bluuebunny/crossref_metadata_2025_split huggingface dataset:
R7 Theatre time trials: an efficiency study of paediatric dentistry lists
Authors: MOONEY* G. , NORTH S. , DAVIDSON L. E. , BENSON R. , RODD H. D. 
Published: August 2006

Objective:  To determine usage of theatre time during Paediatric Dentistry operating lists.Design:  Prospective cross‐sectional study.Setting:  Operating theatres, Sheffield Children's Hospital.Sample and methods:  A standard data collection sheet was employed to record the following information: session (am/pm); type and time of anaesthetic induction; medical status of patient; dental procedures undertaken and total operating time; start and finish time of list and reason for any delays. Each session allocation was 210 minutes.Results:  Data were collected for 36 consecutive Paediatric Dentistry lists over a 4‐month period, involving 95 patients. A further eight patients were cancelled on admission. Only one list started on time, the remaining lists had a mean delay of 16 minutes (SD = 12.9; range = 1–51). Delays were mainly attributed to porter shortages, ward delays and late arrival of the anaesthetist. The mean time taken to anaesthetise a patient was 18 minutes (SD = 7.7; range = 5–42) with no significant differences according to type of intubation or patient's medical status (P > 0.05, ANOVA). Mean operating time was 32 minutes (SD = 19.6; range = 5–128) with significant time differences according to procedures undertaken and the patient's medical condition (P < 0.05, ANOVA). Six lists ran overtime by a mean 28.7 minutes (SD = 30.2; range = 3–85) and 25 lists finished early by a mean 56.4 minutes (SD = 41.2; range = 1–170). Overall, a mean 60 minutes (SD = 42.0; range = 1–184) are ‘wasted’ during every theatre list, with total anaesthetic and operating time accounting for only 71% of the actual session allocation.Conclusions:  This study has revealed significant inefficiencies within hospital systems, which may adversely affect productivity.
C2 Management of a patient exhibiting concomitant supernumerary teeth and hypodontia
Authors: PATCHETT* C. L. , SARGISON A. E. , COLE B. O. I. 
Published: August 2006

Presenting problem:  A 9‐year‐old boy was referred by his General Dental Practitioner for the management of supernumerary teeth in the anterior maxilla. The child had little experience of dental treatment but was concerned with the aesthetics of his teeth. He was medically fit and well. Clinical and radiographic examination revealed the presence of a supplemental megadont tooth in the position of 11, an erupted palatal tuberculate supernumerary tooth causing displacement on closure and hypodontia of 35 and 45 with infraocclusion of 75. Orthodontically, the patient had a Class II division 1 incisal relationship on a mild Class II skeletal base. He was severely crowded in the upper arch but the lower arch was well aligned. Oral hygiene was noted to be poor.Clinical management:  All treatment was provided under the close supervision of an Associate Specialist in Orthodontics and initially involved extraction of 53 and the palatal supernumerary tooth and thorough oral hygiene instruction and preventive advice. Following further dental development, the megadont tooth and 24 were extracted to facilitate orthodontic alignment with an upper fixed appliance. A heat‐treated gold onlay has been provided for 75 and 85 is currently monitored for signs of infraocclusion.Discussion:  There are few reported cases in the literature of concomitant supernumerary teeth and hypodontia. This case describes the multi‐disciplinary management of a child with a complex dental problem.
C4 Staphylococcus aureus infection associated with orofacial granulomatosis
Authors: GILCHRIST* F. , GIBSON J. 
Published: August 2006

Presenting problem:  A 6‐year‐old girl attended the Department of Paediatric Dentistry at Edinburgh Dental Institute complaining of swelling and blistering of her upper lips and adjacent gingivae, which had been present for approximately 1 month. The patient had an unremarkable medical history.Clinical management:  Examination revealed submandibular lymphadenopathy with vesiculation and erythema in the upper incisor region. There was swelling and crusting of the upper lip with slight swelling of the lower lip. Foetor oris was evident. An initial diagnosis of primary herpetic gingivostomatitis was made. Despite treatment the lesions did not resolve. At review, the patient's mother stated that the patient was now suffering abdominal pain and diarrhoea. Haematological investigations revealed no abnormalities. Punch biopsies of the lips carried out under general anaesthesia showed lymphoedema but no granulomata. It was felt by the pathologist that the appearance was of a secondarily infected lesion with an underlying allergic component, most likely to be orofacial granulomatosis (OFG). Swabs sent for bacterial and fungal culture identified no fungal species but Staphlycoccous aureus was present in large numbers. The patient was prescribed Nystaform® cream and oral flucloxacillin which has improved the appearance of the upper lips. The patient has been referred for patch testing, and also to gastroenterology for investigation.Discussion:  Staphylococcal mucositis has been reported previously in a series of patients with OFG. This case demonstrates an unusual presentation of Staphylococcus aureus infection, previously unreported, in a child with OFG.
C5 Oral submucous fibrosis in paediatric patients
Authors: HAYES M. L. , RICHARDS A. M. 
Published: August 2006

Presenting complaint:  This case report relates to two paediatric patients, aged 11 and 13 years, referred to the Birmingham Dental Hospital with limited oral opening. In both instances, this limitation of opening was of unknown duration but thought to be progressive in nature by the referring agent.Clinical management:  On examination, the inter‐incisal opening was found to be approximately 15–20 mm. On questioning, a betel chewing habit was identified in both patients. The mucosa was found to be pale and taut in nature. Both patients and parents were counselled on the adverse effects of betel chewing and the possibility of tissue changes as a result. Symptomatic relief was provided with benzydamine hydrochloride and biopsies of the affected sites were carried out. A histological diagnosis of oral submucous fibrosis was made in both instances.Discussion:  Oral submucous fibrosis is recognized as a pre‐malignant condition. It is thought to be associated with an epithelial inflammatory reaction and subsequent fibro‐epithelial change. This can lead to epithelial atrophy and later mucosal stiffening. The occurrence of oral submucous fibrosis in younger patients is extremely uncommon. This case report highlights the importance of investigating the social history of presenting patients and the need to improve patient and parent education in relation to the habit of betel nut chewing.
C6 A case of facial cellulitis associated with a supplemental tooth
Authors: MITCHELL J. C. , AHLUWALIA* M. 
Published: August 2006

Presenting problem:  An 8‐year‐old boy presented with a facial cellulitis. This appeared to be associated with the right maxillary lateral incisor.Clinical management:  There was no history of dental trauma. It was reported that a primary supplemental tooth had been present in the right premaxilla. On examination the right maxillary lateral incisor had a deep palatal pit and was grade 3 mobile. There was evidence of a tooth erupting palatal to this tooth. The radiographic examination suggested the right lateral incisor tooth was supplemental, invaginated and had an apical radiolucent area. The acute infection was managed by extirpating the pulp and dressing the supplemental tooth with non‐setting calcium hydroxide. It was later removed under inhalation sedation and local anaesthetic. The ectopic tooth was monitored and subsequently erupted palatally. This may require orthodontic interception in the future for the correction of a crossbite.Discussion:  The prevalence of supernumerary teeth in the permanent dentition has been reported as 0.1–3.8%. They are less frequently seen in the primary dentition. However, it is not uncommon for a child to present with dental anomalies in both dentitions. In this case study, the subject had a supplemental lateral incisor in both the primary and permanent dentition. The permanent supplemental tooth was invaginated, confirmed by histological examination. The cellulitis was therefore caused by the invaginated odontome.
Radiographic Evolution of the Forelimb Digit in Ardenner Horses from Weaning to 28 months of Age and its Clinical Significance
Authors: Lejeune J. P. , Schneider N. , Caudron I. , Duvivier D. H. , Serteyn D. 
Published: August 2006

SummaryOssification of collateral cartilages is a common radiographic finding in draught horses and indication of a high frequency of interphalangeal osteo‐arthropathy have been found in Ardenner horses. This study first aimed at following the evolution of the digits of the forelimbs on radiographic images in a group of 32 Ardenner horses from weaning to 852 ± 19 days and, secondly, at evaluating the clinical significance of the observed radiographic changes. At 250 ± 21 days, only 23% of the horses presented a small separate ossification centre of collateral cartilages above the level of the distal sesamoid bone or at the level of the proximal half of the middle phalanx. At 852 ± 19 days, 100% of the horses presented an ossification of collateral cartilages but at different stages and grades. The presence and the extent of the ossification of the lateral cartilages were not significantly associated with lameness. Phalanges changes appeared at the average age of 1 year and they were represented by entheseophytes on the dorsal surface of the middle and distal phalanges. The frequency of affected horses increased with age as well as the size of the entheseophytes. This may reflect mechanical stresses applied to the interphalangeal joints. A significant association with the presence of lameness was pointed out. The presence and the severity of phalanges changes could be of importance, in combination with a clinical examination, in improving the selection of horses able to assume work and/or leisure activities.
Effects of Flunixin Meglumine on Selected Clinicopathologic Variables, and Serum Testosterone Concentration in Stallions after Endotoxin Administration
Authors: Danek J. 
Published: August 2006

SummaryFour clinically normal stallions were infused intravenously with endotoxin (LPS) fromEscherichia coli055:B5 at a dose of 0.3 μg/kg b.w. and four stallions were treated with flunixin meglumine (FM) as a single intravenous injection at a dose of 1.1 mg/kg b.w., 5 min after the infusion of LPS. In response to endotoxin infusion, stallions’ reaction was fever (increased rectal and scrotal skin temperature), increased heart rate (HR) and leucopenia. Administration of endotoxin also influenced the level of testosterone (decrease at 3–24 h and increase at 48–72 h after LPS administration) in the blood serum. FM treatment prevented an endotoxin‐induced increase in rectal and scrotal skin temperature, HR, with no influence on the decrease of leucocytes. Administration of FM only had a significant effect on the latter changes (at 24–72 h) of serum testosterone concentration after addition of endotoxin.
Increased Number of Neurons Expressing Androgen Receptor in the Basolateral Amygdala of Pathologically Aggressive Dogs
Authors: Jacobs C. , Van Den Broeck W. , Simoens P. 
Published: August 2006

SummaryThe present study aimed to determine the extent to which the androgen receptor (AR) is directly involved in the hormonal modulation of pathological canine aggressive behaviour in the basolateral nuclear group (BNG) of the amygdaloid body. A stereological quantification of AR‐positive neurons was performed in the BNGs of normally behaving and aggressive male dogs. The BNG was selected because it is involved in sexual and behavioural activities that are influenced by androgens. In the aggressive dogs the BNG contained a significantly higher number of AR‐positive neurons compared with normally behaving dogs suggesting differences in androgen activity within the BNGs of both the groups. However, additional mechanisms are likely to be involved because the AR‐negative fraction of BNG neurons was also increased in the aggressive dogs. It was concluded that most of the AR was unliganded because a cytoplasmic staining pattern of AR positivity was observed in the canine BNG neurons. This indicates that genomic androgen actions, which are mediated through the AR are of minor importance in the testosterone modulation of canine aggression within the BNG. Other non‐genomic mechanisms through which androgens may exert their action in the BNG are discussed. The aromatase pathway is suggested to be the main mechanism through which testosterone exerts its action within the BNG.
Effect of Vitamin E Supplementation on Lymphocyte Distribution in Gut‐Associated Lymphoid Tissues Obtained from Weaned Piglets
Authors: Fragou S. , Balaskas C. , Fegeros K. , Politis I. 
Published: August 2006

SummaryFifteen piglets were used to determine the effect of vitamin E supplementation on the number of CD4‐immunoreactive (CD4+) T‐lymphocytes, CD8‐immunoreactive (CD8+) T‐lymphocytes and IgA‐immunoreactive (IgA+) B‐lymphocytes per follicle in the Peyer's patch of distal ileum and the mesenteric lymph nodes of weaned piglets. Piglets, following a 3‐day adaptation period after weaning, were assigned to one of three experimental groups: control (no vitamin E supplementation), vitamin E supplementation of 100 mg/kg of diet and vitamin E supplementation of 300 mg/kg of diet. Supplementation of vitamin E lasted for a period of 36 days. The basal diet contained 80 mg α‐tocopherol/kg of diet. All piglets were killed at day 39 after weaning and samples of the distal ileum and adjacent mesenteric lymph nodes were collected. The number of cells for each lymphocyte subset was counted in the Peyer's patch and the mesenteric lymph nodes follicles, in cryostat sections processed for immunohistochemistry. Results showed that vitamin E supplementation (300 mg/kg diet) of piglets caused an increase (P < 0.05) in the number of IgA+ B‐lymphocytes in the Peyer's patch, but not in the mesenteric lymph nodes, compared with the corresponding values in control animals. Vitamin E supplementation had no effect (P > 0.05) on the number of CD4+ and CD8+ T‐lymphocytes in the follicles of the Peyer's patch and the adjacent mesenteric lymph nodes. Thus, vitamin E had relatively minor effects on distribution of the major immunocompetent cells in the gut. The numbers of CD4+ and CD8+ T‐lymphocytes as well as IgA+ B‐lymphocytes per follicle were higher by 26–77% (P < 0.05) in the mesenteric lymph nodes than the corresponding values in the Peyer's patch.
A New Method for Detecting the Abomasal Position and Characteristics of Movement at the Onset of the Left Displacement of the Abomasum in Cows
Authors: Itoh N. , Egawa M. , Kitazawa T. , Ueda M. , Koiwa M. 
Published: August 2006

SummaryA new method has been developed by us to observe the movements of the abomasum by using a magnet and digital magnetometer. Four cows with left displacement of the abomasum underwent conventional correction by rolling without tacking. A doughnut‐type magnet was sutured to the pyloric region in a routine operation. The same was done in three control cows. The position of the pyloric region was observed with a digital magnetometer from outside the cow's body. The magnets in the pyloric region of the control cows were located at the right side of the abdominal cavity at 10–30 cm anterior to the udder base, and moved slightly in various directions within the span of a day. On the other hand, the magnets in the pyloric region of cows with abomasal displacement moved widely in the abdominal cavity from the normal right side to the abnormal left front side. A large movement of the magnet from the normal right side to the abnormal left side of the abdominal cavity was observed within 12 h of the onset of abomasal displacement.
COMPARISON OF MAJOR BILE DUCT INJURIES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY AND OPEN CHOLECYSTECTOMY
Authors: Kaman Lileswar , Sanyal Sudip , Behera Arunanshu , Singh Rajinder , Katariya Rabindra N. 
Published: August 2006

Background:  The mechanism and extent of major bile duct injuries following laparoscopic cholecystectomy differ from those of open cholecystectomy.Methods:  To identify differences in the demographic profile, timing of injury detection, management strategies and outcome, we undertook a retrospective review and analysis of our experience with 55 major bile duct injuries following both laparoscopic and open cholecystectomies over a period of 9 years.Results:  Thirty‐one major bile duct injuries resulted from laparoscopic cholecystectomy (56%) and 24 of them were sustained after open cholecystectomy (44%). The median time of presentation was 7 days after laparoscopic cholecystectomy and 14 days following open cholecystectomy (P < 0.001). Twenty‐eight (51%) patients had injuries recognized intraoperatively in both groups, of whom 18 patients underwent an attempt at primary repair before referral. All patients required subsequent surgical intervention. There were no differences in the clinical presentations between the two groups. However, serum alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase levels were significantly higher following open cholecystectomy (P < 0.05). There was no significant difference in the level of injury between the two groups. All patients underwent surgical repair in the form of a Roux‐en‐Y hepaticojejunostomy (including two revision hepaticojejunostomies in each group). Surgical outcome did not differ between the groups; however, better results were seen with Bismuth grades 1 and 2 strictures compared with Bismuth grades 3 and 4 strictures for both groups (P < 0.002).Conclusion:  Major bile duct injuries following laparoscopic cholecystectomy present earlier and with lower levels of serum alkaline phosphatase, alanine aminotransferase and aspartate aminotransferase. There does not appear to be a significant difference between the Bismuth–Strasberg grading of the strictures and the type of surgery carried out.
NEW STRATEGY TO PREVENT ASCENDING CHOLANGITIS IN LARGER CHOLEDOCHODUODENAL FISTULA
Authors: Li Zhi‐Hua , Ding Jun , Ye Yongqian , Cai Lei , Liu Xiangde , Liu Jikui , Chen Ming , Li Xiaowu , Dong Jiahong 
Published: August 2006

Background:  Choledochoduodenal fistula (CDF) is a complication of common bile duct stones or cholangitis in Asia. It is unclear as to which type of the fistula needs surgical treatment.Methods:  To determine whether the sizes of CDF imply different clinical presentations and treatments, we reviewed 50 patients with CDF and their treatments during a recent 14‐year period. For treatments of CDF, we applied the conventional methods, including removal of stone and complete decompression of biliary obstruction to treat the original bile lesions. In addition, according to the sizes of fistula and the frequencies of ascending cholangitis, we proposed the following strategies for fistula treatments: (i) for fistula orifices larger than 1 cm, a transection of common bile duct was applied to prevent the reflux of duodenal juice; (ii) for fistula orifices between 0.5 and 1.0 cm, an effective biliary drainage was applied; and (iii) for fistula orifices less than 0.5 cm, non‐surgical treatments were applied.Results:  We found that hepatic biliary duct stones and hepatic biliary duct strictures were associated with more severe cholangitis (P = 0.037 and P = 0.009, respectively), but not with the episodes of cholangitis (P = 0.654 and P = 0.664, respectively). In contrast, the sizes of fistula >1 cm were associated with more frequent episodes of cholangitis (r = 0.774; P < 0.001).Conclusion:  The larger fistula increases frequency of cholangitis episodes and needs surgical treatment for fistula itself.
DOES MATRIX METALLOPROTEINASE ACTIVITY PREDICT SEVERITY OF ACUTE PANCREATITIS?
Authors: Aynaci Murat , Tuncyurek Pars , Nart Deniz , Zeytunlu Murat , Ozutemiz Omer , Ersoz Galip , Yilmaz Funda , Mayer Jens , Coker Ahmet 
Published: August 2006

Background:  Matrix metalloproteinases (MMP) modulate end‐organ complications of acute pancreatitis, but the correlation between increased MMP production and histological severity of disease remains unclear. We examined the role of MMP and pancreas histology on experimental acute pancreatitis.Methods:  Forty male Wistar albino rats were subjected to cerulein‐induced pancreatitis (8, 16, 24 and 32 h groups) or sham treatment. The animals were killed at different time points and pancreatic tissues were harvested to assess MMP (1, 2 and 9) activity and inflammatory changes.Results:  Compared with other groups, 8 h group had decreased tissue MMP‐1 concentrations. MMP‐9 concentrations were lower in 24‐h and 32‐h groups, as were histological severity scores. MMP‐2 activity did not differ among groups. Pancreatitis was prominent in 8‐h, 16‐h and 24‐h groups by means of histology.Conclusion:  Induction of pancreatitis by cerulein altered pancreatic MMP levels in the early phase of inflammation. Inhibition of MMP‐2 and MMP‐9 paralleled histological scores. Therefore, MMP may have a predictive value to assess histological severity.
COMPARISON OF THE POSSUM, P‐POSSUM AND CR‐POSSUM SCORING SYSTEMS AS PREDICTORS OF POSTOPERATIVE MORTALITY IN PATIENTS UNDERGOING MAJOR COLORECTAL SURGERY
Authors: Vather Ryash , Zargar‐Shoshtari Kamran , Adegbola Samuel , Hill Andrew G. 
Published: August 2006

Background:  Physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM), ‘Portsmouth’‐physiologic and operative severity score for the enumeration of mortality and morbidity (P‐POSSUM) and ‘Colorectal’‐physiologic and operative severity score for the enumeration of mortality and morbidity (Cr‐POSSUM) are three related scoring systems, which uses individual patient parameters to predict postoperative mortality. POSSUM overpredicts mortality in low‐risk patients and underpredicts mortality in elderly and emergency patients. P‐POSSUM was developed to compensate for these weaknesses. Cr‐POSSUM was developed specifically for colorectal surgery. We aim to establish which of these scoring systems would be most useful in an Australasian context.Methods:  Data were collected for 308 patients and predicted mortality risk values were generated using each of the three systems. The Mann–Whitney U‐test was then carried out on the scores for each system. Receiver–operator characteristic curves were designed to determine the relative accuracy of each approach at discriminating between death and survival.Results:  All three POSSUM scoring systems showed a statistically significant ability to predict postoperative mortality. Additionally, in each system there was a significant difference in the raw physiologic and operative severity scores between survivors and those who died. A risk‐stratification model was applied to each set of data, showing a correlation between an increase in risk and an increase in mortality rate. Finally, the receiver–operator characteristic curves generated showed that in this study group POSSUM, P‐POSSUM and Cr‐POSSUM were all satisfactory predictive tools although the latter tended to be relatively less accurate.Conclusion:  Physiologic and operative severity score for the enumeration of mortality and morbidity, P‐POSSUM and Cr‐POSSUM are all reliable predictors of postoperative mortality in the Australasian context; although there was a trend towards POSSUM and P‐POSSUM being better predictors than Cr‐POSSUM. However, Cr‐POSSUM requires fewer individual patient parameters to be calculated and is thus easier to generate. An ideal preoperative scoring system remains to be developed for predicting mortality in patients undergoing colorectal surgery.