bluuebunny/crossref_metadata_2025 huggingface dataset:
Canal shapes produced sequentially during instrumentation with Quantec LX rotary nickel‐titanium instruments: a study in simulated canals
Authors: Griffiths I. T. , Bryant S. T. , Dummer P. M. H.
Published: March 2003

Aim

The aim of this study was to determine the shaping ability of Quantec LX nickel‐titanium rotary instruments in simulated root canals.

Methodology

Forty simulated canals consisting of four different shapes in terms of angle and position of curvature were prepared with Quantec LX instruments. Sequential still images were taken of the canals using a video camera attached to a computer with image analysis software. Images were taken preoperatively; after, instrument 7 (Size 25, 0.05 taper), instrument 8 (size 25, 0.06 taper), and instrument 10 (size 45, 0.02 taper) were taken to length. Each sequential postoperative image was superimposed individually over the preoperative image in order to highlight the amount and position of material removed during preparation. Intra‐canal impressions after preparation to size 10 were taken to evaluate three‐dimensional canal form.

Results

Overall, the mean preparation time to size 10 was 4.7 min; canal shape did not have a significant effect on speed of preparation. No instruments fractured within the canal, but 7 instruments separated from the latch grip, and a further 3 instruments deformed. All canals remained patent. Following preparation to size 10, 29 canals (72%) retained their length, 7 (17%) lost length, and 4 gained length; the magnitude of the change in length was always below 1 mm. Zips were created in 3 canals (7%) after use of size 10 instruments, but no perforations or danger zones were produced. Excess removal of material along the outer aspect of the curve between the beginning of the curve and the end‐point (outer widening) was found in 22 canals (55%) after instrument 7, in 30 (75%) canals after size 8 and in 35 canals (88%) after size 10. There was a significant difference (P < 0.0001) between canal shapes for the incidence of this aberration at all sizes.

Conclusions

Under the conditions of the study, Quantec LX instruments tended to remove excess material from the outside of the curve between the beginning of the curve and the end‐point. These aberrations increased in prevalence and severity following the use of larger instruments when they were taken to length. Size 8, 9 and 10 Quantec LX instruments should be used with care and short of length, especially in severely curved canals.
Calcium hydroxide in endodontic retreatment after two nonsurgical and two surgical failures: report of a case
Authors: Fava L. R. G.
Published: March 2003

Aim To describe the role of calcium hydroxide in infection control during complex endodontic retreatment.

Summary A case is presented in which two conventional endodontic treatments and two surgical interventions failed to bring periapical healing. Despite this history, a further conventional treatment augmented by long‐term disinfection with calcium hydroxide finally delivered a successful outcome.

Key learning points

Periapical healing follows proper intracanal infection control.

Despite repeated surgical and nonsurgical intervention, careful retreatment can often bring healing.

Calcium hydroxide has long‐acting antimicrobial and soft‐tissue dissolving activity. It is a helpful adjunct in endodontic retreatment.
The influence of specialty training and experience on decision making in endodontic diagnosis and treatment planning
Authors: McCaul L. K. , McHugh S. , Saunders W. P.
Published: March 2003

Aim

The purpose of this study was to compare the diagnostic and treatment‐planning decision making of cohorts of dental surgeons with different experiences and specialty backgrounds.

Methodology

Periapical radiographs of 20 teeth in patients referred for an opinion regarding the provision of endodontic surgical retreatment were taken using a paralleling technique and a film holder. The radiographs were photographed and black and white photographic prints produced to provide an image 10.5 times larger than the original radiograph. Each image was related to a clinical scenario. Each participant was asked to assess whether a periradicular lesion, as manifested by a radiolucency, was present and what clinical management would be prescribed. Ten participants in each of seven groups took part in the study. These groups were chosen to represent those dentists who were most likely to be involved in decision making in similar cases.

Results

In 12 out of 20 cases interobserver agreement for radiographic analysis was ‘excellent’ (above 90%) or ‘good’ (between 70 and 90%). There was less agreement for treatment decisions than for radiographic analysis and the order of agreement for cases for diagnosis was not the same as for treatment. No case achieved ‘excellent’ percentage interobserver agreement. The average percentage interobserver agreement of the endodontists was significantly greater than the average percentage interobserver agreement for the other groups for both radiographic assessment and treatment decisions.

Conclusions

Differences in specialty backgrounds amongst the participants in this study affected both endodontic diagnostic and treatment decisions. Endodontists showed the most consistent agreement amongst the specialty groups.
Endodontic and periodontal treatments of a geminated mandibular first premolar
Authors: Aryanpour S. , Bercy P. , Van Nieuwenhuysen J.‐P.
Published: March 2003

Aim  To describe a rare case of gemination involving a mandibular first premolar.

Summary The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow‐up visit, the distal segment was clinically healthy and continued to satisfy functional demands.

Key learning points

Failure to diagnose the initial crack along a gemination groove resulted in further propagation and finally complete vertical fracture.

Owing to the abnormal morphology of the crown and the complexity of the root canal system in geminated teeth, treatment protocols require special attention.

For asymptomatic cases without aesthetic or orthodontic problems and without associated pathosis, routine review and careful maintenance are required.
Prodromal herpes zoster – a diagnostic challenge in endodontics
Authors: Fristad I. , Bårdsen A. , Knudsen G. C. , Molven O.
Published: March 2003

Fristad I, Bårdsen A, Knudsen GC, Molven O. Prodromal herpes zoster – a diagnostic challenge in endodontics. International Endodontic Journal, 35, 1012–1017, 2002.

This case report highlights the diagnostic challenge that herpes zoster represents if pain develops in the prodromal stage. A 58‐year‐old male presented with pain in the left maxilla. The symptoms had lasted for 7 months. The first premolar had been extracted soon after the onset, and the second premolar root filled shortly thereafter. Symptoms were experienced as sudden pain attacks lasting for several hours and analgesics gave some pain relief. Clinical examination showed that the second premolar was tender to percussion. No sinus tract or swelling were present. Radiographic examination showed previously root‐filled second premolar and first molar teeth, and no evidence of apical pathosis. Due to the uncertainty about the quality of the root filling in the second premolar and incomplete root filling in the first molar, retreatment was started prior to prosthetic treatment in the region. The pain continued and became more intense during the treatment. A diagnosis of herpes zoster was determined, when an acute attack with oedema and vesicles occurred, 2 months after retreatment was started. In the present case, therefore, the primary attack presented itself after months and the herpes zoster diagnosis could not be made until then.

Key learning points

A long lasting prodromal stage is an unusual event.

Symptoms combined with inadequate technical standard of root fillings may confuse the diagnostics.

No available data support or suggest the use of antiviral treatment as a diagnostic tool.
Tolerance to isosorbide dinitrate in isolated strips of rabbit corpus cavernosum
Authors: UMA  , YILDIRIM  , SARIOGLU  , BÜTÜNER  , YILDIRIM
Published: March 2003

The aim of this study was to investigate whether prolonged exposure to a high concentration of isosorbide dinitrate (ISDN) would result in tolerance being developed against its relaxant activity in strips of corpus cavernosum, pre‐contracted by phenylephrine. Under these conditions, relaxation induced by ISDN was found to be significantly reduced. Strips made tolerant to ISDN remained fully responsive to sodium nitroprusside and papaverine. Electrical field stimulation evoked relaxations which were persistent in the presence of tolerance‐inducing conditions. These results indicate that desensitization of guanylate cyclase activity is not likely to be the operating mechanism for nitrate tolerance. We suggest that tolerance may result from the impairment of biotransformation of ISDN in rabbit cavernosal smooth muscle.
Reactive oxygen species influence the acrosome reaction but not acrosin activity in human spermatozoa
Authors: ICHIKAWA  , OEDA  , OHMORI  , SCHILL
Published: March 2003

It is now widely accepted that the higher levels of reactive oxygen species (ROS) produced by damaged or deficient spermatozoa are associated with a loss of motility and a decreased capacity for sperm–oocyte fusion. Furthermore, earlier studies show, under physiological conditions, that some ROS may be involved in capacitation and hyperactivation of human spermatozoa. We measured ROS levels, acrosome reaction (AR) and acrosin activity (AA) in semen samples from suspected subfertile men to reveal the influence of ROS on AR and AA of human spermatozoa. Semen samples were obtained from 60 patients. Samples with ≥ 1 × 106 leukocytes/mL were excluded from the study. ROS production was determined using a chemiluminescence technique. AR was determined using a triple stain technique. The percentage of acrosome‐reacted spermatozoa after low temperature induction of the AR (test value), and the inducibility of AR (= the difference between the test value and the control), were calculated. The AA was analysed by determining the proteolytic potential of spermatozoa on gelatin plates. The mean halo diameter and percentage of halo formation in each sample were measured as AA parameters. Scatter plots of ROS levels and AR parameters showed that the percentage of acrosome reacted spermatozoa and AR inducibility were better in samples with low rather than high ROS levels. On the other hand, there were no apparent similarities between ROS and the AA parameters. Therefore, the percentage of acrosome‐reacted spermatozoa and AR inducibility were significantly higher in the low than in the high ROS group (p = 0.028, p = 0.0001, respectively). In addition, there was no significant difference in AA parameters between groups. These findings suggest that lower ROS in semen may have a role in AR but excessive ROS may exert a negative influence on AR, while ROS in semen has no relationship to AA.
Effects of long‐term treatment with testosterone enanthate in rhesus monkeys: I. Pharmacokinetics of testosterone, testicular volume and liver metabolism of testosterone
Authors: TYAGI ALPANA , RAJALAKSHMI  , BAJAJ  , KUMAR V. MOHAN
Published: March 2003

The effects of long‐term administration of testosterone enanthate on the pharmacokinetics and bioavailability of testosterone were studied in adult male rhesus monkeys (n = 9), injected with 50 mg of testosterone enanthate (TE) once every 14 days for a total of 32 months. Control animals were injected with 0.2 mL olive oil. Serum testosterone levels increased sharply within 24 h of the first injection of TE and reached a peak on day 3 followed by a sharp decline, but baseline values were not reached even by day 14. Subsequent injections of TE caused a similar pharmacokinetic profile until the 55th injection; testosterone levels on day 3 declined from the 56 to 58th injection and remained in a lower range until the last injection. Repeated injections of TE increased the bioavailability of testosterone as shown by the Area Under the Curve. The nocturnal (22.00 h) surge in testosterone levels during the pretreatment phase was abolished by TE injections. TE injections altered the metabolism of testosterone by the liver, as studied in vitro; while liver from control animals converted testosterone to androstenedione as the major metabolite, androsterone was the major metabolite in chronically TE‐treated animals. Spermatogenesis and the associated increase in testicular volume observed in control animals in winter were suppressed in TE‐treated animals. The results indicate that repeated TE injections elevate serum testosterone to supra‐physiological levels with marked fluctuations in circulating testosterone levels after each injection. Possibly in response to these elevated levels, there was a change in the metabolism of testosterone by the liver as observed in vitro.
Immunoreactive relaxin in seminal plasma of fertile boars and its correlation with sperm motility characteristics determined by computer‐assisted digital image analysis
Authors: Sasaki Y. , Kohsaka T. , Kawarasaki T. , Sasada H. , Ogine T. , Bamba K. , Takahara H.
Published: March 2003

Ejaculates from 10 mature fertile large white Yorkshire boars were used to examine the correlation between immunoreactive relaxin levels in seminal plasma and sperm motility characteristics. Seminal plasma levels of immunoreactive relaxin were measured by a time‐resolved fluoroimmunoassay (TR‐FIA). Motility characteristics were assessed using a CellSoft computer‐assisted digital image analysis system. The mean ± SD level of immunoreactive relaxin in seminal plasma was 2.61 ± 0.62 ng/mL. When the correlation between seminal plasma levels of immunoreactive relaxin and parameters of sperm movement was examined, it was found that relaxin levels were significantly correlated with the percentage of motile spermatozoa (r=0.687, p < 0.05), curvilinear velocity (r=0.745, p < 0.05), straight line velocity (r=0.651, p < 0.05), mean amplitude of lateral head displacement (mean ALH) (r=0.844, p < 0.01) and the maximum amplitude of lateral head displacement (max ALH) (r=0.830, p < 0.01), but not with linearity, beat‐cross frequency, or percentage of circular cells. Among these parameters, seminal plasma levels of immunoreactive relaxin showed the strongest correlation with the ALH parameter related to fertilizing ability. These results indicate that immunoreactive relaxin in boar semen may be necessary not only for normal sperm motility but also for normal fertility, suggesting that determination of the profile of immunoreactive relaxin in ejaculates may have value as a potential marker for predicting sperm fertilizing ability of boars.
Differential effect of hyperthyroidism on rat epididymal glycosidases
Authors: Maran R. R. M. , Priyadarsini D. , Udhayakumar R. C. R. , Arunakaran J. , Aruldhas M. M.
Published: March 2003

The impact of hyperthyroidism on epididymal glycosidases was studied in albino rats. Hyperthyroidism was induced in Wistar rats aged 30 days by daily injection of T4 (25 μg/100 g body weight/day intramuscularly) for 30 or 60 days; control rats were injected with vehicle (alkaline saline, pH 7.8). One set of hyperthyroid rats was reverted to euthyroid status by withdrawing T4 treatment after 30 days of hyperthyroidism. To asses the direct effect of thyroid hormone on epididymal hexosaminidases, caput, corpus and cauda tissues were stimulated with 25, 50 or 100 ng/mL T3 for 24 h, after an initial culture of 24 h. The activity of β‐glucosidase decreased in caput, corpus and cauda epididymis of hyperthyroid rats. β‐Galactosidase activity increased in the caput epididymis irrespective of the duration of hyperthyroidism. While a similar decrease occurred in the corpus and cauda epididymis in the 30 day hyperthyroid group, an opposite trend was observed in 60 day hyperthyroid rats. Caput β‐N‐acetylglucosaminidase activities increased at both time points, whereas activity decreased in the corpus and cauda in 30 day, but increased in 60 day hyperthyroid rats. Hyperthyroidism consistently increased caput and corpus β‐N‐acetylgalactosaminidase activity irrespective of the duration. Cauda epididymal β‐N‐acetylgalactosaminidase activity was decreased in 30 day and increased in 60 day hyperthyroid rats. Hyperthyroidism induced changes in caput β‐galactosidase, β‐N‐acetylgalactosaminidases, corpus β‐N‐acetylglucosaminidase and cauda β‐N‐acetylgalactosaminidase which were irreversible while the remaining actvities were brought back to normal when T4 treatment was withdrawn. In vitro studies showed that T3 stimulates epididymal hexosaminidases (β‐N‐acetylglucosaminidase and β‐N‐acetylgalactosaminidase) irrespective of the dose. These data suggest that thyroid hormones have a specific and direct influence on glycosidases in specific regions of the epididymis.
Involvement of Fas system and active caspases in apoptotic signalling in testicular germ cells of ethanol‐treated rats
Authors: Eid Nabil A. S. , Shibata Masa‐Aki , Ito Yuko , Kusakabe Ken , Hammad Hanaa , Otsuki Yoshinori
Published: March 2003

The Fas system is involved in the regulation of germ cell apoptosis associated with testicular injury in experimental animals exposed to various insults. We tested the hypothesis that enhanced germ cell apoptosis mediated by the up‐regulation of the Fas system and the activation of caspases may be involved in ethanol‐induced testicular injury. Adult Wistar rats were fed either ethanol in Lieber–DeCarli liquid diet or an isocaloric control diet for 12 weeks. Marked Sertoli cell vacuolization and germ cell degeneration were observed in the testes of ethanol‐treated rats (ETR) by both light and electron microscopy. Enhanced apoptosis of germ cells in ETR was detected by the terminal deoxynucleotidyl transferase‐mediated deoxy‐UTP nick end labelling (TUNEL) method, transmission electron microscopy, and was associated with elevated activity of caspase‐3, ‐8 and ‐9. The expression levels of the Fas ligand (FasL) in Sertoli cells and of both Fas and caspase‐3 in germ cells of ETR detected immunohistochemically were higher than those of the control testes. Furthermore, reverse transcriptase‐polymerase chain reaction analysis demonstrated an increase in both Fas and FasL mRNA levels in ETR. Fas system up‐regulation and the elevated activity of caspases in the testes of ETR may be a reflection of ethanol‐induced testicular injury resulting in enhanced germ cells apoptosis, which may be involved in infertility associated with alcohol abuse.
A comparison of the NADPH oxidase in human sperm and white blood cells
Authors: Armstrong Jeffrey S. , Bivalacqua Trinity J. , Chamulitrat Walee , Sikka Suresh , Hellstrom Wayne J. G.
Published: March 2003

The mechanism of reactive oxygen species (ROS) generation in human sperm has recently been found to depend upon a novel NADPH‐oxidase (NOX5) resembling the multicomponent NADPH‐oxidase of white blood cells (WBCs). The purpose of our study was to compare the ROS producing activity of NOX5 in sperm and NADPH‐oxidase of WBCs, and to investigate the role of protein kinase C (PKC) in NOX5 activation. A combination of electron paramagnetic resonance (EPR), chemiluminescence (CL), and nitroblue tetrazolium (NBT) dye reduction were used to monitor ROS production by sperm. The involvement of PKC in NOX5 activation was investigated using myristate acetate (PMA), and the PKC inhibitor GF‐109203X. The presence of b cytochrome in NOX5 was investigated by spectrophotometry. PMA‐stimulated WBCs produced superoxide dismutase – inhibitable EPR signals for both superoxide and hydroxyl radicals. Sperm did not produce these spectra with or without PMA stimulation. WBCs generated significantly increased levels of CL and reduced NBT after PMA stimulation; whereas sperm did not increase the CL response or reduce NBT. Adenosine triphosphate (ATP) levels in WBCs were significantly reduced after PMA stimulation, whereas sperm ATP levels did not change. The characteristic spectra of b cytochrome observed after dithionite reduction of WBCs was not observed with sperm under similar conditions. These results indicate that the ROS producing activity of NOX5 is significantly lower than the WBC NADPH‐oxidase, and suggest that the activation mechanism of NOX5 in sperm is independent of PKC.
Stem cells in breast epithelia
Authors: LI PETER , BARRACLOUGH ROGER , FERNIG DAVID G. , SMITH JOHN A. , RUDLAND PHILIP S.
Published: March 2003

The rodent and human nonpregnant mammary glands contain epithelial, intermediate and myoepithelial cells which have all been isolated as cell lines in vitro. Transforming growth factor‐α (TGFα) and basic fibroblast growth factor (bFGF) are produced by myoepithelial cells and can stimulate the growth of intermediate stem cells in vitro. Epithelial and intermediate cells behave like stem cells in vitro, since they can differentiate into alveolar‐like and myoepithelial cells. The myoepithelial differentiation pathway is associated with the early expression of a calcium‐binding regulatory protein called p9Ka and the protease, Cathepsin D. Myoepithelial cells are also present in benign lesions but not in malignant mammary carcinomas of rats or humans, whose resultant cell lines fail to differentiate completely along the myoepithelial cell pathway. Loss of the myoepithelial cell in some invasive carcinomas may be compensated, at least in part, by changes in malignant cells. Over‐expression of TGFα and/or erbB receptors may reduce the requirement for TGFα, whilst ectopic production of bFGF and its receptors and p9Ka/Cathespin D may assist in tumorigenesis and in metastasis, respectively. Thus compensation for, or retention of, molecules potentially involved in the differentiation of mammary cells may be a mechanism by which malignancy progresses in some human invasive carcinomas.
Eotaxin and eotaxin receptor (CCR3) expression in Sephadex particle‐induced rat lung inflammation
Authors: Harrington  , Newton  , Williams  , Hunt  , Dearman  , Kimber  , Coleman  , Flanagan
Published: March 2003

The β chemokine eotaxin is a potent eosinophil activator and chemoattractant. We examined immunohistochemically eotaxin protein expression in a range of normal rat tissues and in rat lung during Sephadex particle‐induced pulmonary inflammation. The time course of eotaxin expression in lung at various time points after Sephadex administration was related to the appearance of eosinophils in the bronchoalveolar lavage fluid and tissue distribution of eotaxin receptor (CCR3) positive cells. Results showed that eotaxin protein was constitutively expressed by both lung airway epithelial cells and gut epithelial cells in normal tissues in the absence of inflammation. During Sephadex induced pulmonary inflammation, eotaxin expression increased in alveolar macrophages prior to the major increase in eosinophil numbers which reached a peak at 72 h. The pattern of eotaxin pulmonary expression and the location of CCR3 receptor positive cells suggest a chemoattractant gradient resulting in migration firstly into the tissue and subsequently through the airway epithelium into the airways. Treatment of rats with the glucocorticoid dexamethasone or the immunosuppressant cyclosporin A reduced eosinophil entry into lung tissue and airways but had no apparent effect on eotaxin expression in vivo, indicating that both these drugs inhibit eosinophil recruitment either by an eotaxin‐independent mechanism, or by targetting factors that synergise with eotaxin, or an event post eotaxin expression.
Increased renal glomerular endothelin‐1 release in gentamicin‐induced nephrotoxicity
Authors: Valdivielso José M. , Rivas‐Cabañero Lina , Morales Ana Isabel , Arévalo Miguel , López‐Novoa José M. , Pérez‐Barriocanal Fernando
Published: March 2003

Gentamicin‐induced acute renal failure is characterized by a decrease in renal plasma flow and creatinine clearance. Endothelins (ET) are potent renal vasoconstrictors. The aim of this work is to assess the role of ET‐1 in gentamicin‐induced renal failure. Renal glomerular release of ET‐1 was measured in rats with gentamicin‐induced nephrotoxicity (100 mg/kg/day, s.c. for 2, 4 or 6 days). Glomeruli were isolated and incubated for 24 h in RPMI‐1640. Glomerular supernatant and plasma concentration of ET‐1 were measured by RIA. Renal failure was assessed by insulin, para‐aminohippuric and creatinine clearance and histological studies. Gentamicin induced a dose number‐dependent increase in plasma creatinine and a decrease in creatinine clearance. This was accompanied by a marked decrease in inulin and para‐aminohippuric acid clearance, as well as by a marked tubular necrosis, without alterations in glomerular structures. Plasma ET‐1 concentration and glomerular ET‐1 release were also increased in gentamicin‐treated rats. When 10−5 m gentamicin was added to control glomeruli, ET‐1 production was not modified (36.4 ± 2.2 vs. 35.2 ± 1.7 pg/ml/24 h). All these results suggest that elevated ET‐1 plasma levels and increased glomerular release of ET‐1 could mediate, at least in part, the decrease in glomerular filtration rate observed in gentamicin‐induced ARF.
Treatment with BB‐94, a broad spectrum inhibitor of zinc‐dependent metalloproteinases, causes deviation of the cytokine profile towards Type‐2 in experimental pulmonary tuberculosis in Balb/c mice
Authors: Hernandez‐Pando Rogelio , Orozco Hector , Arriaga Kutzi , Pavön Lenin , Rook Graham
Published: March 2003

BB‐94 (batimastat) is a broad‐ spectrum hydroxamic acid‐based zinc metalloproteinase inhibitor that inhibits both the matrix metalloproteinases (MMP) and members of the ADAM family of enzymes such as Tumour Necrosis Factor‐α Cleaving Enzyme (TACE). These enzymes are involved in the regulation of inflammatory processes in tuberculosis. Balb/c mice infected with M. tuberculosis via the intratracheal route were treated with BB‐94 for 1 month, starting on the day of infection. Immunohistochemistry, semiquantitative RT‐PCR and ELISA assays for cytokines revealed a deficit in IL‐1 and IL‐2 expression and a premature bias towards IL‐4 expression, accompanied by a delay in granuloma formation and more rapid progression of disease in BB‐94‐treated animals. This situation corrected itself after the drug was withdrawn at 28 days. In contrast, when BB‐94 was administered only after 1 month there were no significant changes apart from the presence of amyloid, and a paradoxically increased expression of IL‐1α. These results cast light on mechanisms of immunity in tuberculosis and also indicate that in patients treated with similar broad‐spectrum MMP inhibitors there may be a risk of inappropriate deviation of some immune responses towards a Type‐2 cytokine profile.
Oral and dental anomalies in Ellis van Creveld syndrome (chondroectodermal dysplasia): report of a case
Authors: Hunter  , Roberts
Published: March 2003

A case of Ellis van Creveld syndrome is described in which, in addition to all the major features constituting the tetrad of chondroectodermal dysplasia, there was (unusually) bipedal hexadactyly. As well as the frequently reported oral anomalies, this case exhibited taurodontism of permanent and some primary molars, a finding rarely reported in this syndrome.
Aberrant root development of the mandibular premolars: a case report
Authors: Prabhu N.T. , John R. , Munshi A.K.
Published: March 2003

A rare case of a patient with aberrant root morphology in all the mandi‐bular premolars is reported. A thorough review of the dental literature revealed little significant data concerning such cases, because much of the literature is concerned with variation in root canal morphology rather than variations in root morphology. Failure to obtain preoperative radiographs of diagnostic quality could result in unexpected complications during endodontic treatment or extraction of such variant teeth.
The safety and efficacy of treatment with air abrasion technology
Authors: Wright G.Z. , Hatibovic‐Kofman S. , Millenaar D.W. , Braverman I.
Published: March 2003

Aims. To evaluate patient and operator exposure to respirable particulates following the use of air abrasion in tooth preparation, and to compare the microleakage of pit and fissure sealants after conventional, bur and air abrasion preparation of the pits and fisures.

Methods. To examine air abrasion safety, sampling data were collected using a physical model of the upper torso of a patient. Previously extracted bovine incisors were prepared using an air abrasion instrument. Patient and operator exposure samples were collected. The variables examined included the size of the alumina oxide particles, the speed of particle delivery and the method of dust collection.

 To assess the efficacy of air abrasion, 36 extracted human molars were divided into three groups. The groups were prepared by conventional acid etching, opening the pits and fissures with a round bur, or by air abrasion. To simulate oral conditions, sealed teeth were immersed in artificial saliva and thermocycled. Teeth were immersed in a 1% solution of methylene blue and sectioned to assess the microleakage associated with each sealant.

Conclusions. (1) Dust from the KCP 1000 is insufficient to be a health hazard to patients or operators, (2) chair‐side suction can be used as an alternative to the KCP 1000 suction, (3) superior sealants were obtained when tooth surfaces were prepared by a bur, compared to air abrasion and conventionally prepared surfaces, and (4) air abrasion tooth surfaces demonstrated less microleakage than conventionally prepared tooth surfaces.
Urinary fluoride excretion in children drinking fluoridated school milk
Authors: Ketley C.E. , Lennon M.A.
Published: March 2003

Summary.
Objective. To determine fluoride excretion under various conditions of fluoride intake and to estimate the fractional urinary excretion of fluoride in individual children participating in a school milk fluoridation scheme.

Design. In the first part of the study, individual urine samples were collected from each of eight 4 to 5‐year‐old children for a continuous period of 55 h. For each child (n = 8) and for each day (n = 3) the maximum urinary fluoride concentration (p.p.m.F), the maximum fluoride excretion rate (μgF/h) and the total daily fluoride excretion (mg) were calculated. The second part of the study was carried out to determine the 24 h fractional percentage of fluoride excreted following administration of a known dose of fluoride in the absence of other sources.

Results. Under usual conditions of fluoride intake (i.e. milk containing 0·5 mg fluoride, customary diet and toothbrushing with fluoride toothpaste) the children’s daily fluoride excretion was 0·33 mg. The fractional urinary fluoride excretion of a 0·5‐mg fluoride tablet was 30%.

Conclusions. It is concluded that the children’s mean 24 h fluoride excretion was somewhere between that reported in low fluoride conditions and that reported in optimally fluoridated areas. The fractional urinary fluoride excretion was found to be in agreement with the findings of other workers.
Dental attendance and dental health behaviour in children from deprived and non‐deprived areas of Salford, North‐West England
Authors: Eckersley A.J. , Blinkhorn F.A.
Published: March 2003

Aims. Firstly, to investigate reported oral health behaviours and changes in behaviour of 3‐year‐old children in deprived and non‐deprived wards of Salford, UK. Secondly, to examine differences in this behaviour between symptomatic and non‐symptomatic attenders. Thirdly, to note sources of dental health advice given to parents.

Design. Interviews using structured questionnaires.

Setting. Play groups and nurseries in Salford, North‐West England.

Method. Interviews with representative groups of mothers of 3‐year‐old children attending play groups and nurseries in selected deprived and non‐deprived wards, enquiring about dental attendance, dental health behaviour and changes in these resulting from dental advice.

Results. Mothers of 284 children were interviewed. Over three‐quarters of the children were reported to have a drink or food at bed‐time, or during the night, often containing non‐milk extrinsic sugars (NMES); more in the deprived wards. All parents reported a tooth brushing habit with over 90% using a fluoride toothpaste, those in non‐deprived wards beginning earlier in life and brushing more frequently. Most parents claimed that their children had seen a dentist at some time; more in the non‐deprived wards. More children in deprived wards were symptomatic attenders sometimes experiencing extractions under general anaesthesia. More parents in deprived wards remembered receiving dental health advice from the dental team and were more inclined to act on that advice.

Conclusion. Children from deprived wards were reported to have different dental health habits from those from non‐deprived wards. They were more likely to be fed NMES in food and drinks at bedtime, begin brushing later in life and brush less frequently and attend the dentist symptomatically. Their parents claimed to have received more dental health advice from the dental team and were more likely to act on that advice.
Space‐regaining treatment for a submerged primary molar: a case report
Authors: Altay N. , Cengiz S. B.
Published: March 2003

Summary.  The aetiology of submerged primary molars is not known and optimal treatment has still not been established. If submerged primary teeth are left untreated, the occlusal consequences are space‐loss due to tipping of adjacent teeth and/or overeruption of the opposing teeth. Normally, treatment consists of extraction of the deciduous teeth or observation for normal exfoliation. Here we report a case where the submerged primary molar was extracted surgically after space‐loss had been regained.
Measuring feeding difficulty in patients with dementia: multivariate analysis of feeding problems, nursing intervention and indicators of feeding difficulty
Authors: Watson Roger , Deary Ian J
Published: March 2003

The feeding difficulty of 196 elderly people with dementia was investigated by means of an 11‐item questionnaire administered to nursing staff The questionnaire was analysed by means of multivariate statistics, namely factor analysis The factor analysis demonstrated that the original items could be reduced to three factors These three factors were named (a) patient obstinacy or passivity, (b) nursing intervention, and (c) indicator of feeding difficulty This quantitative analysis confirms a previous qualitative distinction between items in the questionnaire and suggests avenues of research into the relationship between the factors
An exploratory study into a methodology for the examination of decision making by nurses in the clinical area
Authors: Watson Steve
Published: March 2003

This study was undertaken to explore decision making in the clinical area and why it is that some nurses make seemingly irrational decisions In the past simulations and decision frames have been used by psychologists and clinician researchers to examine decision making, although none of these methods were reported to have been used in the clinical area In the study 11 subjects were observed in the clinical area for 2 hours each and a total of 18 decisions were made by these subjects Each observation was followed by an interview in which the decisions were further explored and three simulations and four decision framed questions were also employed as comparative tools The subjects were also asked about their decision making strategies The method of using observation to collect data was effective and the effect of expenence was highlighted as one of the main factors influencing decision making The other methods proved useful as tools to examine particular aspects of decision making The effect of experience on decision making has wide reaching effects on future nurse education, as well as having professional implications in the area of autonomy, accountability and responsibility Further research in this area is then recommended
The arrogance of power: a reflection on contemporary mental health nursing practice*
Authors: Sines David
Published: March 2003

This paper explores the role of contemporary mental health nursing and challenges practitioners to acknowledge the influence that power relationships have on therapeutic practice and client outcomes It is argued that empowerment and advocacy remain central concepts for nursing and that the art of accurate empathy is a pre‐requisite for contemporary mental health care
A critical evaluation of the use of andragogical models in tackling social inequality in nursing education
Authors: Hughes Robert
Published: March 2003

Issues related to inequalities within nurse education are explored by drawing on issues related to oppression and exploitation in general education, higher education and to the specific ways nurses (pre‐registration and post‐basic) are selected and taught There is analysis of the way in which a holistic approach may be helpful in reducing inequalities, with specific reference being given to experiential learning and distance/open learning approaches The role of the education system in creating and maintaining inequalities is explored in terms of rights, chances and educational outcomes
The community psychiatric nurse in primary care: an economic analysis
Authors: Gournay Kevin , Brooking Julia
Published: March 2003

Community psychiatric nurses (CPNs) in the United Kingdom are increasingly working in primary health care settings with less serious mental health problems This paper describes an economic evaluation of their work using a randomized controlled trial in which 231 patients were assigned to continuing general practitioner care or one of two conditions of CPN intervention This is only the third systematic economic analysis of community mental health nursing in the UK and the first carried out by mental health nurses Various costs to patients, their families and the health care system were determined Results showed that patients receiving CPN intervention experienced less absence from work and that this resulted in a net benefit However, the cost per quality adjusted life year for intervening with this group of patients was probably several times more than for intervening with the seriously mentally ill Therefore, if one considers both the clinical and economic results of the study, taken together with the recent results of the review of mental health nursing, there seems little justification for CPNs continuing to work in this area
Professional responsibility: implications for nursing practice within the realms of cardiothoracics
Authors: Hancock Helen C.
Published: March 2003

Through an exploration of the realms of professional responsibility this paper aims to illustrate its implications in nursing practice with particular refernce to the area of cardiothoracics. Throughout the paper issues surrounding the‘Code of Professional Conduct for the Nurse, Midwife and Health Visitor’ and the‘The Scope of Professional Practice’ released by the United Kingdom Central Council or Nursing, Midwifery and Health Visiting (U.K.C.C.) in 1992 are considered.‘The Code’ as it will subsequently be referred to, and the‘The Scope of Professional Practice’(U.K.C.C.) address issues of current change withing the nursing profession and provide a focus for discussion. While recognising both current constraints to clinical practice and the complexity of professional responsibility, it is concluded that the delivery of research based, quality patient care remains central to the role of all nursing professionals. With a primary focus on others before the self, nursing professionals must continue to address issues surrounding the maintenance and development of this care.
Confidentiality and the acquired immune deficiency syndrome (AIDS): an analysis of the legal and professional Issues
Authors: Hayter Mark
Published: March 2003

Confidentiality is one of the most significant concepts in health care and nursing practice, particularly in the arena of HIV infection and AIDS. The implications for individuals of deliberate or accidental disclosure of their HIV status can and does have far reaching effects. This paper will explore the concept of confidentiality by discussing the legal and professional issue of confidentiality and AIDS. The nature of the law and guidance by professional bodies allow exceptions to the respect of confidentiality in certain situations. AIDS and the need for confidentiality often is in conflict when public health considerations are deemed to be involved. The law is poorly developed in this area and often professional guidance is less than clear.
Nurses' views on empowerment: a critical social theory perspective
Authors: Fulton Yvonne
Published: March 2003

This is the first study which describes British nurses' views on the concept of empowerment. Despite the frequent call for nurses to empower patients there was no evidence in the literature about British nurses' views. The study was carried out prior to a course exploring empowerment for practice. Focus groups were used to gather the data. Critical social theory and the work of Paulo Freire (1972) and Jurgen Habermas (1971, 1979) was used as a theoretical framework to underpin the enquiry. Taped interview transcripts were analysed thematically. Four categories emerged from the data to provide the framework for the themes: ‘empowerment’, ‘having personal power’, ‘relationships within the multidisciplinary team’, and ‘feeling right about oneself’. It is suggested that the nurses in this study manifested signs of being oppressed and striving for liberation. The limitations of the study are identified, but the overall conclusion is that the teaching of critical social theories as an empowerment paradigm is relevant in nurse education today.
Education in the practicum: a study of the ward learning climate in Hong Kong
Authors: Chun‐Heung Lee , French Peter
Published: March 2003

The major concern of this study was the quality of education in the practice setting in Hong Kong. Its purposes were to gain an understanding of how local Hong Kong student nurses perceive their practice experience, and to examine the quality of student nurses' practice experience in the light of an educational paradigm. A broad qualitative approach derived from some of the philosophical perspectives of phenomenology was adopted. The target population were those student nurses studying on hospital‐based pre‐registration programmes in Hong Kong. The total number of informants was 16, two from each of the eight schools of nursing. The semi‐structured interview method using open‐ended questions was used to collect data. All the interviews were conducted in Cantonese, being transcribed into Chinese and then into English. In order to provide some validity check on the adequacy of the translated interview transcripts, back‐translation was carried out. Both structural analysis (latent content analysis) and content analysis (manifest content analysis) were used to analyse the interview data. The 11 themes identified indicated that the practice experience was not an educational experience because the learning methods did not advance student nurses' intellectual development. Students were only equipped with knowledge which enabled them to act as model operators who were expected to carry out routines in an unreflective fashion. The issues of developing an effective clinical curriculum and creating a supportive clinical learning environment are discussed. It is argued that the associated problems are likely to be repeated, if not exacerbated, as baccalaureate nursing programmes are developed if the profession fails to address the issues reported in the current study. The mere transfer of nursing preparation to tertiary education cannot itself solve the problems existing in nursing education in Hong Kong.
Smoking habits among Finnish middle‐aged men: experiences and attitudes
Authors: Koivula Meeri , Paunonen Marita
Published: March 2003

The purpose of this study was to explain smoking habits amongst middle‐aged men in Finland by describing their experiences of smoking and their attitudes towards smoking. As a pilot survey for a major health campaign targeted at 40‐year‐old men, the data for this study were collected using two questionnaires in connection with voluntary medical examinations. The first questionnaire was based on Prochaska’s theory of stages of change in health behaviour. The second instrument was an attitude scale developed specifically for this study on the basis of Green and Kreuter’s theory of factors influencing health behaviour. According to the results 31% of males aged 40 were regular smokers. Men with a lower level of education and out of work smoked more often than others. Non‐smokers reported a better self‐perceived health than smokers. Smoking cessation is a process in which men gradually proceed from one step to the next. In this study 12% of the men were in the contemplation stage and 11% in the preparation stage. One‐quarter of the men had recently given up the habit and were in the action stage, while 2% had quit smoking over 6 months ago and were in the maintenance stage. One‐quarter of the men regarded smoking as an integral part of their way of life and felt that public opinion towards smoking is hostile.
Nursing assessments in New Zealand mental health
Authors: Street Annette , Walsh Chris
Published: March 2003

During 1992 a new Mental Health Act was implemented in New Zealand. The Act created a new role, that of the duly authorised officer (DAO) which has been mainly carried out by community mental health nurses. During 1994 a multi‐site qualitative research study was undertaken to describe the newly structured mental health nursing role and examine the issues related to it. A key issue which emerged was the concern that the nursing role had been defined and resourced by other groups (legal, medical and management) on the basis of its visible tasks rather than the invisible components of professional nursing knowledge and expertise. The legal descriptions of the DAO role negated the highly developed assessment skills of mental health nurses, suggesting that nurses are there for advice and assistance. Yet expert clinical judgement was pivotal to the effective functioning of the new role. This paper argues that the initial nursing mental health crisis assessment which is carried out in the community is a highly skilled nursing activity which must be recognized and resourced accordingly.
Occupational stress and community mental health nursing: what CPNs really said
Authors: Hopkinson Patrick J. , Carson Jerome , Brown Daniel , Fagin Leonard , Bartlett Heather , Leary John
Published: March 2003

The Claybury Nursing Stress Study assessed the levels of occupational stress experienced by both ward‐based and community nurses. This paper presents the results obtained from a qualitative analysis of statements made by community psychiatric nurses during a questionaire based interview. Key areas identified by CPNs as relevant to stress and coping are reported and suggestions for further, qualitative research in this area are made.
The work of clinical nurse specialists (HIV/AIDS) in areas with a low prevalence of HIV infection
Authors: Irwin Robert
Published: March 2003

The role of the clinical nurse specialists (HIV/AIDS) who work in areas with a low known prevalence of HIV is considered and their contribution to patient care, either directly or indirectly through the education and support of other health care workers, is discussed. Attention is given to the implications for nursing practice and the role of the clinical nurse specialist associated with the relative infrequency of contact with patients who have HIV disease; and some of the issues for people living with HIV/AIDS in rural areas are alluded to. Finally, some of the limitations of the clinical nurse specialist role are delineated and some consideration is given to the future role of clinical nurse specialists for HIV and AIDS.