Participation in continuing professional development by dental practitioners in Victoria, Australia in 2007.

BACKGROUND: Mandatory continuing professional development (CPD) was introduced in 2005 in Victoria, Australia to ensure that dental practitioners maintained their skills, knowledge and kept up-to-date with current topics in dentistry. The aim of this study was to investigate the participation, impact on practice and attitudes of Victorian dentists and dental specialists to CPD activities since the commencement of mandatory CPD. METHODS: A cross-sectional survey of a random sample of registered dentists and dental specialists (n = 895) was conducted from May to August 2008 using an anonymous, postal, self-administered questionnaire. RESULTS: The response rate was 66%. More than three quarters of practitioners believed mandatory CPD is a reasonable requirement for continued registration. Dentists reported attending an average of 30.9 h of certifiable clinical CPD whilst specialists attended an average of 33.2 h of certifiable clinical CPD over a 12-month period. Nearly three quarters of respondents reported changing their practice as a result of CPD activities, whilst one quarter attended CPD mainly to meet the mandatory requirements. CONCLUSIONS: Overall there was a positive attitude towards mandatory CPD and a high level of participation in CPD activities by Victorian dentists and specialists in 2007, although nearly half of the respondents attended <20 h of certified clinical CPD during 2007. A number of barriers exist, particularly for rural and female practitioners in accessing CPD, and further research is required to examine the benefits derived from mandatory CPD.

Physical and chemical modifications of adriamycin:iron complex by phospholipid bilayers.

Adriamycin (ADM) and the ADM:Fe(III) complex both interact with phosphatidylcholine bilayers in aqueous vesicle dispersions. The immediate interaction of either ADM or ADM:Fe(III) with phospholipid causes little change in their absorption or emission spectra, but considerably increases the steady-state fluorescence anisotropy of both species. This is followed by a conversion of the ADM:Fe(III) complex (but not of metal-free ADM) into a new compound in periods ranging from minutes to hours depending upon the Fe(III) concentration. This reaction does not require the presence of unsaturated acyl chains, net negatively charged phospholipid head groups, or the participation of molecular oxygen. This new compound has a characteristic absorption and fluorescence emission spectra which differ from those of the ADM:Fe(III) or of metal-free ADM. It can be isolated from the aqueous lipid dispersion by Folch extraction under acidic conditions. It is very lipophilic in comparison to ADM or the ADM:Fe(III) complex. It may be similar to the compound reported to form between cardiolipin and Adriamycin. Preliminary results indicate that it also forms spontaneously in intact biological membranes. Its highly lipophilic character may confine it to bilayers and membranes.

Interactions of Laurdan with phosphatidylcholine liposomes: a high pressure FTIR study.

The interactions of 6-lauroyl-2-dimethylaminonaphthalene (Laurdan) with L-alpha-dimyristoylphosphatidylcholine (DMPC) have been studied isothermally at 28 degrees C by Fourier-transform infrared spectroscopy (FTIR) at two pH values (6.8 and 3.0) and over the pressure range of 0.001-25 kbar. The results obtained with Laurdan are compared with those previously obtained with 6-propionyl-2-dimethylaminonaphthalene (Prodan) (Chong et al. (1989) Biochemistry 28, 8358-8363). The objective of this study is to delineate the differential interactions of Prodan and Laurdan with lipid membranes. The Laurdan carbonyl and naphthalene vibrational bands as well as the correlation field splitting of the methylene scissoring mode all indicate that in phospholipid model membrane systems, Laurdan behaves differently from Prodan. The data suggest that the chromophore of Laurdan is embedded somewhat deeper in the membrane than that of Prodan. The correlation field splitting pressure suggests that Laurdan causes more perturbation to DMPC vesicles than Prodan. Instead of being relocated to the exterior of the membrane as is the case of Prodan, Laurdan is found to remain in the membrane even when it is partially positively charged at pH 3. Apparently the stabilizing forces come from the strong van der Waals and hydrophobic interactions between the lauroyl chain and its neighboring lipid molecules. Laurdan seems to remain in the membrane at high pressures (up to 25 kbar). Using deuterated DMPC (d-DMPC) and deuterated L-alpha-dipalmitoylphosphatidylcholine (d-DPPC), we have demonstrated that, at 1 atm, there is a void space between the lauroyl chain of Laurdan and the acyl chain of the matrix lipid, regardless of the physical state of the matrix lipid. This void space, probably caused by the bulky naphthalene ring, is eventually diminished by elevated pressures.

Depolarization of dehydroergosterol in phospholipid bilayers.

The behavior in phospholipid bilayers of low concentrations of dehydroergosterol, a fluorescent cholesterol mimic, has been examined by fluorometry and calorimetry. In contrast to many fluorescent membrane probes, dehydroergosterol shows a decrease in fluorescence anisotropy when the matrix phospholipid goes from the liquid-crystalline to the gel state. This was observed in three systems in which the matrix lipid was either dipalmitoyl- or dimyristoylphosphatidylcholine or dilauroylphosphatidylethanolamine. The decrease in anisotropy is the result of a large increase in the fluorescence life time of dehydroergosterol in these bilayer systems which is probably the result of thermal quenching of dehydroergosterol by neighboring molecules. The rotation of dehydroergosterol in these bilayers can be described in terms of the thermal coefficient of frictional resistance offered by the environment (Weber et al. (1984) Biochemistry 23, 6785-6788). The thermal coefficients are observed to change abruptly at the onset and completion temperatures of the gel to liquid-crystalline phase transition temperatures of the three matrix phospholipids. These changes are, however, much smaller than are the corresponding changes in the thermal coefficient observed for the fluorescent probe diphenylhexatriene in dilauroylphosphatidylethanolamine bilayers. The difference in behavior of the two fluorescent probes may be the result of lateral phase separation of dehydroergosterol similar to that reported for cholesterol in similar systems.

Interacting effects of temperature, pressure and cholesterol content upon the molecular order of dioleoylphosphatidylcholine vesicles.

Dioleoylphosphatidylcholine (DOPC) multilamellar vesicles containing varying amounts of cholesterol (0-50 mol%) were studied by measuring the polarisation of diphenylhexatriene fluorescence at 6, 23.5, and 35.5 degrees C, and at hydrostatic pressures up to 1.5 kbar . Interactions between temperature and pressure were quantified as the temperature-pressure equivalence which was approximately 19-23 K X kbar -1 for all binary mixtures of cholesterol and DOPC. Polarisation was linearly related to cholesterol/DOPC ratio, except at low temperature. In all cases pressure caused an increase in polarisation (i.e., an increase in molecular order) but did not alter the slope of the graph relating polarisation to cholesterol/DOPC ratio. The relative ordering effect of cholesterol and pressure was quantified by calculating the cholesterol-pressure equivalence. An increase in cholesterol/DOPC ratio of approximately 0.35-0.50 increased polarisation by an amount equivalent to an increase in pressure of 1 kbar . Cholesterol-pressure equivalence tended to decrease as temperature decreased and pressure increased; that is, as membrane order increased.

The effects of pressure and cholesterol on rotational motions of perylene in lipid bilayers.

Using steady-state fluorescence polarization measurements, an isothermal pressure-induced phase transition was observed in dimyristoyl-L-alpha-phosphatidylcholine multilamellar vesicles containing perylene. The temperature-to-pressure equivalence, dT/dP, estimated from the phase transition pressure, P1/2, is about 22 K X kbar-1, which is comparable to values determined from diphenylhexatriene polarization (Chong, P.L.-G. and Weber, G. (1983) Biochemistry 22, 5544-5550). In addition, we have employed a new method, introduced in this paper, to calculate the rate of in-plane rotation (Rip) and the rate of out-of-plane rotation (Rop) of perylene in lipid bilayers. The effects of pressure and cholesterol on the rotational rates of perylene in two lipid bilayer systems have been examined. They are 1-palmitoyl-2-oleoyl-L-alpha-phosphatidylcholine (POPC) multilamellar vesicles (MLV) and 50 mol% cholesterol in POPC (MLV). Rop is smaller than Rip due to the fact that the out-of-plane rotation requires a larger volume change than the in-plane rotation. Cholesterol seems not to affect Rop significantly, but pressure causes a decrease in Rop by about a factor of three. In contrast, the effects of pressure and cholesterol on Rip are less straightforward. At 1 atm cholesterol increases Rip by a factor of about two. Similarly, in the absence of cholesterol 1.5 kbar pressure essentially triples Rip. However, if both cholesterol is added and pressure is applied, Rip decreases sharply. The possible interactions between cholesterol and perylene are discussed.

Spontaneous transfer between phospholipid bilayers of dehydroergosterol, a fluorescent cholesterol analog.

The spontaneous interbilayer transfer of dehydroergosterol, a fluorescent cholesterol analog, was examined using small unilamellar phospholipid vesicles. The kinetic data were best fit by an equation of the form Aexp (-kt) + B. Qualitatively, the general trend of the half-time for transfer and the base values (B) obtained for dehydroergosterol resemble the corresponding values obtained in the earlier studies of cholesterol transfer. However, quantitative differences, which reflect the molecular structure of the sterol, were observed. Acrylamide quenching performed on the donor vesicles at different stages of the transfer indicated that a time-dependent organization of DHE within the vesicles occurs.

Fluorescence properties of pyrylretinol.

A fluorescent analog of retinol, 3,7-dimethyl-9-(1-pyryl)-2E,4E,6E,8E-nonatetr aene-1-ol (referred to as pyrylretinol, or 1) has been synthesized. The fluorescence properties (e.g. quantum yield, lifetime, steady-state anisotropy, and excitation/emission spectra) of this compound in various organic solvents and in dimyristoylphosphatidylcholine (DMPC) liposomes have been studied, and the results are compared with those obtained from 3-methyl-5-(1-pyryl)-2E,4E-pentadiene-1-ol (2), which has the same fused aromatic ring system but a much shorter acyclic chain. 1 and 2 form excimer in aqueous media and fluorescence anisotropies of both 1 and 2 in DMPC liposomes exhibit an abrupt decrease at approximately 21-23 degrees C, which coincides with the main phase transition temperature of DMPC liposomes, indicating that both compounds may be a useful membrane probe. In addition, the binding and quenching capability of pyrylretinol (1) to bovine serum albumin has been investigated. Pyrylretinol (1) binds with BSA with a binding constant of 3.6 x 10(4) M-1, although the value is somewhat lower than that obtained for retinol (3.06 x 10(5) M-1). Pyrylretinol (1) also quenches the BSA intrinsic fluorescence with the quenching rate constant of 1.67 x 10(13) M-1 s-1 and the value is lower than that obtained for retinol (4.06 x 10(13) M-1 s-1). The binding and quenching studies suggest that pyrylretinol (1) may serve as a useful fluorescence probe for structure/function studies of different retinoid binding proteins.

Molecular modeling of archaebacterial bipolar tetraether lipid membranes.

Membranes composed of glycerol dialkylnonitol tetraether (GDNT) lipids from the thermoacidophilic archaebacterium Sulfolobus acidocaldarius have been studied by molecular modeling. GDNT membranes containing eight cyclopentane rings in the molecule are packed much tighter than those without rings. When containing eight cyclopentane rings, the beta-D-galactosyl-D-glucose head-group of GDNT runs almost parallel to the membrane surface. However, when containing no rings, the head-group is oriented perpendicular to the membrane surface. Using molecular dynamics calculations, we have also conducted comparative studies of membrane packing between GDNT and various non-archaebacterial membranes. Compared to gel state dipalmitoylphosphatidylcholine (DPPC) and gel state distearoylphosphatidylcholine (DSPC) bilayers, the GDNT membrane with eight cyclopentane rings has a more negative interaction energy, thus a tighter membrane packing, while the GDNT without rings is less tightly packed than gel state DSPC. Based on the calculated interaction energies, the GDNT membranes (with and without rings) are much more tightly packed than DPhPC (an ester-linked diphytanyl PC) and DPhyPC (an ether-linked diphytanyl PC) bilayers. This suggests that the branched methyl group in the phytanyl chain is not the major contributor of the tight packing of GDNT membranes. The biological implication of this study is that the cyclopentane ring could increase GDNT membrane thermal stability. This explains why the number of cyclopentane rings in archaebacterial lipid increases with increasing growth temperature. Perhaps, through the ring-temperature compensation mechanism the plasma membrane of thermoacidophilic archaebacteria is able to maintain a tight and rigid structure, consequently, a constant proton gradient between the extracellular (pH 2.5) and intracellular compartment (pH 6.5), over a wide range of growth temperatures.

In situ determination of the static inductance and resistance of a plasma focus capacitor bank.

The static (unloaded) electrical parameters of a capacitor bank are of utmost importance for the purpose of modeling the system as a whole when the capacitor bank is discharged into its dynamic electromagnetic load. Using a physical short circuit across the electromagnetic load is usually technically difficult and is unnecessary. The discharge can be operated at the highest pressure permissible in order to minimize current sheet motion, thus simulating zero dynamic load, to enable bank parameters, static inductance L(0), and resistance r(0) to be obtained using lightly damped sinusoid equations given the bank capacitance C(0). However, for a plasma focus, even at the highest permissible pressure it is found that there is significant residual motion, so that the assumption of a zero dynamic load introduces unacceptable errors into the determination of the circuit parameters. To overcome this problem, the Lee model code is used to fit the computed current trace to the measured current waveform. Hence the dynamics is incorporated into the solution and the capacitor bank parameters are computed using the Lee model code, and more accurate static bank parameters are obtained.

The role of carotid endarterectomy in the endovascular era.

OBJECTIVE: Carotid artery angioplasty and stenting (CAS) has been proposed as an alternative to surgery for patients with high-grade symptomatic carotid disease. The purpose of this study was to determine the proportion of patients that were suitable for each type of intervention and to analyse the reasons that precluded stenting. MATERIALS AND METHODS: This was a prospective observational study. All patients considered for intervention for carotid artery disease during an 18-month period were analysed. The management decision was recorded, as were the reasons for unsuitability for stenting. RESULTS: Two hundred and sixty-eight patients' data were analysed, 224 had complete records. Forty-seven patients did not require intervention and received best medical treatment alone. One hundred and seventy-seven patients required intervention, 113 were suitable for stenting and 64 were not. In 51 patients stenting was preferred. Sixty-two patients were suitable for either stent or surgery. Sixty-four patients were unsuitable for stenting. Carotid tortuosity and proximal disease accounted for 70% of this group. CONCLUSIONS: Current enthusiasm for carotid stenting might well be supported by the results of ongoing randomised-controlled clinical trials. However, this study highlights a significant proportion (64/177; 36%) of our patients is presently unsuitable for stenting. The common technical difficulties and limitations of stenting encountered in our unit are related predominantly to carotid anatomy.

Evidence for regular distribution of sterols in liquid crystalline phosphatidylcholine bilayers.

To investigate the lateral organization of sterols in membranes, the fluorescence intensity of dehydroergosterol at different mole fractions in liquid crystalline dimyristoyl phosphatidylcholine bilayers was examined. A number of intensity drops were observed at specific mole fractions, as predicted from a hexagonal super-lattice model. The fluorescence dips provide compelling evidence that a naturally occurring sterol is regularly distributed at fixed compositional fractions, consistent with the presence of hexagonal super-lattices in the fluid membranes. Regularly distributed regions, however, coexist with irregularly distributed regions. The extent of regular distribution varies periodically with sterol mole fraction and, consequently, similar variations take place in the membrane volume and lipid packing. This level of modulation in local membrane structure by minute changes in sterol concentration should have profound implications for the functional role of cholesterol content in cell membranes.

Effects of hydrostatic pressure on the location of PRODAN in lipid bilayers and cellular membranes.

The effects of hydrostatic pressure on the location of 6-propionyl-2-(dimethylamino)naphthalene (PRODAN), an environmentally sensitive fluorescent probe, in phosphatidylcholine lipid bilayers and in goldfish brain synaptic membranes have been studied by fluorescence spectroscopy over the pressure range of 0.001-2 kbar. The emission spectrum of PRODAN in all the membrane systems examined exhibits two local maxima: one centers at around 435 nm and the other at about 510 nm. The intensity ratio of these two peaks, F435/F510, increases as pressure increases; in the particular case of dimyristoyl-L-alpha-phosphatidylcholine multilamellar vesicles [DMPC(MLV)], a dramatic change in F435/F510 appears at the lipid phase transition pressure. As pressure varies, an isoemissive point is seen in both egg yolk phosphatidylcholines and goldfish brain synaptic membranes; however, no isoemissive point is observed in DMPC(MLV). The presence of an isoemissive point is attributed to a pressure-induced relocation of PRODAN from the "polar" disposition (the 510-nm peak) to the "less polar" disposition (the 435-nm peak). The absence of an isoemissive point in the case of DMPC(MLV) is probably due to the lack of void space in the lipid matrix, as a result of tight lipid packing. Apparently, the probe relocation takes place in unsaturated systems, and PRODAN favors a more hydrophobic environment under pressure. However, on the basis of the emission spectra, PRODAN seems to remain more or less at the interfacial region over the pressure range examined. In goldfish brain synaptic membranes, the PRODAN polarization increases with pressure, giving dT/dP values of 15-20 degrees C kbar-1 for both dispositions.(ABSTRACT TRUNCATED AT 250 WORDS)

Interactions between pressure and ethanol on the formation of interdigitated DPPC liposomes: a study with Prodan fluorescence.

Steady-state fluorescence of 6-propionyl-2-(dimethylamino)naphthalene (Prodan) has been employed to study the interacting effects between ethanol and pressure on the formation of the fully interdigitated dipalmitoylphosphatidylcholine (DPPC). At 1 atm and 20 degrees C, a dramatic change in the emission spectrum of Prodan fluorescence is observed at about 1.1-1.3 M ethanol. The emission maximum shifts to longer wavelengths, and the intensity ratio of Prodan fluorescence at 435 nm to that at 510 nm, F435/F510, decreases abruptly with increasing ethanol content. The spectral changes are correlated to the ethanol-induced phase transition of DPPC from the noninterdigitated gel state to the fully interdigitated gel state [Rowe, E.S. (1983) Biochemistry 22, 3299-3305; Simon, S.A., & McIntosh, T.J. (1984) Biochim. Biophys. Acta 773, 169-172]. The spectral changes are attributed to the probe relocation from a less polar environment to a more polar environment due to lipid interdigitation. This relocation is either due to the bulky terminal methyl group of the lipids or due to the partition of Prodan into the bulk solution or both. The present study demonstrates that Prodan is a useful probe in monitoring the formation of the ethanol-induced fully interdigitated DPPC gel phase. Pressure is found to produce spectral changes similar to those induced by ethanol when the ethanol content amounts to 0.8-1.1 M. At lower (e.g., less than 0.4 M) and higher ethanol (e.g., greater than 2.4 M) concentrations, pressure is unable to induce such spectral changes. The critical ethanol concentrations for the formation of the fully interdigitated DPPC gel phase (Cr) have been determined.(ABSTRACT TRUNCATED AT 250 WORDS)