bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvement in electrical properties and thermal stability of low-temperature-processed Hf–Al–O gate dielectrics
Authors: Essary C. R. , Ramani K. , Craciun V. , Singh R. K.
Published: April 2006

In this letter, we report on the low temperature (∼350°C) growth of Hf–Al–O dielectric films with improved thermal stability and electrical characteristics for gate dielectric applications. A higher capacitance and improved interfacial properties were observed in the films deposited with NH3 ambient followed by ultraviolet radiation assisted oxidation annealing. The films containing 10.6at.% Al were found to remain amorphous after a 900°C furnace anneal for 1min in flowing nitrogen. The flat-band voltage was stabilized by nitrogen incorporation with negligible shift. An equivalent oxide thickness of 19Å and a dielectric constant of 20.4 were obtained in the best samples processed in NH3 and ultraviolet radiation ambient.
Vitrification of polymer solutions as a function of solvent quality, analyzed via vapor pressures
Authors: Bercea Maria , Wolf Bernhard A.
Published: April 2006

Vapor pressures (headspace sampling in combination with gas chromatography) and glass transition temperatures [differential scanning calorimetry (DSC)] have been measured for solutions of polystyrene (PS) in either toluene (TL) (10–70°C) or cyclohexane (CH) (32–60°C) from moderately concentrated solutions up to the pure polymer. As long as the mixtures are liquid, the vapor pressure of TL (good solvent) is considerably lower than that of CH (theta solvent) under other identical conditions. These differences vanish upon the vitrification of the solutions. For TL the isothermal liquid-solid transition induced by an increase of polymer concentration takes place within a finite composition interval at constant vapor pressure; with CH this phenomenon is either absent or too insignificant to be detected. For PS solutions in TL the DSC traces look as usual, whereas these curves may become bimodal for solutions in CH. The implications of the vitrification of the polymer solutions for the determination of Flory-Huggins interaction parameters from vapor pressure data are discussed. A comparison of the results for TL/PS with recently published data on the same system demonstrates that the experimental method employed for the determination of vapor pressures plays an important role at high polymer concentrations and low temperatures.
Critical current measurement with spatial periodic bending imposed by electromagnetic force on a standard test barrel with slots
Authors: Nijhuis A. , Wessel W. A. J. , Ilyin Y. , den Ouden A. , ten Kate H. H. J.
Published: April 2006

We have developed and validated a straightforward and fast method to investigate the response of technological superconducting strain sensitive wires (e.g., Nb3Sn) to a spatial periodic bending strain. In the present concept of cabled superconductors for application in nuclear fusion reactors the wires are twisted and cabled in several stages. When subjected to transverse electromagnetic forces after charging the magnet, the individual strands are subjected to spatial periodic bending with wavelengths in the order of 5–10mm. Several apparatuses are presently under development to study the effect of bending on the transport properties, i.e., the voltage-current transition in terms of critical current (Ic) and n value. We propose a supplementary simple method to investigate the influence of bending strain by using a spatial periodic wire support on a broadly used standard Ic measurement barrel in combination with a Lorentz force. The bending force (BI) is varied by changing the applied field B. The peak bending strain in the Nb3Sn filaments is determined by the amplitude of the bending deflection, which is deduced from the mechanical axial tensile stress-strain properties of the wire. Three different spatial periodic wavelengths are applied and the results are in good agreement with the predictions. In addition we found a good agreement with results obtained by a more advanced experiment, named TARSIS, which is described briefly. The “barrel-with-slots” method can be applied easily and straightforward with minor effort and cost in laboratories having a standard Ic measurement facility for superconducting wire.
Associations between earliness, Ascochyta response, and grain yield in chickpea
Authors: Bonfil D. J. , Lichtenzveig Judith , Shai I. , Lerner A. , Tam Sharon , Abbo S.
Published: April 2006

Evidence from an array of dryland systems suggests that chickpea (Cicer arietinum L.) grain yield could be improved through better phenological adaptation. However, information on the relationship between phenology and Ascochyta response genes, and their possible interaction with biomass and grain yield, is missing. Accordingly, the aim of the present study was to determine the associations between the above factors and biomass and grain yield in chickpea. To that end, standard Israeli cultivars and advanced generation bulked progeny from the cv. Hadas × ICC5810 cross were used. Hadas is a late-flowering, high-yielding Israeli kabuli (0.45 g/seed) cultivar with moderate field resistance to Ascochyta blight, whereas ICC5810 is a day-neutral desi (0.15 g/seed) genotype with a strong temperature response, from India. Higher yields were observed among the late-flowering bulks of the Hadas × ICC5810 progeny. No relationship between the Ascochyta response and biomass and grain yield was observed. No interaction between the phenology and Ascochyta response grouping on biomass and grain yield was observed. The results demonstrate the feasibility of combining Ascochyta resistance with earlier flowering and its potential to improve chickpea adaptation to dryland systems.
Feeding an energy supplement with white clover silage improves rumen fermentation, metabolisable protein utilisation, and milk production in dairy cows
Authors: Cohen D. C. , Stockdale C. R. , Doyle P. T.
Published: April 2006

Six rumen-fistulated Holstein-Friesian cows were used in a Latin square design to test the hypothesis that more frequent feeding of a high energy supplement to cows consuming high-protein white clover silage would improve microbial protein production, resulting in greater N retention and higher milk yields. The white clover silage (10.7 MJ metabolisable energy (ME)/kg DM) was fed to cows either alone (WCS) or with 4.5 kg DM of rolled barley grain (12.1 MJ ME/kg DM). The grain was offered either 24 times (WCS/24B) or twice daily (WCS/2B, at 0800 and 1700 hours). Cows offered the supplements, regardless of feeding frequency, had higher (P < 0.05) organic matter (17.3 v. 16.0 kg/day) and estimated ME (208 v. 189 MJ/day) intakes than cows offered white clover silage alone. Mean daily ruminal fluid pH (P < 0.05) and ammonia-N concentrations (P < 0.05) were lower in the supplemented treatments, with total VFA concentrations being highest (P < 0.05) in the WCS/2B treatment. Nitrogen intake and output in the faeces were similar for all 3 treatments. However, nitrogen excretion was lower (P < 0.05) in urine (174 v. 218 g/day) and higher (P < 0.05) in milk (115 v. 93 g/day) of cows offered the supplements. The crude protein consumed by cows on all 3 diets was estimated to be well in excess of cow requirements. The supplements reduced the calculated net losses of ammonia-N from the rumen from 25% of total crude protein intake for WCS to 14% in the 2 supplement treatments, and increased the metabolisable protein supply available for milk production. Increases in metabolisable protein were estimated to be due to a higher microbial crude protein contribution in the supplemented treatments compared with the WCS treatment. Grain supplements increased (P < 0.05) milk yield (22.4 v.19.6 kg/day) and although there were no significant differences in milk fat and protein concentrations between treatments, the latter tended to increase with grain supplementation. Milk yield was higher in the WCS/24B treatment than in the WCS/2B treatment, but neither the calculated nor the measured rumen variables were sufficiently different to explain this effect of frequency of feeding the grain. One possible explanation for the difference was the marked fluctuations in key rumen variables throughout the day in the WCS/2B compared with the WCS/24B treatment. Such fluctuations in the rumen environment are not accounted for in theoretical calculations since associative effects are not considered. The benefits of a higher milk production as a result of more frequent feeding of the supplement to cows should be considered in context of the additional effort or costs associated with more frequent feeding.
Herbal medicine: the science of the art
Authors: Walker Ann F.
Published: April 2006

In the last 50 years science has provided new perspectives on the ancient art of herbal medicine. The present article discusses ways in which the evidence base for the professional use of 'Western' herbal medicine, as therapy to treat disease, known as phytotherapy, can be strengthened and developed. The evidence base for phytotherapy is small and lags behind that for the nutritional sciences, mainly because phytochemicals are ingested as complex mixtures that are incompletely characterised and have only relatively recently been subject to scientific scrutiny. While some methodologies developed for the nutritional sciences can inform phytotherapy research, opportunities for observational studies are more limited, although greater use could be made of patient case notes. Randomised clinical trials of single-herb interventions are relatively easy to undertake and increasing numbers of such studies are being published. Indeed, enough data are available on three herbs (ginkgo (Ginkgo biloba), St John's wort (Hypericum perforatum) and saw palmetto (Serenoa repens)) for meta-analyses to have been undertaken. However, phytotherapy is holistic therapy, using lifestyle advice, nutrition and individually-prescribed mixtures of herbs aimed at reinstating homeostasis. While clinical experience shows that this approach is applicable to a wide range of conditions, including chronic disease, evidence of its efficacy is scarce. Strategies for investigating the full holistic approach of phytotherapy and its main elements are discussed and illustrated through the author's studies at the University of Reading.
Linking biodiversity, diet and health in policy and practice
Authors: Johns Timothy , Eyzaguirre Pablo B.
Published: April 2006

Simplification of human diets associated with increased accessibility of inexpensive agricultural commodities and erosion of agrobiodiversity leads to nutrient deficiencies and excess energy consumption. Non-communicable diseases are growing causes of death and disability worldwide. Successful food systems in transition effectively draw on locally-available foods, food variety and traditional food cultures. In practice this process involves empirical research, public policy, promotion and applied action in support of multi-sectoral, community-based strategies linking rural producers and urban consumers, subsistence and market economies, and traditional and modern food systems. Implementation of the International Plant Genetic Resources Institute's Global Nutrition Strategy in Sub-Saharan Africa offers a useful case study. Relevant policy platforms, in which biodiversity conservation and nutrition are and should be linked, include the Millennium Development Goals, Millennium Ecosystem Assessment, Convention on Biological Diversity, Global Strategy on Diet, Physical Activity and Health, Food-Based Dietary Guidelines, Right to Adequate Food and UN Human Rights Commission's Permanent Forum on Indigenous Issues. The largely unexplored health benefits of cultivated and wild plants include micronutrient intake and functions related to energy density, glycaemic control, oxidative stress and immuno-stimulation. Research on the properties of neglected and underutilized species and local varieties deserves higher priority. In tests of the hypothesis that biodiversity is essential for dietary diversity and health, quantitative indicators of dietary and biological diversity can be combined with nutrition and health outcomes at the population level. That traditional systems once lost are hard to recreate underlines the imperative for timely documentation, compilation and dissemination of eroding knowledge of biodiversity and the use of food culture for promoting positive behaviours.
Three‐Dimensional Reconstruction and Modeling of Middle Ear Biomechanics by High‐Resolution Computed Tomography and Finite Element Analysis
Authors: Lee Chia‐Fone , Chen Peir‐Rong , Lee Wen‐Jeng , Chen Jyh‐Horng , Liu Tien‐Chen
Published: April 2006

Objective: To present a systematic and practical approach that uses high‐resolution computed tomography to derive models of the middle ear for finite element analysis.

Study Design: This prospective study included 31 subjects with normal hearing and no previous otologic disorders. Temporal bone images obtained from 15 right ears and 16 left ears were used for evaluation and reconstruction.

Methods: High‐resolution computed tomography of temporal bone was performed using simultaneous acquisition of 16 sections with a collimated slice thickness of 0.625 mm. All images were transferred to an Amira visualization system for three‐dimensional reconstruction. The created three‐dimensional model was translated into two commercial modeling packages, Patran and ANSYS, for finite element analysis.

Result: The characteristic dimensions of the model were measured and compared with previously published histologic section data. This result confirms that the geometric model created by the proposed method is accurate except that the tympanic membrane is thicker than when measured by the histologic section method. No obvious difference in the geometrical dimension between right and left ossicles was found (P > .05). The three‐dimensional model created by finite element method and predicted umbo and stapes displacements are close to the bounds of the experimental curves of Nishihara's, Huber's, Gan's, and Sun's data across the frequency range of 100 to 8000 Hz.

Conclusion: The model includes a description of the geometry of the middle ear components and dynamic equations of vibration. The proposed method is quick, practical, low‐cost, and, most importantly, noninvasive as compared with histologic section methods.
Vestibular Evoked Myogenic Potential (VEMP) in Patients With Ménière's Disease With Drop Attacks
Authors: Timmer Ferdinand C. A. , Zhou Guangwei , Guinan John J. , Kujawa Sharon G. , Herrmann Barbara S. , Rauch Steven D.
Published: April 2006

Objective: In this retrospective study, we tested the hypothesis that vestibular evoked myogenic potential (VEMP) thresholds are more often elevated or absent in patients with Ménière's disease experiencing Tumarkin drop attacks than in other patients with Ménière's disease.

Methods: Subjects included normal subjects (n = 14) and patients with unilateral Ménière's disease by AAO‐HNS (1995) diagnostic criteria with (n = 12) and without (n = 82) Tumarkin drop attacks at a large specialty hospital otology service. VEMP threshold testing was conducted using 250, 500, and 1,000 Hz tone burst stimuli.

Results: VEMP responses were present in at all frequencies in both ears of all normal subjects. In unaffected ears of patients with unilateral Ménière's disease, VEMPs were undetectable in 13% of measurements attempted. This number rose to 18% in affected ears of patients with unilateral Ménière's disease and to 41% in Meniere ears with Tumarkin drop attacks. Frequency tuning of the VEMP response in normal subjects showed lowest thresholds at 500 Hz. In Meniere ears, the tuning was altered such that the 500‐Hz thresholds were higher than the 1,000‐Hz thresholds. There was a gradient of threshold elevation and altered tuning that corresponded to the gradient of worsening disease.

Conclusion: Our findings support the hypothesis that Tumarkin drop attacks arise from advanced disease involving the saccule and that VEMP may be a clinically valuable metric of disease severity or progression in patients with Ménière's disease.
Audiologic Performance and Benefit of Cochlear Implantation in Usher Syndrome Type I
Authors: Pennings Ronald J. E. , Damen Godelieve W. J. A. , Snik Ad F. M. , Hoefsloot Lies , Cremers Cor W. R. J. , Mylanus Emmanuel A. M.
Published: April 2006

Objective: The objective of this retrospective study was to evaluate the benefit and performance of cochlear implantation in patients with Usher syndrome type 1 (USH1).

Methods: Fourteen patients with a clinical diagnosis of USH1 were included. Mutation analysis of USH1 genes was performed in all of them. All patients filled in the G(C)BI questionnaire, which measures the benefit of implantation. In addition, equivalent hearing level scores (EHL) were calculated to measure performance. Correlations between the mentioned parameters were studied.

Results: One or two pathogenic mutations were identified in seven of the 14 examined patients. Similar to previous studies, it was demonstrated that implantation at an earlier age results in better performance than implantation at higher age. Cochlear implantation performed within the first 2 decades of life was beneficial to 13 of 14 (93%) of the patients with USH1. Finally, the EHL score and the G(C)BI score showed a significant correlation; the benefit of implantation increases with a decreasing EHL score.

Conclusions: Cochlear implantation in patients with USH1 improves the audiologic performance when patients are implanted at an earlier age and is beneficial according to the G(C)BI when performed within the first 2 decades of life.
A Short Course of Oral Prednisone Followed by Intranasal Budesonide Is an Effective Treatment of Severe Nasal Polyps
Authors: Benítez Pedro , Alobid Isam , de Haro Josep , Berenguer Joan , Bernal‐Sprekelsen Manuel , Pujols Laura , Picado Cesar , Mullol Joaquim
Published: April 2006

Background: Nasal polyposis is an inflammatory disease of unknown etiology. This study aimed to evaluate the effect of a short course of oral prednisone followed by intranasal budesonide on nasal symptoms, polyp size, nasal flow, and computed tomography scan.

Methods: Eighty‐four patients with severe nasal polyps were included. After a steroid washout period, patients were randomized into two groups: group A (n = 63) received oral prednisone for 2 weeks and group B (n = 21) did not receive any steroid treatment. Patients from group A received intranasal budesonide for 12 weeks.

Results: Atopy was positive in 36.8% of patients. Blood eosinophilia was higher in asthmatic (7.2 ± 0.7%, P < .05) than in nonasthmatic (3.0 ± 0.4%) patients. Asthmatic patients showed higher scores on nasal obstruction and loss of smell than nonasthmatics. Oral steroids caused a significant improvement in all nasal symptoms and improved polyp size (2.1 ± 0.1, P < .05) and nasal flow (560 ± 35 cm3/s, P < .05) compared with nontreated patients (2.8 ± 0.1 and 270 ± 34 cm3/s, respectively). Intranasal budesonide maintained the improvement on nasal symptoms, polyp size, and nasal flow. Steroid treatment reduced the computed tomography scan score (15.4 ± 1, P < .05) compared with before treatment (18.2 ± 0.8).

Conclusion: A short course of oral steroids improved all nasal symptoms, polyp size, and nasal flow, whereas intranasal steroid maintain this effect.
Soft‐Tissue Sarcomas of the Head and Neck: A Retrospective Analysis of the Alberta Experience 1974 to 1999
Authors: Huber Gerhard Frank , Matthews T Wayne , Dort Joseph C.
Published: April 2006

Background: Soft‐tissue sarcomas (STS) of the head and neck constitute a heterogeneous group of rare malignant tumors occurring in an uncommon site. The most common subtypes of STS in the head and neck are malignant fibrous histiocytoma, dermatofibrosarcoma protuberans, and fibrosarcoma. Evidence based subtype‐specific treatment decisions are often not possible.

Methods: The medical records of 110 patients diagnosed with head and neck sarcomas were reviewed. All were treated at one of the two major Cancer Centers in Alberta, Canada, between 1974 and 1999. Potential prognostic factors including age, sex, tumor size, histology, grade, tumor location (superficial or deep), and use of adjuvant treatment were evaluated. Cox proportional hazards models were developed to study the impact of these covariates on survival.

Results: The median duration of follow‐up was 61.5 months. Five year overall, disease specific, and relapse free survival were 65.8%, 83.4%, and 74.2%, respectively. With use of a Cox proportional‐hazards model, tumor stage and grade were important prognostic factors affecting survival.

Conclusions: Tumor size and grade were important prognostic factors affecting survival. Tumor location in relation to the superficial fascia (depth) was the best predictor of outcome. The overall and disease‐free survival in this patient group was excellent. However, this likely caused by the high proportion of patients with low‐grade tumors in our study.
Merkel Cell Carcinoma: Does Tumor Size or Depth of Invasion Correlate With Recurrence, Metastasis, or Patient Survival?
Authors: Sandel Henry D. , Day Terry , Richardson Mary S. , Scarlett Matthew , Gutman Katharine A.
Published: April 2006

Objective: The objective of this retrospective study and literature review was to compare the clinical and histologic criteria including tumor size and depth of invasion with outcomes in patients with Merkel cell carcinoma.

Methods: The state cancer registry provided patients (n = 46) diagnosed with Merkel cell carcinoma from 1992 through 2002. Pathology slides were reviewed by the author for tumor size, depth of invasion, Clark level, and margin status. Further clinical information and survival data were gathered from patient records. Statistical analysis was performed using t tests and Kaplan‐Meier survival curves. Patients were excluded from specific analysis based on misdiagnosis, unavailability of pathology slides, absent medical records, or those lost to follow up.

Results: Disease‐free survival rates were 52%, 39%, and 9% at 1, 2, and 5 years, respectively. The average disease‐free interval was 18.4 months (range, 1–80 months). No correlation was found between tumor size (P = .49), depth (P = .41), or Clark level (P = .82) to overall survival. A trend was found comparing tumor size or depth of invasion with local recurrence (P = .07) but with no correlation to regional recurrence (P = .93 and P = .60) or distant metastasis (P = .16 and P = .24). Overall recurrence was found in 60.7% of patients with local recurrence occurring in 18.1%, regional recurrence 40.9%, and distant recurrence 47.8%. Comparing patients with positive versus negative margins at initial excision, local recurrence was found in 33.3% versus 9.09% (P = .19), regional recurrence 66.6% versus 27.2% (P = .08), and distant metastasis 66.6% versus 45.4% (P = .36), respectively.

Conclusions: No correlation was found between tumor size or depth of invasion to patient survival or metastasis. However, there was a trend toward increased local and regional recurrence rates when comparing size and depth and in specimens with positive tumor margins. These outcomes are consistent with those reported in recent literature and further characterize the unpredictable nature of this disease. An aggressive approach should be taken, including wide local excision with negative tumor margins and lymph node dissection; however, larger multistate reviews are needed for additional support.
Utility of Positron Emission Tomography‐Computed Tomography in Identification of Residual Nodal Disease after Chemoradiation for Advanced Head and Neck Cancer
Authors: Gourin Christine G. , Williams Haydn T. , Seabolt Wesley N. , Herdman Anne V. , Howington Jed W. , Terris David J.
Published: April 2006

Objectives: Planned neck dissection after chemoradiation (CR) is often advocated in patients with head and neck squamous cell cancer (HNSCC) with advanced nodal disease who demonstrate a clinical complete response to CR because identification of residual occult nodal disease is difficult. We sought to investigate the utility of positron emission tomography‐computed tomography (PET‐CT) in identifying patients with occult nodal disease after CR.

Study Design: Nonrandomized retrospective cohort analysis.

Materials and Methods: The medical records of all patients treated with primary CR for advanced HNSCC with N2 or N3 disease from December 2003 to June 2005 were reviewed. Patients with a clinical complete response were eligible for inclusion if PET‐CT performed at 8 to 10 weeks after CR showed no evidence of distant disease and they were treated with a planned neck dissection.

Results: Seventeen patients met study criteria. PET‐CT was positive for residual nodal disease in 11 (64.7%) patients, with a standardized uptake value (SUV) range of 1.7 to 3.8. Pathologic examination revealed residual viable carcinoma in five (29.4%) patients, with tumor size ranging from 2.0 to 9.5 mm. Carcinoma was present in 2 of 11 (18.2%) patients with positive PET‐CT scans and 3 of 6 (50%) patients with negative PET‐CT scans. The sensitivity and specificity of PET‐CT in predicting occult nodal disease was 40% and 25%, respectively. There was no correlation between PET‐CT findings and histologic findings (P = .26) or between SUV and size of viable tumor (P = .67).

Conclusions: A significant proportion of HNSCC patients with advanced neck disease harbor residual occult metastases after CR. PET‐CT is not sufficiently specific or sensitive to reliably predict the need for posttreatment neck dissection.
Systematic review: microscopic colitis
Authors: NYHLIN N. , BOHR J. , ERIKSSON S. , TYSK C.
Published: April 2006

Background

Collagenous and lymphocytic colitis are fairly common causes of chronic non‐bloody diarrhoea, especially in elderly female.

Aim

To present a systematic review of microscopic colitis.

Methods

A PubMed search using the MeSH terms microscopic colitis, collagenous colitis, lymphocytic colitis and chronic diarrhoea was performed.

Results

Annual incidence of each disorder is 4–6/100 000 inhabitants. The aetiology is unknown. Clinical characteristics are well described and there is an association with autoimmune diseases. Budesonide is the best‐documented short‐term treatment of collagenous colitis. In meta‐analysis pooled odds ratio for clinical response after 6–8 weeks of treatment was 12.3 (95% CI: 5.5–27.5) in comparison with placebo. The evidence for bismuth subsalicylate is weaker and the effectiveness of other alternatives such as loperamide, cholestyramine, aminosalicylates, probiotics, or Boswellia serrata extract is unknown. Although unproven, in unresponsive severe disease azathioprine or methotrexate may be tried. No controlled trials have been carried out in lymphocytic colitis. The long‐term prognosis of microscopic colitis is good, serious complications are rare and there is no increased mortality.

Conclusions

Clinical and epidemiological aspects of microscopic colitis are well described. Budesonide is the best‐documented short‐term therapy in collagenous colitis, but the optimal long‐term strategy needs further study. Controlled treatment data of lymphocytic colitis are awaited for.
Declining incidence of peptic ulcer but not of its complications: a nation‐wide study in The Netherlands
Authors: POST P. N. , KUIPERS E. J. , MEIJER G. A.
Published: April 2006

Background

Despite reports of decreasing hospitalizations and mortality due to peptic ulcer, it is unclear whether the incidence has truly declined over time.

Aim

To investigate time trends in the incidence of and in hospital admission rates for peptic ulcer in the Netherlands.

Methods

The nationwide registry of pathology reports (PALGA) and the national registry of hospital admissions (Landelijke Medische Registratie) were used. Standardized morbidity ratios were calculated to assess the magnitude of the changes.

Results

The age‐adjusted incidence of gastric ulcer halved for both men (standardized morbidity ratio 0.48; CI 0.46–0.49) and women (standardized morbidity ratio 0.49; CI 0.47–0.51). Although the number of gastric biopsies obtained at endoscopy increased, the proportion with a diagnosis of peptic ulcer decreased by more than 50% (standardized morbidity ratio 0.47; CI 0.46–0.49). The admission rate for peptic ulcer more than halved between 1980 and 2003. In contrast, admission rates for complicated ulcers barely changed and slightly increased among women.

Conclusions

The incidence of histopathologically confirmed gastric ulcer halved between 1992 and 2003 in the Netherlands. As the number of gastric biopsies increased in this period, a true decrease is likely. Hospital admissions for peptic ulcer declined dramatically between 1980 and 2003, but remained unchanged or slightly increased for complicated ulcers.
Immigrants of Mediterranean origin
Authors: TRISELIOTIS J. P.
Published: April 2006

SUMMARY
The main focus of this article is on the children of first generation immigrants, mainly from Cyprus and to a lesser extent Italy. The article follows the process of immigration, and describes some general social background characteristics of the groups discussed here. Finally it describes the main problems faced by the children in their relationships within the family, with systems that surround them, such as education, leisure and employment, and with the wider community.
The rotation of confusable letters in the writing of depressed children
Authors: MACAUSLAN A. , QUIN V.
Published: April 2006

SUMMARY
The writing of thirty‐five school children suffering from depressive disease was examined for rotational errors when writing words containing spatially confusable letters. All except eight received treatment with antidepressant drugs. Of the fifteen children who improved clinically as the result of drug therapy, only one was found to make rotational errors on re‐examination. It was considered that at least one aspect of the psychological functions of a child was disturbed by depressive disease, but returned to normal with successful treatment.
PLAYFULNESS AND THE DEVELOPMENT OF DIVERGENT THINKING ABILITIES
Authors: CHAPMAN JUDITH A.
Published: April 2006

Summary The purpose of this paper is to extract from current literature about play those concepts which seem to have most significance in the psychomotor development of the young child. For the purposes of this paper physical education is limited to that physical activity which occurs within the confines of a school. Very brief reference is made to play in relation to sport and the wider context of present‐day culture. The concept of mastery play and stimulus seeking are examined as part of the child's growing maturity and the question is posed whether playfulness shown at an early age may be associated with a particular style of thinking in later years.
The risk of ocular involvement in non‐accidental injury
Authors: HENDELES S. , BARBER K. , WILLSHAW H. E.
Published: April 2006

Summary
A consecutive group of 22 children admitted to our hospital with a diagnosis of non‐accidental injury, underwent detailed ophthalmic examination within 24 hours of their admission. Five of these children had obvious periocular soft tissue injury, but only two had serious ocular involvement. The indications for ophthalmic examination in cases of suspected non‐accidental injury are discussed in the light of these findings.
Early stimulation: psychomotor development of two girls with Aicardi syndrome
Authors: TALÉNS CONSUELO , ANDRÉS MERCEDES , REBAGLIATO MARISA
Published: April 2006

Summary
The psychomotor development achieved by two girls with the Aicardi syndrome is described. Until now this syndrome has been considered to produce a total dissociation from the environment in those affected. The results of early intervention, although not spectacular, are sufficient to recommend early stimulation in these children.
The effects of a tactile stimulation/range‐finding programme on the development of very low birth weight infants during initial hospitalization
Authors: HELDERS PAUL J.M. , CATS BERNARD P. , VAN DER NET JANJAAP , DEBAST SYLVIA B.
Published: April 2006

Summary
During 1984 and 1985, after their referral to the intermediate care nursery, 51 healthy very low birth weight infants were subjected to a tactile stimulation programme imitating the spatial limitation which occurs towards the end of gestation. The sensory motor development of the study group was compared with the development of a control group during initial hospitalization. The study and control group differed significantly in the neonatal period after completion of the programme. The study group showed better auditive responses (P < 0.02), more variations in hand movements (P < 0.01), less hypotony (P < 0.02), more sucking (P < 0.02), and less bradycardia and apnoea (P < 0.01).
What do health visitors again from behavioural workshops?
Authors: HEWITT KEVIN , HOBDAY ANGELA , CRAWFORD WENDY
Published: April 2006

Summary Health visitors’ ratings of their role, competence, methods and effectiveness in resolving each of seven common types of preschool behaviour problem were obtained both prior to attending a behavioural training workshop and about 9 months later. At follow‐up a structured interview examined their current practice in relation to preschool behaviour problems. Results suggest that these experienced health visitors perceived themselves as reasonably self‐sufficient in dealing with these problems prior to training. Training had a significant but consolidating effect on these views. Possible mismatches between the health visitor's view of herself as a behaviour change agent and her training experiences in behavioural methods are examined and some suggestions are made regarding future liaison between health visitors and clinical child psychologists.
Impaired motor skill (clumsiness) in otherwise normal children: a review
Authors: SMYTH T. R.
Published: April 2006

Summary
Some children, who are otherwise normal, experience unusual difficulties with the acquisition and performance of motor skills. These children are commonly described as being clumsy. Impaired performance of motor skills, to the degree experienced by clumsy children, is unlikely to present a serious problem. However, a review of the literature suggests that significant associated and secondary emotional problems are common. In particular, such problems are likely to result in children not achieving their full potential. Therefore, it is important that the cause of affected children's impaired motor skills be recognized early so that these problems can be avoided, or at least minimized, by a sympathetic understanding of their difficulties. The problem is that, whilst severely affected children can be readily recognized, identification of mildly and moderately clumsy children is difficult.
Children with liver disease: maternal reports of their adjustment and the influence of disease severity on outcomes
Authors: BRADFORD R.
Published: April 2006

Summary
Mothers of 45 children with a liver disease (biliary atresia) completed a questionnaire concerned with their child's health status and psychological adjustment. Emotional and behavioural problems were found to be common; 46% of children under 5 and 43% over 5 years of age scored above the cut‐off on standardized measures of adjustment. Maternal mental health difficulties were present in 36% of the sample. The study examined factors that predicted child adjustment, results indicating that maternal perceptions of severity accounted for 40% of the variance in children's psychological adjustment. Neither maternal mental health, nor objective parameters of the child's health status contributed significantly to child adjustment. The findings are discussed in terms of Wallander's model of adaptation to chronic disease and the practical implications for clinical practice are discussed.
Evaluating therapy in cerebral palsy
Authors: BOWER E. , McLELLAN D. L.
Published: April 2006

Summary
The optimal design for most clinical trials of treatment is the randomized controlled group trial. This methodology is not, however, uniformly applicable or appropriate. The evaluation of physiotherapy in the management of cerebral palsy in childhood is a good example of treatment for which modification of this trial design is needed. Some of the problems with eight studies in this field published between 1960 and 1993 are reviewed here and an alternative approach proposed. A representative series of single case studies with individual goal setting and a validated outcome measurement, using randomized treatment, would overcome many of the disadvantages of published studies at a greatly reduced cost. The results would enable more effective group trials to be mounted in due course to evaluate the probable impact of providing treatment to a defined population of subjects.
Letter writing to parents following paediatric outpatient consultation: a survey of parent and GP views
Authors: Cowper D M , Lenton S W
Published: April 2006

Summary
This study examined the practice of writing to parents following paediatric outpatients consultation (general practitioners (GPs) receive a copy of the letter to parents). One hundred and three questionnaires were sent to both parents and GPs in order to elicit their views. Fifty‐one parents responded (RR 50.5%) and 56 GPs (RR 54.4%). Ail parents were in favour of the idea of specialists writing directly to parents/patients and none of the parents were in favour of the letter being sent to the GP alone. The majority of GPs considered that the letter(s) would improve parental satisfaction (85.7%) and improve compliance with medical advice (83.3%); 83.6% of GPs stated that the copy of the letter to parents was at least as helpful, if not more so, than the usual type of clinic letters they receive. Despite this, GPs expressed mixed feelings about the idea of all specialists writing direct to patients/parents, with 46.3% in favour of the idea and 40.7% against.
Allergic broncho‐pulmonary aspergillosis
Authors: McCARTHY D. S. , PEPYS J.
Published: April 2006

In IU out of 143 U.K. patients with pulmonary eosinophilia evidence of allergic broncho‐pulmonary aspergillosis was present, consisting of transitory pulmonary shadows, eosinophilia of blood and sputum. Type I and Type HI reactions to prick and intracutaneous tests respectively with A. fumigatus. Precipitins were present in 92% of sera tested with and without concentration. Sputum plugs usually with pulmonary shadows were present in 56% and contained fungal mycelium, and the sputum gave positive cultures in 58%. Characteristic proximal bronchiectasis was present and fibrosis, mainly of the upper lobes, was found in chronic cases. These features were absent in the patients with no evidence of allergy to A. fumigatus.

Patients with early onset of symptoms had a higher atopic status and a much longer interval before pulmonary eosinophilia appeared than those with late onset symptoms. Episodes of pulmonary eosinophilia with aggravation of all symptoms, with fever and positive cultures in 83% for A. fumigatus, were common in the winter months, when there are more spores in the air. Precipitins to one or more of H. influenzae, Str. pneumoniae and Staph. aureus were present in 60% of sputa examined and positive cultures were obtained in 45%, indicating a high incidence of secondary infection.

Increasing airways obstruction with decreasing reversibility was common and some had reduction of CO gas transfer factor. Pulmonary hypertension was uncommon. Corticosteroids reduced sputum plugs, positive cultures and hastened resolution of pulmonary shadows.

Diagnoses such as pneumonia, tuberculosis, bronchiectasis and carcinoma were not uncommonly made before that of allergic broncho‐pulmonary aspergillosis.
Studies on vasculitis
Authors: PARISH W. E.
Published: April 2006

The sera of eleven persons with cutaneous vasculitis following streptococcal infection had less antibody than the sera of sixteen persons convalescent from similar infection without vasculitis, to M protein from the culture isolated from the serum donor and tested by monospecific antiglobulin haemagglutination, and to group A polysaccharide tested by latex particle agglutination.

The sera were assayed for neutralizing antibodies to streptolysin O, streptokinase, hyaluronidase, proteinase and erythrogenic toxin. The mean titres of each antitoxin for the groups of persons with or without vasculitis after streptococcal infection were similar, and were higher than the mean titres for ten normal, uninfected persons. The two groups of infected persons differed, in that persons without vasculitis formed antibody to each toxin synthesized by the cultures isolated from the serum donor, whereas persons with vasculitis formed little or no antibody to one or two of the toxins synthesized by the cultures isolated from them, though responding well to the other toxins.

If cutaneous vasculitis is induced by complexes of bacterial antigen with antibody, low levels of antibody could predispose the person to formation of harmful complexes in antigen excess of equivalence to antibody, and low levels of antitoxins might incompletely prevent toxic changes in blood vessels, predisposing them to penetration by harmful complexes.
Allergic broncho‐pulmonary aspergillosis Clinical immunology: (2) Skin, nasal and bronchial tests
Authors: McCARTHY D. S. , PEPYS J.
Published: April 2006

Skin, nasal and bronchial tests with extracts of Aspergillus fumigatus and in particular with its protein fraction elicit dual. Type I plus Type III, allergic reactions in all three organs in patients suffering from allergic broncho‐pulmonary aspergillosis.

The immediate asthmatic reaction is readily reversible and less severe than the late asthmatic reaction which lasts for many hours and is only temporarily reversed by the inhalation of isoprenaline. The late reaction develops slowly in contrast to the acute onset of the immediate reaction and may be accompanied by fever and leucocytosis.

The dual nasal reaction elicited in patients with allergic broncho‐pulmonary aspergillosis contrasts with the production of only an immediate nasal reaction in subjects with Type I allergy and no precipitins.
Studies on vasculitis
Authors: PARISH W. E.
Published: April 2006

The sera of persons with cutaneous vasculitis following bacterial infection were examined for antibacterial anaphylactic antibodies that could have predisposed tissues to deposition of harmful antigen‐antibody complexes.

Sera of persons with or without cutaneous vasculitis after bacterial infection had no reagins to streptococcal or staphylococcal cellular or extracellular antigens detectable by monkey passive cutaneous anaphylaxis or histamine release from monkey lung, and no IgE antibodies to the extracellular antigens were found by radio‐immunodiffusion precipitation gel tests. One person with, and one without, vasculitis after streptococcal tonsilitis had heat‐stable short‐term passive sensitizing antibodies mediating increased vascular permeability in monkey skin, and one person had reagins to Candida albicans cellular antigens.

The sera of three persons sensitive to tetanus toxoid were used to control the reliability of the above tests. One serum mediated monkey PC A and histamine release from monkey lung, and all three were found to contain IgE anti‐tetanus toxoid antibodies.

It is concluded that either small amounts of IgE reagin to lipopolysaccharides are not detected due to technical difficulties, or anaphylactic sensitivity to polysaccharides may sometimes be mediated by other classes of antibody.
Mechanisms of reaginic hypersensitivity: a review
Authors: ISHIZAKA KIMISHIGE , ISHIZAKA JERUKO
Published: April 2006

Gamma E antibodies represent the major part of human reaginic antibodies. The antibodies sensitize human and monkey skin, human leucocytes and primate lung tissues. The allergen‐γE antibody reaction mediates the release of histamine from human leucocytes and both histamine and SRS‐A from monkey lung tissues. The immunoglobulin is formed in lymphoid tissues especially those In respiratory and gastrointestinal tracts. Turnover rate of this protein in the blood is only 2–3 days, suggesting that human reaginic antibodies are being formed continuously in atopic patients. However, γE injected into normal skin sites is retained for a long time. The half‐time of loss of the immunoglobulin was 9–14 days in human skin and 8–10 days in monkey skin.

Evidence has accumulated that IgE combines with target cells through the Fc portion of the molecules. The Fc fragments block passive sensitization of human skin with reaginic antibodies and passively sensitize human leucocytes and monkey lung tissue for reversed type reactions. Target cells in human leucocytes were identified as basophil leucocytes. The immunoglobulin binds with tissue mast cells upon passive sensitization.

The initial step in reaginic hypersensitivity seems to be the bridging of cell‐bound IgE with allergen. It appears that the interaction between the IgE molecules or consequent structural changes in the Fc portion of the molecules may induce enzymatic sequences leading to the release of histamine and SRS‐A. The enzyme activated by the allergen‐γE antibody reaction is not the complement system. The biochemical pathways subsequent to the γE‐γE interaction and prior to the release of chemical mediators are unknown. However, evidence has accumulated that the β adrenergic system or the intracellular accumulation of cyclic‐AMP regulate the biochemical pathways.
Studies on vasculitis
Authors: PARISH W. E.
Published: April 2006

The lesions of several cutaneous vascular diseases, examined by immunofluorescence, contained γG, γA, γM and β1C globulins. Acetone‐fixed sections of some lesions contained C‐reactive protein. Antigens of streptococci, Candida, Mycobacteriwn tuberculosis and staphylococci were also found, sometimes combined with IgG indicating the formation of bacterial antigen‐antibody complexes. There was indirect evidence of the formation of complexes in vivo in that the patients had rheumatoid and anti‐IgG factors and immunoconglutinin in their sera more frequently than normal persons.

It has not been established that cutaneous vasculitis is induced by complexes. Antibody in the patient's sera rarely combined with bacterial antigen in the lesions, and in only one instance was IgG in the lesions demonstrated to be antibacterial antigen, though these tests were severely impaired by technical difficulties. The globulin and bacterial antigen may have been deposited fortuitously and harmlessly.
Mites and house dust allergy
Authors: ROMAGNANT S. , BILIOTTI G. , PASSALEVA A. , RICCI M.
Published: April 2006

House dust and mite (Dermatophagoides pteronyssinus and D. farinae) dialysed extracts were fractionated by gel filtration and ion‐exchange chromatography. The protein and sugar content of each fraction was determined, respectively, by absorbance at 280 mμ and by the orcinol method. Pooled fractions were injected into house dust and mite sensitive patients and their capacity to induce positive skin reactions determined. A certain amount of allergenically active material was dialysable but the greater part remained inside the dialysis bag. The most active non‐dialysable house dust and mite extract material was eluted in the excluded Sephadex G‐50 fractions and appeared to be located immediately after the Sephadex G‐75 excluded fractions. On the basis of calibration curves, its molecular weight was estimated between 10,000 and 50,000.

By further chromatography of active Sephadex fractions on DEAE‐Sephadex, the most potent antigen‐containing material of house dust and mite extracts was recovered using 0‐3 and 02 M NaC1 as elution media. These data offer further evidence of the existence of a close relationship between the major antigenic substances of house dust and mite extracts.