bluuebunny/crossref_metadata_2025 huggingface dataset:
Vaccinia virus replication is not affected by APOBEC3 family members
Authors: Kremer Melanie , Suezer Yasemin , Martinez-Fernandez Yolanda , Münk Carsten , Sutter Gerd , Schnierle Barbara S
Published: October 2006

Background

The APOBEC3G protein represents a novel innate defense mechanism against retroviral infection. It facilitates the deamination of the cytosine residues in the single stranded cDNA intermediate during early steps of retroviral infection. Most poxvirus genomes are relatively A/T-rich, which may indicate APOBEC3G-induced mutational pressure. In addition, poxviruses replicate exclusively in the cytoplasm where APOBEC3G is located. It was therefore tempting to analyze whether vaccinia virus replication is affected by APOBEC3G.

Results

The replication of vaccinia virus, a prototype poxvirus, was not, however, inhibited in APOBEC3G-expressing cells, nor did other members of the APOBEC3 family alter vaccinia virus replication. HIV counteracts APOBEC3G by inducing its degradation. However, Western blot analysis showed that the levels of APOBEC3G protein were not affected by vaccinia virus infection.

Conclusion

The data indicate that APOBEC3G is not a restriction factor for vaccinia virus replication nor is vaccinia virus able to degrade APOBEC3G.
Nerve Injury Induces Robust Allodynia and Ectopic Discharges in Nav1.3 Null Mutant Mice
Authors: Nassar Mohammed A , Baker Mark D , Levato Alessandra , Ingram Rachel , Mallucci Giovanna , McMahon Stephen B , Wood John N
Published: October 2006

Changes in sodium channel activity and neuronal hyperexcitability contribute to neuropathic pain, a major clinical problem. There is strong evidence that the re-expression of the embryonic voltage-gated sodium channel subunit Nav1.3 underlies neuronal hyperexcitability and neuropathic pain.

Here we show that acute and inflammatory pain behaviour is unchanged in global Nav1.3 mutant mice. Surprisingly, neuropathic pain also developed normally in the Nav1.3 mutant mouse. To rule out any genetic compensation mechanisms that may have masked the phenotype, we investigated neuropathic pain in two conditional Nav1.3 mutant mouse lines. We used Nav1.8-Cre mice to delete Nav1.3 in nociceptors at E14 and NFH-Cre mice to delete Nav1.3 throughout the nervous system postnatally. Again normal levels of neuropathic pain developed after nerve injury in both lines. Furthermore, ectopic discharges from damaged nerves were unaffected by the absence of Nav1.3 in global knock-out mice. Our data demonstrate that Nav1.3 is neither necessary nor sufficient for the development of nerve-injury related pain.
TheUltrabithoraxHox gene ofDrosophilacontrols haltere size by regulating the Dpp pathway
Authors: de Navas Luis F. , Garaulet Daniel L. , Sánchez-Herrero Ernesto
Published: October 2006

The halteres and wings of Drosophila are homologous thoracic appendages, which share common positional information provided by signaling pathways. The activity in the haltere discs of the Ultrabithorax(Ubx) Hox gene establishes the differences between these structures,their different size being an obvious one. We show here that Ubxregulates the activity of the Decapentaplegic (Dpp) signaling pathway at different levels, and that this regulation is instrumental in establishing the size difference. Ubx downregulates dpp transcription and reduces Dpp diffusion by repressing the expression of master of thick veins and division abnormally delayed and by increasing the levels of thick veins, one of the Dpp receptors. Our results suggest that modulation in Dpp expression and spread accounts, in part, for the different size of halteres and wings.
Canonical Wnt signaling through Lef1 is required for hypothalamic neurogenesis
Authors: Lee Ji Eun , Wu Shan-Fu , Goering Lisa M. , Dorsky Richard I.
Published: October 2006

Although the functional importance of the hypothalamus has been demonstrated throughout vertebrates, the mechanisms controlling neurogenesis in this forebrain structure are poorly understood. We report that canonical Wnt signaling acts through Lef1 to regulate neurogenesis in the zebrafish hypothalamus. We show that Lef1 is required for proneural and neuronal gene expression, and for neuronal differentiation in the posterior hypothalamus. Furthermore, we find that this process is dependent on Wnt8b, a ligand of the canonical pathway expressed in the posterior hypothalamus, and that both Wnt8b and Lef1 act to mediate β-catenin-dependent transcription in this region. Finally, we show that Lef1 associates in vivo with the promoter of sox3, which depends on Lef1 for its expression and can rescue neurogenesis in the absence of Lef1. The conserved presence of this pathway in other vertebrates suggests a common mechanism for regulating hypothalamic neurogenesis.
Targeted mutation of serine 697 in theRettyrosine kinase causes migration defect of enteric neural crest cells
Authors: Asai Naoya , Fukuda Toshifumi , Wu Zaiqi , Enomoto Atsushi , Pachnis Vassilis , Takahashi Masahide , Costantini Frank
Published: October 2006

The RET receptor tyrosine kinase plays a critical role in the development of the enteric nervous system (ENS) and the kidney. Upon glial-cell-line-derived neurotrophic factor (GDNF) stimulation, RET can activate a variety of intracellular signals, including the Ras/mitogen-activated protein kinase, phosphatidylinositol 3-kinase(PI3K)/AKT, and RAC1/JUN NH2-terminal kinase (JNK) pathways. We recently demonstrated that the RAC1/JNK pathway is regulated by serine phosphorylation at the juxtamembrane region of RET in a cAMP-dependent manner. To determine the importance of cAMP-dependent modification of the RET signal in vivo, we generated mutant mice in which serine residue 697, a putative protein kinase A (PKA) phosphorylation site, was replaced with alanine(designated S697A mice). Homozygous S697A mutant mice lacked the ENS in the distal colon, resulting from a migration defect of enteric neural crest cells(ENCCs). In vitro organ culture showed an impaired chemoattractant response of the mutant ENCCs to GDNF. JNK activation by GDNF but not ERK, AKT and SRC activation was markedly reduced in neurons derived from the mutant mice. The JNK inhibitor SP600125 and the PKA inhibitor KT5720 suppressed migration of the ENCCs in cultured guts from wild-type mice to comparable degrees. Thus,these findings indicated that cAMP-dependent modification of RET function regulates the JNK signaling responsible for proper migration of the ENCCs in the developing gut.
Intrinsic chiral properties of theXenopusegg cortex: an early indicator of left-right asymmetry?
Authors: Danilchik Michael V. , Brown Elizabeth E. , Riegert Kristen
Published: October 2006

Vertebrate embryos define an anatomic plane of bilateral symmetry by establishing rudimentary anteroposterior and dorsoventral (DV) axes. A left-right (LR) axis also emerges, presaging eventual morphological asymmetries of the heart and other viscera. In the radially symmetric egg of Xenopus laevis, the earliest steps in DV axis determination are driven by microtubule-dependent localization of maternal components toward the prospective dorsal side. LR axis determination is linked in time to this DV-determining process, but the earliest steps are unclear. Significantly, no cytoskeletal polarization has been identified in early embryos capable of lateral displacement of maternal components. Cleaving Xenopus embryos and parthenogenetically activated eggs treated with 2,3-butanedione monoxime(BDM) undergo a dramatic large-scale torsion, with the cortex of the animal hemisphere shearing in an exclusively counterclockwise direction past the vegetal cortex. Long actin fibers develop in a shear zone paralleling the equator. Drug experiments indicate that the actin is not organized by microtubules, and depends on the reorganization of preexisting f-actin fibers rather than new actin polymerization. The invariant chirality of this drug response suggests a maternally inherited, microfilament-dependent organization within the egg cortex that could play an early role in LR axis determination during the first cell cycle. Consistent with this hypothesis, brief disruption of cortical actin during the first cell cycle randomizes the LR orientation of tadpole heart and gut.
brachyenteronis necessary for morphogenesis of the posterior gut but not for anteroposterior axial elongation from the posterior growth zone in the intermediate-germband cricketGryllus bimaculatus
Authors: Shinmyo Yohei , Mito Taro , Uda Tomohiro , Nakamura Taro , Miyawaki Katsuyuki , Ohuchi Hideyo , Noji Sumihare
Published: October 2006

In the long-germband insect Drosophila, all body segments and posterior terminal structures, including the posterior gut and anal pads, are specified at the blastoderm stage. In short- and intermediate-germband insects, however, posterior segments are sequentially produced from the posterior growth zone, a process resembling somitogenesis in vertebrates, and invagination of the posterior gut starts after anteroposterior (AP) axial elongation from the growth zone. The mechanisms underlying posterior segmentation and terminal patterning in these insects are poorly understood. In order to elucidate these mechanisms, we have investigated the roles of the Brachyury/brachyenteron (Bra/byn) homolog in the intermediate-germband cricket Gryllus bimaculatus. Loss-of-function analysis by RNA interference (RNAi) revealed that Gryllus byn(Gb'byn) is not required for AP axial elongation or normal segment formation, but is required for specification of the posterior gut. We also analyzed Gryllus caudal (Gb'cad) RNAi embryos using in situ hybridization with a Gb'byn probe, and found that Gb'cad is required for internalization of the posterior gut primordium, in addition to AP axial elongation. These results suggest that the functions of byn and cad in posterior terminal patterning are highly conserved in Gryllus and Drosophiladespite their divergent posterior patterning. Moreover, because it is thought that the progressive growth of the AP axis from the growth zone, controlled by a genetic program involving Cdx/cad and Bra/byn, might be ancestral to bilaterians, our data suggest that the function of Bra/byn in this process might have been lost in insects.
Oskar allowsnanosmRNA translation inDrosophilaembryos by preventing its deadenylation by Smaug/CCR4
Authors: Zaessinger Sophie , Busseau Isabelle , Simonelig Martine
Published: October 2006

Anteroposterior patterning of the Drosophila embryo depends on a gradient of Nanos protein arising from the posterior pole. This gradient results from both nanos mRNA translational repression in the bulk of the embryo and translational activation of nanos mRNA localized at the posterior pole. Two mechanisms of nanos translational repression have been described, at the initiation step and after this step. Here we identify a novel level of nanos translational control. We show that the Smaug protein bound to the nanos 3′ UTR recruits the deadenylation complex CCR4-NOT, leading to rapid deadenylation and subsequent decay of nanos mRNA. Inhibition of deadenylation causes stabilization of nanos mRNA, ectopic synthesis of Nanos protein and head defects. Therefore, deadenylation is essential for both translational repression and decay of nanos mRNA. We further propose a mechanism for translational activation at the posterior pole. Translation of nanos mRNA at the posterior pole depends on oskar function. We show that Oskar prevents the rapid deadenylation of nanos mRNA by precluding its binding to Smaug, thus leading to its stabilization and translation. This study provides insights into molecular mechanisms of regulated deadenylation by specific proteins and demonstrates its importance in development.
Antiretroviral drug-resistant HIV-2 infection – a new therapeutic dilemma
Authors: Maniar Janak K , Damond Florence , Kamath Ratnakar R , Mandalia Sundhiya , Surjushe Amar
Published: October 2006

HIV-2 drug resistance in a case of dual HIV infection presents a formidable challenge to the treating physician. We report a patient with dual infection on highly active antiretroviral therapy (HAART) since March 2001 presented with clinical failure. Laboratory assays showed undetectable HIV-1 viral RNA copies, but with low CD4 count. Suspecting HIV-2 resistance, specific genotype assays were performed. Mutations at codons M184V and Q151M conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs) in HIV-1 infection were detected, as were mutations at codons V71I and L90M implying indinavir and nelfinavir resistance as well. Salvage therapy was initiated with good clinical response.
Reconnaissance assessment of risks for HIV transmission through health care and cosmetic services in India
Authors: Correa Mariette , Gisselquist David
Published: October 2006

Available information shows frequent unsterile medical injections in India, but less is known about other invasive procedures. To assess the variety and frequency of blood exposures in health care and cosmetic services, we interviewed people living with HIV/AIDS in four districts with high HIV prevalence. Eighty percent reported from 1–300 injections in the five years before testing HIV-positive. Common lifetime exposures include dental care (31%), surgery (20%), blood tests (100%), and tattooing (47%). Through observation and interviews with doctors, dentists, and others, we found evidence for common to routine re-use of unsterilized equipment for blood tests (lancets), dental care, tattoos, and surgery. Health-care professionals and the public are misinformed about HIV survival outside the body and underestimate HIV transmission efficiency through blood exposures. The challenge to implement infection control for all invasive procedures remains undefined, while attention focuses on partial solutions, including single use of disposable syringes.
The impact of conflict on HIV/AIDS in sub-Saharan Africa
Authors: Mills Edward J , Singh Sonal , Nelson Brett D , Nachega Jean B
Published: October 2006

Sub-Saharan Africa disproportionately represents the largest incidence of both HIV/AIDS and internal conflicts. The impact of conflict on HIV incidence is largely unknown. Current epidemiological evidence paradoxically suggests that in most populations affected by conflict, HIV prevalence is lower than surrounding communities. However, in situations of conflict, the most vulnerable populations, such as women and children, are at increased risk for HIV through sexual violence, forced occupational exposure and an absence of access to health care or testing. Together, these dimensions of conflict create a complex and challenging situation for prevention of HIV/AIDS and delivery of care to conflict-affected populations. We examine the complexity of monitoring HIV/AIDS in conflict settings. We argue that increased efforts are needed to protect vulnerable populations and design health-delivery systems that are sustainable in settings of conflict.
Factors associated with sexual dysfunction in men with HIV infection
Authors: Richardson Daniel , Lamba Harpal , Goldmeier David , Nalabanda Ananth , Harris J R W
Published: October 2006

Where men have had access to successful treatment for HIV (highly active antiretroviral therapy), expectations of both patients and physicians alike have changed significantly over the past decade. Such men, living with HIV, expect to lead fully functional lives including a normal sex life. Sexual dysfunction is well described among men with HIV. We retrospectively analysed details of 190 consecutive men attending a dedicated sexual dysfunction service in our HIV unit over an 18-month period. We took note of the specifics of their HIV disease, illnesses other than HIV, as well as other risk factors associated with sexual dysfunction. Men with sexual dysfunction all commonly reported recreational drug use, hepatitis B and C co-infection, anxiety and depressive illnesses, peripheral neuropathy and lipodystrophy. There was a significant relationship between men complaining of retarded ejaculation and peripheral neuropathy. Sexual dysfunction in non-HIV settings is known to lead to poor adherence to prescribed medications, e.g. antihypertensive agents. Iatrogenic sexual dysfunction in patients may similarly have a potential to lead to poor antiretroviral compliance if not addressed.
Sexual behaviour in Russia: who exhibits a higher risk? Evidence from longitudinal data
Authors: Wall Martin , Tkatchenko-Schmidt Elena , Renton Adrian
Published: October 2006

The object of the paper is to assess the social and economic determinants of 'risky' sexual behaviour in Russia. We used secondary data from a nationally representative survey of 6168 persons between the ages of 14 and 49 years conducted in 2001 and 2003. Sexual risk is defined as having had unprotected (without a condom) penetrative sexual intercourse with two or more partners in the 12 months preceding the survey. The analysis uses a multivariate random effects model. There was a significant reduction in sexually risky behaviour between 2001 and 2003. Men and those employed exhibited significantly greater risk as did those between the ages of 25 and 44 years. Those who considered themselves economically secure also were significantly more likely to have had risky sexual contacts in the year before the survey. Those with only a basic education were significantly less likely to exhibit such behaviour. Those at highest risk in Russia of contracting sexually transmitted diseases (STDs) including HIV are not in marginal or socially excluded groups but instead are part of the core economically active population.
Primary pneumococcal peritonitis as a presenting feature of HIV infection
Authors: Alifrangis Constantine , Thompson Phillip , Thwaites Guy , Churchill Duncan
Published: October 2006

We report a case of primary pneumococcal peritonitis in a 28-year old previously healthy woman. There are no previously reported associations between this rare form of spontaneous peritonitis and HIV infection, and it is usually associated with underlying cirrhosis, ascites or other immune compromise. In this case this was the presenting illness of HIV infection. When atypical infections such as this arise in previously healthy adults the clinician must have a high index of suspicion of HIV or other underlying immunodeficiency.
Clinching the contacts: a tale of two audits before and after the introduction of a contacts' clinic
Authors: Raval Bhavin , Challenor Rachel
Published: October 2006

Contact tracing outcomes were good (0.8 contacts per case) at the Plymouth genitourinary (GU) medicine clinic when it was a 'walk-in' service. After moving to an appointments-only service, less than 0.5 contacts were seen. From October 2004, we introduced weekly contacts' clinics, which provided early appointments for partners of chlamydia-positive patients. We undertook audits of contact-tracing outcomes before (2004) and after (2005) the introduction of the contacts' clinics. Before, in 2004, 0.46 (95% confidence interval [CI] 0.36–0.56) contacts per case were seen within four weeks of the initial partner notification interview. After, in 2005, 0.66 (95% CI 0.57–0.75) contacts were seen within four weeks ( P=0.005). Partner notification outcomes were significantly associated with follow-up ( P<0.001). There was no difference in success whether the follow-up was by re-attendance or by telephone. This simple change in the clinic schedule has allowed the specialty's evidence-based National Outcome Standards to be met.
The role of health care in the spread of HIV/AIDS in Africa: evidence from Kenya
Authors: Deuchert Eva , Brody Stuart
Published: October 2006

It is commonly asserted that the sub-Saharan African HIV/AIDS epidemic is predominantly due to heterosexual transmission. However, recent re-examination of the available evidence strongly suggests that unsafe health care is the more likely vector. The present report adds to the evidence for health-care transmission by showing that Kenyan women who received prophylactic tetanus toxoid injections during pregnancy are 1.89 times (95% confidence interval [CI]:1.03–3.47) more likely to be HIV-1 seropositive than women who did not receive this vaccination. In contrast, recent sexual behaviour (condom use, number of partners) was not related to HIV status. The findings are unconfounded by reverse causality (all injections were purely prophylactic rather than for treatment of any HIV-related illnesses, and none of the women reported knowing that she was HIV seropositive). Focus on a specific injection may have improved participant recall. The results are consistent with health care being a very important vector for HIV in sub-Saharan Africa. It is recommended that there be a reallocation of resources to address healthcare transmission of HIV/AIDS.
HSV-2 antibodies in female sex workers in Vietnam
Authors: O'Farrell Nigel , Vu Thuong Nguyen , Van Nghia Khuu , Thu Tram Luong , Thanh Long Nguyen
Published: October 2006

Little information is available on the prevalence of herpes simplex type-2 (HSV-2) antibodies among groups at potential high risk of HIV in Asia. This study was carried out to determine the prevalence of HSV-2 antibodies and correlates of HSV-2 infection in female sex workers (FSWs) in border provinces of Vietnam. Nine hundred and four FSWs in five border provinces of Vietnam were interviewed about selected sociodemographic and behavioural characteristics, and information about partners by a standard interview schedule. Serological samples were collected for HSV-2 antibodies, syphilis and HIV. The overall prevalence of HSV-2 antibodies was 27.7% (95% confidence interval [CI]: 24.8–30.7%). The prevalence of HSV-2 in southern provinces (Dong Thap 32.3%, An Giang 33.3% and Kien Giang 29.9%) was higher than that in the central (Quang Tri 20.8%) and northern border areas (Lai Chau 5.0%). In multivariate analysis, Kinh ethnicity (odds ratio [OR] = 2.59, P = 0.02), direct sex work (OR = 1.61, P = 0.01), ≥9 clients/week (OR = 2.11, P = <0.001), ever worked outside Vietnam (OR = 2.12, P = 0.05), >1 pregnancy termination (OR = 1.58, P = 0.05), syphilis (OR = 5.19, P = <0.001) and HIV (OR = 2.68, P = 0.01) were associated with HSV-2. Age ≤20 (OR = 0.65, P = 0.05) and current oral contraceptive use (OR = 0.55, P = 0.01) were protective for HSV-2 antibodies. A significant proportion of FSWs in border provinces have HSV-2 antibodies, more so in the southern region. FSWs should be educated about recognition of signs and symptoms of genital herpes and the role this infection has in facilitating HIV transmission.
The sensitivity of syphilis assays in detecting different stages of early syphilis
Authors: Manavi K , Young H , McMillan A
Published: October 2006

Our aim was to determine the sensitivity of the Murex ICE enzyme immunoassay (EIA) as a screening test for early syphilis and to determine how many additional cases of infection were detected by performing additional tests when requested on clinical grounds.

This was an observational study on consecutive patients diagnosed with syphilis in the Department of Genitourinary Medicine, Edinburgh between January 1st 2004 and April 1st 2005. Additional tests were performed on sera that gave a positive or equivocal EIA on screening as well as by clinical request on sera from contacts of syphilis, and those with clinical signs of syphilis. Additional tests included a Venereal Diseases Research Laboratory (VDRL) carbon antigen test, a Treponema pallidum particle agglutination (TPPA) test, INNO-LIA line immunoblot assay, and an EIA specific for anti-treponemal IgM.

A total of 105 patients were diagnosed with syphilis: primary (50), secondary (26), early latent (8), and of unknown duration (21). The TPPA was the most sensitive test in primary syphilis and had a sensitivity of 96% (48/50), which was significantly higher ( P <0.05) than the sensitivity of 84% (42/50) for the screening EIA: seven of the EIA negatives were detected by EIA–IgM, six by TPPA, five by immunoblot, and two by VDRL. EIA–IgM was negative in six primaries; all were positive by TPPA and immunoblot.

We conclude that, in order to maximize the serological detection of primary syphilis a specific EIA–IgM test and a TPPA test should be performed whenever there is a clinical suspicion of primary infection. This is particularly important when an EIA such as Murex ICE is used as a single screening test as it is less sensitive than the TPPA in primary infection.
Routes of HIV transmission in India: assessing the reliability of information from AIDS case surveillance
Authors: Correa Mariette , Gisselquist David
Published: October 2006

India's AIDS case surveillance system attributes 86% of HIV infections to sexual risks, 2.4% to injection drug use, 2.0% to blood transfusions, 3.6% to perinatal transmission, and 6.0% to others or not specified. To assess the reliability of this information, we examined the process of AIDS case surveillance in four high HIV-prevalence districts in southern India. We reviewed forms and interviewed doctors, counsellors, officials of State AIDS Control Societies, and a convenience sample of people living with HIV/AIDS. Current surveillance practices are not sensitive to parenteral exposures; forms have no space to report blood exposures other than transfusions and injections, and counsellors often ignore parenteral risks. The system does not distinguish high from lower risk sexual behaviours; all cases with sexual risks are reported in one category. We propose changes in forms and practices to improve the reliability and usefulness of information on risks from AIDS case reporting.
Is there demand for a masterclass on sexual dysfunction?
Authors: Green Pippa , Goldmeier David ,   BASHH Special Interest Group for Sexual Dysfunction
Published: October 2006

A postal survey was sent out to all members of the British Association for Sexual Health and HIV (BASHH) in September 2005 asking what their educational needs were in the sexual dysfunction (SD) area of their practice. Of a total of 912 members, 340 replied. Two hundred and eighty-seven respondents (87%) expressed an interest in attending masterclasses and indicated the area(s) of SD that should be covered at these events.
The male sexual pain syndromes
Authors: Luzzi G A , Law L A
Published: October 2006

Pain provoked by sexual intercourse in men is a well-recognized symptom that has received surprisingly little attention in the medical literature and has rarely been the subject of systematic study. Sexual pain disorders have generally been considered in the context of the sexual dysfunctions, and in men have received much less attention than in women. Reports of male sexual pain lack use of a uniform definition for the condition. Sexual pain, especially ejaculatory pain, is a common feature of chronic prostatitis/chronic pelvic pain syndrome (CPPS). However, a range of physical and medical causes for sexual pain in men has been reported, usually in the form of isolated clinical reports. Our understanding of the aetiology and pathogenesis of male sexual pain is very limited, and systematic evaluations of treatment approaches are lacking.
An evolution of therapy for mucocutaneous candidiasis
Authors: Kornblut Alan David
Published: October 2006

Chronic mucocutaneous candidiasis is a relatively uncommon form of candida infection, and can be found in patients with primary deficiencies of their immune systems. When such infection occurs in patients with non‐lethal immune deficiences, defects of chemotaxis or cellular immunity can be found. In addition, significant endocrinopathies may occur, particularly involving the parathyroid and adrenal glands.

A number of therapies have been devised for the treatment of chronic candidiasis, and have included both local and systemic medications. The most useful of these in the past have included the polyene antibiotics — most notably, nystatin and amphotericin B. Antifungal activity has also been demonstrated clinically with the use of 5‐fluorocytosine (a fluorinated pyramidine) and clotrimazole (a synthetic imidazole derivative). However, long‐term therapy with medication has been required, and re‐emergence of symptomatic infection has occurred when medications have been stopped. More recently, immune reconstitution with transfer factor has been employed in the treatment of patients who have been found to be anergic to candida. Such treatment in conjunction with chemotherapy has indicated that effective patient remissions can be obtained in those patients who develop and maintain cell‐mediated immunity to candida.

Twelve patients with chronic mucocutaneous candidiasis are profiled. Sites of involvement in the head and neck included the skin and hair (9), ears (9), nose (4) and throat (12). One patient had candida laryngitis, while five patients had evidence for esophageal disease. Of this latter group, one (a 5‐year old boy) developed esophageal stenosis which required gastrostomy and retrograde esophageal dilatations. Nine patients were found to be anergic to candida. In these patients, systemic chemotherapy (as amphotericin B or 5‐fluorocytosine) was used to induce remissions of disease and transfer factor was given to induce reactivity to candida. By so doing, topical or oral medications (utilizing miconazole, clotrimazole and nystatin) were found to suffice in maintaining effective local control of infection.
CEREBROSPINAL FLUID OTORRHEA
Authors: Hicks George W. , Wright J. William , Wright J. William
Published: October 2006

Cerebrospinal fluid (CSF) otorrhea is a dangerous and potentially life threatening occurrence for which the otolaryngologist is often consulted. CSF otorrhea occurs on the basis of skull fracture, tumor, infection, congenital anomalies, and operative trauma. Forty‐three patients with CSF otorrhea of varied etiology are reviewed in this paper. Eight cases are of congenital or labyrinthine origin confirming at surgery the probable connection between the subarachnoid and perilymphatic spaces. Eleven cases had spinal fluid otorrhea due to infection. All cases presented with symptoms of chronic infection: 4 cases had a history of previous surgery for chronic ear disease; 7 cases had temporal lobe abscess; 1 case had a cerebellar abscess; 8 had tegmen defects secondary to cholesteatoma; in 1 case the tegmen defect was due to previous surgery for chronic infection. Nine of 11 cases have serviceable hearing postoperatively. Fourteen cases of spinal fluid otorrhea resulted from trauma: 1 case was due to traumatic stapes footplate fracture in a congenitally malformed ear; 4 were due to transverse temporal bone fracture; and 9 were due to longitudinal temporal bone fractures. All transverse fractures resulted in nonhearing ears. Three cases were due to a combination of temporal bone fracture and infection. In 2 of these cases chronic infection preceded the fracture; in 1 case the fracture led to chronic ear disease with spinal fluid leakage. One patient required 1 surgical procedure for closure of the otorrhea, 1 patient 2 procedures, and 1 patient 3 procedures. Ten cases are due to translabyrinthine acoustic neuroma removal: 7 cases had resolution of the spinal fluid leakage after conservative nonsurgical treatment; and 3 required surgical intervention using muscle, fat and fascia obliteration of the spinal fluid pathway.
Autophony and the patulous eustachian tube
Authors: O'Connor A. Fitzgerald , Shea John J.
Published: October 2006

Autophony and the patulous Eustachian tube is a real but rare clinical entity often misdiagnosed because the symptoms so mimic those of middle ear effusion. The diagnosis is made by the history of fullness or blockage and hearing ones own voice and breath sounds in the ear. The drum is usually atrophic and moves with respiration but this may not be visible. The usual past history is of weight loss. The diagnostic test is to observe a regular increase or decrease in middle ear pressure when increasing or decreasing the ambient pressure while measuring the impedance in a pressure chamber. The usual variations in pressure with opening and closing of the tube are not seen because the tube remains open all the time. Few patients need operative intervention and explanation is all that is usually required. When surgical treatment is necessary the application of 20% silver nitrate to the lumen of the tube on a wire covered by cotton has given results with few complications. Injection of Teflon® paste anterior to the mouth of the Eustachian tube has been stopped by the manufacturer of the paste because of serious complications caused by the Teflon® paste being accidently injected into the internal carotid artery.

Why some patients with a patulous tube and movement of the drum with respiration have no symptoms and other patients with very bothersome symptoms have so few objective signs and no movement of the drum, that can be observed with respiration, remains a mystery that needs further study.
The effect of preoperative adriamycin and dihydroxyanthracenedione on wound healing
Authors: Mullen Brooks M. , Mattox Douglas E. , Hearne Erwin M. , Hoff Daniel D.
Published: October 2006

Preoperative adjuvant chemotherapy is being used with increasing frequency in advanced head and neck cancer; however, the effects of chemotherapy on wound healing have not been fully elucidated. To evaluate the effect of preoperative chemotherapy, experimental animals were given chemotherapeutic drugs, wounded, and the subequent wound breaking strength determined.

Rats received a single dose of intravenous tumoricidal drugs (adriamycin or dihydroxyanthracenedione) either one week before or simultaneously with wounding. Wound breaking strength of treated animals and control animals receiving no chemotherapy was measured one and two weeks after wounding.

All wounds, regardless of treatment, were stronger at two weeks than at one week after wounding. Wound breaking strength was reduced at both times when chemotherapy was administered one week before wounding. Wound breaking strength in animals that were simultaneously wounded and received chemotherapy was similar to controls.

Both adriamycin and dihydroxyanthracenedione have a deleterious effect on one parameter of wound healing — wound breaking strength — when administered one week before wounding.
Unilateral polyposis and mucoceles in children
Authors: Finn Douglas G. , Hudson William R. , Baylin George
Published: October 2006

Children presenting with unilateral opacification of one or more of the paranasal sinuses must be considered at risk for serious disease. If an expansile lesion is noted, the most likely diagnosis is that of mucocele. Six children are presented with such findings and the diagnosis and treatment discussed. In five polyps were noted, indicating a probable allergic origin. Radiographic evaluation of the lesion is stressed with emphasis on the value of tomograms.
Experience with tympanoplasty for atelectatic ears
Authors: Paparella Michael M. , Jung Timothy T. K.
Published: October 2006

Atelectasis is, unfortunately, still a common sequela of otitis media with effusion (OME) — including serous otitis media (SOM) and mucoid otitis media (MOM). When atelectatic ears provide a functional deficit, i.e., a conductive loss of sufficient magnitude or a residual conductive loss after aerating the middle ear with ventilaiton tube or early or strongly suspected attic cholesteatoma, a simple corrective procedure has been used which has stood the test of time. The procedure as well as experience with 51 patients (60 ears) will be described and discussed.

The procedure consists of re‐establishing the mesotympanic space, strengthening the tympanic membrane by an underplant fascial graft, cutting the tensor tympani, extirpation of any disease, re‐establishment of ossicular mobility and continuity and the insertion of a ventilation tube in the anterior drumhead remnant along with silicone rubber sheeting and a moist Gelfilm® implant. Methods and results are discussed.
A non‐invasive method of qualitative and quantitative measurement of drugs
Authors: Westerman S. Thomas , Gilbert Liane M.
Published: October 2006

Methods for quick qualitative and quantitative evaluation of drug intake are needed, especially during emergency situations such as drug overdose and alcohol intoxication. The electronystagmograph was used in an attempt to develop a non‐invasive method for identification of drug intake, and to study the effects of alcohol and other drugs on the vestibular system. Results of the study reveal that alcohol, diazepam, opiates, barbiturates, cocaine, marijuana, and hallucinogenic drugs produce a characteristic printout pattern which can be evaluated qualitatively. This method is a practical, non‐invasive, objective procedure that provides rapid assessment of quality of drug intake. Its potential uses are extensive, including such possibilities as evaluation of drug intake in emergency drug overdose situations, monitoring anesthesia during surgery, evaluating drug intake in women about to deliver, (as well as the effects on the newborn), and determining whether or not persons who are being tested on a polygraph are under the influence of drugs.
Carcinoma of the oral tongue: A study of patient selection and treatment results
Authors: Marks James E. , Lee Franciska , Zivnuska Frederick R. , Freeman Richard B. , Ogura Joseph H.
Published: October 2006

Retrospective review of 118 primarily treated cancers of the oral tongue was done to study patient selection and to search for improved treatment strategies. Small surface lesions were treated by local excision (LE); most small lesions invading muscle of the tongue without lymph node metastases were treated by radiation alone (RA) while larger lesions and those with palpable nodes were treated by preoperative radiation and surgery (R+S). Ultimate control of the primary tumor and lymph nodes after initial treatment and surgical salvage was high for the lesions treated by LE (91%), the T1N0 lesions treated by RA (88%) and for the TxN+ lesions treated by R+S (57%). Improved treatment strategies are suggested for T2N0 lesions treated by RA because of poor tumor control (53%) and a high rate of radiation complications (25%), and for T3N0 lesions because so many of these patients died from causes other than cancer within two years. Second primary cancers were most common in those patients with a good prognosis.
The clonal assay of head and neck tumor cells: Results and clinical correlations
Authors: Johns Michael E.
Published: October 2006

Since the application of in vitro techniques to assess the activity of antibiotics against bacteria, there has been an interest in using tissue culture techniques to predict the effects of antineoplastic agents on human cancers. Generally, the in vitro effects have not always correlated with the clinical actions.

Recently a refined method for measuring the number of cells in a given tumor capable of being cloned and the effects of cytotoxic agents on the cloned tumor cell growth has been developed. There is now good clinical correlation in patients with multiple myeloma and ovarian carcinomas with the responses to chemotherapeutic agents determined in vitro.

The soft agar clonal assay has been used to study the biology of head and neck tumor stem cells. At the University of Virginia, 73 squamous cell carcinomas (SCC) of the head and neck were cloned. The basic characteristics of cloned head and neck tumor cell growth was studied in terms of 1. single cell origin, 2. cloning efficiency, 3. colony development, 4. linearity, 5. effects of enzyme disaggregation and 6. ultrastructural characteristics. The clinical characteristics of T class, N class, stage, survival, and Jakobsson's rating of tumor differentiation were correlated with cloning efficiency to determine if there are predictive survival data.

Obtaining single cells from the tumors continues to be a major problem. The use of enzymes (collagenase and DNase) has aided in the production of single cells for culture. The enzymes are superior to mechanical techniques and do not compromise viability or cloning efficiency. Electron microscopy is valuable in documenting the malignant nature of the cloned tumor cells.

Of the 73 squamous cell carcinomas that were cultured, 49% demonstrated clonal growth. A number of non‐squamous cell carcinomas were also successfully cloned. The cloning efficiency was variable ranging from .001% to .05%. For the SCC's the median cloning efficiency was .005%. Twenty‐nine SCC's were available for clinical correlations. Chemosensitivity testing was often not feasible because of inadequate numbers of tumor cells in the small specimens and frequent failure of clonal growth. A statistically significant correlation of high cloning efficiency with advanced nodal class, stage, and survival was observed. There was no correlation with T class or Jakobsson's rating. A cloning efficiency of ≤ .005% was associated with a high likelihood of death from disease or the development of recurrent disease. For head and neck squamous cell carcinomas, the determination of cloning efficiency in soft agar appears to be a valuable prognostic indicator.
Binocular infrared oculography
Authors: Kumar Arvind , Krol Glenn
Published: October 2006

A new system of infrared oculography has been developed which provides binocular recordings and allows simultaneous measurement of horizontal and vertical eye movements. The sensitivity of the system is 1 minute of arc, and it has a horizontal range of ± 30 degrees and a vertical range of ± 20 degrees. Using this system for routine clinical evaluations, it was possible to record divergent spontaneous nystagmus and divergent thermally induced nystagmus. Rotatory nystagmus can also be recorded. The binocular infrared oculographic system (BIRO) satisfies nearly all the requirements of an ideal recording system.
DentaScan™: A new diagnostic method for evaluating mandibular and maxillary pathology
Authors: King Jeffrey M. , Caldarelli David D. , Petasnick Jerry P.
Published: October 2006

Although computerized tomography (CT) is valuable for evaluating head and neck pathology, it can be suboptimal when evaluating the presence or extent of mandibular and maxillary involvement by tumor, infection, or other pathology. The presence of dental restoration artifact, CT gantry positioning problems, and the inability to obtain cross‐sectional images will diminish the accuracy of standard CT images.

A program, termed either DentaScan™ or multiplanar reformation (CT/MPR), eliminates these problems by processing axial CT scan information to obtain true cross‐sectional images and panoramic views of the mandible and maxilla.

In this study, DentaScan imagery was used in 26 patients whose mandibles or maxillas were affected by tumor, osteomyelitis, or other pathology. CT scanning with multiplanar reformation proved useful in the precise location, assessment, monitoring, and treatment of various pathologies of the mandible and maxilla. Selected case studies illustrate the therapeutic implications and advantages of this new imaging technique.
Use of a multichannel cochlear implant in the congenitally and prelingually deaf population
Authors: Waltzman Susan B. , Cohen Noel L. , Shapiro William H.
Published: October 2006

Fourteen children and three adults, each congenitally and prelinguistically deaf, received the Nucleus® multichannel implant. All underwent extensive evaluations and rehabilitation. The surgery was uneventful, and no patients have been lost to follow‐up.

Results have shown a significant increase in auditory and speech reception and perception skills in all children. Some children have open‐set speech recognition using the prosthesis alone. The adults have shown an increased awareness of sound along with minimal improvement in perceptual skills.

This supports the concept that early implantation of congenitally and prelinguistically deaf individuals results in improved performance.
Effects of botulinum toxin therapy in patients with adductor spasmodic dysphonia: Acoustic, aerodynamic, and videoendoscopic findings
Authors: Zwirner Petra , Murry Thomas , Swenson Michael , Woodson Gayle E.
Published: October 2006

Botulinum toxin has been previously reported to be successful in the treatment of spasmodic dysphonia. To objectively document results, 11 patients with adductor spasmodic dysphonia who received unilateral treatment of the thyroarytenoid muscle were studied. Acoustic analyses and airflow rates during sustained phonation and flexible videoendoscopy were performed prior to, 1 week and 1 month after injection. 1. Acoustic parameters demonstrated significant voice improvement, although abnormal characteristics remained. 2. Mean airflow rates were increased 1 week after injection with almost normal values 1 month later. 3. Videolaryngoscopy showed an effective reduction of intrinsic laryngeal muscle hyperfunction with less effect on extrinsic muscle activity. Interrelations between videolaryngoscopic rating scores, acoustic results and aerodynamic results are discussed.
Inferior mastoidectomy‐hypotympanic approach for surgical removal of glomus jugulare tumors: An anatomical and radiologic study emphasizing distances between critical structures
Authors: Maniglia Anthony J. , Sprecher Robert C. , Megerian Cliff A. , Lanzieri Charles
Published: October 2006

The technique of inferior mastoidectomy‐hypotympanic dissection, with preservation of the middle and inner ear structures, has been established for radical surgical removal of glomus tumors involving the skull base.

In order to study the gross anatomic differences and correlate with the computed tomography (CT) scan, 20 human temporal bones were dissected and accurate measurements between vital structures were made. This study revealed a wide variation in distances between the neurovascular structures, whereas the distances between inner ear structures were not statistically different.

This original study of critical distances of gross topographic anatomical structures and CT correlation is very helpful indeed in the understanding of variations found in the surgical removal of lesions involving this important and challenging area of the skull base.

The inferior mastoidectomy‐hypotympanic dissection has been performed in the removal of six suitable tumors involving the jugular bulb area. This technique, combined with upper cervical dissection, is very useful for the radical removal of such neoplasms with preservation of external and middle ear structures as well as the function of the facial, eighth, and other lower cranial nerves.
Vocal evaluation of thyroplastic surgery in the treatment of unilateral vocal fold paralysis
Authors: Gray Steven D. , Barkmeier Julie , Jones David , Titze Ingo , Druker David
Published: October 2006

Vocal function was assessed in 15 patients who received thyroplasty type I for the rehabilitation of unilateral vocal fold paralysis. The function was assessed by perceptual evaluation, voice intensity and frequency range profiles, and questionnaire. Goals of the study were to evaluate the efficacy of thyroplasty in improving the voice, to compare postoperative thyroplasty voices to normal voices, and to correlate objective measurements to the results of the questionnaire regarding satisfaction with the voice. Perceptual evaluations were performed by randomizing normal and thyroplasty voices on a recording tape. The voices on the tape were then rated by independent, blinded, trained listeners. The perceptual qualities of pitch, intonation, and loudness were not statistically different than normals; however, voice qualities of strain, breathiness, hoarseness, harshness, and unsteadiness were different than normals. Mean frequency range and mean intensity range were moderately to severely reduced from normals with a wide variation being present in the results. The correlation between the higher threshold phonation pressures and decreased intensity ranges found in some patients is discussed.

Questionnaire results indicated that a high degree of satisfaction with the surgery was present (92%). Extreme or general satisfaction with voice was present in 73%. The most difficult voicing was experienced at work, with 25% needing to adjust their employment to accommodate their voice abilities. These results indicate that thyroplasty type I is effective in partially rehabilitating unilateral voice fold paralysis. Voice function is still not normal, probably in part due to the underlying disease.