursing practice are made by integrating the use of interpersonal pattern with aesthetic knowing in nursing.
Maintaining health: proactive client‐oriented community day treatment centres for the chronic mentally ill
Authors: YURKOVICH  , SMYER  , DEAN
Published: March 2003

This grounded theory study compared the definition of health by clients of two rural mental health day treatment centres, Big Sky Centre and Montana Centre. Based on an original grounded theory study of seven chronic mentally ill/disabled clients in Big Sky Centre ( Yurkovich et al. 1997
), the core variable, ‘preventing loss of control’ and related properties, were validated with nine residents of Montana Centre. While establishing a ‘fit’ with previous research findings, differences emerged between these two centres. These differences related to the staffs’ philosophical approaches in providing treatment to the chronic mentally ill. Big Sky Centre care providers empowered their clients to learn new behaviours from their peers and assume new roles such as newcomer, member and leader. They also encouraged a prosocial attitude, and created a sense of belonging through valued involvement in their treatment. Montana Centre clients were not empowered to try out new behaviours in the treatment environment, or seek social support networks among their peers at the centre, which would foster a sense of belonging. The result was that clients from Montana Centre relied on the formal healthcare system more often than clients from the Big Sky Centre. The competing forces in healthcare today – family members, mental health providers, and insurance or managed care providers – make it easy to lose sight of or fail to gain the client's perspective about their health status and maintenance, particularly as it concerns day treatment centres. The importance of the day treatment centre as a therapeutic community which requires educational processes, innovative nursing practice, and client‐centred interventions will be discussed.
Chronic mentally ill individuals reentering the community after hospitalization. Phase II: the urban experience
Authors: Johnson B , Montgomery P.
Published: March 2003

The purpose of this qualitative study was to explore the experiences of persons reentering an urban community after hospitalization for mental illness. The sample consisted of five men and three women, aged early 30’s to mid‐50’s, mostly diagnozed with schizophrenia, and who had had several hospitalizations within the previous year. Most returned to places where they had lived before, frequently to boarding homes for former psychiatric patients. Most lived alone. Each participant was interviewed shortly before discharge and one to two times in the community. The tape‐recorded interviews were analyzed according to the Giorgi method. Three themes emerged from the data, related, respectively, to the hospital and its environs remaining a focus of the participants’ lives, the added burden of social and financial conditions, and the presence of goals which nevertheless had barriers to their achievement. Contrasts are drawn with the findings of Phase I ( Montgomery & Johnson 1998), in which there was found a much stronger sense of discharge marking a new beginning. The findings add to our knowledge about what it is like for chronic mentally ill individuals to live outside hospital, but also raise questions about the influence of particular diagnoses, community characteristics and changes in adjustment over time.
An evaluation of the implementation of a liaison service in an A&E department
Authors: Morgan V. , Coleman M.
Published: March 2003

This paper describes the results of an evaluation of a multidisciplinary liaison service based in an A&E department of a district general hospital in South Wales. The aims of the services were to increase the rate of referral for psychosocial assessment of individuals who presented at the department following acts of deliberate self‐harm and to increase the number of such assessments completed within 24 h. The paper describes the context in which such a service was developed and outlines how this preliminary evaluation was completed. Data were collected from hospital records, over two corresponding five‐month time‐periods, in the year before the implementation of the service and the year following implementation of the service. The results show that the implementation of the service led to a statistically significant increase in the rate of referral for assessment by accident and emergency staff. Amongst other positive outcomes, the rate of repeat presentations was reduced for the period of one year following initial presentation. The implications of these results are discussed in relation to other research in the area and the suggestion is made that nursing staff may be more clinically and cost effective in completing psychosocial assessments in A&E departments than medical staff.
Substance misuse, offending and mental illness: a review
Authors: Phillips P.
Published: March 2003

The literature concerning the associations between violence, mental disorder, comorbidity and substance misuse are discussed in this review, which focuses on the findings of several international studies that demonstrate significantly higher rates of violence in substance misuse and dual diagnosis (when compared with ‘single’ diagnosis groups). The need for the development of an effective psychiatric nursing response in terms of assessment, liaison and joint clinical management approaches to those with a dual diagnosis is discussed in the context of United Kingdom Government legislation and policy in both forensic mental health services, and in statutory substance misuse services.
Absurdity and being‐in‐itself. The third phase of phenomenology: Jean‐Paul Sartre and existential psychoanalysis
Authors: Jones A.
Published: March 2003

Existentialism and phenomenology are closely linked philosophies. Existentialism preceded phenomenology and is not considered a single philosophy but several schools of thought, both theist and atheist in thinking, which grew out of a reaction to traditional philosophy. The development of phenomenology is divided into three separate phases ultimately merging with existentialism. Following Second World War, the phenomenological movement gained momentum in France and encompassed many of the ideas of Edmund Husserl and Martin Heidegger. Gabriel Marcel, Maurice Merlieu‐Ponty and, notably, Jean‐Paul Sartre established a ‘third phase’ of phenomenology. This paper explores some of Sartre’s ideas related to being and later applications through Medard Boss and R.D. Laing, and offers a short illustrative case vignette that shows the concepts as they might apply to nursing practice. Consideration is finally given to existential psychoanalysis as an applied research methodology
An overview of the role and functions of a psychiatric consultation liaison nurse: an Australian perspective
Authors: Sharrock J. , Happell B.
Published: March 2003

The role of the psychiatric consultation liaison nurse (PCLN) has increased substantially in popularity over the last few years. Despite the growth of this position, a paucity of literature regarding the role, functions and effectiveness of psychiatric consultation liaison nursing continues to exist. The current study was undertaken as part of the Victorian Nurse Practitioner Project. A significant aspect of this study concerned collection of data on the activities of the PCLN. This approach enabled an extensive and detailed profile of the PCLN to be formulated. The findings indicate that the PCLN provided a service to nursing, medicine and allied health in relation to patients experiencing mental health problems in the general hospital setting. Patients referred to the PCLN presented varied clinical features in terms of medical, surgical and mental health disorders. The PCLN performed a range of interventions. The results of this study make a significant contribution to address the current paucity of literature.
An evaluation of staff and patient views of and strategies employed to manage inpatient aggression and violence on one mental health unit: a pluralistic design
Authors: Duxbury J.
Published: March 2003

Following an initial springboard study, a further more extensive piece of research was conducted to identify and evaluate approaches used to manage patient aggression and violence on three acute mental health wards. Data were gathered using an incident form, a questionnaire and interviews. The views of patients (n = 80), nurses (n = 72) and medical staff (n = 10) were explored. Findings revealed a clear distinction between the way staff and patients view both the problem and the response. Patients’ view present staff approaches as ‘controlling’ and believe that environmental and poor communication factors underpin aggressive behaviour. Staff, conversely, attribute aggressive behaviour to internal patient and external factors, which may explain the reason for approaches used. A strong correlation was found between type of patient aggression and response (r = 0.36, P < 0.000) and a high percentage of incidents reported were of an aggressive, as opposed to violent, nature. For example 70% of incidents involved verbal abuse or threat. Despite this, 47% (n = 103) of approaches incorporated the use of medication, restraint or seclusion. These are commonly referred to as traditional methods. Patients clearly view this controlling style as a part of the problem and an emphasis upon control and symptom reduction may be inappropriate given the type of aggression encountered. Key issues were further analysed using an internal, external and situational model, each of which endeavour to explain reasons for patient aggression from different perspectives. It is this emphasis upon sole perspectives that may both contribute to and result in the use of a limited number of management approaches adopted in practice. The integration of all three models to examine the complex nature of patient aggression and violence from a variety of perspectives may be the way forward. As a result, approaches to deal with this problem could be more meaningful and subsequently effective.
The relationship between 6‐sulphatoxymelatonin and polysomnographic sleep in good sleeping controls and wake maintenance insomniacs, aged 55–80 years
Authors: LUSHINGTON KURT , DAWSON DREW , KENNAWAY DAVID J. , LACK LEON
Published: March 2003

The pineal hormone, melatonin, is reported to possess hypnotic properties. This has led to an investigation of the relationship between the endogenous melatonin rhythm and sleep. However, this relationship has yet to be fully examined in aged insomniacs and controls. From media advertisements, 16 good sleeping controls (11F, 5 M) and 16 sleep maintenance insomniacs (11F, 5 M), aged over 55 years, were recruited to participate in a study involving four nights of polysomnographically (PSG) measured sleep followed by a 26 h constant routine. During the constant routine, 2 h urine samples were collected and analysed for the melatonin metabolite, 6‐sulphatoxymelatonin (aMT.6S). This was used to determine total melatonin excretion. As well, the following circadian melatonin parameters were calculated from fifth order polynomial curve fitting analyses, the goodness of the polynomial curve fit, peak melatonin concentration, the phase of the melatonin rhythm, and melatonin and sleep rhythm synchrony. Apart for one control, all subjects showed significant circadian melatonin rhythms. Although insomniacs showed a greater amount of wakefulness, less sleep in total, and lower sleep efficiency, no significant group differences were observed in any of the melatonin parameters. In addition, while subjects with more reliable melatonin curve fits showed shorter sleep latencies and higher sleep efficiencies, correlational analyses revealed no other significant relationships between any melatonin and PSG sleep parameters. Overall, the present results suggest that neither melatonin amplitude nor phase are related to sleep quality in the aged.
Word recall correlates with sleep cycles in elderly subjects
Authors: Mazzoni G. , Gori S. , Formicola G. , Gneri C. , Massetani R. , Murri L. , Salzarulo P.
Published: March 2003

Morning recall of words presented before sleep was studied in relation to intervening night sleep measures in elderly subjects. Night sleep of 30 elderly subjects aged 61–75 years was recorded. Before sleep, subjects were presented with a list of paired non‐related words and cued recall was asked immediately after the morning awakening. Recall positively correlated with average duration of NREM/REM cycles, and with the proportion of time spent in cycles (TCT) over total sleep time (TST). No significant correlations were found with other sleep or wake measures. These results suggest the importance of sleep structure for sleep‐related memory processes in elderly adults.
The effects of leptin on REM sleep and slow wave deltain rats are reversed by food deprivation
Authors: Sinton Christopher M. , Fitch Thomas E. , Gershenfeld Howard K.
Published: March 2003

Leptin (ob protein) is an adipose tissue derived circulating hormone that acts at specific receptors in the hypothalamus to reduce food intake. The protein is also critically involved in energy balance and metabolic status. Here the effect of leptin on sleep architecture in rats was evaluated because food consumption and metabolic status are known to influence sleep. Sprague‐Dawley rats were chronically implanted with electrodes for EEG and EMG recording and diurnal sleep parameters were quantified over 9‐h periods following leptin administration. Murine recombinant leptin (rMuLep) was administered systemically to rats that either had undergone 18 h of prior food deprivation or had received food ad libitum. In the normally fed rats, leptin significantly decreased the duration of rapid eye movement sleep (REMS) by about 30% and increased the duration of slow wave sleep (SWS) by about 13%, the latter effect reflecting enhanced power in the delta frequency band. These results are consistent with studies that have linked changes in metabolic rate with effects on sleep. Leptin administration has previously been shown to alter neuroendocrine parameters that could have mediated these changes in sleep architecture. Unexpectedly, prior food deprivation negated the effect of leptin on both REMS and SWS, a result that emphasizes the significance of the apparent coupling between sleep parameters and energy status.