Negotiating the maze: problem based, collaborative distance learning in dentistry.
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Biomedical subjects
Publications and source records attributed to T Winning.
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UNLABELLED: Langerhans cells are believed to originate from the monocyte lineage and have been reported to increase in number with plaque accumulation and gingival inflammation. The aim of this study was to investigate the effects of local gingival epithelial factors on the induction of CD1a, a Langerhans cell phenotype, on monocyte rich populations. MATERIALS AND METHODS: Peripheral blood monocyte rich in populations from healthy subjects were cultured for 24 h with either healthy gingival or periodontally diseased gingival epithelial supernatants. Additionally, the monocyte rich populations were cultured with cytokines IL-I alpha, IL-I beta, IL-6 and TNF-alpha which are known to be produced by epithelial cells or co-cultured with autologous epithelial cells. The per cent CD1a positive cells was determined using FACS analysis. RESULTS: Healthy gingival supernatants did not induce CD1a expression in monocyte rich populations, however, a significant increase in per cent CD1a+ cells for monocyte rich populations cultured with five (P < 0.01) of six periodontal gingival epithelial supernatants was found. IL-I alpha or TNF-alpha (10 ng/well) resulted in a significant increase in the per cent CD1a+ cells (P < 0.01). Depletion of CD1a+ Langerhans cells from healthy gingival epithelium did not enhance induction of CD1a expression in monocyte rich populations. Monocyte rich populations cultured together with non-depleted epithelial cultures resulted in a decreased per cent of CD1a+ cells. CONCLUSION: These findings indicated that epithelial factor/s associated with periodontally involved epithelia, may be involved in inducing a Langerhans cell phenotype in monocyte rich populations. The data also provide indirect evidence for a role of Langerhans cells in inhibiting induction of CD1a in healthy epithelium.
The first year of a new Bachelor of Dental Surgery curriculum was introduced at the University of Adelaide in 1993. Four integrated streams replaced the previous large number of separate subjects, with an overall reduction in formal contact hours, more exposure to clinical practise, and an emphasis on problem-based learning and student self-directed learning. This report compares students attitudes to the new programme with their attitudes to the previous course. Evaluation forms were completed by 30 of 53 first-year students in 1992 and 38 of 47 first-year students in 1993. Comparisons between years, made using the Student's that, indicated significant differences for several questions. For example, the workload in the previous course was considered to be significantly heavier, with too much theory and too many topics. It was felt that the aims and objectives of the new course were significantly clearer; there was more time to understand material; more opportunities to choose areas to study; students were encouraged more to think for themselves; and staff were more understanding and supportive. The authors conclude that the new problem-based Adelaide dental curriculum has facilitated a more contextual and better-balanced learning environment for students.
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A 35-year-old patient with Sheehan's syndrome presented with hypothyroidism and hypo-adrenalism despite having received treatment with regular daily L-thyroxine (0,3 mg) and prednisone (30 mg) for the preceding 12 months. Replacement of the prednisone with 37,5 mg cortisone acetate resulted in satisfactory control of the disease. The observations suggest that large doses of prednisone may interfere with thyroxine treatment.