Gadd45, a p53-responsive stress protein, modifies DNA accessibility on damaged chromatin

This report demonstrates that Gadd45, a p53-responsive stress protein, can facilitate topoisomerase relaxing and cleavage activity in the presence of core histones. A correlation between reduced expression of Gadd45 and increased resistance to topoisomerase I and topoisomerase II inhibitors in a variety of human cell lines was also found. Gadd45 could potentially mediate this effect by destabilizing histone-DNA interactions since it was found to interact directly with the four core histones. To evaluate this possibility, we investigated the effect of Gadd45 on preassembled mononucleosomes. Our data indicate that Gadd45 directly associates with mononucleosomes that have been altered by histone acetylation or UV radiation. This interaction resulted in increased DNase I accessibility on hyperacetylated mononucleosomes and substantial reduction of T4 endonuclease V accessibility to cyclobutane pyrimidine dimers on UV-irradiated mononucleosomes but not on naked DNA. Both histone acetylation and UV radiation are thought to destabilize the nucleosomal structure. Hence, these results imply that Gadd45 can recognize an altered chromatin state and modulate DNA accessibility to cellular proteins.

Gonococcal pilin variants in experimental gonorrhea

When pilus+ Gc were introduced into a male subject's urethra, they gave rise to pilus+ variants whose pilin mRNAs differed from that of input Gc. The differences stemmed from the Gc genome's single complete pilin gene having undergone gene conversion by different partial pilin genes' sequences and by different length stretches of a single partial pilin gene. In some instances, the variant's pilin mRNA appeared to reflect two independent gene-conversion events that used sequences from two different partial pilin genes. The resulting variants' pilins exhibited antigenic differences compared with the pilin polypeptide of input Gc; these differences were discernible by immunoblotting with mAbs. Amino acid and antigenic changes occurred in a segment of the variants' pilin polypeptides that previously was thought to be conserved or constant in sequence.

Retention and stability: a review of the literature

Long-term posttreatment stability is an issue of great concern to all orthodontists. This article highlights the factors reported to play a role in posttreatment crowding and reviews the long-term retention studies evaluating the stability of various treatment modalities. Recommendations, based on well-documented basic principles, are made to try to insure greater posttreatment stability of our orthodontically treated cases.

Role of E2F transcription factor in E1A-mediated trans activation of cellular genes

Adenovirus E1A-dependent trans activation of the adenovirus E2 gene involves the activation of the cellular transcription factor E2F. E2F binding sites have also been identified in the 5'-flanking region of a number of cellular genes, raising the possibility that such genes are targets for E1A trans activation. We now demonstrate that two genes that possess E2F recognition sites, N-myc and DHFR, are stimulated by E1A, dependent on the E2F sites. We also find that although there are multiple E2F sites in these promoters, a single intact E2F binding site is sufficient for E1A-mediated induction, although not to the full wild-type level. These results thus demonstrate that a variety of cellular genes that possess E2F binding sites are subject to E1A trans activation. Moreover, since the products of most of these genes are likely critical for cellular proliferation, there are obvious consequences of this trans activation for cellular phenotype.

Inhibition of p53 transcriptional activity by the S100B calcium-binding protein

The levels of S100 Ca(2+)-binding proteins correlate with the progression of certain tumors, but their role, if any, in carcinogenesis is still poorly understood. S100B protein associates with both the p53 oligomerization domain (residues 325-355) and the extreme C terminus of the tumor suppressor p53 (residues 367-392). Consequently, S100B inhibits p53 tetramer formation and p53 phosphorylation mediated by protein kinase C, on p53 C-terminal end. In this report, we show that the S100B protein decreases p53 DNA binding and transcriptional activity. The effect of S100B is reflected in vivo by a reduced accumulation of p53, p21, and MDM2 protein levels in co-transfection assays and in response to bleomycin. The S100B can still interact with p53 in the absence of p53 extreme C-terminal end and reduce the expression of p53 downstream effector genes. These data indicate that S100B does not require p53 extreme C-terminal end to inhibit p53 activity. Collectively, these findings imply that elevated levels of S100B in tumors such as astrocytomas and gliomas could inhibit p53 functions and contribute to cancer progression.

Intracytoplasmic sperm injection in dysmorphic human oocytes

Fertilisation and development of dysmorphic human oocytes recovered from hyperstimulated ovaries have been evaluated following intracytoplasmic sperm injection (ICSI) for treatment of male infertility. A total of 2968 oocytes at metaphase II of meiosis were injected, of which 806 (27.2%) were dysmorphic at the light microscopic level. Cytoplasmic abnormalities included granularity, areas of necrosis, organelle clustering, vacuoles, and accumulating saccules of smooth endoplasmic reticulum. Anomalies of the first polar body and zona pellucida, as well as non-spherical shapes of oocytes, were also noted. Contrary to previous findings linking some dysmorphisms to non-assisted fertilisation failure, in this study no single abnormality led to a reduction in the fertilisation rate, nor was fertilisation compromised in oocytes with multiple abnormalities. The incidence of normal fertilisation (two pronuclei and two polar bodies) was 69% in both the dysmorphic and non-dysmorphic oocytes. While overall pregnancy and implantation results were not altered in the group of patients (n = 242) in whom at least one dysmorphic oocyte was injected, exclusive replacement of embryos which originated from dysmorphic oocytes led to a higher incidence of early pregnancy loss. It is concluded that aberrations in the morphology of human oocytes--most probably a product of controlled ovarian stimulation--are of little or no consequence to fertilisation or early cleavage after ICSI. It is possible, however, that these embryos have a reduced potential for implantation and further development.

Predictors of prostate carcinoma: accuracy of gray-scale and color Doppler US and serum markers

PURPOSE

To determine the accuracy of detecting prostate cancer by using (a) gray-scale and color Doppler transrectal ultrasonography (US), (b) serum and excess prostate-specific antigen (PSA) levels, and (c) targeted and sextant transrectal US-guided biopsy. The relationship between US-detected neovascularity and tumor biologic activity was also evaluated.

MATERIALS AND METHODS

Between 1995 and 1999, 544 patients with elevated PSA levels and/or abnormal digital rectal examination underwent transrectal US-guided sextant biopsy and targeted biopsy of US abnormalities. Sensitivity, specificity, and accuracy of gray-scale US, color Doppler US, targeted biopsy, and PSA and excess PSA were calculated.

RESULTS

Gray-scale US depicted 78 (41.1%) of 190 cancers, whereas color Doppler US depicted 30 (15.8%) additional cancers. Targeted biopsy was used to detect 108 (56.8%) cancers, whereas sextant biopsy was used to detect 82 (43.2%) additional cancers. Although US-visible cancers had a higher Gleason grade than did cancers discovered at sextant biopsy (P <.05), 25 of the 66 cancers identified with sextant biopsy alone were Gleason grade 6 or higher. Color Doppler US-depicted hypervascularity correlated with biologically aggressive tumors. Excess PSA was normal in 58 (30.5%) cancers, with an accuracy of 67.3%, resulting in better prediction of prostate tumors than with serum PSA level alone.

CONCLUSION

Gray-scale transrectal US, even coupled with color Doppler US, is inadequate for prostate carcinoma screening; therefore, targeted biopsy should always be accompanied by complete sextant biopsy sampling.

Properties of the major outer membrane protein from Neisseria gonorrhoeae incorporated into model lipid membranes

The major outer membrane protein from Neisseria gonorrhoeae was incorporated into artificial planar bilayer membranes by a detergent-dilution procedure. The integrated protein forms voltage-dependent aqueous pores with a minimal pore diameter estimated to be 11 A. A pore of this size suggests a role for this protein in macromolecular sieving at the level of the outer membrane. This protein self-associates preferentially in triplets of three equal unit conductance steps of 130 pS (in 0.1 M NaCl) each. The two-state model may be applied to explain the voltage-dependent conductance. The average lifetime of the open state of single channels is strongly dependent on the applied voltage, the channels shifting to the closed state at higher voltages. The pore is anion selective, differing from porins of other Gram-negative bacteria studied so far but resembling the voltage-dependent anion-selective channel of the outer membrane of mitochondria.

MR imaging of bone oedema: mechanisms and interpretation

Widespread use of MRI now allows the routine identification of previously unevaluated traumatic bone marrow oedema and haemorrhage. Similar marrow oedema is identified in patients with tumours, hyperaemia and medullary congestion. Patterns and extent of traumatic bone marrow oedema and haemorrhage are dictated by mechanism. Diffusion techniques may allow precise evaluation of severity of injury. Illustrative examples and discussion are presented. Eustace, S. (2001). Clinical Radiology56, 4-12.

A radiographic comparison of apical root resorption after orthodontic treatment with the edgewise and Speed appliances

Apical root resorption is a serious iatrogenic problem sometimes associated with orthodontic treatment. The Speed appliance (Strite Industries, Ltd., Ontario, Canada) provides a continuous rotatory and torque action through its spring clip mechanism, in contrast with the edgewise appliance that may provide an interrupted force. The effect of continuous action on root resorption compared with the interrupted action of the edgewise system has not been investigated previously. The purpose of the present investigation is to test the null hypothesis that there is no difference in the apical root resorption seen after orthodontic treatment with the edgewise straight wire and the Speed appliance systems. Pretreatment and posttreatment periapical radiographs of 63 patients, (30 treated with the Speed 0.018 bracket and 33 with the 0.018 edgewise bracket) were studied. The long cone paralleling technique was used for all the radiographs. Any image distortion between the pretreatment and posttreatment radiograph was calculated and compensated for by using the crown length measurements, on the assumption that the crown length remains unaltered during the treatment period. Quantitative measurements of crown and root lengths for the maxillary and the mandibular central and lateral incisors were compared. Means and standard deviations for the percentage root resorption per tooth group were calculated. A three-factor analysis for variance (ANOVA test) was performed to determine whether there was an appliance, treatment, or gender effect on the amount of root resorption seen after treatment. No statistically significant difference in root resorption between the two appliance systems was found.(ABSTRACT TRUNCATED AT 250 WORDS)

The N-terminal domain of c-Myc associates with alpha-tubulin and microtubules in vivo and in vitro

The polymerization of alpha- and beta-tubulin into microtubules results in a complex network of microfibrils that have important structural and functional roles in all eukaryotic cells. In addition, microtubules can interact with a diverse family of polypeptides which are believed to directly promote the assembly of microtubules and to modulate their functional activity. We have demonstrated that the c-Myc oncoprotein interacts in vivo and in vitro with alpha-tubulin and with polymerized microtubules and have defined the binding site to the N-terminal region within the transactivation domain of c-Myc. In addition, we have shown that c-Myc colocalizes with microtubules and remains tightly bound to the microtubule network after detergent extraction of intact cells. These findings suggest a potential role for Myc-tubulin interaction in vivo.

A clinical evaluation of a blood conservation device in medical intensive care unit patients

OBJECTIVES

This study was designed to a) document the efficacy of a device intended to conserve blood in critically ill patients; b) determine the effect of this blood conservation on hemoglobin concentration and the need for blood transfusions; c) determine if the blood conservation device resulted in interference with arterial pressure waveforms; d) determine if use of the blood conservation device resulted in a difference in the number of accidental needle punctures suffered by healthcare workers.

DESIGN

Prospective, randomized, controlled trial. A clinical trial using prospective, random allocation of consecutive eligible patients.

SETTING

The medical intensive care unit (ICU) of a university hospital located in a large metropolitan area.

PATIENTS

A total of 100 patients who were admitted to the medical ICU, required arterial line monitoring for clinical purposes, and were managed by the ICU medical service. Exclusion criteria included active bleeding or chronic renal failure at the time of ICU admission.

INTERVENTIONS

Patients in the experimental group had a blood conservation device incorporated into the arterial pressure monitoring system, while patients in the control group received a conventional arterial pressure monitoring system.

MEASUREMENTS AND MAIN RESULTS

Data gathered included: age; gender; ICU discharge status; the duration of ICU stay; time in the study; volume of all blood drawn, discarded, or lost due to leakage; hemoglobin concentrations; blood transfusions; and accidental needle injuries. Arterial pressure waveforms were recorded and inspected for dampening or other deformation. Mean hemoglobin concentrations were compared on ICU admission and at 12-hr intervals. Demographic and clinical characteristics of the two groups were not significantly different. The volume of blood drawn and discarded from arterial catheters was significantly lower in the blood conservation group (blood conservation device: 5.7 +/- 7.5 mL; control: 96.4 +/- 88.5 mL; p < .0001), as was the total volume of blood discarded (blood conservation device: 19.4 +/- 47.4 mL; control: 103.5 +/- 99.9 mL; p < .0001). Mean hemoglobin concentration on admission was similar in the two groups (blood conservation device group: 11.8 +/- 2.5 g/dL; control group: 12.6 +/- 2.3 g/dL). In both groups, the mean hemoglobin concentration declined most rapidly in the first 24 hrs of ICU care and, thereafter, declined more slowly. Although the mean hemoglobin concentration was higher in the blood conservation group after 6 days, statistical significance was not reached until 9.5 days of ICU care. The mean change in hemoglobin concentration (overall: 1.2 +/- 2.2 g/dL) during the study represents a statistically significant (p < .0001) decrease of 9.7%. Hemoglobin concentration during the study decreased by 1.4 +/- 2.2 g/dL in the control group and 1.0 +/- 2.3 g/dL in the blood conservation group (p = nonsignificant). Univariate and multiple regression analysis demonstrated discarded blood volume to be a significant and independent predictor of the decline in hemoglobin concentration. Transfusion requirements were similar in both groups. The blood conservation system did not alter or interfere with pressure waveforms. There were no accidental needle injuries noted.

CONCLUSIONS

The conservation of blood in critically ill patients must be a high-priority concern of all healthcare workers. Our data indicate that the blood conservation system eliminates a significant factor in the decline in hemoglobin concentration. With devices as described here, there is no reason to continue the practice of wasting the blood of critically ill patients in order to prevent preanalytic error.

Purification of Legionella pneumophila major outer membrane protein and demonstration that it is a porin

We have purified the major outer membrane protein (MOMP) of Legionella pneumophila, determined that it is associated with peptidoglycan, and characterized it as a porin. To purify the MOMP, we used a simple, rapid, three-step procedure that gave us the protein in high yield. The first step of the purification procedure involved selectively extracting the MOMP from whole bacterial cells with calcium and zwitterionic detergent. The second and third steps achieved purification by ion-exchange and molecular-sieve chromatography. The dissociation of the MOMP into monomers was dependent upon the presence of a reducing agent and was enhanced by treatment at 100 degrees C. To study the relationship of the MOMP to peptidoglycan, we extracted the protein by a modification of the Rosenbusch procedure. Like the Escherichia coli porins, the MOMP was peptidoglycan associated. The MOMP was at least partially dissociated from peptidoglycan in sodium dodecyl sulfate and a high salt concentration. To study the ion channel-forming properties of the MOMP, we reconstituted the MOMP in planar lipid membranes. The MOMP formed ion-permeable channels with a single-channel conductance size of 100 picoSiemens. The MOMP channels exhibited a fourfold selectivity for cations over anions and voltage-independent gating. These findings demonstrate that the MOMP is a porin with properties similar to those of E. coli porins.

Analysis of diffusion changes in posttraumatic bone marrow using navigator-corrected diffusion gradients

OBJECTIVE

This study was undertaken to analyze diffusion characteristics of normal and posttraumatic bone marrow.

MATERIALS AND METHODS

Fifty consecutive patients with knee pain underwent both conventional and diffusion-weighted MR imaging (b values, 0-980 sec/mm2). Diffusion maps derived from source data were analyzed on a workstation using region-of-interest techniques. Apparent diffusion values recorded in normal marrow were compared with values recorded in abnormal posttraumatic bone marrow (square centimeters per second).

RESULTS

Normal bone marrow identified in 35 patients showed minimal diffusion, with a mean value of 0.15x10(-5) cm2/sec. Bone marrow in 15 patients sustaining direct traumatic injury (21 bone bruises) showed markedly increased diffusion, with a mean value of 0.8x10(-5) cm2/sec (range, 0.4-1.3 cm2/sec).

CONCLUSION

Marrow injury after trauma with trabecular damage allows increased movement or diffusion of interstitial water relative to normal marrow. The magnitude of diffusion change appears to reflect the severity of marrow injury.

The association between emotions and eating behaviour in an obese population with binge eating disorder

There is utility in understanding the antecedents of binge eating (BE), with a view to explaining poorer weight loss treatment responses in this subgroup. A systematic review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with the aim of exploring associations between emotions and eating behaviour in a population affected by obesity and binge eating disorder (BED). A comprehensive literature search of four electronic databases (2004-2014) yielded 15 studies for inclusion. Included studies performed poorly on data quality analysis with respect to controlling for confounding variables, and sample size. Included papers largely focused on negative emotions as antecedents of BE; depression was consistently associated with a BED-obese classification and BE. Negative mood, sadness, tension and instability of emotions were found to be antecedents of BE in an adult BED-obese sample. However, findings were mixed regarding the role of stress, anger and positive emotions within the BED-obese population. Recommendations are presented for the identification of BED, and ecologically valid experimental designs that further understanding of the complex and varied emotions that associate with BE. The implications of these and other limitations for both researchers and practitioners are discussed. The paper concludes with recommendations for future research alongside suggestions for practitioners. © 2015 World Obesity.

Voltage gating of conductance in lipid bilayers induced by porin from outer membrane of Neisseria gonorrhoeae

Porins, polypeptides of approximately 35 kDa, are present as integral membrane proteins in the outer membranes of a variety of Gram-negative bacteria. As reported previously for a purified porin from Escherichia coli, voltage gating of conductance was found to be induced in a lipid bilayer by the solubilized purified porin, protein I, from Neisseria gonorrhoeae. The unitary response to an applied potential showed a cascade of current from an initial level through at least three levels, more or less equal, to a persisting lower level. The initial level of current corresponded to 1.0-1.3 nS for 0.2 M NaCl on either side of the bilayer. Briefly reducing the potential to zero restored the current to its initial level. Interpretation of the unitary response is suggested by electron microscopic data obtained on negatively stained outer membranes of E. coli indicating the presence of "pores" appearing in triplets. Moreover, low-resolution x-ray and neutron diffraction studies on crystals obtained with an E. coli porin show that three polypeptides associate to form a unit. Combining such structural data with the present electrical data lends support for the hypothesis that the unitary response results from three pores acting as a unit in response to an applied potential. Evidence obtained with the patch-clamp technique is mounting for a similar mechanism of many channels operating as a unit in a variety of cell membranes. The porin channel holds promise as a concrete model for the analysis of voltage gating of ionic conductance.

Constructing regions for small area analysis: material deprivation and colorectal cancer

BACKGROUND

This paper is about constructing small areas for the analysis of health data with the aims of health service delivery in mind. The areal framework should enable the analyst to link health data and census data and the areas should have large enough populations to ensure that rates are reliable and be homogeneous with respect to important socio-economic attributes.

METHODS

An information-based statistic is used for the construction of regions in Sheffield based on the Townsend deprivation index. Enumeration districts are used as the geographical building blocks for the regions. The new regional framework is used for computing Bayes adjusted standardized incidence rates for colorectal cancer (CRC) across Sheffield. The paper then examines the statistical relationship between CRC incidence and deprivation across the set of regions using bivariate regression.

RESULTS

The method yields regions that are considerably more homogeneous in terms of deprivation than wards, and using this framework it is shown that there is a (weak) statistical association at the regional scale between deprivation and CRC.

CONCLUSION

We conclude that statistical tools can be employed to provide regions that meet the criteria for small area analysis of health data and the analyst does not have to be tied to large administrative units such as wards. There are some benefits to executing this work within a Geographic Informative System. The method should be of interest to those concerned with health service delivery and the identification of 'problem regions'.

Pilin expression and processing in pilus mutants of Neisseria gonorrhoeae: critical role of Gly-1 in assembly

Spontaneous mutants of Neisseria gonorrheae failing to express pili or having diminished levels of piliation were studied with regard to pilin expression. All mutants displayed altered pilin processing detectable as the release of soluble, truncated pilin molecules (S-pilin). Of particular interest was the finding, in one mutant, that substitution of serine for glycine at position -1 of propilin, a highly conserved residue among N-metPhe and related pilins, abolished pilus expression but not S-pilin release. The degree of S-pilin processing and the levels of membrane-associated pilin varied among the different classes of mutants, suggesting that each was blocked at a distinct step of pilus biogenesis. The data support a model in which increased S-pilin processing is a result of a decreased rate of pilus polymerization.

Intra-strain heterogeneity of gonococcal pili is related to opacity colony variance

We have purified pili from isogenic opacity colony variants that were derived from 14 gonococcal strains. Pili purified from opaque colonies of one strain usually differed from pili purified from transparent colonies of the same strain. In 10 of the 14 strains examined, the apparent subunit molecular weight of pilin isolated from the opaque variants was larger than that seen with pilin obtained from transparent variants. In addition there were demonstrable intra-strain differences in the isoelectric point and buoyant density of pili derived from the opacity variants. Because gonococci express differing opacity phenotypes during the menstrual cycle, it is possible that the pili of these organisms may also alter in vivo.

The myc intron-binding polypeptide associates with RFX1 in vivo and binds to the major histocompatibility complex class II promoter region, to the hepatitis B virus enhancer, and to regulatory regions of several distinct viral genes

We demonstrated that MIF-1, identified initially as a binding activity that associated with the intron I element of the c-myc gene, consists of two polypeptides, the myc intron-binding peptide (MIBP1) and the major histocompatibility class II promoter-binding protein, RFX1. Using a polyclonal antiserum directed against either oligonucleotide affinity-purified MIBP1 or a peptide derived from RFX1, we showed that MIBP1 and RFX1 are distinct molecules that associate in vivo and are both present in DNA-protein complexes at the c-myc (MIF-1) and major histocompatibility complex class II (RFX1) binding sites. We have also found that MIBP1 and RFX1 bind to a regulatory site (termed EP) required for enhancer activity of hepatitis B virus. In addition, we have identified MIF-1-like sequences within regulatory regions of several other viral genes and have shown that MIBP1 binds to these sites in cytomegalovirus, Epstein-Barr virus, and polyomavirus. We have also demonstrated that the MIF-1 and EP elements can function as silencers in the hepatocarcinoma HepG2 and the cervical carcinoma HeLa cell lines. These findings indicate that MIBP1 and EP/RFX1 can associate in vivo and may regulate the expression of several distinct cellular and viral genes.

Studies on gonococcus infection. XVII. IgA1-cleaving protease in vaginal washings from women with gonorrhea

Vaginal washings from women attending a veneral disease clinic were examined for the presence of protease that cleaved IgA subclass 1 (IgA1). In a crude assay, vaginal washings cleaved [125I]IgA1 in 19 of 25 specimens from individuals from whom Neisseria gonorrhoeae were cultivated. Forty-six specimens from 104 women whose cultures were negative for N. gonorrhoeae also cleaved [125I]IgA1. Vaginal washings from six of six women with culture-proven gonorrhea cleaved [125I]IgA1 into low-molecular-weight components identical to those produced by partially purified IgA1-specific protease from gonococci. The hydrolysis of [125I]IgA1 by vaginal washings from women whose cultures were negative for N. gonorrhoeae yielded cleavage products that resembled those of trypsin or alpha-chymotrypsin. These findings indicate that gonococci residing in the female genital tract produce IgA1-specific protease that can be detected in the vaginal washings of infected women.

Electron beam intraoperative radiation therapy for pediatric neoplasms

BACKGROUND

Intraoperative radiation therapy (IORT) has potential advantages over conventional external beam radiation in that a single large dose is delivered to the tumor and its regional bed at the time of surgical exploration. The therapeutic ratio is enhanced by direct tumor visualization, precise treatment volume, and exclusion of normal organs. In childhood, local tumor control is critical for lesions that cannot be totally excised or residual disease not ablated by systemic therapy.

METHODS

During the past decade, the authors evaluated IORT in pediatric patients with unresectable or recurrent tumors. Fifty-nine patients were treated, 48 for advanced malignant disease and 11 for histologically benign but locally aggressive tumors. Sixty-four operations were performed, during which 84 separate radiation fields were used. High energy electrons at 5-11 MeV were delivered at a dose of 1000-1700 cGy to a tissue depth of 0.5-3 cm.

RESULTS

Of 25 children with advanced neuroblastoma, 15 were alive 14-104 months (mean, 51 months) after treatment. The survival of all patients with solid malignancies was 63%. Local tumor control was achieved in 75% of children with cancer and 91% of those with benign tumors. Complications of IORT at the doses used were trivial.

CONCLUSIONS

Electron beam therapy can be safely and efficiently delivered to young patients during operations intended to treat the primary tumor. The outcome achieved for overall survival and local control of the primary tumor is encouraging, and an acceptable complication rate during intermediate to long-term follow-up has been noted.

Multidisciplinary case-based learning for undergraduate students

This report describes the introduction of case-based learning into the final-year dental programme at the Dublin Dental School. Students attended a series of one-hour sessions in groups of 8. Each group appointed a chairman for each session and a tutor facilitated the discussion. Case details were provided during the session with relevant diagnostic records. At weekly discussion sessions, the group findings and treatment options were considered. The diagnosis and treatment plans were then discussed by clinicians involved in the treatment of the case. Following the last session, the case-based learning programme was evaluated by means of a questionnaire distributed to both tutors and students. Both students and tutors rated the sessions positively. Case-based learning was found to be a worthwhile progression from problem-based learning.