The GDC - a law unto itself?

The following two pieces are published here to help highlight the parlous state of affairs between the British Dental Association ([BDA] the dental profession) and its regulator, the General Dental Council (GDC). The first piece by Mick Armstrong details the background to one of the letters he sent to Mr William Moyes, Chair of the GDC and provides a link to rest of the lengthy correspondence. The second piece by BDA Chief Executive Peter Ward questions how autonomous the GDC can actually be under the law and asks whether such a body is in fact acting without the law.

Complement activation by individual and combinations of monoclonal antibodies to Actinomyces viscosus T14V fimbriae: a probe for epitope distribution on these polymeric proteins.

The spatial requirements for IgG activation of the classical complement pathway has provided a basis for utilizing complement consumption by individual and pairs of monoclonal antibodies (mAbs) to compare the repeating epitope patterns of the type 1 and type 2 fimbriae of Actinomyces viscosus T14V and to examine the co-operative effects of mAbs against these polymeric proteins. Three of five mAbs specific for the type 1 fimbriae consumed complement when assayed individually. Four patterns of complement consumption were detected with pairs of these mAbs: inhibition, addition, enhancement or synergy. Inhibition occurred when both members of a pair reacted with the same epitope but only one consumed complement. A strictly additive effect was observed if both mAbs consumed complement and, in addition, recognized the same epitope. Complement consumption by mAbs against certain epitopes was enhanced by non-complement consuming mAbs that reacted with different epitopes. Synergy was observed with extremely low concentrations of two mAbs each of which reacted with a different epitope and consumed complement. In contrast to the anti-type 1 mAbs, only one of seven mAbs against the type 2 fimbriae consumed more than 20% of the available complement. Pairs of anti-type 2 mAbs exhibited only inhibition or synergy. The latter effect was particularly striking as pairs containing mAbs that reacted with different epitopes and failed to consume complement or were minimally active when assayed individually were extremely efficient. These data indicated that the spatial arrangements of individual mAbs bound to repeating epitopes in the type 1, but not the type 2, fimbriae were appropriate for activation of complement. Thus, the repeating epitope patterns of the two types of fimbriae apparently differ.

Rapid method for improving slide quality in the bone marrow micronucleus assay; an adapted cellulose column procedure.

Micronuclei are routinely scored in anucleate erythrocytes in bone marrow smears stained with acridine orange. Intense fluorescence from the many nucleated cells in the preparations can interfere with micronucleus detection and cause fatigue in the reader. A method for removing nucleated cells by filtering bone marrow through cellulose packed in syringes was developed by Romagna some ten years ago, but has not been used routinely because of the excessive time needed to prepare columns. We have modified the method very simply by filling chromatography columns by pipet with a cellulose suspension. We show here that column filtration of bone marrow does not affect the numbers of micronucleated polychromatic erythrocytes (MN-PCEs) scored from mice treated with the chromosome breaking agents mitomycin C and cyclophosphamide, or the aneuploidy-inducing spindle poisons, colchicine and vinblastine. The extra preparation time is only about half an hour for a full scale micronucleus assay, and results in better slides and faster scoring.

Reconstructive microsurgery: reviewing the past, anticipating the future.

This article gives an overview of reconstructive microsurgery It is written for residents and fellows training in plastic and microsurgery and practitioners who are intimately involved in the clinical practice of complex reconstructions. The authors describe the highlights of the history of microsurgery and relevant clinical principles. The final portion of this article is designed to elucidate some of the tremendous advances in limb transplantation and the future directions of microsurgery.

Dentists and community care.

April 1993 saw the introduction of the 'Community Care' element of the 1990 NHS and Community Care Act. The term 'Community Care' describes the relocation of long-stay hospital residents to community accommodation. Much public attention has recently been focused on the welfare of psychiatric patients in the community, in particular whether they currently receive adequate care and supervision.

Expanding the auxiliaries debate.

The recent debate about the registration of dental auxiliaries and their role in the dental team of the future has been a vigorous one, with strongly held opinions expressed on all sides. I would like to approach the subject from a different perspective by suggesting that the debate so far has been incomplete and has omitted the role that other health professionals might play in delivering dental care in the community, in particular, the highly qualified community nurse or nurse practitioner.

Treatment of facial synkinesis and facial asymmetry with botulinum toxin type A following facial nerve palsy.

Facial synkinesis and asymmetry commonly impair the outcome of facial nerve palsy. Botulinum toxin type A is a neurotoxin which prevents acetylcholine release at the neuromuscular endplate, paralysing skeletal muscle. This paper examines its use in 24 patients with synkinesis and asymmetry affecting the eye and mouth. Sixty-eight of 72 treatments produced improved cosmesis. Dose-related complications occurred in 26 treatments but were generally mild and transient. The total dosages of toxin used were analysed. The higher dose group compared with the lower dose group had no significant advantage in overall cosmetic improvement but the complication rate was significantly higher in the higher dose group (20/39) compared with the lower dose group (6/33) (chi 2 6.675, P > 0.05).