Using digital photography to visualize, plan, and prepare a complex porcelain veneer case.

Visualization and pre-operative plan are critical to efficient and thorough case preparation. Congenitally missing teeth, coupled with improper tooth positioning, can compromise the aesthetic rehabilitation outcome. Utilizing pre-treatment digital photography as an outline for tooth reduction and laser tissue re-contouring may help to create a symmetric and pleasing smile, even under less ideal conditions.     

September 11th related stress and trauma in New Yorkers

Exposure to trauma and stress has been linked with poor health, while forgiveness appears to be positively associated with health outcomes. The current study investigates whether traits such as forgiveness and ruminative tendencies predict levels of trauma and stress experienced by New York City residents on the 1‐year anniversary of the September 11th terrorist attack. Seventy‐one students and staff members (57 females, 14 males) of a graduate school in New York City were administered the Impact of Events Scale, the Perceived Stress Scale, and questionnaires designed for the purpose of this study to measure ruminative tendencies and forgiveness on September 11, 2002. Rumination predicted levels of trauma (p < 0.05) and perceived stress (p < 0.01). Lower levels of forgiveness predicted perceived stress (p < 0.05), but not trauma. Rumination mediated the relationship between forgiveness and perceived stress. These findings suggest that individuals with higher levels of rumination have an elevated risk of experiencing trauma and stress‐related symptoms following a traumatic event. Forgiveness is associated with lower levels of stress, but not trauma, perhaps because trauma is an extreme form of stress. Forgiveness appears to serve as a buffer against stress more so in individuals with low levels of rumination than in individuals with high levels of rumination. Copyright © 2005 John Wiley & Sons, Ltd.     

Immunization-induced inflammatory infiltration of the central nervous system in transgenic mice expressing a microbial antigen in astrocytes

Transgenic mice expressing a defined microbial antigen from central nervous system (CNS) cell type-specific promoters can be utilized to investigate the consequences of induction of peripheral immune responses to foreign antigens produced by different CNS cell types. Immunization of mice expressing β-galactosidase (β-gal) in astrocytes with this protein resulted in antigen-dependent infiltration of the CNS by mononuclear cells, principally CD4⁺ T lymphocytes and monocyte/macrophages. The perivascular and intraparenchymal infiltrates, which were located predominantly in the hippocampal formation and cerebellum, the areas of highest β-gal expression, were associated with astrocytosis, microgliosis, and a generalized increase in blood-brain barrier permeability. The resemblance of these pathological changes to aspects of human immune inflammatory CNS disorders e.g. multiple sclerosis, suggests that an initiating step in the process by which such complex diseases are produced could be the induction of peripheral immune responses to antigens expressed in astrocytes.     

A semi-quantitative direct contact assay using fluorescein diacetate and L929 mouse fibroblasts in monolayer culture

Summary A semi-quantitative procedure is described for measuring cell viability after short-term exposure to a test substance using a monolayer culture. Test substances are placed in direct contact with cell monolayers for various time intervals. The substances are removed and the monolayers are incubated in the presence of fluorescein diacetate. Monolayers are viewed under a fluorescent microscope and the percentage of fluorescing (viable) cells is estimated. The method is suitable for examining cytotoxic effects at short times of exposure and for discriminating between test substances that give similar, low toxicity endpoints in standard 24-h assays.     

An Interdisciplinary Clinical Advancement Program Within a Patient-Centered Care Model

Restructuring in health care does not have to compromise the pursuit of clinical excellence and quality patient care. The clinical advancement program (CAP) at the Hospital for Special Care is a newly developed multidisciplinary reward and recognition program for clinical staff. The program is integrated into the hospital's structure of service line management and, unlike traditional advancement programs, is open to all levels of care providers: professional personnel, technical staff, and aides. This article describes the basic features of the CAP model and how it was developed by a multidisciplinary task force.     

A Case of Complete Iatrogenic Amnioreduction at 20 Weeks' Gestation

EDITORIAL COMMENT": The editorial committee found this case report irresistible as an example of triumph over misfortune and disability. Iatrogenic, accidental, prolonged and complete amnioreduction is unique in the editor's clinical experience and knowledge of the literature. Importantly the case also illustrates that conservative management of 'premature rupture of the membranes'can be successful. The favourable outcome may have been related to the abdominal rather than the usual cervical route of amnioreduction, and the restoration of normal liquor volume after the amnioreduction was discontinued. Moreover, in spontaneous rupture of the membranes the cause of the problem is likely to be persistent.
Summary: A successful outcome for an infant following complete iatrogenic amnioreduction at 20 weeks gestation is possible without any invasive medical treatment.