bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Vocational Training in Graduate Education
Authors: Seth‐Smith A 
Published: April 2006

New dental graduates are required to undertake vocational training (VT) in many European countries. Arrangements for this training vary and to some extent there are different perceptions of its purpose. In some countries without VT there are established practices for taking the new graduate into an independent working environment. In these countries would VT be a better (perhaps more expensive) system for the new dentist and for patients?The presentation touched on the different systems of VT and how they complement the knowledge and experience gained earlier at dental school. As the 5‐year undergraduate curriculum develops the content and delivery of VT should be reviewed.Vocational training provides a stepping‐stone from the supported environment of a dental school to the commercial realities of running a business with high patient expectation. On the completion of the undergraduate dental degree and VT a dentist should be expected to have progressed from theory through competence to proficiency. It is important to look at how this achievement is tested at the end of VT.Vocational training places a responsibility on trainers to ensure the trainees develop good clinical technique, communicate well with patients and colleagues, and generally become more assured in practising routine dentistry. Ideally VT should prepare the dentists for the rest of their careers, leading naturally to postgraduate education and a commitment to continuing professional development. VT should give new dentists the opportunity to make informed decisions on the future direction of their career.In certain parts of the UK there are programmes extending the 1 year of VT to a 2‐year structure, which includes periods of hospital and community dentistry. Proposals are now being made to formalise the 2 years into a system, which provides a postgraduate qualification. This may then lead to further pathways of training and qualification.
The Interface Between Undergraduate and Graduate Education
Authors: Divaris K 
Published: April 2006

Latest developments in the harmonisation process of dental education in Europe have resulted in a broad consensus of the ‘Profile of the European Dentist’. The ‘Profile’ defines the major competencies that graduating students must have attained, but allows a significant degree of variation in the educational content and methods employed by dental schools in order to achieve them. Consequently, differing ‘supporting competences’ adopted in dental curricula may be influencing the interface between undergraduate and graduate education and their content. This borderline remains mostly unclear among countries/dental schools and yet adhering to the ‘Profile’.This presentation provided insight into the dental student standpoint on the aims and content of undergraduate education, the role of research in education and their ‘exposure’ to all domains of clinical dentistry. Undergraduate motives and expectations of graduate education were discussed. Finally, practical issues for dental schools operating a broad spectrum of graduate programmes were considered, with regard to undergraduate training.
Burning mouth syndrome: Clinical presentation, diagnosis and treatment
Authors: Savage Neil W , Boras Vanja V , Barker Kate 
Published: April 2006

SUMMARYBurning mouth syndrome is an oral dysaesthesia presenting as a burning sensation of the tongue and less frequently other oral and peri‐oral sites. There may be other coincident symptoms and signs, but the defining feature is the absence of any obvious organic cause. Because of this the condition frequently remains unrecognized for extended periods with a variable progression of symptoms. The current paper describes the complex presentation of burning mouth syndrome with the major aim of increasing recognition.
Skin care in occupational contact dermatitis of the hands
Authors: Moyle Mignon , Keegel Tessa , Noonan Amanda , Nixon Rosemary 
Published: April 2006

SUMMARYA survey of patients attending an occupational dermatology clinic with suspected occupational contact dermatitis affecting the hands was undertaken to determine if optimal skin care treatment had been instituted prior to referral for patch testing. Appropriate treatment for contact dermatitis of the hands was defined as concurrent use of a soap substitute, use of a lipid‐rich moisturizer, and if appropriate, use of a topical corticosteroid in an ointment vehicle. Patients were asked about the use of a particular soap substitute, the name and type of any moisturizer used and the name and type of topical corticosteroids currently used. The products were examined where possible. Only one‐third of all patients were using the complete package at the time of their clinic appointment. Nearly all of these patients had seen a dermatologist prior to this appointment. Of the group of patients with work‐related diseases who reported having seen a dermatologist prior to the clinic appointment, only 38% were using the complete skin care routine.
Chronic urticaria due to Blastocystis hominis
Authors: Gupta Ritu , Parsi Kurosh 
Published: April 2006

SUMMARYA 24‐year‐old woman had a 9‐week history of second to third daily urticaria that began after an episode of contact urticaria to topical bufexamac. She was found to have an underlying gastrointestinal infection with Blastocystis hominis. This was thought to be clinically relevant as she had a history of mild chronic diarrhoea. After treatment of the Blastocystis hominis, her urticaria ceased. This could indicate the importance of performing stool microscopy and culture on all patients with chronic urticaria of unknown aetiology. The relationship of urticaria to intestinal parasites and the possibility that non‐steroidal anti‐inflammatory medications could act as cofactors that help precipitate an urticarial reaction is discussed.
Successful treatment of type I adult‐onset pityriasis rubra pilaris with infliximab
Authors: Manoharan Shobhan , White Stephen , Gumparthy Krishna 
Published: April 2006

SUMMARYA 59‐year‐old woman presented with a painful, pruritic eruption that had commenced as an erythematous, dry patch on the upper back but progressed to erythroderma. Examination revealed orange‐tinged erythroderma, scalp scaling, ectropion, palmoplantar keratoderma and nail changes. A diagnosis of type I adult‐onset pityriasis rubra pilaris was made, and a subsequent skin biopsy was consistent with this. She was treated with a number of topical and systemic agents with minimal improvement or major side‐effects. The patient was then treated with intravenous infliximab 5 mg/kg. She improved dramatically within 2 weeks and was no longer erythrodermic. Five further infusions resulted in additional improvement. Methotrexate was briefly added to the regime, but was ceased owing to nausea. Topical tar and keratolytics were used on the scalp. The patient was left with minimal disease activity and was maintained on emollients.
Multiple periungual pyogenic granulomas following systemic 5‐fluorouracil
Authors: Curr Nathan , Saunders Helen , Murugasu Anand , Cooray Prasad , Schwarz Max , Gin Douglas 
Published: April 2006

SUMMARYA 65‐year‐old man presented with a 7‐month history of eight bleeding periungual lesions on both feet. The clinical diagnosis of multiple pyogenic granulomas was confirmed by histological examination. Historically, the pyogenic granulomas appeared 3 months after commencing 5‐fluorouracil chemotherapy for rectal carcinoma, suggesting a possible causative relationship. Chemotherapy was ceased by the supervising oncologist. Resolution occurred after two lesions had been treated with curettage and diathermy, and the remaining lesions with occlusive dressings over Kenacomb ointment (triamcinolone acetonide 0.1%, neomycin sulphate 0.25%, gramicidin 0.025%, nystatin 100 000 U/g) topically twice daily for a period of 3 months.
Role of uric acid in different types of calcium oxalate renal calculi
Authors: GRASES FÉLIX , SANCHIS PILAR , PERELLÓ JOAN , COSTA‐BAUZÁ ANTONIA 
Published: April 2006

Aim:  The presence of uric acid in the beginning zone of different types of ‘pure’ calcium oxalate renal calculi was evaluated with the aim of establishing the degree of participation of uric acid crystals in the formation of such calculi.Methods:  The core or fragment of different types of ‘pure’ calcium oxalate renal calculi was detached, pulverized and uric acid extracted. Uric acid was determined using a high‐performance liquid chromatography/mass spectrometry method.Results:  In calcium oxalate monohydrate (COM) papillary calculi with a core constituted by COM crystals and organic matter, 0.030 ± 0.007% uric acid was found in the core. In COM papillary calculi with a core constituted by hydroxyapatite, 0.031 ± 0.008% uric acid was found in the core. In COM unattached calculi (formed in renal cavities) with the core mainly formed by COM crystals and organic matter, 0.24 ± 0.09% uric acid was found in the core. In COM unattached calculi with the core formed by uric acid identifiable by scanning electron microscopy (SEM) coupled to X‐ray microanalysis, 20.8 ± 7.8% uric acid was found in the core. In calcium oxalate dihydrate (COD) unattached calculi containing little amounts of organic matter, 0.012 ± 0.004% uric acid was found. In COD unattached calculi containing little amounts of organic matter and hydroxyapatite, 0.0030 ± 0.0004% of uric acid was found.Conclusions:  From these results it can be deduced that uric acid can play an important role as inducer (heterogeneous nucleant) of COM unattached calculi with the core formed by uric acid identifiable by SEM coupled to X‐ray microanalysis (these calculi constitute the 1.2% of all calculi) and in COM unattached calculi with the core mainly formed by COM crystals and organic matter (these calculi constitute the 10.8% of all calculi).
Identification of autoantibodies elicited in a patient with prostate cancer presenting as dermatomyositis
Authors: MOONEY COLIN J , DUNPHY EDWARD J , STONE BRAD , MCNEEL DOUGLAS G 
Published: April 2006

Objectives:  Dermatomyositis is an uncommon autoimmune disease distinguished by proximal muscle weakness and a characteristic skin rash. Dermatomyositis has also frequently been associated with malignancy, typically heralding the diagnosis of ovarian, lung, gastric, or colorectal cancer. We report an unusual case of prostate adenocarcinoma preceded by a diagnosis of dermatomyositis. We hypothesized that in this particular patient, proteins produced by the neoplastic prostatic tissue, which might be normally expressed in muscle tissue, were immunologically recognized as autoantigens.Methods:  Serum from this patient was used to screen a cDNA lambda phage expression library from normal prostate tissue for prostate protein‐specific IgG.Results:  We identified several immunoreactive plaques encoding known autoantigens, and several encoding known muscle‐related proteins, including aldolase C, eukaryotic translation elongation factor 1 α 1, transgelin, and acetyl‐coenzyme A acyltransferase 1. IgG specific for these proteins were not specifically recognized in sera from other patients with prostate cancer compared with male control blood donors, and were not specifically recognized in a small panel of sera from patients with breast or ovarian cancer and dermatomyositis.Conclusions:  Our results demonstrate that this patient with prostate cancer presenting as dermatomyositis had autoantibodies to specific proteins, possibly associated with his autoimmune myopathy. Moreover, given this patient's history and the multiple treatment options for prostate cancer, the identification of dermatomyositis in men should prompt an evaluation to exclude a concurrent diagnosis of prostate cancer.
Peroxisome proliferator‐activated receptor gamma is frequently underexpressed in renal cell carcinoma
Authors: YUAN JINYANG , TAKAHASHI ATSUSHI , MASUMORI NAOYA , ITOH NAOKI , TSUKAMOTO TAIJI 
Published: April 2006

Aim:  To examine peroxisome proliferator‐activated receptor gamma (PPARγ) mRNA expression quantitatively in human renal cell carcinoma (RCC) cell lines and RCC tissue, as well as in corresponding normal kidney tissue.Methods:  We examined PPARγ mRNA expression quantitatively in six human RCC cell lines by real‐time reverse transcription–polymerase chain reaction. In addition, we evaluated the relationship between cell growth inhibition by PPARγ ligands and the level of PPARγ mRNA expression. We compared the expression of PPARγ mRNA in 47 RCC tissues with that in corresponding normal kidney tissue, and investigated the relationship between clinicopathological features and the level of PPARγ mRNA expression.Results:  Among the six RCC cell lines, five showed decreased PPARγ mRNA expression. There was no relationship between the inhibitory effects of PPARγ ligands and PPARγ mRNA expression levels. Of the tissues from 47 RCC patients, 25 (53%) showed decreased expression of PPARγ mRNA compared to corresponding normal kidney tissue, and one was equivalent to normal tissue. These patients had distant metastasis at diagnosis more frequently than the remaining patients with high expression. There was also a trend for these patients to have a higher stage.Conclusions:  Most RCC cell lines showed decreased expression of PPARγ mRNA. However, the level of PPARγ mRNA expression did not affect cell growth inhibition by PPARγ ligands. More than half of the tissues from RCC patients had low expression of PPARγ mRNA, and such carcinomas might have more aggressive behavior.
Robotic urological surgery in patients with prior abdominal operations is not associated with increased complications
Authors: NAZEMI TANYA , GALICH ANTON , SMITH LYNETTE , BALAJI KC 
Published: April 2006

Background:  The da Vinci Surgical Robotic System is being increasingly used to perform complex urological operations by minimally invasive techniques. Prior abdominal surgery associated with intra‐abdominal adhesions may complicate robotic surgery.Methods:  We used a cohort of consecutive 49 patients undergoing a variety of robotic urological procedures at our institution to study the impact of prior abdominal operations on early perioperative complications.Results:  A total of 21/49 (43%) patients (Group A) had no history of prior abdominal surgery and the rest 28/49 (57%; Group B) had undergone prior abdominal surgery. The incidence of peritoneal adhesions was significantly higher in patients with prior abdominal surgery compared to the rest of the cohort, 54% versus 10% (P = 0.002). The median operative time, estimated blood loss, postoperative drop in hemoglobin, time to hospital discharge, postoperative narcotic analgesic use and postoperative complication rate between group A and group B were not statistically different. The overall perioperative complication rate for the entire cohort was 14.3%, with 6–8% of complications occurring in each of the two groups (P = 1.0). Comparative subset analysis of 28 patients in Group B, 15 (54%) and 13 (46%) with or without intra‐abdominal adhesions did not reveal a significant difference in perioperative complication rates either. However, operative time was longer in patients with intra‐abdominal adhesions compared to patients without, median of 590 (281‐922) and 434 (153–723) min respectively, although not statistically significant (P = 0.059).Conclusion:  Our study demonstrates that robotic urological surgery can be performed in patients with prior abdominal surgery without increased perioperative complications.
Comparison of the effects of on‐pump versus off‐pump coronary artery bypass surgery on serum prostate‐specific antigen levels
Authors: PARLAKTAS BEKIR S , NASERI ERDINC , ULUOCAK NIHAT , ELALMIS ALTAY O , ERDEMIR FIKRET , ETIKAN ILKER 
Published: April 2006

Aim:  To compare the effects of coronary artery bypass operation with or without extracorporeal circulation on serum total prostate‐specific antigen levels.Methods:  Seventy‐six men with a mean age of 57.04 ± 9.27 years (range 44–77 years), who underwent coronary artery bypass surgery were enrolled to the study. In 50 patients (Group I), coronary revascularization was performed using extracorporeal circulation, and in 26 patients (Group II) coronary bypass grafting was performed on the beating heart without using extracorporeal circulation. All the patients had serum total prostate‐specific antigen levels measured preoperatively and twice postoperatively in the first and fifth postoperative days. Differences in mean total prostate‐specific antigen levels between the two groups in the postoperative period were analysed.Results:  The mean preoperative total prostate‐specific antigen levels in Group I and Group II were 1.28 ± 1.13 ng/mL and 1.11 ± 0.93 ng/mL, respectively, and there was no significant difference in the preoperative total prostate‐specific antigen values between the two groups (P = 0.519). In Group I, postoperative means were 4.96 ± 6.29 ng/mL and 5.86 ± 9.09 ng/mL in the first and fifth days, respectively (P = 0.0001, P = 0.0001). Total prostate‐specific antigen means in the same postoperative period for Group II were 2.13 ± 2.72 ng/mL and 2.00 ± 2.20 ng/mL, respectively (P = 0.014, P = 0.024). The comparison of total postoperative prostate‐specific antigen levels between the groups showed significantly higher elevation in Group I (postoperative day 1: P = 0.013; day 5: P = 0.05).Conclusions:  Coronary revascularization can cause a statistically significant rise in serum total prostate‐specific antigen levels. This rise is more marked in patients undergoing conventional coronary revascularization.
Serum human glandular kallikrein 2 (hK2) for distinguishing stage and grade of prostate cancer
Authors: STEPHAN CARSTEN , JUNG KLAUS , NAKAMURA TERUKAZU , YOUSEF GEORGE M , KRISTIANSEN GLEN , DIAMANDIS ELEFTHERIOS P 
Published: April 2006

Background:  Human glandular kallikrein (hK2) has been shown to add important information regarding the early detection and staging of prostate cancer. Preliminary analysis pointed out that hK2 may discriminate between pT2 and pT3 tumors, and that hK2 may predict Gleason grade 4/5 cancer volume, better than prostate‐specific antigen (PSA) or percent free PSA (% fPSA). We investigated the role of hK2 serum values for predicting pathological stage, grade and Gleason score.Methods:  Prostate‐specific antigen, free PSA and hK2 were measured on 222 untreated prostate cancer patients who had received radical prostatectomy at the Charité Hospital, Berlin, Germany. Pathological work up revealed pT2‐cancer in 111 patients and pT3‐cancer in 111 patients. Grade 2 was found in 118 patients whereas grade 3 tumors were found in 104 patients.Results:  For pT2 and pT3 patients, the % fPSA (P = 0.006), the ratios hK2/fPSA (P = 0.08) and hK2 × tPSA/fPSA (P = 0.002) were all significant different whereas hK2 (P = 0.143) and PSA (P = 0.1) did not differ. Between grade 2 and grade 3 tumors, the hK2 alone (P = 0.27), the % fPSA (P = 0.13), the ratios hK2/fPSA (P = 0.94) and hK2 × tPSA/fPSA (P = 0.12) did not separate, whereas PSA (P = 0.039) showed a difference. The same relationships were found between the two groups in Gleason score <7 and ≥7. Neither the hK2 ratio, nor % fPSA was different.Conclusion:  Human glandular kallikrein was not different between pT2 and pT3, nor between G2 versus G3 or Gleason scores <7 and ≥7 prostate cancer. Together with % fPSA, hK2 may only help to distinguish preoperatively between pT2 and pT3 prostate cancer but cannot add further information.
Laparoscopic ureterolithotomy: Its role and some controversial technical considerations
Authors: KIJVIKAI KITTINUT , PATCHARATRAKUL SUTHEP 
Published: April 2006

Objective:  To define the role of laparoscopic ureterolithotomy in the management of urolithiasis and evaluate the controversial techniques of this operation.Methods:  Between July 1997 and December 2004, retroperitoneoscopic ureterolithotomy was performed as a primary procedure in 30 patients who had either large or impacted stones in the upper ureter. The other indications were stones which could not be fragmented by shock wave lithotripsy or the patients could not afford the cost of shock wave lithotripsy. The mean (range) age of the patients was 44.07 years (17–78) and the mean (range) stone size was 19.03 mm (10 – 40). The ureter was closed with intracorporeal laparoscopic suture without placing a stent.Results:  The stone was removed in all but one case. The mean (range) operative time was 121.38 min (75–270). No intraoperative complications were recorded. The mean (range) postoperative drain removal was 2.86 days (2–10). Postoperative complications included prolonged urinary leakage in one patient. On the sixth month of follow up, all patients were stone free without any evidence of ureteral stricture.Conclusion:  Laparoscopic ureterolithotomy is a minimally invasive treatment and may be considered as the useful first‐line management for large impacted upper ureteric stones. The technical recommendations were retroperitoneal access and suturing the ureterotomy incision. Ureteral stent should be placed in only cases of severe inflammation of the ureter or inappropriate suturing.
Deterministic and probabilistic modelling of brittle fracture mechanisms in ferritic steels
Authors: KNOTT J. F. 
Published: April 2006

ABSTRACTThe paper shows how an understanding of the micro‐mechanisms of fracture, quantified by deterministic models, can be used to provide a physical basis for probabilistic assessments, particularly when the results of a limited data set have to be extrapolated to low failure probabilities. The variability in results may reflect the effect of random experimental errors in measuring what is essentially a single‐valued parameter; it may reflect spatial heterogeneity in the source material; or it may reflect both factors simultaneously. Results obtained for high‐quality, pedigree steels and model micro‐structures tend to typify homogeneous behaviour, with variability dominated by random experimental errors. More general sampling from structural steels can, however, introduce a further degree of variability, resulting from spatial heterogeneity. This affects the validity of extrapolation of fracture toughness values to low failure probabilities.
Crack opening displacement in plate with bonded repair patch
Authors: RATWANI M. M. , KIEBOOM O. T. , HESLEHURST R. B. 
Published: April 2006

ABSTRACTMathematical techniques are extended to compute crack opening displacements in a cracked plate with an adhesively bonded composite patch. The plate and the patch are considered as orthotropic materials. The problem is reduced to the solution of integral equations. A software program is written to compute shear stresses in adhesive, stress intensity factors in the plate and the crack openings at the centreline of the crack. The effects of adhesive thickness, adhesive modulus, patch thickness and plate thickness on crack openings are investigated. A test program is carried out to obtain crack opening displacements in plate with bonded patch. A good agreement with analytical predictions is obtained. The effects of patches bonded on one or both sides of a plate on stress intensity factors are evaluated.