bluuebunny/crossref_metadata_2025 huggingface dataset:
Woolly Hair – Study of a Family
Authors: Verbov Julian
Published: October 2009

A white English family is described with autosomal dominant woolly wiry hair. The propositus had woolly curly scalp hair, congenital perceptive deafness and dominant ichthyosis vulgaris. Her brother was epileptic and also deaf, but his skin and hair were normal and a male first cousin had dominant ichthyosis vulgaris but normal hair and hearing. Consanguinity was an interesting additional feature in this family.
Neurodermatitis and Intralesional Steroids
Authors: Vasistha L.K. , Singh Gurmohan
Published: October 2009

The present work describes the results of treatment of 30 cases of neurodermatitis circumscripta by intralesional injections which were given by Dermo-Jet®. 15 cases were treated with triamcinolone acetonide (0.25 mg/cm2 of the skin) and the rest with aqua distillata every week for 8 weeks and were followed for another 4 weeks. The results of treatment were excellent in 66% of triamcinolone treated cases and 46% of aqua distillata treated cases. The difference in the response was statistically insignificant. So we conclude that aqua distillata might have worked as suggestion therapy in emotionally labile individuals.
Sensitivity of Gonococcus Strains Isolated in Rotterdam to Epicillin, Ampicillin, Penicillin and Tetracycline
Authors: Stolz E. , Michel M.F. , Schuller J.L. , de Koning G.A.J.
Published: October 2009

Quantitative determinations of the sensitivity to epicillin, ampicillin, penicillin and tetracycline were carried out for 67 gonococcus strains isolated from 67 males with urogenital gonorrhoea, and 38 strains isolated from 38 females with urogenital/rectal gonorrhoea. The results of the sensitivity determinations for ampicillin, penicillin and tetracycline were compared with the findings of a previous investigation. It was found that the gonococcus strains isolated from males had become slightly more sensitive to ampicillin and tetracycline, and slightly less sensitive to penicillin between 1971–1972 and 1976. The percentages of strains isolated from females which were relatively resistant to ampicillin, penicillin and tetracycline had not changed during this period. It was also striking that the in vitro activity of epicillin for strains isolated both from males and females was significantly greater than that of ampicillin.
Trichilemmal Cysts
Authors: Kimura Shunji
Published: October 2009

Recently experienced cases of trichilemmal cysts were studied by light and electron microscopy. Although ultrastructural findings in the present case were basically consistent with those reported in the literature, they were in contrast to them in some important respects: (1) a few, oval and small-sized keratohyalin and a large number of membrane-coating granules were observed in the cytoplasm of keratinizing cells beneath the keratinized cells and (2) the junctional structure between the keratinized cells and the keratinizing cells beneath them showed interdigitation. From these findings, it is shown that trichilemmal cysts have close similarities to and might be derived from the trichilemmal sac surrounding the lower end of the catagen or telogen hair.
La chimiothérapie par voie generate dans le traitement du mycosis fongoïde
Authors: Kenis Y.
Published: October 2009

The clinical experience with chemotherapy in mycosis fungoides is practically limited to the action of different types of chemotherapeutic agents on the lesions in far-advanced cases. A large number of agents from almost all classes – alkylating agents, antimetabolites, antibiotics, alkaloids, hormones – have some efficacy in clearing skin lesions. Despite this fact, combination chemotherapy has been the subject of a very small number of publications with conflicting results. The influence on survival, the comparative effects of combination versus single-agent chemotherapy, the value of chemotherapy combined to other treatment modalities have not been submitted to scientific evaluation. Considering the low frequency of the disease and the great variability of the clinical picture, it seems mandatory to implement large cooperative trials, possibly on an international scale.
Dyskeratosis congenita with Epidermodysplasia verruciformis of Lewandowsky and Lutz
Authors: Bundino S. , Zina A.M. , Bernengo M.G.
Published: October 2009

The case is reported of a 30-year-old man suffering from dyskeratosis congenita with severe pancytopenia, in association with generalized verrucosis. Viral particles were detected electron microscopically. The importance of an impaired immunological state, demonstrated in this case by lymphocyte stimulation and rosette tests, is discussed.
Localized Chronic Pemphigoid
Authors: Nieboer C. , Roeleveld C.G. , Kalsbeek G.L.
Published: October 2009

A case of a chronic remittant blistering eruption on the left temple in a 62-year-old woman is described. Only after repeated biopsies did direct immunofluorescence (DIF) studies reveal a linear staining of the epidermal basement membrane with anti-IgG, C1q, C4, C3 and C5. In addition, heavy deposits of fibrin were observed. The importance of repeated DIF examination in initially negative cases has been stressed. Localized chronic pemphigoid should be considered as a distinct subform of the pemphigoid syndrome.
Tricho-Rhino-Phalangeal Syndrome
Authors: Voigtländer Volker , Osswald Fritz
Published: October 2009

A family with tricho-rhino-phalangeal syndrome in 3 female members is reported. The pedigree is consistent with an autosomal-dominant mode of inheritance.
Papillon-Lefèvre-Syndrom
Authors: Krebs A.
Published: October 2009

Papillon-Lefèvre syndrome in a 13-year-old boy is described. His two great-grandfathers were first-degree cousins (consanguinity). However, no other case of the syndrome nor of palmoplantar keratoderma exists in the family. The palmoplantar keratoderma, which had started before becoming 1 year of age, is usually more pronounced during spring and autumn as well as during feverish diseases. However, it is of the trans-gradient type and is not necessarily very severe. The loss of the deciduous and permanent teeth was a consequence of severe juvenile parodontitis and of bone destruction. The boy could extract his teeth easily by himself and has total prothesis since the age of 14 years. Every treatment was unsuccessful.
Yersinia Enterocolitica as a Cause of Erythema nodosum
Authors: Debois J. , Vandepitte J. , Degreef H.
Published: October 2009

54 cases of erythema nodosum, seen in the Department of Dermatology at the St. Raphael University Hospital, Louvain, were reviewed for their possible aetiology. A search for Yersinia enterocolitica (Y.e.) agglutinins was performed in 21 patients of whom 8 had significant serum antibody titres. These cases are presented and discussed. Gastro-intestinal symptoms, preceding by 2 weeks the erythema nodosum, are strongly suggestive for an aetiologic link with Y.e. Our observations confirm and extend to this part of Europe, the experience of other, mainly Scandinavian, authors.
Animal Models of Percutaneous Penetration: Comparison between Mexican Hairless Dogs and Man
Authors: Hunziker Nicole , Feldmann Robert J. , Maibach Howard
Published: October 2009

In an attempt to find better animal models for percutaneous penetration studies relevant to man, urinary excretion of 14C-labeled compounds was studied in the Mexican hairless dog and in man. With benzoic acid, progesterone and testosterone, the total absorption and maximum absorption rate v/ere greater in man than in the hairless dog. As urinary excretion lasted days longer in the dog than in man, it is possible that the thin dog skin held the chemicals longer than man. Surface-counting experiments with a Geiger counter with a thin mica window protected by a special screen of fine stainless steel wires showed that benzoic acid and progesterone did persist on the dog skin far longer than on human skin. We conclude that the Mexican hairless dog has permeability characteristics significantly different from those of human skin.
Effect of Topical Salicylic Acid on Animal Epidermopoiesis
Authors: Weirich Erich G. , Longauer Josef K. , Kirkwood Alan H.
Published: October 2009

In contrast to its antihyperplastic effect on pathological proliferation of the epidermis, salicylic acid promotes epidermopoiesis in the normal guinea pig skin. After the application of 1 % w/w salicylic acid in acetone-ethanol for 4 weeks, the thickness of the surface epithelium was increased by 40% and that of the deep epithelium by 19%. The mitotic index rose by 17%.
Remissions of Mycosis Fungoides Induced by Nitrogen Mustard (HN2)
Authors: Volden Gunnar , Larsen Tove Eeg
Published: October 2009

In this study 12 patients with mycosis fungoides were treated with whole body topical application of HN2. In addition 4 of these patients had gauzes moistened with the same HN2 solution placed upon plaques and tumours. 4 patients developed an allergic contact dermatitis, and this complication was overcome by percutaneous desensitizing in 3 of them. After starting hydration of plaques and tumours with HN2, the average time to obtain complete clinical remission was shortened from 4.4 to 2.5 months. A little later at the optimal histologic response, there was no or almost no cellular infiltration in 5 cases, while in 6 cases there was only a slight, unspecific, lymphocytic infiltrate in the dermis.
Erythema dyschromicum perstans
Authors: Palatsi Riitta
Published: October 2009

Four patients with ashy dermatosis are described. Their ages varied from 8 to 12 years. Three had typical widespread macular eruptions and one had a linear lesion not described before. The follow-up investigation revealed that the eruption disappeared within 2 years in three of the patients. One patient could not be followed. The duration of the disease and the linearity of one lesion resembled lichen ruber planus.
Psoriasis in North India
Authors: Bedi Tilak R.
Published: October 2009

Analysis of 162 psoriasis patients revealed a distinct male preponderance with a sex ratio of 2.5:1. The mean age of males (31.44) was 6 years higher than that of females (25.73). More than half the patients were in their 3rd to 4th decade and the mean age of onset was lower among the females than the males by approximately 5 years. Two-thirds had onset before the age of 30 years. Familial occurrence was recorded in 13.6% of the cases. Itching appeared to be a prominent feature and only a fourth of the total patients showed traditionally quoted worsening in colder months. The scalp and the extremities were the commonest sites of involvement and a large majority (74%) showed nail changes of one type or another. Psoriatic arthropathy and especially mutilating arthritis were rare.
Systemic Retinoid Therapy of Systematized Verrucous Epidermal Nevus
Authors: Happle R. , Kastrup W. , Macher E.
Published: October 2009

In a patient with systematized verrucous epidermal nevus, marked improvement was obtained with oral administration of a new aromatic retinoid (Ro 10–9359). Mild cheilitis and thinning of scalp hair were the only side effects obser Withved. continuous treatment the good result was maintained for 10 months. Further investigation is needed to determine, whether long-term oral administration of this new drug is feasible.
Quantitative Analysis of Neonatal Intrapersonal Synchrony between Crying Vocalization and Arm Movement
Authors: Watanabe Tomio , Mizukami Keiko , Kobayashi Noboru
Published: October 2009

Neonatal microrhythms and their intrapersonal synchrony between crying vocalization and arm movement were preliminarily researched using a newly developed quantitative analyzing methodology aimed at developing a neurological assessment index. Subjects were twelve 1- to 17-day-old full-term appropriate-for-date neonates. Significant synchronous as well as lagged relationships between crying vocalization and arm movement were revealed. It was found that at the beginning of the cry, movement preceded the cry, while there was no dominant action seen at the end of the cry. It is suggested that this methodology is important as a possible indicator of the integrity of early neural mechanisms.
Congenital Ichthyosis and Medulloblastoma
Authors: Walach Natalio
Published: October 2009

Occurrence of ichthyosis and malignancy together is unusual. An 18-year-old patient suffering from congenital ichthyosis was found to have a medulloblastoma of cerebellum. A short review of the literature of cases of tumors with ichthyosis, and neurological syndromes with ichthyosis is presented.
A Study on Leukocytes Phospholipid Composition in Mycosis fungoides
Authors: Capetanakis J. , Tsambaos D. , Kalofoutis A.
Published: October 2009

Leucocyte phospholipids composition was determined in 16 patients with mycosis fungoides and 20 healthy controls. Statistically significant differences namely, an increase in phosphatidylcholine and diphosphatidylglycerol and a decrease in phosphatidylserine and phosphatidylinositol concentrations between patients and healthy subjects were observed.
Der Naevus teleangiectaticus der Gesichtshaut: Möglichkeiten und Probleme der plastischen Wiederherstellung
Authors: Clodius L.
Published: October 2009

If a portwine stain (capillary hemangioma) or a cavernous hemangioma of the facial skin is not camouflaged by cosmetics, surgical excision and full-thickness skin grafting appears to be the method of choice. Exact planning (donor areas) and perfected technique are prerequisites for results in which the grafted skin matches in color, texture, contour and thickness the unaffected facial side.
Behandlung von Präkanzerosen und Karzinomen am Kopf
Authors: Ott F. , Clodius L.
Published: October 2009

Treatment of actinic keratoses and skin cancer of the head is discussed. The methods of treatment based on an 8-year co-operative study between dermatologists and reconstructive surgeons are presented.
Die Strahlentherapie der Hämangiome
Authors: Jung Ernst G.
Published: October 2009

A controlled study has been performed in 100 children with hemangiomatas. The therapeutic effect of X-ray treatment is compared with that of pseudo-irradiation. No significant differences are observed after 6 years
Untersuchungen zur Wirkung der Vitamin-A-Säure bei experimentell ausgelöster Follikelkeratose
Authors: Kroepfli P.
Published: October 2009

Topical application of Benzoxazole to the inner surface of the ear of the rabbit induced a considerable and histologically verified follicular keratosis. This effect could be intensified by a preceding treatment of the animal with androgens. Vitamin A acid, applied topically, is able to eliminate this follicular keratosis.
Treatment of Psoriasis vulgaris with a New Retinoic Acid Derivative Ro 10-9359
Authors: Dahl Birgit , Møllenbach Kirsten , Reymann Flemming
Published: October 2009

The retinoic acid derivative Ro 10-9359, given orally in maximum daily doses of 100 mg to 15 patients with psoriasis vulgaris, led to clearing of the lesions in 8 patients. The average period of treatment was 9 weeks. In 14 patients side-effects were observed, the most important being palmo-plantar desquamation, shivering, thirst and diffuse hair loss. In 2 patients scaling led to withdrawal. In 6 patients abnormal alkaline phosphatase and glutamic-aspartatic transaminase values, partly transient, developed (glutamic-aspartatic transaminase, p < 0.01).
Hypersensitivity Reactions to Gerovital
Authors: Förström L. , Hannuksela M. , Heikkilä Idänpään , Salo O.P.
Published: October 2009

Procaine chloride, which was a common cause of allergic reactions in earlier years, has lost importance as a contact allergen because its use for local anaesthesia has ceased. Recently, we have seen hypersensitivity reactions in three patients after the use of Gerovital®, which is known to contain procaine chloride. A word of warning is warranted against indiscriminate use of Gerovital, particularly of its topical preparations.
Warty Dyskeratoma
Authors: Vandaele R. , de Wael R.
Published: October 2009

A female patient is described with two lesions of warty dyskeratoma and probably a third in its early stages, all localized on the hairy scalp. We agree with other authors that warty dyskeratoma is a distinct entity and has no relation to dyskeratotic actinic keratosis nor to Darier’s disease.
A New Method for Identifying Parakeratosis in Human Epidermis
Authors: Tring Charles , Murgatroyd Lyndon B.
Published: October 2009

Skin surface biopsies taken from normal and parakeratotic skin and stained with a 4-4-diamidinodiphenylamine dihydrochloride (M & B 938) were examined microscopically using bright field and ultraviolet light illumination. No fluorescence was seen in squames from normal skin when microscopically examined using ultraviolet light illumination. In marked contrast, brilliantly fluorescent nuclei were observed in squames from parakeratotic skin. Control preparations treated with DNAse and stained with M & B 938 did not exhibit nuclear fluorescence. The fluorochrome is not specific for DNA since it stains cartilage and goblet cells and appears to behave as a basic dye.
La forme vésiculo-bulleuse de Pérythrasma interdigito-plantaire
Authors: Grigoriu D. , Delacrétaz J.
Published: October 2009

7 cases of vesiculo-bullous erythrasma of the feet are reported. Wood’s light, microbiology and histology permit to separate this entity from dysidrotic eczema and dermatophytosis.
Spermienagglutinationstest Spermienimmobilisationstest und Spermienimmunfluoreszenztest bei Ehepaaren mit unerklärbarer Infertilität
Authors: Heite Hans-J. , Maucher Ortrun M.
Published: October 2009

Thirty-four married couples with clinically unexplained infertility and normal spermiograms in all male partners were investigated for sperm antibodies by means of the sperm agglutination, sperm immobilization and sperm immunofluorescence test. In 50% of the couples, sperm antibodies were found in at least one of the partners and with at least one of the tests, e.g. ten times in the female partner alone, six times in the male partner alone, and once in both partners. The correspondance of the three tests was astonishingly low; it is assumed, therefore, that they indicate different types of antibodies. On the basis of the present investigations it is not possible to assess which type of antibody is responsible for the infertility of the female or male partner respectively. This seems only possible when the decrease of certain antibody types can be determined after a period of no antigen contact (avoidance of sperm contact) and when conception has taken place. The significance of autoanti bodies against sperm in clinically healthy men with normal spermiograms remains open.
Influence of Lipophilic Substances on Fungal Infections of the Human Skin
Authors: Schmid Peter , Chelf Bruce
Published: October 2009

A three-factor factorial experiment was performed to assess the efficiency of lipid extraction from the back of human volunteers. Chloroform-methanol (2:1 v/v) proved substantially superior to acetone or diethyl ether. The latter two solvents were also significantly more efficient than n-hexane. The implication of the findings is discussed with regard to the isolation and characterization of fungistatic and bacteriostatic agents on the surface of the skin.
Acute-Onset Unilateral Psychogenic Hearing Loss in Adults: Report of Six Cases and Diagnostic Pitfalls
Authors: Oishi Naoki , Kanzaki Sho , Kataoka Chinatsu , Tazoe Mami , Takei Yasuhiko , Nagai Keiichi , Kohno Naoyuki , Ogawa Kaoru
Published: October 2009

We encountered 6 rare cases of acute-onset unilateral psychogenic hearing loss in adults. All were women in their 20s and 30s. Three cases had severe hearing impairment characterized by hearing loss at every frequency; 2 cases had profound hearing impairment, and 1 case had low-frequency hearing impairment. Of the 6 cases, 3 had a history of hearing loss, and 1 had a history of psychogenic visual disturbance. All 6 cases were initially diagnosed as having idiopathic sudden sensorineural hearing loss; all subsequently received steroid therapy. Three cases were not diagnosed as being psychogenic in origin until otoacoustic emissions and auditory brain responses were performed. Although the presence of distinctive clinical features (age, gender, and past history) is important for suspecting psychogenic hearing loss, objective audiological tests such as otoacoustic emissions are essential for diagnosing some cases. Compared to the existing reports of similar cases, our cases had a poorer prognosis (only 2 cases were cured).
Hautnebenwirkungen interner Arzneimittel
Authors: Widmer O. , Zürcher K. , Krebs A.
Published: October 2009

This, the fourth part of a synopsis of cutaneous side effects of drugs, covers the drugs affecting the central nervous system: antiepileptics, hypnotics, narcotics and psychopharmaceutics; the myorelaxants and antiallergics follow, and lastly there is a section on drug addiction and placebo. The various cutaneous side effects are listed in chart form referring to more than 500 sources. A drug index is attached for handy reference. The reviews of certain drug induced skin disorders are continued with tables covering photosensitivity and changes in skin colour. Phototoxicity, photoallergy and light sensitivity by porphyria are differentiated. The various pigmentation disorders, colour changes due to metal deposits as well as different localisations are included.
A Case of Xanthomatosis and Hyperlipoproteinemia Type V Propably Induced by Overdosage of Insulin
Authors: Vermeer B.J. , Polano M.K.
Published: October 2009

A woman, aged 46 years, with a hyperlipoproteinemia phenotype V, an unusual type of xanthomatosis, as well as lipemia retinalis, diabetes mellitus, and nephropathia, is discussed. The withdrawal of 64 IU insulin and the institution of a hypocaloric diabetes diet resulted in the disappearance of the skin lesions and a regression of the eye lesion. During this treatment the total lipid-level became almost normal (6,965 mg% before treatment and 947 mg% after 10 weeks). The chylomicrons disappeared but the VLDL content remained relatively and absolutely elevated, as in type IV hyperlipoproteinemia.
Screening for 6-Phosphogluconate Dehydrogenase Abnormalities in the Blood of Dermatological Patients
Authors: Cotton D.W.K. , van Rossum Elisabeth
Published: October 2009

The results of screening for 6-phosphogluconate dehydrogenase abnormalities in the blood of dermatological patients are reported. No differences were found between controls, psoriatics, psoriatics receiving methotrexate and a group of mixed patients. The results are discussed in relation to the effects of methotrexate on glucose-6-phosphate dehydrogenase.
Ingestion of Ammonium Nitrate as a Possible Cause of Erythema dyschromicum perstans (Ashy Dermatosis)
Authors: Jablonska S.
Published: October 2009

Clinically and histologically typical erythema dyschromicum perstans has been provoked by repeated ingestion of very small amounts of a fertilizer, ammonium nitrate. It has been used by a boy who has noticed accidentally that after licking the fertilizer he developed hyperpigmentations. His main purpose was to avoid school attendance, and he developed a very ingenious method of licking the fertilizer once in several weeks in such a way that it did not produce any digestive or other troubles. His brother, an uniovular twin who had no contact with ammonium nitrate, was healthy. The case supports Pinkus’ hypothesis that this type of lesions may be related to some environmental contaminant. Attention is called to a possible food contamination by ammonium nitrate.
Störung zellvermittelter Immunreaktionen bei Neurodermitis atopica
Authors: Schöpf Erwin
Published: October 2009

In 17 patients with atopic dermatitis and in 17 healthy control persons, rosette-forming T cells from peripheral blood were investigated. The percentage of rosette-forming T cells in atopies was significantly lower (p < 0.0025) than in the control group. In patients with atopic dermatitis there was a significant correlation between IgE serum levels and the number of rosette-forming T cells. Increase in IgE level is correlated to a decrease in the number of rosette-forming T cells. It is suggested that the primary defect in the immunological system in atopies may be found in the thymus- or T-cell-mediated immunological system, and that this defect be characterized by a decrease or lack of T cells with suppressor function for IgE formation.
Correlation between Immunological Parameters and Cutaneous Manifestations of Systemic Lupus erythematosus
Authors: Levo Y. , Pick A.I. , Nir M.A. , Weiss C. , Feuerman E.J.
Published: October 2009

A patient with systemic lupus erythematosus with predominant skin involvement is described. A good correlation between disease activity manifested by skin lesions and between the titer of anti-DNA antibodies and C 3 component of complement was observed. Disease activity was accompanied by a high titer of anti-DNA antibodies and by a low level of the C3 component of complement; these parameters were reversed during remission. We conclude that these parameters are useful in the diagnosis and management of patients with systemic lupus erythematosus limited to the skin.
Beeinflussen lokal applizierte Corticosteroide den Heilverlauf der Epidermophytien?
Authors: Fischer E.
Published: October 2009

During in vitro studies of the effect of hydrocortisone (50 mg/ml) and of Locorten (2 mg/ml) upon the growth rate of trichophyton mentagrophytes, trichophyton rubrum, microsporon gypseum and c. albicans neither a stimulating nor inhibiting effect could be demonstrated. Local application of Locorten ointment (Ciba) increased the rate of healing of experimental Trichophyton gypseum asteroides infection in guinea pigs.
Auditory Processing in Children with Specific Language Impairments: Are there Deficits in Frequency Discrimination, Temporal Auditory Processing or General Auditory Processing?
Authors: Nickisch Andreas , Massinger Claudia
Published: October 2009

Background/Aims: Specific language impairment (SLI) is believed to be associated with nonverbal auditory (NVA) deficits. It remains unclear, however, whether children with SLI show deficits in auditory time processing, time processing in general, frequency discrimination (FD), or NVA processing in general. Patients and Methods: Twenty-seven children (aged 8–11) with SLI and 27 control children (CG), matched for age and gender, were retrospectively compared with regard to their performance on five NVA skills in terms of just noticeable differences (JND) and time order judgments (TOJ). JND was used for FD, intensity discrimination, and gap detection, while TOJ was used for FD and clicks. Results: Children with SLI performed significantly worse than the CG only on the FD tasks (JND and TOJ). The other nonverbal tasks showed no significant intergroup differences. Additionally, moderate associations were found between the FD tasks and phonological skills, as well as between FD tasks and language scores. Conclusion: Children with SLI appear to have restricted FD skills compared to controls, but there was no evidence for a common NVA deficit or reduced temporal auditory abilities.
Statistical Models of F2 Slope in Relation to Severity of Dysarthria
Authors: Kim Yunjung , Weismer Gary , Kent Raymond D. , Duffy Joseph R.
Published: October 2009

Objective: This study investigated the distribution of second-formant (F2) slopes in a relatively large number of speakers with dysarthria associated with two different underlying diseases. Patients and Methods: Forty speakers with dysarthria (20 with Parkinson’s disease, PD; 20 with stroke) and 5 control speakers without a history of neurological disease were asked to repeat six words (coat, hail, sigh, shoot, row and wax) 10 times. Acoustic analysis was performed to derive F2 slope, and speech intelligibility data were collected using a direct magnitude estimate technique to examine its relationship to F2 slope. Results: Statistical analysis revealed that both clinical groups showed significantly reduced F2 slopes compared to healthy speakers for all words but row. No group difference was found between speakers with PD and stroke; however, different words showed varying sensitivity to the speech motor control problems. The F2 slopes of only two words, shoot and wax, were significantly correlated with scaled speech intelligibility. Conclusion: The findings support the idea that distributional characteristics of acoustic variables, such as F2 slope, could be used to develop a quantitative metric of severity of speech motor control deficits in dysarthria, when the materials are appropriately selected and additional distributional characteristics are studied.
Objective Acoustic Analysis of Pathological Voices from Patients with Vocal Nodules and Polyps
Authors: Jiang Jack J. , Zhang Yu , MacCallum Julia , Sprecher Alicia , Zhou Liang
Published: October 2009

Objective: We aim to examine the abilities of objective acoustic analysis methods (nonlinear dynamic and traditional perturbation measures) to describe voices from individuals with vocal nodules and polyps. Subjects and Methods: Sustained vowel recordings from normal subjects, patients with vocal nodules, and patients with vocal polyps were analyzed. Perturbation measures of jitter and shimmer were obtained with the Multi-Dimensional Voice Program (MDVP) and CSpeech. Signal-to-noise ratio was calculated using CSpeech. Nonlinear dynamic measures of phase space reconstruction and correlation dimension were also applied to analyze the voices. Results: A significant difference between normal and polyp groups was found in jitter and shimmer obtained from MDVP, as well as in jitter and signal-to-noise ratio from CSpeech. However, no parameters significantly differentiated between normal and nodule groups. Shimmer from CSpeech did not reveal any significant differences among any of the groups. Correlation dimension values for the nodule and polyp groups were significantly higher than the normal group. Conclusion: Nonlinear dynamic analysis has great potential value for the characterization of voice from patients with vocal nodules and polyps. The combination of traditional perturbation and nonlinear dynamic measures may improve our ability to provide objective clinical analysis of voices with vocal mass lesions.
Outpatient Hysteroscopy with Combined Local Intracervical and Intrauterine Anesthesia
Authors: Agdi Mohammed , Tulandi Togas
Published: October 2009

Background/Aims: To evaluate the degree of pain during and after office hysteroscopy with combined intracervical and intrauterine anesthesia compared to intracervical anesthesia only. Methods: We evaluated the amount of pain experienced during office hysteroscopy using combined local intracervical and intrauterine anesthesia, 10, 30, and 60 min after, and during endometrial biopsy prospectively in 37 infertile women (study group). We used a visual analog scale ranging from 0 to 10. Seventy-six women who received only intracervical anesthesia served as historical controls. Results: The mean ages of patients in the control and study groups were comparable. Patients’ perception of pain was significantly higher during endometrial biopsy than during or after hysteroscopy in the study patients (p < 0.01, 95% CI 0–3). The mean pain score in the control group was significantly higher than that in the study group during hysteroscopy (3.3 ± 0.2 vs. 2.2 ± 0.3; p < 0.05, 95% CI 0–2). However, there was no significant difference in the pain scores between the control and study groups during endometrial biopsy and 10, 30, and 60 min after the procedure. Conclusion: Endometrial biopsy is associated with more pain than office hysteroscopy. Additional intrauterine anesthesia with 1% lidocaine significantly reduces pain sensation during office hysteroscopy.
Quantitative Analysis of Amplitude-Integrated Electroencephalogram Patterns in Stable Preterm Infants, with Normal Neurological Development at One Year
Authors: Niemarkt H.J. , Andriessen P. , Peters C.H.L. , Pasman J.W. , Blanco C.E. , Zimmermann L.J. , Bambang Oetomo S.
Published: October 2009

Background: The amplitude-integrated EEG (aEEG) is feasible for monitoring cerebral activity in preterm infants. However, quantitative data on normal patterns in these infants are limited. Objective: To study maturational aEEG changes in a cohort of stable preterm infants by automated quantification. Methods: In a cohort of stable preterm infants with gestational age (GA) <32 weeks and normal neurological follow-up at 1 year, weekly 4 h EEG recordings were performed. aEEG traces were obtained from channel C3-C4. The upper margin amplitude (UMA), lower margin amplitude (LMA) and bandwidth (BW) were quantitatively calculated using an expert software system. In addition, the relative duration of discontinuous background pattern (discontinuous background defined as activity with LMA <5 µV, expressed as DC-%) was calculated. Results: 79 aEEG recordings (4–6 recordings/infant) were obtained in 18 infants. Analysis of the first week recordings demonstrated a strong positive correlation between GA and LMA, while DC-% decreased significantly. Longitudinally, all infants showed increase of LMA. Multivariate analysis showed that GA and postnatal age (PA) both contributed independently and equally to LMA and DC-%. We found a strong correlation between postmenstrual age (GA + PA) and LMA and DC-%, respectively. Conclusion: To our knowledge, this is the first study where aEEG development was studied by automated quantification of aEEG characteristics in a cohort of stable preterm infants with a normal neurological development at 1 year of age. LMA and DC-% are simple quantitative measures of neurophysiologic development and may be used to evaluate neurodevelopment in infants.
Pulmonary Vascular Endothelial Growth Factor Expression and Disaturated Phospholipid Content in a Chicken Model of Hypoxia-Induced Fetal Growth Restriction
Authors: Been Jasper V. , Zoer Bea , Kloosterboer Nico , Kessels Carolina G.A. , Zimmermann Luc J.I. , van Iwaarden J. Freek , Villamor Eduardo
Published: October 2009

Background: Prenatal hypoxia is an important cause of intrauterine growth retardation that affects fetal lung maturation, although previous studies have rendered conflicting results. The fetal chicken model allows the study of the isolated effects of hypoxia during development. Objectives: We hypothesized that prenatal hypoxia would differentially affect surfactant synthesis, depending on timing and duration of hypoxia. Pulmonary vascular endothelial growth factor (VEGF) expression was analyzed as a possible link between oxygen sensing and surfactant production. Methods: Fertilized White Leghorn eggs were incubated in normoxia, hyperoxia (60% O2) from day 15 or hypoxia (15% O2) from either day 6 or day 15 of incubation. Whole lung disaturated phospholipids (DSPL) and mRNA expression of VEGF isoforms were quantified at day 16 and 19. Results: Lung DSPL content increased approximately threefold between day 16 and 19 in control animals. Both hypoxia and hyperoxia from day 15 significantly increased DSPL content at day 19 versus control (103 ± 22 and 116 ± 18 vs. 81 ± 15 µg/mg protein, p < 0.01 and p < 0.001, respectively), while long-term hypoxia tended to decrease DSPL content (65 ± 17 µg/mg protein, p = 0.056). No differences in DSPL content were observed at day 16. Short-term hypoxia transiently up-regulated VEGF146 1.5-fold at day 16 (p < 0.05). A similar trend was observed for VEGF122 (p = 0.058) and VEGF190 (p = 0.08), while no differences were present at day 19. Conclusions: Both prenatal hypoxia and hyperoxia induced during critical windows of lung development differentially modulate surfactant synthesis. Our data support the concept that fetal oxygen tension is a key signal in the regulation of the surfactant system.
Efficacy of an Experimental Tin-F-Containing Solution in Erosive Tissue Loss in Enamel and Dentine in situ
Authors: Schlueter N. , Klimek J. , Ganss C.
Published: October 2009

The aim of this study was to evaluate the effects of an experimental tin-containing fluoride solution on erosive tissue loss in human enamel and dentine using a cyclic de- and remineralization model in situ. The study was a three-cell (7 days each) crossover design involving 20 healthy volunteers. Samples were mounted on buccal shields of mandibular mouth appliances and worn for 24 h, except during meals and oral hygiene. Samples were demineralized extraorally with 0.05 M citric acid (pH 2.3) for 6 × 5 min per day. Fluoride treatment was performed intraorally once per day for 30 s after the first demineralization. Three solutions were used: placebo (negative control); NaF solution (positive control, 1,000 mg/kg F, pH 4.5), and an experimental solution (1,900 mg/kg Sn as SnCl2, 500 mg/kg F as NaF, 500 mg/kg F as amine fluoride, pH 4.5). Tissue loss was determined profilometrically. In enamel, tissue loss was 33.6 ± 15.4 μm in the negative control group, 24.2 ± 9.2 μm (p ≤ 0.05) in the positive control group and 9.2 ± 3.4 μm (p ≤ 0.001) in the experimental solution group. The respective values for dentine were 47.8 ± 15.5 μm in the negative control group, 34.1 ± 9.3 μm (p ≤ 0.001) in the positive control group and 23.9 ± 6.4 μm (p ≤ 0.001) in the experimental solution group. The tin-containing solution was very effective in inhibiting erosive mineral in enamel in situ, even under severe conditions and with short application times, but was less effective in dentine.
What Difference Does Using Bitewing Radiographs Make to Epidemiological Estimates of Dental Caries Prevalence and Severity in a Young Adolescent Population with High Caries Experience?
Authors: Gowda S. , Thomson W.M. , Foster Page L.A. , Croucher N.A.
Published: October 2009

The study aimed to determine the relative contributions of bitewing radiography and clinical examination to caries estimates for a New Zealand child population with high caries experience. An epidemiological survey was conducted of 171 12- and 13-year-old children attending schools in five communities. Examinations were conducted in dental clinics. Bitewing radiographs were taken at the time of the clinical examination. These were developed and read later, and the data from those were used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the posterior teeth. For almost all parameters, the use of radiographs resulted in higher estimates, although at the whole-mouth prevalence level the difference was not great. The percent difference between the estimates ranged from –0.1 to 166.7%. There were moderate differences between the clinical-only and radiographically adjusted whole-mouth estimates for mean DMFT, DT, DMFS and DS, but only a minor difference in caries prevalence. With the mesial and distal surfaces only, the prevalence and severity estimates were significantly greater, with a one-surface difference (on average) in mean DS being the largest difference observed, at 166.7%. The diagnostic discrepancy was much greater for approximal than occlusal surfaces. These findings support but also build upon earlier findings and again underline the need for bitewing radiographs to be a routine part of oral epidemiological surveys wherever logistics and funding permit.
Relation between Axial Length and Ocular Parameters
Authors: Park Sang Hoon , Park Ki Ho , Kim Joon Mo , Choi Chul Young
Published: October 2009

Purpose: To investigate the relation between axial length (AL) and ocular parameters. Methods: Measurements of ocular biometric parameters were performed with an optical biometer, pachymeter, optical coherence tomography, and an automatic refractometer. AL, refractive error (RE), central corneal thickness, anterior chamber depth (ACD), corneal curvature (CC), white-to-white distance (WWD), and retinal nerve fiber layer (RNFL) thickness were measured. AL was evaluated in relation to ocular parameters. The Pearson correlation coefficient (r) was used to statistically evaluate each scattergram. Results: With elongation of the AL, the mean RE (r = –0.790, p < 0.001), CC (r = –0.444, p < 0.001), and RNFL thickness (r = –0.306, p < 0.001) all decreased, while the mean ACD (r = 0.506, p < 0.001) and WWD (r = 0.279, p < 0.001) increased. Conclusions: In shorter eyes, there was a tendency toward hyperopia, a steeper cornea, and a thicker RNFL, and in longer eyes toward myopia, a flatter cornea, and a thinner RNFL.
Postoperative Pulmonary Complications after Laparotomy
Authors: Smith Peter R. , Baig Muhammad A. , Brito Veronica , Bader Fayez , Bergman Michael I. , Alfonso Antonio
Published: October 2009

Background: The frequency of, and risks for, postoperative pulmonary complications (PPCs) after laparotomy are incompletely understood. The wide-ranging incidence of PPCs in the literature reflects methodological issues including variable definitions of PPCs and varied patient populations. Objectives: We sought to elucidate the incidence of PPCs after laparotomy and clarify risks for their development. Methods: We conducted a retrospective study of all laparotomies in adult patients on the general surgery service at our university-affiliated hospital in 2004. The definition of PPCs was rigorous and relevant in terms of key outcomes (morbidity, mortality, length of stay). We used a template for the review of medical records to identify PPCs and their consequences. Results: Twenty-five PPCs (7.0%) occurred in 359 laparotomies. Logistic regression modeling identified the following independent predictors of risk: upper abdominal incisions (OR 15.3; p = 0.025), reoperation (OR 7.1; p = 0.013), emergency surgery (OR 6.3; p = 0.001) and nasogastric tubes (OR 5.4; p = 0.008). PPCs were associated with increased mortality (OR 6.17; p = 0.01), intensive care unit care (OR 13.0; p = 0.001), increased mean hospital length of stay (17.7 days longer; p = 0.001) and longer mean postoperative length of stay (15.2 days longer; p = 0.001). Conclusions: The incidence of PPCs after laparotomy in this study is lower than in many prior reports and reflects the relevant definition of PPCs used. Upper abdominal surgery carried the greatest risk. Reoperation was a risk not identified previously. Emergency procedures and the use of nasogastric tubes were confirmed as key risks. Morbidity, mortality and lengths of stay were significantly increased after PPCs.
Fibrin clot properties are altered in patients with chronic obstructive pulmonary disease
Authors: Kaczmarek Przemyslaw , Sladek Krzysztof , Stepien Ewa , Skucha Wojciech , Rzeszutko Marcin , Gorkiewicz-Kot Izabela , Tracz Wieslawa , Undas Anetta
Published: October 2009

Increased risk of thrombotic events occurs in chronic obstructive pulmonary disease (COPD). Elevated fibrinogen and C-reactive protein (CRP), being common in COPD, are associated with formation of dense fibrin clots resistant to lysis. Statins have been found to display anti-inflammatory and antithrombotic effects. We investigated fibrin clot properties in COPD patients prior to and following statin therapy. Ex vivo plasma fibrin clot permeability, compaction, and fibrinolysis were assessed in 56 patients with stable COPD,aged 64.9 ±9.2 years (mean FEV1, 54.7 ±15.9% predicted), versus 56 controls matched for age, sex and cardiovascular risk factors. Patients were then randomly assigned to receive simvastatin 40 mg/day (n = 28) or to remain without statins for three months (n = 28). Patients with COPD had lower clot permeability (6.1±1.07 versus 9.2 ±0.9 10−9 cm2; p <0.0001), decreased compaction (44.9 ±4.5 versus 63.9 ± 6.1%; p <0.0001), higher maximum D-dimer levels released from clots (4.23 ±0.55 versus 3.53 ±0.31 mg/l; p <0.0001) with a decreased rate of this release (75.0 ±8.3 versus 80.9 ±8.0 43;g/ l/min; p = 0.03) and prolonged lysis time (9.84 ±1.33 versus 8.02 ±0.84 min; p <0.0001) compared with controls. Scanning electron microscopy confirmed denser clot structure in COPD. Multiple linear regression analysis after adjustment for age and fibrinogen showed that in the COPD patients, CRP was the only independent predictor of permeability (R2 = 0.47; p <0.001) and lysis time (R2 = 0.43; p <0.001). Simvastatin improved clot properties (p <0.05) despite unaltered CRP and irrespective of cholesterol reduction. Our study shows that fibrin clots in COPD patients are composed of much denser networks that are more resistant to lysis, and these properties can be improved by statin administration.
Diagnosis of deep-vein thrombosis: Adherence to guidelines and outcomes in real-world health care
Authors: Gerlach Horst , Hach-Wunderle Viola , Rabe Eberhard , Riess Hanno , Carnarius Heike , Eberle Sonja , Bauersachs Rupert , Schellong Sebastian
Published: October 2009

Current guidelines recommend optimised algorithms for diagnosis of suspected deep-vein thrombosis (DVT). There is little data to determine to what extent real-world health care adheres to guidelines, and which outcome in terms of diagnostic efficiency and safety is achieved. This registry involved patients with clinically suspected DVT of the leg recruited in German ambulatory care between October and December 2005. Registry items were: diagnostic methods applied; diagnostic categories at day 1; and venous thromboembolic events up to 90 days in patients without firmly established DVT. A total of 4,976 patients were recruited in 326 centres. Venous ultrasonography was performed in 4,770 patients (96%), D-dimer assay in 1,773 patients (36%) and venography in 288 patients (6%). At day 1, DVT was confirmed in 1,388 patients (28%), and ruled out in 3,389 patients (68%), and work-up was inconclusive in 199 patients (4%).The rate of venous thromboembolism at 90 days was 0.34% (95% confidence interval [CI]: 0.09 to 0.88) in patients in whom the diagnosis of DVT had been ruled out, and 2.50% (95% CI: 0.69 to 6.28) in patients with inconclusive diagnostic workup. This nationwide evaluation in German ambulatory care revealed that the diagnostic work-up for suspected DVT did not adhere to current guidelines. However, the overall diagnostic safety was excellent, although there is potential for improvement in a well defined minority of patients.

The TULIPA registry was funded by GlaxoSmithKline GmbH und Co KG, Munich.
Inhibition of acute vascular thrombosis in chimpanzees by an anti-human tissue factor antibody targeting the factor X binding site
Authors: Jiao Jin-an , Kelly Andrew , Marzec Ulla , Nieves Esperanza , Acevedo Jorge , Burkhardt Martin , Edwards Ana , Zhu Xiao-yun , Chavaillaz Pierre-Andre , Wong Alice , Wong Jeffrey , Egan Jack , Taylor Dean , Rhode Peter , Wong Hing
Published: October 2009

Tissue factor (TF) antagonists targeting the factor VII (FVII) binding domain have been shown to interrupt acute vascular thrombus formation without impairing haemostasis in non-human primates. In this study, we evaluate whether a human/mouse chimeric monoclonal antibody (ALT-836, formerly known as Sunol-cH36) blocking the factor X/factor IX (FX/FIX) binding site of tissue factor could achieve similar clinical benefits in an arterial thrombosis model induced by surgical endarterectomy in chimpanzees. In this model, sequential surgical endarterectomies on right and left superficial femoral arteries were performed 30 days apart in five chimpanzees. A bolus (1 mg/kg) of ALT-836 was injected intravenously immediately preceding the restoration of flow in the endarterectomised femoral artery. Pre-surgical labelling of autologous platelets using 111In-Oxine and post-surgical gamma camera imaging of 111In-platelet deposition at endarterectomy sites was performed. The manipulated arterial segments were harvested for patency analysis 30 days following surgery. The results indicate that ALT-836 was highly effective at reducing acute vascular thrombosis, with no significant variations in surgical blood loss and template-bleeding time in the treated group compared to the control animals. These data suggest that ALT-836 is an effective and safe antithrombotic agent in preventing TF-initiated vascular thrombogenesis without compromising haemostasis.