bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Routine Laparoscopy Help to Reduce the Rate of Explorative Laparotomies for Gastric Cancer? Laparoscopy in Gastric Cancer
Authors: Roviaro Gian Carlo , Varoli Federico , Sonnino Davide , Nucca Ombretta , Rabughino Gianni , Scarduelli Alessandro
Published: August 2007

1. Background We developed this surgical protocol about performing intraoperative laparoscopy for staging in every patient affected by stomach cancer. Sensitivity and specificity of intraoperative laparoscopy are compared with conventional preoperative
staging techniques.

2. Methods From January 1994 to June 1999, 83 patients affected by stomach cancer were accepted in our department: 12 patients (14.5%) were excluded from our study after the preoperative staging; in 71 patients (85.5%) an explorative laparoscopy as the first step
of the operation was performed.

3. Results Laparoscopy confirmed preoperative staging in 53 cases (74.6%), in 12 patients demonstrated an overstaging. Laparoscopy demonstrated in 6 patients unsuspected causes of unresectability.

4. Conclusions When performed in patients affected by malignant neoplasm and declared resectable, intraoperative laparoscopy can demonstrate conditions not detectable
by traditional preoperative investigations, consequently reducing to zero explorative laparotomies.
Combined Cisplatinum and Laser Thermal Therapy for Palliation of Recurrent Head and Neck Tumors
Authors: Paiva Marcos B. , Saxton Romaine E. , Blackwell Keith E. , Buechler Peter , Cohen Alen , Liu Carson D. , Calcaterra Thomas C. , Ward Paul H. , Castro Dan J.
Published: August 2007

In recent years endoscopically controlled laser‐induced thermal therapy (LITT) has been
increasingly accepted as a minimally invasive method for palliation of advanced or recurrent
head and neck or gastrointestinal cancer. Previous studies have shown that adjuvant
chemotherapy can potentiate endoscopic laser thermal ablation of obstructing tumors leading
to improved palliation in advanced cancer patients. Eight patients with recurrent head and
neck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial, and also
elected to be treated with systemic chemotherapy (cisplatin, 80 mg/m2) followed 24 h later by
palliative laser thermal ablation. Laser treatments were repeated in patients with residual
disease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laser
thermal chemotherapy remained alive after a median follow‐up of 12 months. Of the 12 tumor
sites treated, complete responses were located in the oral cavity (3), oropharynx (1),
hypopharynx (1), maxillary sinus (1), and median survival for these patients was 9.5 months.
This initial experience with cisplatinum‐based laser chemotherapy indicates both safety and
therapeutic potential for palliation of advanced head and neck cancer but this must be confirmed
by longer follow‐up in a larger cohort of patients.
A New Technique for Improving Visualization of Mucosal Lesions During Endoscopic Photodynamic Therapy
Authors: Mimura Seishiro , Narahara Hiroyuki , Murakami Takashi , Otani Toru , Hirano Toru , Suzuki Kenji
Published: August 2007

A new device consisting of a conventional fiberscope and a new TV system (model OTV‐S5,
Olympus Optical Co., Tokyo, Japan) has been developed to achieve accurate irradiation of
laser light in photodynamic therapy for gastric cancer. This model has high resolution and
sensitivity, and its signal can be transmitted by red, green and blue. In front of the CCD we
inserted a special interference filter which has specific absorption of red light with 2.3%
transmissivity at a 630 nm wavelength and a 50 nm absorption band of full width at half
maximum. The average transmittance in the visible region, except for at 630 nm, was 90%.
A neutral density filter with 16% transmittance was added to adjust to the sensitivity of the
CCD. The device makes it possible to perform accurate irradiation, because we can observe
both the lesion and the laser spot on a monitor in original colors during irradiation.
An Early Stage Diffuse B‐Cell Lymphoma Within a Visible Site of Bronchofiberscope Accompanied by Peripheral Lung Cancer
Authors: Shimatani Hideaki , Furukawa Kinnya , Ebihara Yoshirou , Serizawa Hiromi , Tsuboi Masahiro , Ogata Akihiko , Konaka Chimori , Kato Harubumi
Published: August 2007

We report a case of non‐Hodgkin′s lymphoma found at the orifice of right B2 accompanied by peripheral lung cancer in a 66‐year‐old asymptomatic man. Chest X‐ray films showed a mass
shadow in the left lower lung field. Transbronchial lung biopsy of left S9 demonstrated
squamous cell carcinoma. Simultaneously wall thickening at the orifice of the right B2 was
found coincidentally. The biopsy specimen from that site showed non‐Hodgkin′s lymphoma
(diffuse B‐cell type). After left lower lobectomy, systemic chemotherapy was performed. It is
rare for malignant lymphoma to be recognized bronchofiberscopically.
Endoscopic Laser Treatment for Pediatric Nasal Allergy
Authors: Araki Susumu , Suzuki Nobuhiro , Sato Harushiro , Yamaguchi Taro , Fujita Hiroyuki , Umezawa Yoko , Suzuki Mamoru
Published: August 2007

We have used the carbon dioxide (CO2) laser and the gallium aluminium arsenide (GaAlAs) diode laser with flexible fiber delivery instruments for vaporization of the inferior nasal
turbinate in pediatric patients since 1993. Under endoscopic control, the whole inferior
turbinate was vaporized by 5–10 W laser output delivered via an optical fiber. Generally, the
nasal mucosa changes into normal mucosa, and symptoms improve. The greatest symptomatic
improvement was in nasal obstruction. The results obtained by the two laser devices
were similar although they have had different characteristics. Endoscopic laser surgery is
effective in the treatment of pediatric nasal allergy.
Helicobacter pylori Infection in Endoscopic Biopsy Specimens of Gastric Antrum: Laboratory Diagnosis and Comparative Efficacy of Three Diagnostic Tests
Authors: Malik G. M. , Mubarik M. , Kadla S. A.
Published: August 2007

Aims and objectives The present study was undertaken to compare the diagnostic yield
of three available test procedures for detecting Helicobacter pylori (H. pylori) infection in endoscopic biopsies.

Methods H. pylori infection was sought in 150 patients referred for upper gastrointestinal
(GI) endoscopy. Multiple (about six) biopsy specimens were taken from pyloric
antrum in each patient. Two biopsy specimens were subjected to one minute endoscopy
room test – OMERT (a modified form of urease test), two were sent for histopathological
analysis, where multiple sections were subjected to Giemsa staining and two were sent for
microbiological evaluation after Gram′s staining of heat fixed biopsy material.

Results H. pylori positivity using histology, microbiology and OMERT was observed
to be 33%, 30% and 27% respectively. However, overall 40% patients were infected when
the results from three test procedures were combined, as H. pylori positivity was repeated
more than once by these procedures separately. Histology was found to be superior to other
two tests in our study, especially when multiple sections were examined, for the distribution
of the organism was patchy. Amongst the infected, H. pylori was seen in only 30% of all
3–8 sections cut from a biopsy, whereas in 70% it was noted in a single section only.

Conclusion The study revealed that histology has the highest detection rate and can be
chosen as the “gold standard” amongst the three low cost test procedures available at present
in our setup.
Prevalence of Helicobacter pylori Infection in Peptic Ulcer Patients of Highly Endemic Kashmir Valley
Authors: Romshoo Gh. Jeelani , Malik G. M. , Basu J. A. , Bhat M. Yousuf , Khan A. R.
Published: August 2007

Objective This study aimed to find out prevalence of Helicobacter pylori (H. pylori) in peptic ulcer disease (PUD) which is highly endemic disease in Kashmir.

Method This study consisted of 50 PUD patients and 30 asymptomatic volunteers.
Peptic ulcer was diagnosed by endoscopic examination and H. pylori was detected by histology
(using Giemsa stain), one minute endoscopy room test (OMERT) and modified
Gram′s staining. Positive results from OMERT plus histology were considered as the
“gold standard” for the presence of H. pylori.

Results Out of 50 patients, 46 had duodenal ulcer (DU), 2 had benign gastric ulcer
(GU) and 2 had both DU and GU. The sensitivity and specificity of OMERT were 94%
and 96.70%, histology 97.90% and 96.90% and Gram′s staining 91.30% and 85.30%,
respectively, as compared to our gold standards. H. pylori was present in 76.09% of DU,
50% of GU, whereas patients with duodenitis, channel ulcers, chronic active DU and those
with multiple ulcers were 100% H. pylori positive. H. pylori was present in 10 (33.33%) of healthy volunteers.

Conclusion A significant association between H. pylori infection and PUD was found in this study. However, there seem to be other causative factors as well which contribute
for this highly endemic disease.
Magnified Examination of Small Colorectal Polyps Using a Prototype Electronic Endoscope
Authors: Katayama O. , Namiki K. , Iwakoshi K. , Fujita H. , Yasuhara H. , Ohi I. , Tomatsu S.
Published: August 2007

Magnifying electronic endoscopes are frequently used to evaluate the pit patterns of the
colorectal mucosa, but such endoscopes suffer from a number of problems. For example, they
tend to have long, hard tips and heavy controller sections. In addition, the magnified
endoscopic images obtained are often quite coarse due to the small number of pixels in the
charge‐coupled device (CCD). As a result, at higher magnification ratios, the orientation of
the field of view is easily lost. A newly developed prototype colorectal electronic endoscope
(Toshiba Corporation, Tokyo) overcomes these problems. The length of the hard tip of the
scope and the weight of the controller section are comparable to those of the TCE‐3680MH
(Toshiba Corporation). High‐resolution magnified images can be obtained, because a
410,000‐pixel CCD is employed. Two magnification methods are available, optical
magnification and electronic zooming, permitting images to be magnified by a factor of up
to 90–120 without losing the orientation of the field of view. This newly developed magnifying
electronic endoscope was found to be very useful, allowing us to observe the pit patterns of the
colorectal mucosa in 82 small colorectal polyps measuring 7 mm or less in diameter.
Laryngeal Saccular Cyst
Authors: Benoit Craig , Day Terry
Published: August 2007

We present a case report of a 66‐year‐old female with a laryngeal saccular cyst that was
treated endoscopically. Although this is an uncommon laryngeal anomaly, when it is recognized
and managed appropriately early in the course of its presentation patient complications
and morbidity can be avoided. The laryngeal saccular cyst can mimic or be associated with
other, more serious, laryngeal pathology, including carcinoma of the larynx. Because of the
known association between carcinoma of the larynx and laryngeal saccular cysts, these
lesions should be fully evaluated endoscopically and surgically excised. Direct microlaryngoscopy
with the use of the operating microscope is a safe and effective method for the treatment
of laryngeal saccular cysts.
Endoscopically Based Endonasal and Transnasal Lasersurgery
Authors: Scherer Hans , Hopf Juergen U. G. , Hopf Marietta
Published: August 2007

The endoscopically based endonasal and transnasal laser surgery is
a surgical procedure, which offers the ENT‐specialist a safe and
effective method to cure or to improve a number of diseases of the
upper and middle airways. Coagulative lasers are used in contact
and noncontact mode. Their light is mainly absorbed by hemoglobin
but rarely by water. The laser–tissue interaction is performed via
flexible glass fibers. For the delivery of the laser beam we use
specially designed applicator sheaths, which incorporate the
endoscope, the laser fiber and the suction channel. The procedure
is controlled online via the endoscopic image on the monitor
(“video‐endoscopy”). The patient suffers less trauma
using this treatment compared to the standard endoscopic surgery
and the procedure is much quicker. Pre‐ and post‐operative
rhinomanometric and rhinoresistometric measurements reveal that
the air flow rate of the nose can be improved effectively.
Clinical Course of Laryngeal Granuloma Without Surgical Treatment
Authors: Horiguchi Satoshi , Suzuki Mamoru , Takagi Hideo , Yamanishi Toshiro , Nakamura Kazuhiro
Published: August 2007

Laryngeal granuloma is a rather common pathological entity, but its therapeutic strategy is
still controversial. In general, therapeutic strategy consists of medications such as steroids or
tranilast, in addition to vocal hygiene and surgery. Surgical removal is most commonly
performed. However, it has recently been reported that recurrence after surgery is high.

We successfully treated 19 of 20 cases of laryngeal granuloma without surgical removal. It
took 28–328 days for the granulomas to disappear. Therefore conservative treatments should
be the first choice of treatment.
Endoscopic Surgery for Facial Lipoma Excision
Authors: Koike H. , Kitano H. , Fujimura M. , Kinoshita T. , Kataoka H. , Hirano M. , Seno S. , Kitajima K.
Published: August 2007

Minimally invasive endoscopic surgery in the neck, first reported by Gagner in 1996, has been
adopted by a number of other surgical specialties. We have developed new techniques for
performing endoscopic enucleation lipoma. Using our new techniques, various complications,
such as injury to nerves and vessels, are prevented. The technique generates cosmetically
satisfying results. Expansion of minimally invasive surgery into the facial area will be
enhanced by the future development of instruments for this area, and decrease operating time
and hospital stay.
Angioscopic Evaluation of Stabilizing Effects of Bezafibrate on Coronary Plaques in Patients With Coronary Artery Disease
Authors: Uchida Yasumi , Fujimori Yoshiharu , Ohsawa Hidefumi , Hirose Jyunichi , Noike Hirofumi , Tokuhiro Keiichi , Kanai Masahito , Yoshinuma Masaki , Mineoka Kazuhito , Hitsumoto Takashi , Aoyagi Kaneyuki , Sakurai Takeshi , Sato Shin , Yoshinaga Kokushi , Ozegawa Masaaki , Morio Hiroshi , Yamada Katsumi , Terasawa Kimiko , Uchida Yuuko , Oshima Tomomitsu
Published: August 2007

Background Since long‐term administrations of anti‐hyperlipidemic
agents result in reduction in % stenosis or increase in
minimum lumen diameter (MLD) of stenotic coronary
segments, it is generally believed that anti‐hyperlipidemic agents
stabilize vulnerable coronary plaques. However, recent pathologic
and angioscopic studies revealed that vulnerability of coronary
plaques is not related to severity of stenosis and the rims rather
than top of the plaques disrupt, and therefore, angiography is not
adequate for evaluation of vulnerability.

Angioscopy enables macroscopic pathological evaluation of the coronary plaques.
Therefore, we carried out a prospective angioscopic open trial for evaluation of the
stabilizing effects of bezafibrate on coronary plaques.

Methods From April, 1997 to December, 1998, 24 patients underwent
coronary angioscopy of the plaques in the non‐targeted vessels
during coronary interventions and 6 months later. The patients
were divided into control (10 patients, 14 plaques) and
bezafibrat (14 patients, 21 plaques) groups. Oral
administration of bezafibrate (Bezatol SR, 400mg/day) was
started immediately after the interventions and was continued for
6 months. The vulnerability score was determined based on
angioscopic characteristics of plaques and it was compared before
and 6 months later.

Results Six months later, vulnerability score was reduced
(from 1.6 to 0.8;p < 0.05) in bezafibrate group and
unchanged (from 1.4 to 1.3; NS) in control group. In
bezafibrate group, the changes in vulnerability score was not
correlated with those in % stenosis or MLD.

Conclusion The results indicate that bezafibrate can stabilize coronary plaques.
Evaluation of Annuloaortic Ectasia by Angioscopy and IVUS “Report of 2 cases”
Authors: Tokuhiro Keiichi , Uchida Yasumi , Kawamura Kouhei , Sakuragawa Hiroshi , Masuhara Hiroshi , Oosawa Hidefumi , Koyama Nobuya
Published: August 2007

We attempted combined use of angioscopy and intravascular
ultrasonography (IVUS) to localize the coronary ostia and
determine the aortic segment to be replaced in patients with
annuloaortic ectasia, because these preoperative informations are
important for selection of an appropriate technique for
reconstructing the coronary artery, to prevent complications, and
also to postoperative follow‐up. Two cases with annuloaortic
ectasia underwent angioscopy and IVUS both pre‐ and
post‐operatively. Structure of aortic cusps, position of coronary
ostia, the extent of ectasia with very thin wall were clearly
observed by IVUS. Angioscopy showed milky white luminal surface of
the ectasic segment. After Cabrol’s operation, the sutured portion
of native aorta and graft was clearly identified by IVUS and mural
thrombus and naked surface of graft were observed by angioscopy.
Complications were observed in none. The results indicate
feasibility of combined use of angioscopy and IVUS for
determination of surgical approach and follow‐up in patients with
AAE.
Surgeon at Work: Hand‐Assisted Laparoscopic Construction of Gastric Conduit for Thoracic Esophageal Cancer
Authors: Aoki Tatsuya , Tsuchida Akihiko , Osaka Yoshiaki , Takagi Yu , Shinohara Motoo , Okada Ryosuke , Tomioka Hidenori , Koyanagi Yasuhisa
Published: August 2007

A method for hand‐assisted laparoscopic construction of gastric conduit for thoracic
esophageal cancer was developed. Since this endoscopic surgical procedure is less invasive
than open surgery, it contributes to improvement of post‐operative respiratory functions
and reduces respiratory complications. What distinguishes our surgical procedure is that
unlike methods described in previous reports, it begins with treatment of the left gastroepiploic
vessels at the height of the inferior edge of the spleen, followed by dissection from
the esophageal hiatus to the lesser curvature and then dissection and excision of left gastric
arteries and veins. Finally, the exposed esophagus and stomach are drawn outside the body
and the right gastroepiploic blood vessels are preserved, followed by dissection of the
greater omentum. This approach to gastric conduit construction was undertaken in 6
patients and the mean operating time was 123 minutes. Although in the first 3 of these
patients the operating time was 150 minutes or more, the time required shortened to around
90 minutes for each of the last 3 cases, as the procedure was mastered. In each case, the
volume of intraoperative hemorrhage did not exceed 50 ml.
Angiotensin-Converting Enzyme and Vascular Remodeling
Authors: Heeneman Sylvia , Sluimer Judith C. , Daemen Mat J.A.P.
Published: August 2007

Vascular remodeling is the result of a close interplay of changes in vascular tone and structure. In this review, the role of angiotension-converting enzyme (ACE) and the impact of ACE inhibition on vascular remodeling processes during vascular injury and restenosis, hypertension, atherosclerosis, and aneurysm formation are discussed. The role of ACE and angiotensin II (Ang II) in neointimal thickening has been firmly established by animal studies and is mediated by Ang II type 1 (AT
1
) receptor signaling events via monocyte chemoattractant protein-1 and NAD(P)H oxidase. ACE and Ang II are involved in the remodeling of large and resistance arteries during hypertension; here, cell proliferation and matrix remodeling are also regulated by signaling events downstream of the AT
1
receptor. In atherosclerosis, Ang II is involved in the inflammatory and tissue response, mediated by various signaling pathways downstream of the AT
1
receptor. Although ACE inhibition has been shown to inhibit atherosclerotic processes in experimental animal models, results of large clinical trials with ACE inhibitors were not conclusive. Remodeling of vessel dimensions and structure during aneurysm formation is counteracted by ACE inhibition. Here, a direct effect of ACE inhibitors on matrix metalloproteinase activity has to be considered as part of the working mechanism. The role of ACE2 in vascular remodeling has yet to be established; however, ACE2 has been shown to be associated with vascular changes in hypertension and atherosclerosis.
The Met Allele of the BDNF Val66Met Polymorphism Predicts Poor Outcome Among Survivors of Aneurysmal Subarachnoid Hemorrhage
Authors: Siironen Jari , Juvela Seppo , Kanarek Katarzyna , Vilkki Juhani , Hernesniemi Juha , Lappalainen Jaakko
Published: August 2007

Background and Purpose—

Brain-derived neurotrophic factor (
BDNF
) plays a role in neuronal survival, plasticity and neurogenesis. The
BDNF
gene contains a common Val66Met polymorphism; the Met allele is associated with lower depolarization-induced
BDNF
release and differences in memory functions and brain morphology. We hypothesized that the Met allele is associated with poor recovery from subarachnoid hemorrhage.

Methods—

A sample of 105 survivors was assessed at 3 months after subarachnoid hemorrhage using Glascow Outcome Scale. Poor outcome was defined as severe disability or worse. DNA samples were genotyped for the Val66Met polymorphism.

Results—

Higher percentage of the Met carriers had a poor outcome (29%) as compared with the Val/Val group (10%;
P
=0.011). In multiple logistic regression, this association between the Met allele and poor outcome was independent of several other prognostic factors such as patient age, clinical condition, and radiological severity of the bleeding (odds ratio 8.40; 95% CI, 1.60 to 44.00;
P
=0.012).

Conclusions—

Genetically influenced variation in
BDNF
function plays a role in recovery from subarachnoid hemorrhage. These data indicate that augmentation of
BDNF
signaling may be beneficial to recovery from brain injury.
Impaired Endothelial Function of Forearm Resistance Arteries in CADASIL Patients
Authors: Stenborg Anna , Kalimo Hannu , Viitanen Matti , Terent Andreas , Lind Lars
Published: August 2007

Background and Purpose—

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary arteriopathy, which mainly involves the brain causing stroke and dementia. Mice expressing the mutated protein display early dysfunction in vasoreactivity in resistance arteries, but studies of patients have been inconclusive so far.

Methods—

We examined peripheral endothelium-dependent vasodilatation in 10 CADASIL-patients and 20 controls using 3 methods: venous occlusion plethysmography of forearm blood flow with intraarterial acetylcholine and sodium nitroprusside infusions for evaluation of resistance arteries, ultrasound with flow mediated vasodilatation (FMD) of the brachial artery for evaluation of a conduit artery, and the pulse wave method with measurements before and after terbutaline for evaluation of systemic endothelium-dependent vasodilation.

Results—

The CADASIL patients displayed reductions in both basal (
P
=0.034) and stimulated blood flow (
P
=0.023 for the highest dose of acetylcholine) and an impaired endothelium-dependent vasodilation when investigated in forearm resistance arteries (
P
=0.019). The FMD and the pulse wave method did not show any reduction in endothelium-dependent vasodilation in the patients.

Conclusions—

Endothelium-dependent vasodilation was impaired in resistance arteries, but not in a conduit artery, in the forearm of CADASIL patients.
Simulation of the Last 21 000 Years Using Accelerated Transient Boundary Conditions*
Authors: Timm Oliver , Timmermann Axel
Published: August 2007

The earth system model of intermediate complexity ECBilt-CLIO has been used for transient simulations of the last deglaciation and the Holocene. The forcing effects of the ice sheets, greenhouse gas concentrations, and orbital configurations are prescribed as time-varying boundary conditions. In this study two key aspects of the transient simulations are investigated, which are of broader relevance for long-term transient paleoclimate modeling: the effect of using accelerated boundary conditions and of uncertainties in the initial state. Simulations with nonaccelerated boundary conditions and an acceleration factor 10 were integrated. These simulations show that the acceleration can have a significant impact on the local climate history. In the outcropping regions of the high southern latitudes and the convective regions in the North Atlantic, the acceleration leads to damped and delayed temperature response to the boundary conditions. Furthermore, uncertainties in the initial state can strongly bias the climate trajectories in these areas over 500–700 model years. The affected oceanic regions are connected to the large heat capacities of the interior ocean, which cause a strong delay in the response to the forcing. Despite the shown difficulties with the acceleration technique, the accelerated simulations still reproduce the large-scale trend pattern of air temperatures during the Holocene from previous simulations with different models. The accelerated transient model simulation is compared with existing proxy time series at specific sites. The simulation results are in good agreement with those paleoproxies. It is shown that the transient simulations provide valuable insight into whether seasonal or annual signals are recorded in paleoproxies.
Evaluation of the AR4 Climate Models’ Simulated Daily Maximum Temperature, Minimum Temperature, and Precipitation over Australia Using Probability Density Functions
Authors: Perkins S. E. , Pitman A. J. , Holbrook N. J. , McAneney J.
Published: August 2007

The coupled climate models used in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change are evaluated. The evaluation is focused on 12 regions of Australia for the daily simulation of precipitation, minimum temperature, and maximum temperature. The evaluation is based on probability density functions and a simple quantitative measure of how well each climate model can capture the observed probability density functions for each variable and each region is introduced. Across all three variables, the coupled climate models perform better than expected. Precipitation is simulated reasonably by most and very well by a small number of models, although the problem with excessive drizzle is apparent in most models. Averaged over Australia, 3 of the 14 climate models capture more than 80% of the observed probability density functions for precipitation. Minimum temperature is simulated well, with 10 of the 13 climate models capturing more than 80% of the observed probability density functions. Maximum temperature is also reasonably simulated with 6 of 10 climate models capturing more than 80% of the observed probability density functions. An overall ranking of the climate models, for each of precipitation, maximum, and minimum temperatures, and averaged over these three variables, is presented. Those climate models that are skillful over Australia are identified, providing guidance on those climate models that should be used in impacts assessments where those impacts are based on precipitation or temperature. These results have no bearing on how well these models work elsewhere, but the methodology is potentially useful in assessing which of the many climate models should be used by impacts groups.
Importance and Challenges of Studying Marketed Drugs: What Is a Phase IV Study? Common Clinical Research Designs, Registries, and Self‐Reporting Systems
Authors: Glasser Stephen P. , Salas Maribel , Delzell Elizabeth
Published: August 2007

The new drug application database submitted to the US Food and Drug Administration for drug approval (phases I‐III or phases 1–3) is limited both in scope and size. Although randomized controlled trials, the hallmark of phase III trials, are the gold standard for the drug‐approval process, they invariably have a number of limitations, including relatively small sample sizes, selective populations, short follow‐up, the use of intermediate (surrogate) endpoints (almost always), and limited generalizability. The challenges of monitoring drugs once approved are also numerous. After approval by the Food and Drug Administration, marketed drugs undergo continued scrutiny, and this scrutiny is increasing because of problems that have surfaced with some drugs after their approval. Postmarketing research includes a variety of study designs and the use of registries and self‐reporting of drug side effects. Along with this has come great confusion about what postmarketing research is and what a phase IV study is. Among the important strengths of phase IV research are the exposure of a broader range of patients to the drug under study, resulting in more “real‐world” information about the drug's safety and efficacy, and consideration of a broader range of clinical endpoints. As a result, phase IV, or postmarketing research, has become an integral part of the drug evaluation process for a wide range of agents. The authors discuss the different types of study designs that are common under the phase IV terminology and provide some examples. They also discuss the use of registries and self‐reporting of adverse events using the MedWatch System.
Measuring College Students' Alcohol Consumption in Natural Drinking Environments
Authors: Clapp John D. , Holmes Megan R. , Reed Mark B. , Shillington Audrey M. , Freisthler Bridget , Lange James E.
Published: August 2007

In recent years researchers have paid substantial attention to the issue of college students' alcohol use. One limitation to the current literature is an over reliance on retrospective, self-report survey data. This article presents field methodologies for measuring college students' alcohol consumption in natural drinking environments. Specifically, we present the methodology from a large field study of student drinking environments along with some illustrative data from the same study. Field surveys, observational methods, sampling issues, and breath alcohol concentration sample collection are detailed.
Quantification of Health States with Rank-Based Nonmetric Multidimensional Scaling
Authors: Krabbe Paul F. M. , Salomon Joshua A. , Murray Christopher J. L.
Published: August 2007

Objectives. An alternative methodology is introduced to generate cardinal valuations of health states. This methodology is based on the ranking of differences between health states combined with an associated scaling model that transforms the individual rank data into group values on the interval level. Methods. Data were collected in a Dutch EuroQol EQ-5D valuation study, in which a representative sample (n = 212) of the Dutch population valued a set of 18 EQ-5D health states and death. Three computational steps were undertaken: 1) differences in visual analog scale (VAS) values were computed for each pair of health states based on individual data; 2) the rank ordering of these pairwise differences was derived; 3) nonmetric multidimensional scaling was used to recover cardinal scale values for each state based on these rankings of differences. Results. Scaling of ranked differences between health states using multidimensional scaling produced cardinal values that were nearly identical to the mean VAS valuations. The rank-based values explained 98% of the variance in the VAS values. Conclusion. Ordinal data collection techniques, combined with scaling models, may offer an attractive alternative to direct cardinal elicitation methods for valuing health states.
Calculating Partial Expected Value of Perfect Information via Monte Carlo Sampling Algorithms
Authors: Brennan Alan , Kharroubi Samer , O'Hagan Anthony , Chilcott Jim
Published: August 2007

Partial expected value of perfect information (EVPI) calculations can quantify the value of learning about particular subsets of uncertain parameters in decision models. Published case studies have used different computational approaches. This article examines the computation of partial EVPI estimates via Monte Carlo sampling algorithms. The mathematical definition shows 2 nested expectations, which must be evaluated separately because of the need to compute a maximum between them. A generalized Monte Carlo sampling algorithm uses nested simulation with an outer loop to sample parameters of interest and, conditional upon these, an inner loop to sample remaining uncertain parameters. Alternative computation methods and shortcut algorithms are discussed and mathematical conditions for their use considered. Maxima of Monte Carlo estimates of expectations are biased upward, and the authors show that the use of small samples results in biased EVPI estimates. Three case studies illustrate 1) the bias due to maximization and also the inaccuracy of shortcut algorithms 2) when correlated variables are present and 3) when there is nonlinearity in net benefit functions. If relatively small correlation or nonlinearity is present, then the shortcut algorithm can be substantially inaccurate. Empirical investigation of the numbers of Monte Carlo samples suggests that fewer samples on the outer level and more on the inner level could be efficient and that relatively small numbers of samples can sometimes be used. Several remaining areas for methodological development are set out. A wider application of partial EVPI is recommended both for greater understanding of decision uncertainty and for analyzing research priorities.
Poly(methyl methacrylate)/Multi-wall Carbon Nanotubes Composites Prepared by Solvent Cast Technique: Composites Electrical Percolation Threshold
Authors: Slobodian P. , Lengálová A. , Sáha Petr , Šlouf M.
Published: August 2007

Polymer composites based on poly(methyl metacrylate)/multi-wall carbon nanotubes, (PMMA/MWNT), were prepared by the solvent cast technique from dispersions of MWNT in PMMA solutions. Three different solvents like toluene, chloroform and acetone were selected to solve PMMA, covering a broad range of Hansen solubility parameters. Composite mixing was done by sonication of solutions with MWNT in a broad concentration range up to 20 wt.% of MWNT. Electrical conductivity of composites as a function of MWNT concentration was measured. The different percolation thresholds were found for used systems like PMMA/solvent/MWNT which were found to be related to values of Hansen solubility parameters. Increasing the dispersion component, together with lower values of polar and hydrogen bonding components, leads to a lower value of percolation threshold.
Effect of Normal Load and Sliding Velocity on Friction and Wear Behavior of Carbon Fiber Reinforced Epoxy Composites
Authors: Suresha B. , Chandramohan G.
Published: August 2007

Friction and dry sliding wear behavior of [0°/90°]S and unidirectionally (UD) oriented carbon-epoxy (C-E) composites has been studied using block-on-roller test set up. The dry sliding wear experiments were conducted for the following C-E composites namely 0°/90°, parallel and anti-parallel surfaces with respect to the sliding direction. The coefficient of friction and wear of the composites for two different loads and various sliding velocities have been determined. It was observed that the wear loss increases linearly with increase in sliding velocity/loads. Besides conventional weighing, determination of the coefficient of friction and examination of worn surface features by scanning electron microscopy (SEM) were undertaken to study the tribological behavior. Disorientation of fibers, fiber fracture, matrix deformation and wear debris damage mechanisms were observed under SEM. Composite wear was accompanied by material transfer onto the counter surface.
Polyvinyl Chloride/Organoclay Nanocomposites: Effects of Filler Loading and Maleic Anhydride
Authors: Ismail H. , Munusamy Y.
Published: August 2007

Polyvinyl chloride (PVC)/organoclay nanocomposites were melt compounded in an internal mixer, Haake Rheometer, at 170°C and 50 rpm rotor speed. Effects of organoclay loading (from 2 to 10 phr — parts per hundred of resin) and maleic anhydride (MAH), as a compatibilizer, on the tensile properties, thermal degradation, and morphology were investigated. Results indicate that the presence of organoclay increases the tensile properties and resistance towards thermal degradation. The optimum organoclay loading was achieved at 2 phr. The intercalated/partially exfoliated structure affects the properties of PVC/organoclay nanocomposites as evidenced from the morphological and X-ray diffraction (XRD) studies. The addition of MAH had improved the tensile properties and thermal degradation as a result of better filler-matrix interaction. More intercalation/ partial exfoliation of the organoclay was formed in the PVC matrix in the presence of MAH.
Estimating the Elastic Modulus through the Thickness Direction of a Uni-direction Lamina which Possesses Transverse Isotropic Property
Authors: Kuo Y.-M. , Lin H.-J. , Wang C.-N. , Liao C.-I
Published: August 2007

This investigation presents three formulae of the material constants. A simple method is applied to determine the material properties of a unidirectional lamina (UD) in the through-thickness direction. The mechanical characteristics of an orthotropic composite material generally require nine parameters: three Young's moduli; three shear moduli; and three Poisson's ratios. Most studies concentrate on two orthogonal axial moduli, a shear modulus and a Poisson's ratio in the plane of the lamina. Four material parameters were adopted in those works instead of nine. Some cases in many studies are based on three-dimension modeling, making the nine material constants necessary, as the four material parameters cannot satisfy such cases. However, the material constants through the thickness direction cannot easily be measured experimentally. In this work, the relationships between the nine mechanical properties are revealed by the wave equations of an orthotropic material. Two restrictions in the study are considered: first, the suitable cases are limited to UD possessing the transverse isotropic property; second, the distribution of the fibers in the cross-section of UD laminate must be uniform. On the base, the shear modulus and the Poisson ratio through the thickness direction of the UD material can be computed from the simple relationships.
SMN Transcript Stability: Could Modulation of Messenger RNA Degradation Provide a Novel Therapy for Spinal Muscular Atrophy?
Authors: Heier Christopher R. , Gogliotti Rocky G. , DiDonato Christine J.
Published: August 2007

Proximal spinal muscular atrophy is caused by deletion or mutation of the survival motor neuron 1 gene, SMN1. Rentention of a nearly identical copy gene, SMN2, enables survival but is unable to fully compensate for the loss of SMN1. The SMN1 and SMN2 genes differ by a single nucleotide that results in alternative splicing of SMN2 exon 7 due to the disruption of a binding site for an essential splicing factor. This alternatively spliced form encodes a partially functional truncated protein. Because SMN2 is present in patients with spinal muscular atrophy, it is an ideal therapeutic target. Some of the current approaches to increase SMN protein levels are aimed at increasing the transcription from SMN2 or at preventing exon 7 skipping. One area that has yet to be investigated is the stability of messenger ribonucleic acid (RNA) transcripts produced from SMN2. We postulated that transcripts derived from SMN2 may be less stable because alternative splicing, recruitment of RNA-binding proteins, and alteration of stop codons have been associated with changes in rates of messenger RNA decay; these features are all characteristic of SMN2. Accordingly, transcript degradation was examined within primary fibroblast cells that exclusively contained SMN1 or SMN2 by treating cultures with a transcriptional inhibitor to observe messenger RNA stability. The results indicate that SMN transcript instability does not play a role in the disease mechanism, suggesting that therapeutic modulation of messenger RNA degradation would not target a molecular defect in patients with spinal muscular atrophy, although it could provide general benefits by increasing total pools of SMN2 transcripts.
Modern Management of Spinal Muscular Atrophy
Authors: Iannaccone Susan T.
Published: August 2007

Spinal muscular atrophy is an incurable disease with a frequency of 8 per 100 000 live births. The disease gene, survival motor neuron 1 ( SMN1), was identified with a disease modifying gene, SMN2. There is a high mortality rate in infancy and severe morbidity in childhood. Management depends on treating or preventing complications of weakness and maintaining quality of life. Weakness may affect several organ systems: respiratory, due to restrictive lung disease; gastrointestinal, in terms of dysphagia and constipation; and orthopedic, with progressive deformities. This review focuses on management of restrictive lung disease, the most common and most serious complication. Three areas of recent development are noninvasive ventilation using new technology, new awareness of the importance of identifying sleep-disordered breathing, and a new multidisciplinary approach to standard of care. Noninvasive ventilation and improved airway clearance are helpful for preoperative and postoperative management. Standard of care requires a multidisciplinary approach.
Population Displacement and Housing Dilemmas Due to Catastrophic Disasters
Authors: Levine Joyce N. , Esnard Ann-Margaret , Sapat Alka
Published: August 2007

As Hurricane Katrina revealed, coastal communities have become far more vulnerable to tropical storms and the long-term displacement of residents. Yet, because the emergency management model presumes that recovery quickly follows response, governments focus only on short-term, localized displacement. However, long-term and long-distance displacement exposes a gray area between immediate shelter and permanent housing, along with concerns about vulnerability, housing availability, and land development. We begin this article by discussing the transition between response and recovery. We then review literature regarding social vulnerability, displacement, provision of temporary housing, households' return decisions, and disaster-driven land development and housing construction processes. We close with thoughts on future research to increase planners' understanding of the issues involved and to help them craft effective policies.
The Professional Value of Temporary Study in Another European Country: Employment and Work of Former ERASMUS Students
Authors: Teichler Ulrich , Janson Kerstin
Published: August 2007

Temporary study in another European country supported by the ERASMUS programmes spread from a few thousand participants in the late 1980s to about 150,000 annually in recent years. Such a study period is not only viewed as academically, culturally, and linguistically valuable but is also expected to have a positive impact on subsequent employment and work. Three major studies of former ERASMUS students underscore in many respects the professional value of temporary study in another European country. But former ERASMUS students do not believe that they excel in income and social status during their early career. Moreover, the distinct professional value of temporary study in another country is declining over time. However, temporary study in another European country has remained an exceptional and professionally highly rewarded experience for students from Central and Eastern European countries.
Research on Internationalisation in Higher Education
Authors: Kehm Barbara M. , Teichler Ulrich
Published: August 2007

This contribution provides an overview of the developments of research undertaken since the mid-1990s on international higher education. The general state of research is characterised by an increase of theoretically and methodologically ambitious studies without a dominant disciplinary, conceptual, or methodological “home.” The main topics of research on internationalisation in higher education reach from mobility, mutual influence of higher education systems, and internationalisation of the substance of teaching and learning to institutional strategies, knowledge transfer, cooperation and competition, and national and supranational policies. The modes of inquiry are varied but have not changed much over time. A brief localisation of the role of the Journal of Studies in International Education in the context of research about internationalisation in higher education is followed by conclusions emphasising a certain amount of continuity but also a broadening of the field with an increasing number of ambitious studies. The contribution closes with a few proposals for future research.
Internationalization of Higher Education in the OECD Countries: Challenges and Opportunities for the Coming Decade
Authors: van der Wende Marijk
Published: August 2007

This article explores the possible development of internationalization of higher education in Organisation for Economic Co-operation and Development (OECD) countries, analyzing how the main driving forces may influence the internationalization process, globalization and the changing role of nation-states, regional and international bodies, and multilateral frameworks and agreements. The analysis is carried out based on four future scenarios for higher education developed by the OECD. Implications of various scenarios are analyzed in terms of their broader meaning for the main functions of higher education and issues of access, quality, and equity. Consequently, the implications for internationalization are derived. A special focus is placed on the consequences of the various scenarios for cooperation and competition as major strategic categories in the internationalization process. Finally, some further questions are raised with respect to the internationalization mission of higher education institutions in a globalized world and how the concept of internationalization may evolve.
Internationalization of Higher Education in the Developing and Emerging Countries: A Focus on Transnational Higher Education in Asia
Authors: Futao Huang
Published: August 2007

This article begins with an introduction to the context and general situation of transnational higher education (TNHE) in Asia, especially in East and Southeast Asia. It then examines development of TNHE in some selected Asian countries from different perspectives and provides a detailed description of TNHE in China. The article concludes by discussing challenges and opportunities for the development of TNHE in Asia.
The Process of Internationalization of Latin American Higher Education
Authors: Avila Jocelyne Gacel
Published: August 2007

The purpose of this article is to analyze the present tendencies and characteristics, as well as the present and future perspectives of the process of internationalization in Latin American universities, in light of the results yielded by studies carried out in the region by the World Bank and the European Commission. Emphasis will be placed on the extent to which the characteristics specific to the universities in the region, product of their particular sociohistorical situation, and the challenges and shortcomings they present at the beginning of the 21st century, hinder or help their response and ability to adapt to the global context.
Intervening in the Learning of U.S. Students Abroad
Authors: Vande Berg Michael
Published: August 2007

This article traces the outlines of a profound and ongoing change in U.S. attitudes about study abroad. In chronicling the shift from a Junior Year Abroad paradigm that governed study abroad theory and practice as recently as two decades ago, to an emerging Student Learning paradigm that increasingly informs study abroad attitudes and goals today, the author argues that there is a widening gulf between what U.S. study abroad professionals believe their students ought to learn through studying abroad and what many programs abroad aim to provide.