bluuebunny/crossref_metadata_2025 huggingface dataset:
An in vitro comparison of canal preparation using two automated rotary nickel–titanium instrumentation techniques
Authors: Jardine S. J. , Gulabivala K.
Published: March 2003

Aim

The aim of this study was to compare the efficacy of root canal preparation using two automated rotary nickel–titanium instrumentation techniques with a double flared balanced forces hand preparation technique, using stainless steel files in extracted human teeth.

Methodology

Sixty root canals in extracted human teeth were matched for curvature, length and diameter and divided evenly between three groups (group 1 = double flare using Flexofiles®, group 2 = rotary nickel–titanium using McXIM® instruments and group 3 = rotary nickel–titanium using Profile® .04 TaperTM Series 29 instruments). The instruments were used according to the manufacturer’s instructions in a torque controlled motor and handpiece (groups 2 and 3) and according to a predetermined procedure in group 1. A standardized radiographic technique using mercury as a contrast medium was used to evaluate the canal shape before and after preparation in the plane of maximum curvature. The pre‐ and postoperative radiographic images were compared against each other and with a predicted ‘ideal preparation’ calculated from a projection of the final instrument dimensions. The outcome measures were changes in canal dimensions as quantified by measuring the changes in the position of the inner and outer wall at 1 mm intervals. Alteration in canal curvature could be inferred by comparison with the ideal preparation.

Results

The degree of canal curvature did not influence the effectiveness of any of the techniques. The results showed no statistically significant differences in the outcome measures between the groups (two‐way anova). There were no significant differences in canal wall position changes at any level except the apical three, where significantly less change occurred in all groups (P = 1%). Instruments fractured in three canals, with acute curves in groups 2 and 3.

Conclusions

Canal curvatures were equally and well maintained following preparation in all the groups, as long as the instrument did not fracture.
Cytotoxicity of resin‐, zinc oxide–eugenol‐, and calcium hydroxide‐based root canal sealers on human periodontal ligament cells and permanent V79 cells
Authors: Huang F.‐M. , Tai K.‐W. , Chou M.‐Y. , Chang Y.‐C.
Published: March 2003

Aim The purpose of this study was to determine the cytotoxicity of three different types of root canal sealer on human periodontal ligament (PDL) cells and a permanent hamster cell line (V79 cells).

Methodology Set specimens from two resin based sealers (AH26 and AHPlus), three zinc oxide–eugenol‐based sealers (Canals, Endomethansone and N2) and one calcium hydroxide‐based sealer (Sealapex) were eluted with culture medium for 1, 2, 3 and 7 days. Cytotoxicity was judged using tetrazolium bromide reduction assay on human primary PDL cells and V79 cells derived from a Chinese hamster.

Results The results showed that elutes from resin‐based, zinc oxide–eugenol‐based, and calcium hydroxide‐based sealers were cytotoxic to primary human PDL cultures and V79 cells. Calcium hydroxide‐based sealer was the least toxic sealer amongst the chemicals tested in both cultures. The cytotoxic response decreased in an order of N2 > Endomethansone > AH26 > AHplus > Canals > Sealapex.

Conclusions The sensitivity of toxicity depended on the materials tested and the cell culture system used. Thus, the use of both permanent and primary cells is recommended for screening of the cytotoxic effects of root canal sealers. In addition, the results confirmed that root canal sealers constantly dissolve when exposed to an aqueous environment for extended periods, possibly causing moderate or severe cytotoxic reactions. Use of calcium hydroxide‐based material as a root canal sealer initially may result in a more favourable response to periradicular tissues.
Role of testicular fine needle aspiration in the diagnosis of azoospermia
Authors: DAJANI  , KILANI
Published: March 2003

Fine needle aspiration (FNA) of the testis is gaining recognition as an important step in the diagnosis of azoospermia. In 1000 azoospermic men receiving a short‐acting anaesthetic, each testis was subject to FNA from three standard sites – lower, middle and upper zones – using 26‐gauge needles. Azoospermia was graded in the following way: adequate spermatozoa (A1), low, scanty or rare spermatozoa (A2), spermatid arrest (B1), spermatocyte arrest (B2), Sertoli cell‐only pattern (C) and sclerosis (D). The FNA grade showed a strong correlation with cell yield, testicular volume and serum follicle stimulating hormone (FSH) levels (all p < 0.0001). Excretory and secretory azoospermia corresponded strongly with FNA grades A1 and A2, respectively. FNA grading was predictive of clinical outcome in terms of sperm yield at testicular sperm extraction, fertilization and pregnancy. In our series, FNA of the testis was relatively free of complications; we recommend its use in the routine diagnosis of azoospermia.
Secular and seasonal changes in semen quality among young Danish men: a statistical analysis of semen samples from 1927 donor candidates during 1977–1995
Authors: GYLLENBORG  , SKAKKEBÆK  , NIELSEN  , KEIDING  , GIWERCMAN
Published: March 2003

The objective of this study was to investigate whether semen quality has changed during the years 1977–1995 in a group of unselected semen donor candidates, and to determine whether semen quality is subject to seasonal variation, by analysis of time‐ and season‐related changes in semen quality using multiple regression and ANOVA. The study was based on analysis of the first semen sample delivered by 1927 semen donor candidates in Copenhagen during the period 1977–1995, with determination of semen volume, sperm concentration, total sperm count, percentage motile spermatozoa, and a semi‐quantitative sperm motility score.

Multiple linear regression analysis with year, sexual abstinence and season as covariates showed a significant increase in mean sperm concentration from 53.0 × 106/mL in 1977 to 72.7 × 106/mL in 1995 (p < 0.0001) and in mean total sperm count from 166.0 × 106 to 227.6 × 106 (p < 0.0001). Mean semen volume and percentage motile spermatozoa did not change. Sperm motility deteriorated, as the spermatozoa in 74.2% of the samples were of excellent motility in 1977–1980 compared to only 41.9% in 1993–1995 (χ2=130.0, p < 0.0001). Analysis of variance showed significant variation between seasons regarding sperm concentration (p < 0.0001) and total sperm count (p < 0.0001). Highest sperm counts were found in spring, with a mean concentration (95% C.I.) of 77.6 × 106/mL (71.9–83.7), and lowest in summer, with a mean of 57.5 × 106/mL (50.1–65.4). No other semen parameter varied with season. It is concluded that sperm counts increased, whereas sperm motility decreased, in a group of Danish semen donor candidates, from 1977 to 1995. Due to the retrospective design and the anonymity of the donors, we were unable to control for variation in donor age, and we cannot exclude the possibility that some donor candidates were selected by being accepted as donors by other semen donor services in Copenhagen. With these limitations in mind, we suggest our results should be interpreted cautiously and regarded as a contribution to the ongoing dispute on whether or not there is a continuous decrease in sperm quality.

The seasonal variations found in sperm concentration and total sperm count were pronounced and were not attributable to seasonal differences in the length of sexual abstinence. Additionally, the same seasonal pattern was observed in five successive year‐intervals. These findings strongly indicate that human testicular function is influenced by season, a phenomenon well known in many lower mammals.
Replicate and technician variation associated with computer aided bull sperm head morphometry analysis (ASMA)
Authors: Gravance  , Garner  , Pitt  , Vishwanath  , Sax‐Gravance  , Casey
Published: March 2003

Associations of abnormal spermatozoa with bull fertility have yielded varying results. Manual methods of analysis are subjective and highly variable within and between technicians, which may account for these differences. Computer‐aided sperm head morphometry appears to be a precise method of assessing sperm head dimensions; however, the effects of replication and technician on sperm head morphometry have not been assessed. The objective of this study was to determine the inter‐ and intra‐analysis and technician variation associated with computer‐aided bull sperm head morphometry analysis. Semen from 10 bulls was diluted to 200 × 106sperm/mL, and slide smears were prepared and stained using haematoxylin and rose bengal. Each of two technicians analysed 250 images from each slide, 3 times, using computer‐aided sperm head morphometry analysis. The morphometric dimensions of area, perimeter, length, width and width/length for individual sperm heads of each analysis were assessed by GLM‐ANOVAfor effects of bulls, replications and technicians. The coefficient of variation was recorded for each analysis and across replications. The mean coefficients of variation within and between analyses were compared between technicians by GLM‐ANOVA. No differences (p > 0.1) between technicians were found between or among bulls for area (29.63 vs. 29.26 μm2), perimeter (23.73 vs. 23.86 μm), length (8.73 vs. 8.71 μm), width (4.47 vs. 4.46 μm), or width/length (0.51 vs. 0.51). No differences (p > 0.1) between replicates for sperm head dimension were detected within or among bulls for either technician. No intra‐ or inter‐analysis differences (p > 0.1) between technicians on CVs were observed. The mean intra‐analysis CVs for all bulls for both technicians were area = 6.9%, perimeter = 4.9%, length = 4.5%, width = 5.6% and width/length = 6.5%. The mean interanalysis CVs for both technicians were area = 3.0%, perimeter = 2.4%, length = 2.0%, width = 2.0%, and width/length = 1.7%. The results indicate that ASMA is a repeatable and objective method of assessing bull sperm head morphometry within and between technicians. No differences between replications were detected, and hence replicate analyses are not necessary to acquire accurate morphometric data.
The mean of sperm parameters in semen donations from the same donor. An important prognostic factor in insemination
Authors: ECOCHARD  , COTTINET  , MATHIEU  , RABILLOUD  , CZYBA
Published: March 2003

We analysed 12 100 consecutive cycles of artificial insemination by donor spermatozoa in 1901 infertile couples. In our analysis, particular attention was given to finding an appropriate way of taking into account the respective effects of female and male factors on the pregnancy success rate and the level at which these factors act (cycle vs. woman and donation vs. donor). A total of 1213 pregnancies occurred. The pregnancy rate per cycle was lower as the age of the woman increased (p < 0.0001) and varied with the type of infertility: fecundity was higher (p = 0.03) in the case of azoospermia than of severe oligozoospermia. After taking into account these factors, significant unexplained variation in likelihood to conceive remained. A part of this heterogeneity was shown to be due to variation in fecundability between semen donors. In order to explain this heterogeneity between donors, compositional covariates were used, particularly the mean of results of the semen analysis performed for donations from the same donor. For each semen characteristic, the overall mean of the different donations of a donor was an important predictive factor of successful insemination: after taking into account all of the other factors, the odds ratios for an increase of 50 × 106/mL spermatozoa, of a 20% increase in sperm motility and of a 2 point increase in the post‐thaw quality index, were, respectively, 1.13, 1.37 and 1.56. After adjustment for these factors, the specific characteristics of each semen donation were no longer significantly predictive of successful insemination. This observation has a biological interpretation: sperm with low parameters but produced by a normally fertile man can have a satisfactory success rate.
Changes in testicular transferrin concentrations measured by enzyme immunoassay after FSH administration to beagle dogs
Authors: Kawakami  , Arai  , Oishi
Published: March 2003

A sensitive enzyme immunoassay (EIA) was developed for transferrin (Tf) in the canine testis, as an effective marker of Sertoli cell function. Tf was purified from male dog serum by DEAE‐Affi‐Gel Blue chromatography and gel filtration. Rabbits were immunized with the Tf, and anti‐dog Tf antibody was purified from the rabbit serum by affinity chromatography as primary antibody for EIA. Peroxidase‐conjugated goat anti‐dog Tf antibody was used as the secondary antibody for microtitre plate double‐antibody EIA. The EIA was applied to measurement of testicular Tf concentrations in five normal beagle dogs. All of the dogs were given five injections of 2 mg porcine pituitary FSH at 12 h intervals, and testicular biopsy was performed. The testicular tissue was used for EIA of Tf. The optimum dilutions of the primary and secondary antibodies for the standard curves of canine Tf were 1 : 4000 and 1 : 1000, respectively. The limits of sensitivity of our EIA were between 30 ng Tf/plate‐well and 2500 ng/well. The intra‐ and inter‐assay coefficients of variation, and the recovery rate were 8.6, 7.6 and 86.0%, respectively. Before FSH administration, the mean ±SEM Tf concentration in the testis of normal dogs was 357 ± 31 ng/mL. At 12 h after the final FSH administration, Tf concentrations were significantly increased (p < 0.5) when compared with values before the start of treatment. Thus, Tf in the canine testis, measured by our EIA, appears capable of serving as a marker of Sertoli cell function.
Prediction of bull fertility by combined in vitro assessments of frozen–thawed semen from young dairy bulls entering an AI‐programme
Authors: Zhang  , Larsson  , Lundeheim  , Håård  , Rodriguez‐Martinez
Published: March 2003

In the present study, we assessed the degree to which various bull sperm traits, including the ability to bind to homologous zona pellucidae (ZP) and to fertilize in vitro, were related to field fertility after AI as 56d‐non‐return rates (56d‐NRR based upon 8620 AIs) with frozen–thawed semen from 12 Swedish Red and White young (11–13 months) bulls (3 freezing batches/bull, 1–2 consecutive ejaculates/batch), entering a national breeding program and housed at two AI‐bull stations. Significant (p < 0.01) correlations among in vitro tests were found for swim‐up separated spermatozoa (concentration and concentration of motile spermatozoa) with the ZP‐binding assay (ZBA, r=0.72 and r=0.73, respectively) and blastocyst rates (r=0.79 and r=0.79, respectively). A strong correlation was found between cleavage and blastocyst rates (r=0.81, p < 0.01). Whereas bull station influenced (p < 0.05–0.001) all these variables, bull only affected (p < 0.05) ZBA and cleavage. There was no significant difference in 56d‐NRRs (p > 0.05, range 62–67.2%) among bulls, once the absolute NRRs had been corrected for season, area and parity. Neither bull, batch nor station had a significant effect on field fertility (p < 0.05). None of the single sperm traits/tests in vitro correlated significantly with in vivo fertility. A correlation with bull fertility was, however, found when measures of sperm traits were combined and predicted NRRs, calculated by regression analyses, were tested against observed 56d‐NRRs. The predictive bull fertility, based on the tested three frozen batches, varied from 61.8 to 67.5% (p < 0.05) and was highly correlated with the observed fertility NRRs (r=0.92, p < 0.001). Although the results suggest that the combined analyses of swim‐up separated sperm traits, ZBA and IVF can be used to predict bull fertility, it might not be possible to determine the life‐time fertility of a breeding sire owing to the limited number of observations made.
Duplex ultrasound evaluation of cavernosal peak systolic velocity and waveform acceleration in the penile flaccid state: clinical significance in the assessment of the arterial supply in patients with erectile dysfunction
Authors: Mancini  , Bartolini  , Maggi  , Innocenti  , Villari  , Forti
Published: March 2003

The aim of this paper was to establish if duplex ultrasound parameters obtained for assessment of the patency of cavernosal arteries in the penile flaccid state can give sufficient clinical information without the use of intracavernosal injection of vasodilatory drugs. We assessed mean cavernosal peak systolic velocity (PSV) in the penile flaccid state (basal PSV), and after PGE1 injection (dynamic PSV) in 339 unselected patients with erectile dysfunction. In 55 of these patients the waveform acceleration in the flaccid state was also assessed. The results of the study can be summarized as follows: (1) a significant relationship was found between basal and dynamic PSV in the 339 patients (r=0.477; p < 0.0001); (2) a basal PSV >12.5 cm/sec was predictive of a dynamic PSV ≥30 cm/sec in 129/139 (92.8%) of the patients, whereas in patients with a basal PSV ≤12.5 a dynamic PSV both > or <30 cm/sec could be found; and (3) an acceleration >1 m/sec2 in the flaccid state was coupled to a dynamic PSV >30 cm/sec in 43/46 (93.5%) of the patients independent of the basal PSV. In conclusion, these results suggest that the combined duplex ultrasound assessment of PSV and waveform acceleration in the penile flaccid state can predict arterial dynamic inflow in the majority (51/55; 92.7%) of patients with erectile dysfunction, with less time and expense and less discomfort for the patient.
Torsion‐induced injury in rat testes does not affect mitochondrial respiration or the accumulation of mitochondrial mutations
Authors: Ahmed Farag A. , Whelan James , Jequier Anne M. , Cummins James M.
Published: March 2003

Male rats were subjected to 1 h testicular torsion of the spermatic cord or 1 h torsion followed by detorsion and recovery up to 4 weeks. The extent of tissue damage was evaluated by a testicular biopsy score count and mitochondrial function. Torsion for 1 h followed by detorsion induced significant morphological damage, which became more severe with longer periods of recovery. This morphological damage could not be correlated with mitochondrial damage as assessed by measuring the 4834 bp mitochondrial DNA ‘common deletion’ using a quantitative competitive polymerase chain reaction (PCR) assay. Mitochondrial respiratory chain activity, as measured by mitochondrial oxygen consumption using an oxygen electrode, did not vary between the treated animals and the controls. We conclude that the common mitochondrial DNA deletion and oxygen consumption are not good indicators of testicular damage induced by torsion.
Specific localization of RBM1a in the nuclei of all cell types except elongated spermatids within seminiferous tubules of the human
Authors: Österlund C. , Ståbi B. , Bhasin S. , Kvist U. , Pousette Å. , Arver S.
Published: March 2003

Recent studies have indicated that at least three regions (AZF a–c) on the long arm of the Y‐chromosome code for factors are involved in spermatogenesis. One of the candidate genes in the AZFb region is RBM1a, coding for a protein with an RNA binding motif. In this study, poly clonal antibodies raised against a 15 amino acid peptide, corresponding to residues 263–304 of the deduced amino acid sequence of RBM1a, has been used to localize the RBM1a protein in the human testis. Immunohistochemistry on normal human testis using this RBM1a antibody, localized the antigen to the nuclei of spermatogonia, primary spermatocytes, and round spermatids but not to the nuclei of elongated spermatids. The antibody also specifically identified the nuclei of Sertoli cells, although the fluorescence was not as strong as in the germ cell nuclei it identified. No specific fluorescence was seen in the nuclei of either peritubular, endothelial or Leydig cells. Western blot of normal human testicular tissue using the anti‐RBM1a antibody gave rise to a single specific band of approximately 55 kDa, corresponding to the expected size of RBM1a. In view of its expression in germ cells, and because RBM1a has an RNA binding domain, RBM1a may be involved in RNA processing, such as RNA splicing or RNA export which are events necessary for normal spermatogenesis.
Parathyroid hormone induces bone resorption in human peripheral blood mononuclear cells
Authors: FULLER  , CHAMBERS
Published: March 2003

Osteoclasts are known to derive from a macrophage colony‐stimulating factor (M‐CSF)‐dependent precursor shared with macrophages. Cells capable of forming osteoclasts are present in peripheral blood. We characterized this population by incubating human peripheral blood mononuclear cells (PBMCs) with osteoclast‐inductive UMR 106 cells, human macrophage colony stimulating factor (hM‐CSF) and parathyroid hormone (PTH) or 1,25(OH)2vitamin D3 on slices of devitalised cortical bone. We found that PBMCs were capable of substantial bone resorption, to levels comparable to those of haemopoietic tissue. Cells plated at very low densities and screened for the presence or absence of excavations revealed a linear relationship (r = 0.994) between the number of cells plated and the number of excavations formed. The limiting dilution analysis suggested that 1 in every 300–600 plated cells (0.15–0.3% of the PBMC population) had the capacity to resorb bone. The precursor was found in the rapidly adherent fraction, and typically generated very small numbers of excavations, suggesting that it was a relatively mature cell type. Co‐cultures of PBMCs with UMR 106 cells would not generate osteoclasts without PTH/1,25(OH)2vitamin D3, even with M‐CSF, indicating that osteoclast‐induction by stromal cells is not attributable to hormonal induction of M‐CSF in UMR 106 cells, but that PTH induces some other activity, necessary for osteoclast but not macrophage formation, in UMR 106 cells. Osteoclasts did not form if PTH was omitted in the first few days of the culture period. Thus, osteoclasts appear to form not from cells committed to macrophage differentiation, but from a discrete subpopulation of relatively mature bipotential or osteoclast‐committed precursors which, in the absence of an osteoclast‐inductive stimulus, become irreversibly lost to the osteoclast lineage.
Massive acinar cell apoptosis with secondary necrosis, origin of ducts in atrophic lobules and failure to regenerate in cyanohydroxybutene pancreatopathy in rats
Authors: Kelly Lyndell , Reid Lynne , Walker Neal I.
Published: March 2003

Cyanohydroxybutene (CHB), a glycosinolate breakdown product, causes pancreatic injury when given to animals in large amounts. To determine the course of CHB‐induced pancreatopathy, rats were given a single subcutaneous dose of CHB and the pancreas weighed and examined by light and electron microscopy and immunohistochemistry at intervals from 2 h to 28 days. The pancreatic lesion was unusual in that there was marked early oedema with limited inflammatory cell infiltration, rapid synchronous onset of acinar cell apoptosis and early advanced atrophy engendering only a limited regenerative response. Acinar cell apoptosis was atypical in that cell fragmentation was limited and phagocytosis delayed, resulting in extensive secondary necrosis. As ducts were unaffected by CHB, the crowded ducts making up the epithelial component of atrophic lobules could be clearly shown to derive from their condensation and proliferation, not the redifferentiation of pre‐existing acinar cells, widely held to produce this lesion. Although the basis of CHB selectivity and toxicity for pancreatic acinar cells remains unknown, the potential therapeutic benefit of such an agent in patients with pancreatitis or pancreatic tumours warrants further investigation.
Systemic administration of interferon‐γ‐expressing plasmid reduces late allergic bronchitis in a mouse model of asthma
Authors: HAYASHI T. , MAEDA K. , HASEGAWA K. , NAKAI S. , HAMACHI T. , IWATA H.
Published: March 2003

Summary.  Asthma might be caused by a helper T(Th)2 immune response. We hypothesized that the systemic administration of the Th1 cytokines may reduce the Th2 type late asthmatic response (LAR). We examined the effect of the intraperitoneal injection of interferon(IFN)‐γ‐expressing plasmid, a Th1 cytokine, or interleukin(IL)‐4‐expressing plasmid, a Th2 cytokine, at the time of sensitization on a mouse model of asthma induced by ovalbumin in BALB/c mice. We demonstrated that the IFN‐γ‐expressing plasmid reduced the LAR, whereas the IL‐4‐expressing plasmid enhanced the LAR as compared with the saline or plasmid‐only treated group. The present study suggests that the systemic administration of IFN‐γ‐expressing plasmid may have a modulating ability of Th1/Th2 balance to down‐regulate Th2 response by a mutual inhibitory mechanism between Th1 and Th2 cells, leading to the reduction of the LAR.
Antiproliferative effect of thalidomide alone and combined with carmustine against C6 rat glioma
Authors: ARRIETA OSCAR , GUEVARA PATRICIA , TAMARIZ JOAQUÍN , REMBAO DANIEL , RIVERA ERIKA , SOTELO JULIO
Published: March 2003

Thalidomide could have therapeutic applications in neoplasms and in other diseases, particularly those of autoimmune origin. The objective of this study was to investigate the effect of various doses of thalidomide on the growth of C6 glioma in rats, and to determine its effects on parameters of cell proliferation and angiogenesis. Additionally, we investigated a potential enhancement of the antitumoral action of thalidomide when combined with a low dose of the antineoplastic carmustine. C6 glioma cells were implanted subcutaneously in Wistar rats. A highly malignant glioma developed in 80% of animals. When the tumour reached 2.0 cm diameter thalidomide was administered at doses of 100, 200 or 400 mg/kg/day. When given at a dose of 400 mg/kg/day thalidomide significantly reduced the tumour volume, the mitotic index and cell proliferation but not the vascular density. The combination of thalidomide plus carmustine increased the inhibitory effect on tumoral growth. Our results indicate that thalidomide is effective against malignant glioma; apparently by an antiproliferative effect, rather than by inhibition of angiogenesis; when combined with carmustine it could increase the response of glioma to antineoplastic treatment.
A case report of an unusual mandibular swelling in a 4‐year‐old child possibly caused by a jellyfish sting
Authors: Tahmassebi  , O’sullivan
Published: March 2003

Animal bites and stings may not figure highly in the differential diagnosis of facial swelling in the United Kingdom but should be considered in those who have been in a tropical area. This case report documents details of the presentation and investigation of a case of jellyfish sting that appeared as a facial swelling in a 4‐year‐old girl who had recently been on holiday in Greece. The report emphasizes the requirement to consider unusual aetiological factors in cases of facial swelling.
Multiple endocrine neoplasia syndrome type IIb: a case report
Authors: Edwards  , Reid
Published: March 2003

Multiple endocrine neoplasia type IIb (MEN IIb) is a syndrome, part of which can involve neoplastic change in the thyroid and adrenal glands. It has unusual oro‐facial manifestations including mucosal neuromata on the lips, cheeks and tongue. A child aged 3 years and 10 months presented with mucosal tags at the corners of the mouth, early eruption of permanent teeth, malocclusion and facial asymmetry. Biopsy of the excess mucosal tissue suggested a diagnosis of either MEN type IIb or neurofibromatosis. Genetic testing eventually confirmed MEN type IIb. The patient has been followed up regularly for 9 years. He has developed modular lesions on his tongue and irregular enlargement of his lower lip, but to date there have been no signs of tumour development. This report emphasizes the importance of thorough examination of the oral mucosa and follow‐up of any abnormalities.
Idiopathic internal resorption followed by apposition of calcified deposits in primary molars: a case report
Authors: Holan
Published: March 2003

This article describes an unusual case of internal resorption in primary molars followed by apposition of calcified deposits. Expanded borders of the coronal pulp chambers of all four first primary molars were first observed on a routine recall examination at age 7 years 7 months. Exposure of the process to the surrounding bone linked the bone to the calcified tissue formed in the pulp and caused ankylosis and infraocclusion of the affected teeth. The internal resorption and remodelling process in this case were of an unknown aetiology. Two possible explanations are suggested: (1) pulp response to a mild but lasting stimulation created by bruxism, and (2) pulp response to a short but forceful closure of the mouth due to a chin injury at age 3. Spontaneous arrest of internal resorption processes in primary molars may be consid‐ered as a possible outcome if the process does not have an inflammatory background.
Peri‐radicular inflammation related to dens invaginatus treated without damaging the dental pulp: a case report
Authors: Pitt Ford H.E.
Published: March 2003

A 12‐year‐old boy was referred with a discharging sinus tract related to the maxillary left lateral incisor, and with a non‐vital maxillary left central incisor. The lateral incisor gave a positive response to sensitivity testing. The lesion did not heal after disinfection of the root canal of the central incisor, but healed subsequently after ‘endodontic’ treatment of an invagination in the lateral incisor. After 2 years the lateral incisor continued to give a positive response to sensitivity testing.
Three cases of palatal polyps in infants
Authors: Tomizawa M. , Kohno M. , Noda T. , Suzuki M.
Published: March 2003

Fibrous lesions are common in the oral cavity, however, in infants they are rarely reported. We present three cases of palatal polyps in infants aged 2 days, 3 months and 7 months. In two cases, the treatment was surgical removal and in one case the polyp decreased in size and surgical removal was not required. In two infants, the diagnosis was confirmed histologically as fibroepithelial hyperplasia.
Microleakage of composite resins in cavities of upper primary molars
Authors: Nozaka K. , Suruga Y. , Amari E.
Published: March 2003

Objective. To improve the quality of resin restorations, studies are necessary not only of the physical properties of materials but also of the cavity geometry. We have evaluated marginal microleakage for two types of photo‐curing composite resin applied to cavities with different marginal structures.

Sample and methods. The test materials were 91 extracted upper primary molars. The two composite resins used in this experiment were Liner Bond II (LBII) and Photo Clearfil A (PCA). A class 1 cavity was created in each tooth; the cavity configuration was a round bevel, a straight bevel and a butt joint. The tooth was then restored with each composite resin. Each tooth was exposed to thermal cycles, followed by immersion in 0·2% basic fuchsin solution. Three sections, through the mesial, central and distal areas of each tooth were taken. The penetration of the dye was examined with a stereoscopic microscope. The sites of observation for examination of microleakage were awarded scores of between 0 and 7.

Results. LBII–among the three marginal forms, absence of leakage was observed most frequently in the straight bevel group followed by the round bevel and the butt joint groups, in the mesial and distal sections. In the central section, the straight bevel did not show any scores of 0, 6 or 7.

PCA–an absence of leakage in the mesial section occurred most frequently for the round bevel group. However, the absence of leakage in the central and distal sections was most frequent for the straight bevel group. Microleakage of the central section (with scores from 1 to 7) was frequently lower than that for the mesial and distal sections. Scores of 5 and above in the central section were observed only in the butt joint group.

The frequency and mean score of leakage were clearly higher in LBII than in PCA, with one significant exception. For both composite resins, the butt joint group showed higher‐mean scores of leakage than did either the round or straight bevel group, but for PCA, the mean score of the central section was lower than the other two sections in all groups.

Conclusion. Our study shows that bevelling does reduce marginal leakage. This leakage was more frequently observed with the use of LBII than with PCA. However, the amount of tooth ground away was greater for the bevel‐treated cavity. In considering these features, special care is necessary in selecting the bur for treating a bevelled cavity.
Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors
Authors: Jälevik B. , Norén J.G.
Published: March 2003

Objectives. The aim of this study was to investigate the morphological appearance of severe hypomineralized enamel of permanent first molars by means of polarized light microscopy, and to estimate the possible time, severity and longevity of the insult. Furthermore, the aim was to survey some commonly implicated aetiological factors in order to gain knowledge about possible pathogenesis of the enamel disturbances which could be compared with future epidemiological studies.

Sample and methods. Seventy‐three teeth, which had been extracted due to severe hypomineralizations of the enamel, were collected and serially cut longitudinally in a bucco‐lingual direction. The sections were examined in polarized light, dry and embedded in water. The children were also examined with respect to the demarcated opacities of other permanent teeth than those that were extracted. The parents were asked about their health during the mother’s pregnancy, the time of gestation, birth weight and any complications. They were also asked about the child’s health during the first 2 years of its life, the length of time of breast‐feeding and also about fluoride supplements.

Results. The hypomineralized areas extended cervically from the cusps, comprising about half of the buccal and lingual sides. The cervical borders to normal enamel were well defined and mainly followed the lines of Hunter‐Schreger. The hypomineralized zones were covered by thin well‐mineralized enamel. The majority of the children had demarcated opacities of all their first molars and also of some permanent incisors. No obvious correlation to the anamnestic data could be found.

Conclusions. The hypomineralized enamel in the investigated teeth demonstrated areas of porosity of varying degrees. The yellow/brown defects were more porous than the white‐cream and extended through the whole enamel layer, while the white‐cream opacities were situated in the inner parts of the enamel. There had probably been an interacting disturbance of short duration of systemic origin of the activity of the ameloblast during the first 2 years of the child’s life, resulting in chronological dispersed hypomineralized demarcated opacities in the developing teeth.
An investigation of the oral status and reported oral care of children with heart and heart‐lung transplants
Authors: Al‐Sarheed M. , Angeletou A. , Ashley P.F. , Lucas V.S. , Whitehead B. , Roberts G.J.
Published: March 2003

Aim. To investigate the oral health status and oral microflora of children who have received heart and heart‐lung transplants. Parental knowledge and current practice of oral health procedures by the child were also investigated.

Sample and method. Thirty‐five children attending the Cardio‐Thoracic Transplant Unit, Great Ormond Street Hospital for Children were included. Measurements were compared with children matched by age and gender attending the trauma clinic at the Department of Paediatric Dentistry, Eastman Dental Hospital. Teeth were examined for the presence or absence of caries or enamel defects. Plaque deposition, gingivitis, gingival bleeding and gingival enlargement were measured and a swab was taken to look at the oral microbial flora. A questionnaire was used to assess parental knowledge of dental health procedures and the current practice of these.

Results. There were no significant differences between transplant and control children in caries experience, plaque or gingivitis. Children with heart or heart‐lung transplants had significantly greater numbers of enamel defects and more gingival enlargement than control children, children in the heart transplant group had significantly more gingival bleeding. There was little difference in the dental knowledge and reported behaviour of the transplant group compared to the control group.

Conclusion. The dental needs of heart and heart‐lung transplant patients treated at the Great Ormond Street Hospital for Children were similar to those of the control group in this study, however further improvement could be made in educating parents and children on the importance of caries prevention and good oral hygiene.
The influence of three Erbium:YAG laser energies on the in vitro microleakage of Class V compomer resin restorations
Authors: Roebuck E.M. , Whitters C.J. , Saunders W.P.
Published: March 2003

Summary.
Objectives. To investigate the influence of three Erbium:YAG pulse energies (200 mJ, 240 mJ, and 300 mJ with a 100 mJ dentine finish) on the microleakage of Class V compomer restorations (Compoglass).

Design. In vitro study

Sample and methods. Sixty‐one extracted human premolar teeth were randomly allocated to three groups (according to pulse energy). Each tooth hosted one test cavity prepared with one of the three Er:YAG pulse energies using a pulse repetition rate of 5 Hz and a pulse duration of 250 μs, and one control cavity prepared with a conventional diamond bur in a high‐speed hand piece. Both cavities were placed at the cervical margin of the tooth and were restored and finished according to the manufacturer’s instructions. Each tooth was then stored in 0·12% thymol solution at 37 °C for three months, before being thermocycled through water baths between 5 °C and 55 °C for 240 cycles. Microleakage was assessed using a methylene blue dye penetration technique and was quantified using a score 0 (none) to 4 (to and into the axial wall). The data was analysed using the Kruskal–Wallis and Mann–Whitney U‐tests.

Results. Leakage was seen in all groups at both the dentine and enamel margins. There were no statistically significant differences in leakage (P < 0·05) at either the enamel or dentine margins, except for the 240 mJ lased enamel margins. This group performed significantly better than the enamel margins prepared with 200 mJ (P = 0·03) and the 300/100 mJ (P = 0·01) laser energies as well as the conventionally prepared enamel margins (P < 0·001).

Conclusion. Cavity preparation with this Erbium:YAG laser did not influence the microleakage of Compoglass restorations adversely. Different pulse energies were required for optimum cavity sealing at the enamel and dentine margins and for different materials.
Children choosing between general anaesthesia or inhalation sedation for dental extractions: the effect on dental anxiety
Authors: Arch L.M. , Humphris G.M. , Lee G.T.R.
Published: March 2003

Summary.
Aim. To compare the levels of dental anxiety experienced by children having dental extractions using general anaesthesia (GA) with those having extractions using local anaesthesia and inhalation sedation (IHS) when offered a programmed choice between the two techniques prior to treatment.

Design. Structured interview with child at pre‐treatment and at one week (approximately) follow up.

Setting. Community: primary health care centre.

Subjects. Children aged 9–15 years referred to a local NHS Trust dental clinic (n = 88).

Intervention. Child and parent provided with information about IHS and its benefits over GA for the assistance in tolerating extraction of teeth and provided with a choice of procedure.

Main outcome measure. An eight question modified child dental anxiety scale.

Results. Full information was received from 76 children giving an 86% response rate. Post‐operative dental anxiety was lower in children who had chosen (with their parent) IHS in comparison to those who had chosen general anaesthesia (P < 0·05). Dental anxiety remained unchanged in the group who chose to have their extractions under GA.

Conclusion. Children and their parents who select IHS as opposed to GA to assist in extractions demonstrate less psychological distress.
Conventional versus resin‐modified glass‐ionomer cement for Class II restorations in primary molars. A 3‐year clinical study
Authors: Hübel S. , Mejàre I.
Published: March 2003

Summary. Objective. To compare the clinical performance of two glass‐ionomer cements (GICs)for Class II restorations in primary molars: a conventional cement (Fuji II®) and a resin‐modified cement (Vitremer®).

Design. Split mouth and random assignment to the two materials were used for the majority of the molars.

Sample and methods. Forty consecutive 4–7‐year‐old children were included. One operator made 115 restorations: 53 with Vitremer and 62 with Fuji II. The restorations were evaluated clinically, radiographically and from colour photographs.

Results. The cumulative success rate of the Vitremer restorations was 94% and that of the Fuji II restorations 81%. The difference is statistically significant. The risk of a failed restoration was more than five times higher with Fuji II than with Vitremer as the restorative material. Of the 13 unsuccessful restorations, seven had lost their retention, four had secondary caries, and two were fractured.

Conclusions. The resin‐modified GIC offered advantages over the conventional GIC for restoring approximal caries in primary molars.
Intensive care: situations of ethical difficulty
Authors: Soderberg Anna , Norberg Astrid
Published: March 2003

Twenty enrolled nurses (ENs), 20 registered nurses (RNs) and 20 physicians working in intensive care in northern Sweden narrated 255 stones about their experience of being in ethically difficult care situations The ENs’ stones mainly concerned problems relating to relationship ethics, the stones narrated by the physicians mainly concerned problems relating to action ethics, while the RNs’ stones gave equal attention to both kinds of problems The most common theme of both the RNs’ and the physicians’ stones was that of too much treatment An obvious similarity between the ENs, RNs and physicians was that they saw themselves as equally lacking in influence in ethically difficult care situations The only apparent difference between the three groups, however, was that the ENs brought up relationship problems more often than the others Thus, the differences between the RNs and the physicians were fewer than usually reported in the literature This might be related to the specialization of intensive care
Teamwork in primary care: the views and experiences of nurses, midwives and health visitors
Authors: Wiles Rose , Robison Judy
Published: March 2003

This paper reports on findings from a study of teamwork in primary care in one family health services authority in England It is based on interviews using a semi‐structured questionnaire with practice nurses, district nurses, health visitors and midwives in 20 practices Six topics emerged as important in relation to the views of nurses, midwives and health visitors and their experiences of teamwork team identity, leadership, access to general practitioners, philosophies of care, understanding of team members' roles and responsibilities, and, disagreement regarding roles and responsibilities Differences in the various views and experiences of teamwork were identified Midwives and health visitors emerged as the least integrated members of the primary health care team Recent changes to the organization of primary health care services, as well as professional changes, are seen as accounting for the different experiences of the nursing groups The potential for teamwork in the future is discussed
The reflective dialogue and repertory grid: a research approach to identify the unique contribution of nursing, midwifery or health visiting to the therapeutic milieu
Authors: Scholes Julie , Freeman Marnie
Published: March 2003

This paper seeks to demonstrate the use of two research methods within the interpretive paradigm the reflective dialogue and the repertory grid At first sight, the use of these two methods might appear contradictory, however this paper seeks to demonstrate the complementary fashion in which both techniques elicit rich and contextualized data Both methods use extended interviews to illuminate practitioners’ perceptions about their unique contribution to the therapeutic milieu The approach primarily seeks to identify how practitioners’ perceptions alter in the light of contextual change and seeks to enable practitioners to identify their developmental needs to meet future challenges Fundamental assumptions underpin the approach reciprocity, the equality of researcher and participant, and that research can be an act of empowerment and education These issues are explored throughout the paper which closes with an invitation to add to the debate about the evolution of such an approach
From special hospital to regional secure unit: a qualitative study of the problems experienced by patients
Authors: Skelly Christopher
Published: March 2003

For those patients in the United Kingdom who are compulsorily detained in a special hospital the most common route of release is via other psychiatric hospitals, especially regional secure units That a large percentage of these patients are subsequently readmitted (43% in this study) indicates that they experience problems within the regional secure unit A grounded theory approach was used to investigate this experience from the patients’ perspective by interviewing a sample of 14 patients who had been readmitted to one special hospital Data analysis can prove difficult in grounded theory and the approach that was used — a variant of the constant comparative method — is described A number of inductively developed categories were generated from the interview data and one category is reported here From these categories a theory of‘failure’ is postulated that, it is contended, both describes and explains the process of readmission Finally, the implications for practice in terms of the preparation of patients for transfer are addressed
Nursing for change: the orientations and values of Project 2000 diploma and undergraduate nursing students
Authors: Pleasance Paul I , Sweeney John
Published: March 2003

The introduction of pre‐registration nursing degree and diploma programmes in the United Kingdom has provoked considerable scrutiny of a range of issues such as funding arrangements, links between colleges of nursing and midwifery and higher education and the impact of the new courses on education and service provision Less attention has been devoted to the changing orientations and values of diploma and undergraduate students during their courses of study The parallel commencement in 1991 of 3‐year undergraduate and diploma programmes in Leicestershire provided an opportunity to chart the changing orientations (personal, political, ethical, professional and academic) of two cohorts of students matched by age, gender and branch programme Research is being undertaken, a primary aim of which is to assess the changes that occur in these orientations over time and to relate these to the educational progression of the students through successive phases of their respective courses The focus of the research concerns the student's personal experience and developing insights into health, nursing and care delivery This paper seeks to provide an overview of the literature relevant to the study