Development of a Patient-Reported Experience Measure Tool for Ambulatory Patients With Acute Unexpected Needs: The APEX Questionnaire.

The aim of this study was to develop a patient-reported experience measure (PREM) for comparing the experience of care received by ambulatory patients with acute unexpected needs presenting in emergency departments (EDs), walk-in clinics, and primary care practices. The Ambulatory Patient EXperience (APEX) questionnaire was developed using a 5-phase mixed-methods approach. The questionnaire was pretested by asking potential users to rate its clarity, usefulness, redundancy, content and face validities, and discrimination on a 9-point scale (1 = strongly disagree to 9 = strongly agree).

Structure and organization of odontoblasts.

Differentiation of odontoblasts involves cell-to-cell recognition, contact stabilization involving the formation of attachment specializations, cytoplasmic polarization, development of the protein synthetic and secretory apparatus, and the active transport of mineral ions. The secretory odontoblast is characterized by an extensive rough-surfaced endoplasmic reticulum, a highly developed Golgi complex, and the presence of specific secretion granules. Type I collagen, a major constituent of dentin matrix, appears to be secreted by the odontoblast into predentin at the proximal portion of the odontoblast process, the major cytoplasmic process extending from the odontoblast cell body into the dentin.

The contributions of Etienne Bourdet (1722-1789) to the diagnosis and treatment of periodontal disease.

Two of the most important figures in the development of the dental profession in eighteenth-century France were Pierre Fauchard and Etienne Bourdet. The title, father of modern dentistry, rightly belongs to Fauchard, for his treatise was the first comprehensive description of dental practice. He broke new ground, and in so doing he set high standards for those who would follow.

Multinucleated fibroblastic cells in the periodontal ligaments of aged rats.

Using 12- to 18-month-old rats, we examined the ultrastructural and cytochemical features of multinucleated fibroblastic cells (MFCs) in the periodontal ligament (PDL) of molars. In aged rats, the MFCs were distributed randomly in the PDL and exhibited cytoplasmic structural variations which were not dependent on the number of nuclei. There was a tendency for the MFCs to cluster in the PDL.

Occurrence of epidermal growth factor-binding sites during differentiation of cementoblasts and periodontal ligament fibroblasts of the young rat: a light and electron microscopic radioautographic study.

Occurrence of epidermal growth factor (EGF)-binding sites during differentiation of cementoblasts and periodontal ligament (PDL) fibroblasts was investigated using radioautography after I. V. injection of 125I-EGF to 14-day-old rats.

Voltaire, medicine, and dentistry.

Voltaire, the leading French intellect of the 18th century, was a notorious hypochondriac. His numerous letters contain hundreds of references to his medical and dental disorders, as well as to those of close friends. Voltaire lived to be 84 years old, but not without suffering from several systemic medical disorders and from periodontal disease that left him nearly edentulous by his mid-50s.

The status of dental education at Stony Brook in 1991.

The School of Dental Medicine was planned and functions as an integral part of the Health Sciences Center at the State University of New York at Stony Brook. It has been in operation for almost 20 years. The mission of the school is multifaceted.

Lessons to be learned from Pierre Fauchard.

Pierre Fauchard possessed the following attributes: Curiosity, intelligence, courage, perseverance, honesty, dexterity, and social responsibility. I suspect that these qualities would have assured him success in whatever career he might have followed. He chose surgery, and through his experience as a ship's doctor in the French navy, he specialized in diseases of the mouth and teeth (common among seamen), qualifying as a surgeon-dentist prior to establishing his highly successful private practice in Paris.

Radioautographic study of [3H]mannose utilization during cementoblast differentiation, formation of acellular cementum, and development of periodontal ligament principal fibers.

The formation of acellular cementum and the deposition of [3H]mannose-labeled extracellular matrix were studied in 14-day-old Sprague-Dawley rats. The sequential events of cementogenesis and periodontal ligament formation observed by light and electron microscopy were described from the stage of an intact root sheath to postcementogenesis. Ultrastructural examination of cementoblasts and periodontal ligament fibroblasts revealed [3H]mannose labeling of the Golgi apparatus at 10 minutes, collagen secretion granules at 30 minutes, and the extracellular matrix beginning at 30 minutes.

Radioautographic demonstration of receptors for epidermal growth factor in various cells of the oral cavity.

Mouse iodinated epidermal growth factor (EGF) was localized by light and electron microscopic radioautography in basal cells of oral epithelium, papillary cells of the enamel organ, periodontal ligament fibroblasts, preodontoblast precursor cells, and preosteoblasts of the alveolar bone of 13-day-old Sprague-Dawley rats. The specificity of binding in these cells was suggested by an observed reduction of about 90% in the labeling when excess unlabeled EGF was injected along with the 125I-EGF. In contrast, fully differentiated cells, such as ameloblasts, odontoblasts, and osteoblasts, were only poorly labeled.

H+-K+-ATPase activity in the rat incisor enamel organ during enamel formation.

The enamel organ of growing rat incisors was perfusion-fixed with a mixture of formaldehyde and glutaraldehyde and processed for ultracytochemical demonstration of ouabain-resistant, K+-stimulated p-nitrophenylphosphatase representing the second dephosphorylative step of H-K-ATPase by use of the one-step lead method. Throughout the stages of amelogenesis, the enzymatic activity was found in the plasma membranes, mitochondrial membranes, and lysosomal structures of the cells of stratum intermedium, papillary layer, and ameloblast layer. Gap junctions and desmosomes between these cells were, however, free of reaction product or showed slight precipitates of reaction.

Mitochondrial migration and Ca-ATPase modulation in secretory ameloblasts of fasted and calcium-loaded rats.

Migration of mitochondria and modulation of Ca-ATPase activity in secretory ameloblasts were investigated ultrastructurally and ultracytochemically by using lower incisors taken from normally fed, 30-hr-fasted, and calcium (Ca)-loaded rats. In normally fed rats, almost all mitochondria were localized in a narrow infranuclear compartment between the nucleus and proximal cell webs of secretory ameloblasts. In 30-hr-fasted rats, a prominent migration of many mitochondria into the supranuclear region of the cells was noted.

3H-mannose utilization by fibroblasts of the periodontal ligament.

The synthesis, intracellular translocation, and secretion of mannose-containing glycoproteins(s) by periodontal ligament fibroblasts have been investigated by means of electron microscopic radioautography. Tritiated mannose was administered to young mice via jugular vein, and radioautographs were prepared at 5, 10, 20, and 35 minutes, 4 and 8 hours after injection. Analysis of electron microscopic radioautographs revealed a maximum labeling (94%) with 3H-mannose of the rough endoplasmic reticulum at 5 minutes.