bluuebunny/crossref_metadata_2025_split huggingface dataset:
The microscopic diagnosis and treatment of a mandibular second premolar with four canals
Authors: Al‐Fouzan K. S. 
Published: March 2003

AbstractAimThe purpose of this article is to report the case of a mandibular second premolar with four distinct canals.SummaryIt is generally recognized that incomplete instrumentation and cleaning of root canals will lead to failure in root‐treated teeth. Before root canal treatment is performed, the clinician should be aware of the configuration of the pulp space of the tooth that is to be treated. Frequently, root canals are left untreated because the clinician fails to identify their presence, particularly in teeth that have anatomical variations or additional root canals. Traditionally, additional canals have been detected by clinical examination of the floor of the pulp chamber, and sometimes found radiographically. More recently microscopic examination of the pulp chamber using endodontic microscopy has assisted the identification of extra canals. A case report is presented that deals with the successful treatment of a mandibular second premolar with four canals.Key learning points

Even in teeth with a low frequency of abnormal root canal anatomy, the possibility of additional root canals has to be considered in the clinical and radiographic examination of the patient.
The ability to recognize and locate unsuspected canals is enhanced by microscopic investigation of the pulp chamber.
Measurement of strain on tooth roots during post removal with the Eggler post remover
Authors: Castrisos T. V. , Palamara J. E. A. , Abbott P. V. 
Published: March 2003

AbstractCastrisos T, Palamara JEA, Abbott PV. Measurement of strain on tooth roots during post removal with the Eggler post remover. International Endodontic Journal, 35, 337–344, 2002.Aim The aim was to measure root surface strains in teeth when removing cast post/cores with the Eggler post remover.Methodology Two groups of 10 teeth each were tested: group 1 had 1 mm thickness of dentine coronally, and group 2 had 2 mm thickness of dentine. After root filling, 10 mm long cast post/cores were constructed and cemented with zinc phosphate cement, and strain gauges were applied to the roots. The post/cores were removed with the Eggler post remover whilst strain measurements were being recorded. Posts were removed twice: initially along the long axis of the tooth and then at a 10° angle to the long axis. Comparisons between groups 1 and 2 were analysed statistically with the Mann–Whitney U‐test whilst strains within each group were analysed with the Wilcoxon Signed Rank test at the 95% level of confidence.Results There was no significant difference in the strains measured between groups 1 and 2, and no significant difference within each group when removing posts along the long axis of the tooth and at a 10° angle. Three teeth in group 1 and one tooth in group 2 fractured when removing posts at the 10° angle. Three fractures were small slivers of dentine at the point where the Eggler’s repeller arms contacted the tooth mesially and distally, whilst one tooth (from group 1) fractured obliquely.Conclusions Post removal with the Eggler device is a relatively safe procedure but care must be taken when there is a possibility of pulling the post out in a nonaxial direction or when less than 1 mm of dentine surrounds the apical end of the post.
Bacterial and fungal microleakage of AH26 and AH Plus root canal sealers
Authors: Miletić I. , Prpić‐Mehičić G. , Maršan T. , Tambić‐Andrašević A. , Pleško S. , Karlović Z. , Anić I. 
Published: March 2003

AbstractAim To evaluate the penetration of Candida albicans alone and a combination of bacteria through root canals filled with gutta‐percha and one or other root canal sealers, AH26 and AH Plus.Methodology Eighty teeth were randomly divided into two groups of 40 teeth each and obturated with gutta‐percha using either AH26 or AH Plus sealer. A further 10 teeth served as negative controls and 10 as positive controls. The external surface of each root, except the apical 2 mm, was covered with two layers of nail varnish. The teeth were inserted into Eppendorf plastic tubes and suspended in glass bottles containing sterile Schaedler broth. Streptococcus mutans, Streptococcus mitis, Prevotella melaninogenica and Lactobacillus acidophilus were placed in the access cavities of 20 teeth filled with AH26 and 20 with AH Plus. Candidaalbicans was placed in the access cavities of the other teeth. The culture medium with microorganisms was changed every 7 days. Every 72 h bacterial or fungal growth in the broth was tested up to a period of 90 days.Results Leakage in the experimental teeth occurred between 14 and 87 days. Leakage was present in 47% of all samples. From the samples with AH26, 45% leaked bacteria and 60% leaked fungi; whilst from the samples with AH Plus, 50% leaked bacteria and 55% fungi. There was no statistically significant difference in penetration of bacteria and fungi between the sealers.Conclusion In this in vitro study, gutta‐percha and the sealers AH26 and AH Plus allowed leakage of bacteria and fungi.
Effect of calcium hydroxide as a supplementary barrier in the radicular penetration of hydrogen peroxide during intracoronal bleaching in vitro
Authors: Lambrianidis T. , Kapalas A. , Mazinis M. 
Published: March 2003

Abstract Lambrianidis T, Kapalas A, Mazinis M. Effect of calcium hydroxide as a supplementary barrier in the radicular penetration of hydrogen peroxide during intracoronal bleaching in vitro. International Endodontic Journal, 35, 985–990, 2002. Aim To examine pH changes in the cervical external root surface, when calcium hydroxide was used as a supplementary barrier to the protective base material during intracoronal bleaching. Methodology Twenty‐eight single‐rooted human premolars extracted for orthodontic reasons were instrumented with K‐Flex files, obturated with gutta‐percha and subjected to thermocatalytic bleaching. The teeth were divided into four groups. In group A, a glass‐ionomer cement barrier was placed at the cemento–enamel junction (CEJ) level and in group C, the barrier was placed 1 mm apical to the CEJ. In groups B and D, Ca(OH)2 was placed in contact and apical to the glass‐ionomer cement at the CEJ and 1 mm apical to the CEJ, respectively. The teeth were placed in vials containing distilled water and the pH values of the medium surrounding the teeth were recorded after 1, 2, 4, 10 and 15 days, following renewal of the medium. Results The pH in the medium became acidic in all groups. No statistically significant differences existed between groups for all the experimental days (P = 0.790). Conclusion The placement of Ca(OH)2 as a supplementary barrier during intracoronal bleaching did not have a significant effect in reversing the acidic pH created at the external root surface in vitro. Its potential effect during these procedures in vivo needs to be further investigated.
The effect of biological dyes and contrast media on the vas deferens in Long Evans rats
Authors: CHANG  , CHEN  , HSIEH  , SHUN  , LAI  
Published: March 2003

The conventional diagnostic procedure of vasography utilizes a contrast medium to evaluate the patency of the vas deferens. With the development of microsurgical reconstruction for obstructive azoospermia in the past two decades, intraoperative vasography with saline or biological dye injection has replaced the use of radiographic contrast media. However, there are few reports on the effect of biological dyes on the healthy vas deferens. Therefore, we used experimental vasography to evaluate histological changes and functional patency of the vas deferens after infusion with a contrast medium and biological dye.Four groups of 10 Long Evans male rats were injected by vasopuncture with 1% methylene blue, 1% gentian violet and 38% Urografin or saline into the vas deferens. The animals were killed 30 days later, and the vasa deferentia were excised and examined for histological changes and for functional patency. Vasopuncture with saline injection induced minimal change both at the puncture site and in the distal vas deferens. In both the Urografin‐ and methylene blue‐injected groups, inflammation at the puncture site was found in 20–22% of cases, and 10–11% of cases revealed functional obstruction of the vasal lumen. In the gentian violet‐injected group, severe histological and obliterated changes were found in all cases. Leakage of the dye and contrast medium or the sperm reaction may be responsible for the inflammation; otherwise, methylene blue and urografin did not seem to be harmful to the vas deferens. Although gentian violet is a blue dye, as is methylene blue, it has marked destructive effects on the vas deferens. It is concluded that some biological dyes used for vasal injection can cause occlusion of the vasal lumen, while inflammatory responses can occur from placing a needle transmurally.
Comparison of sibling oocyte outcomes after intracytoplasmic sperm injection and in vitro fertilization in severe teratozoospermic patients in the first cycle
Authors: Kihaile Paul E. , Misumi Junichi , Hirotsuru Keiko , Kumasako Yoko , Kisanga Ramzy E. , Utsunomiya Takafumi 
Published: March 2003

SummaryTo follow up the outcome of sibling oocytes subjected to both conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in the first cycles of severe teratozoospermic patients with normal sperm morphology (NSM)≤4%, a total of 1193 sibling metaphase II oocytes (MII) in 85 cycles were randomly allocated into two groups: 588 underwent IVF and 605 ICSI and the embryo outcomes between the two groups were compared. The fertilization rate was significantly higher in the ICSI groups than in the IVF group (p < 0.05) and fertilization failure rate in the ICSI group (2.3%) was lower than in the IVF group (28.2%). Subsequently, the rates of embryo arrest as well as grade 1 and 2 embryo formation before day 3, ≥6 cell embryos on day 3 and blastocyst formation on days 5 and 6, did not differ significantly between the two groups. There was a trend towards a high pregnancy rate cycle in mixed ICSI/IVF embryo transfer (ET) (49.1%). In conclusion, this study showed that in couples with only severe teratozoospermia, there was a benefit in subjecting sibling oocytes to both IVF and ICSI in the first cycle because 24 (28.2%) cycles of total fertilization failure were avoided. Furthermore, despite initially significant higher fertilization rates in ICSI than IVF oocytes, subsequent rates of development from ≥6 cells up to blastocyst stage were the same suggesting that ICSI should be used with caution, as after day 3, ICSI‐derived embryo development was compromised compared with IVF.
Hepatitis B virus (HBV)‐transgenic mice as an investigative tool to study immunopathology during HBV infection
Authors: AKBAR SK. MD. FAZLE , ONJI MORIKAZU 
Published: March 2003

An overview is given regarding the use of hepatitis B virus (HBV) transgenic mice as an animal model of the HBV‐carrier state. Initially, we show how HBV‐transgenic mice have contributed insights into the immunopathobiological processes during HBV infection and later, we show how this new information from the experiments with HBV‐transgenic mice could be used to develop new methods to combat HBV infection.By microinjecting the full or selected parts of the HBV‐genome into the fertilized eggs of inbred mice, different laboratories have developed different lines of HBV‐transgenic mice, which express products of the HBV genome and also show signs of HBV replication. Studies in HBV‐transgenic mice have provided insights into the process of destruction of hepatocytes, the critical role of cytokines in controlling HBV replication and gene expression, mechanisms underlying the immune response defect in chronic HBV‐carriers and the critical role of antigen presenting cells (APC), especially that of antigen presenting dendritic cells in persistent HBV infection. All this new information has given us a better understanding about HBV immunopathobiology, and has led to the development of new therapeutic approaches to combat HBV infection.
Pattern of soft tissue injuries to the oro‐facial region in Nigerian children attending a teaching hospital
Authors: Oginni F. O. , Fagade O. O. , Akinwande J. A. , Arole G. F. , Odusanya S. A. 
Published: March 2003

Summary. Objective. This study was designed to determine the aetiological factors and pattern of oro‐facial soft tissue injuries among children in a suburban Nigerian population. The problems encountered in the management of the patients are also highlighted.Setting. Obafemi Awolowo University Teaching Hospitals’ Complex, Ile‐Ife, Osun State Nigeria.Sample and methods. This prospective study was carried out in children aged ≤ 15 years who presented with oro‐facial soft tissue injuries between July 1996 and December 1997. Data was collected from a clinical examination of the child and a questionnaire completed by the parent or carer.Results. During the study period, 174 children were managed for oro‐facial soft tissue injuries, an incidence of 1·1%, out of a total of 15 582 child admissions. A male preponderance was found (1 : 0·74). The mean age ± SD was 7·3 ± 4·2 years and the range was 9 months–15 years. Falls were the most common aetiology followed by road traffic accident. The forehead was the most frequently injured site. A mortality of 3·4% was found. Although animal bites and burns accounted for only 13·8% of all injuries, all the deaths were a result of these aetiologies. Road traffic accidents and burn victims had the longest hospital stay.Conclusion. Although falls and road traffic accidents are frequent causes of oro‐facial soft tissue injuries, less common causes, like burns and dog bites are more likely to result in death.
Progress's Pilgrim: a critical narrative of research in progress
Authors: Tilley Stephen , Pollock Linda , Ross Linda , Tait Louise 
Published: March 2003

Progress's Pilgrim: a critical narrative of research in progress There is increasing interest in the use of stories to develop nursing and health care practice. This paper reports on how we used story to understand and develop research on nursing practice. Story (or narrative) and science can be seen as distinct but complementary paradigms. We have found that a story framework can help researchers to reflect on a process of social scientific investigation, and to consider how to `go on' in that process. In a study on `Community psychiatric nurses' empowerment of people with enduring mental disorders in the community: involving users to develop services' we have encountered a number of interesting and challenging issues related to design and use of methods. We present these issues within a framework of story analysis, focusing on issues related to empowerment. This analysis draws on Burke's `pentad' of story elements as a framework for narrative analysis. We present the elements of the `story of the study‐as‐funded' and as it was carried out through the pilot stage, and outline the story of developments in the main study. `Trouble' in a story centres on a problematic `ratio' of story elements. The `trouble' at this stage in the progress of our study relates to lack of fit between some parts of the instruments (the methods) and the goal (empowerment), and to the status of the CPNs as actors or agents. Narrative analysis sensitizes us to these issues of `trouble' and provides a means of addressing them. Like John Bunyan's Pilgrim, we have learned through our progress; unlike Pilgrim, we know not our end.
The changing nature of nurses’ job satisfaction: an exploration of sources of satisfaction in the 1990s
Authors: Tovey Elizabeth J. , Adams Ann E. 
Published: March 2003

The changing nature of nurses’ job satisfaction: an exploration of sources of satisfaction in the 1990s This paper focuses on the changing nature of nurses’ job satisfaction. It compares the major sources of satisfaction and dissatisfaction experienced by acute ward nurses in the English National Health Service (NHS) in the early 1990s, with sources identified in previous research. In the light of findings from a pilot study, the suitability of existing research approaches and measurement tools for portraying nurses’ contemporary work experiences is examined. The study comprised content analysis of a random sample of 130 nurses’ comments about ward organizational issues, collected as part of a national survey. Findings suggest that new measurement tools need to be developed, because new sources of satisfaction and dissatisfaction emerged, directly associated with change arising out of the introduction of the NHS internal market. These include pressures associated with new roles, role conflict, lack of job security, ‘tight’ resources, using new technology, a perceived lowering of standards of patient care, coping with increased amounts of paperwork, and the experience of working in a rapidly and constantly changing environment. Findings also suggest that the nature of nurses’ job satisfaction is increasingly being shaped by their position within the organization, denoted by clinical grade, and the organizational culture of individual NHS Trusts. Ward leaders experience dissatisfaction as a result of role conflict and strain, while nurses of lower clinical grades are increasingly concerned with managerial and resource constraints on their ability to provide good quality care. Nurses’ satisfaction with management and morale were found to be significantly different between NHS Trusts. While findings may be specific to England, it is argued that they have relevance for the wider, international nursing community. This is because developing an understanding of the changing nature of nurses’ job satisfaction may help to resolve recruitment and retention problems.
Adolescents and HIV: theory‐based approaches to education of nurses
Authors: Stewart Katharine E. , DiClemente Ralph J. , Ross Dana 
Published: March 2003

Adolescents and HIV: theory‐based approaches to education of nursesHIV infection is increasingly prevalent in adolescents, and primary prevention programmes have been most effective when based on existing theories, including social cognitive theory (SCT). Nurses play an important role in assessing adolescents’ risk for HIV infection and in recommending preventive behaviour change, if their comfort with these activities is increased. Practising nurses (n=88, mean age=40·8) from a university medical centre and surrounding hospitals participated in either a didactic or SCT‐based workshop and a vignette‐based assessment. Utilizing a randomized controlled design, this study compared the effectiveness of the two types of workshops by measuring HIV‐related knowledge and attitudes, as well as comfort with and intent to perform HIV‐related risk assessments. Differences in comfort and intent based on target patients’ cultural descriptors were also evaluated. The SCT‐based workshops yielded more positive results for all four outcome variables at the 8‐week follow‐up (F2,71=4·27, P < 0·02). Cultural stereotyping also appeared to play a role in nurses’ intent to perform assessments (F2,74=11·81, P < 0·001). Suggestions for improving the workshops and incorporating other theory‐based approaches are discussed.
Perceived family dynamics of persons with chronic pain
Authors: Smith A. Ann , Friedemann Marie‐Luise 
Published: March 2003

Perceived family dynamics of persons with chronic painThis qualitative study was conducted to gain an understanding of the experiences of persons with chronic pain and their relationships with family members and the family as a whole. The framework of systemic organization was used to define the areas of investigation guiding the formulation of broad questions relative to family functioning. Thirty persons with chronic pain (age 31–82 years, 73% women, 83% married, 83% European‐American, 17% African‐American) participated in the study. A semi‐structured interview was conducted to elicit narrative descriptions of the participants’ perspective of the pain experience and family functioning. The data were analysed using a constant comparison method of analysis described by Strauss. The dominant themes that emerged included: (i) emotional distress, (ii) distancing from family members, (iii) inability to share difficult feelings, (iv) intense mutual involvement with family members and identification with others’ problems, (v) family isolation from community, and (vi) attempt at healing. A mid‐range theory developed out of the data and explicated with the framework of systemic organization, was one of balancing and counterbalancing connectedness (spirituality) with personal autonomy or separateness (control) in order to find congruence for the family and individuals within. The pain sometimes acted as a mechanism regulating the distance and closeness among family members. Based on this information, nurses can facilitate better understanding among family members, encourage autonomy, assist individuals to express feelings and needs more directly, and facilitate members to respond to each other.
Model for the self‐care of home‐dwelling elderly
Authors: Backman Kaisa , Hentinen Maija 
Published: March 2003

Model for the self‐care of home‐dwelling elderlyThe aim of this study was to develop a model to clarify the existing knowledge concerning the self‐care of home‐dwelling elderly people. The data were collected in Oulu, a medium‐sized city in northern Finland, by interviewing 40 home‐dwelling elderly persons aged 75 or more. Data were analysed using the constant comparative method of the grounded theory approach. The model consists of four modes of self‐care with different conditions for action and different meanings: responsible self‐care consists of responsible activity by the elderly person based on a positive orientation towards the future and a positive experience of ageing. The meaning of responsible self‐care is a desire to continue living as an active agent. Formally guided self‐care consists of uncritical observance of instructions and routine performance of daily tasks. This approach is based on life experiences of taking care of others and realistic awareness of the effects of old age. The meaning of formally guided self‐care is a tendency to accept life as it comes. Independent self‐care is based on the person’s desire to listen to his/her own internal voice. These persons aim to manage in life independently and deny the prospect of growing old. The meaning of independent self‐care is an attempt to maintain the constancy of life. Abandoned self‐care is characterized by helplessness and lack of responsibility. It involves bitterness and a negative attitude towards ageing. The meaning of abandonment is a desire to ‘give up’. According to this study, self‐care is not a separate part of old men’s or women’s lives, it is associated closely with their past life and with the future. As an activity, self‐care is not just a rational way to maintain health. It also reflects the person’s overall attitude towards health care, illnesses and manner of living.