bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Rules of Interaction for Object Manipulation in Cluttered Virtual Environments
Authors: Ruddle Roy A. , Savage Justin C. D. , Jones Dylan M.
Published: January 2003

A set of rules is presented for the design of interfaces that allow virtual objects to be manipulated in 3D virtual environments (VEs). The rules differ from other interaction techniques because they focus on the problems of manipulating objects in cluttered spaces rather than open spaces. Two experiments are described that were used to evaluate the effect of different interaction rules on participants' performance when they performed a task known as “the piano mover's problem.” This task involved participants in moving a virtual human through parts of a virtual building while simultaneously manipulating a large virtual object that was held in the virtual human's hands, resembling the simulation of manual materials handling in a VE for ergonomic design. Throughout, participants viewed the VE on a large monitor, using an “over-the-shoulder” perspective. In the most cluttered VEs, the time that participants took to complete the task varied by up to 76% with different combinations of rules, thus indicating the need for flexible forms of interaction in such environments.
Method of Adjustments versus Method of Constant Stimuli in the Quantification of Accuracy and Precision of Rendered Depth in Head-Mounted Displays
Authors: Rolland J. P. , Meyer C. , Arthur K. , Rinalducci E.
Published: January 2003

The utilization of head-mounted displays (HMDs) in high-end applications such as medical, engineering, and scientific visualization necessitates that the position of objects be rendered accurately and precisely. Accuracy and precision of rendered depth for near-field visualization were measured in a custom-designed bench prototype HMD. Experimental results were compared to theoretical predictions established from a computational model for rendering and presenting virtual images by Robinett and Rolland (1992). Such a theoretical model provided the necessary graphics transformations required so that rendered virtual objects be perceived at the rendered depth in binocular HMDs. Three object shapes of various sizes were investigated under two methodologies: the method of constant stimuli modified for random size presentation and the method of adjustments. Results showa2mm and an 8 mm performance for the accuracy and the precision of rendered depth in HMDs, respectively. Results of the assessment of rendered depth in HMDs for near-field visualization support employing the method of adjustments over the method of constant stimuli whether or not the method of constant stimuli is modified for random size presentation.
Measurement, Analysis, and Display of Haptic Signals During Surgical Cutting
Authors: Greenish Stephanie , Hayward Vincent , Chial Vanessa , Okamura Allison , Steffen Thomas
Published: January 2003

The forces experienced while surgically cutting anatomical tissues from a sheep and two rats were investigated for three scissor types. Data were collected in situ using instrumented Mayo, Metzenbaum, and Iris scissors immediately after death to minimize postmortem effects. The force-position relationship, the frequency components present in the signal, the significance of the cutting rate, and other invariant properties were investigated after segmentation of the data into distinct task phases. Measurements were found to be independent of the cutting speed for Mayo and Metzenbaum scissors, but the results for Iris scissors were inconclusive. Sensitivity to cutting tissues longitudinally or transversely depended on both the tissue and on the scissor type. Data from cutting three tissues (rat skin, liver, and tendon) with Metzenbaum scissors as well as blank runs were processed and displayed as haptic recordings through a custom-designed haptic interface. Experiments demonstrated that human subjects could identify tissues with similar accuracy when performing a real or simulated cutting task. The use of haptic recordings to generate the simulations was simple and efficient, but it lacked flexibility because only the information obtained during data acquisition could be displayed. Future experiments should account for the user grip, tissue thickness, tissue moisture content, hand orientation, and innate scissor dynamics. A database of the collected signals has been created on the Internet for public use at www.cim.mcgill.ca/∼haptic/tissue/data.html .
Visual Cues for Perceiving Distances from Objects to Surfaces
Authors: Hu Helen H. , Gooch Amy A. , Creem-Regehr Sarah H. , Thompson William B.
Published: January 2003

An accurate perception of the distance between an object and a nearby surface can increase a viewer's sense of presence in an immersive environment, particularly when a user is performing actions that affect or are affected by this distance. Two experiments were conducted examining the effectiveness of stereoscopic viewing, shadows, and interreflections at conveying this distance information. Subjects performed simple tasks based on the perception of the distance between a fixed virtual table and an approaching block in a virtual environment. In the first experiment, subjects lowered a virtual block to a virtual table. For this task, both stereoscopic viewing and shadows had statistically significant effects on subject performance. In the second experiment, subjects mechanically reported the perceived distance between a virtual block and virtual table. For this task, viewing condition, shadows, and interreflections were shown to be statistically significant distance cues.
Embedding Context of Use in CVE Design
Authors: Turner Phil , Turner Susan
Published: January 2003

A consideration of eventual context of use is crucially important for the success of virtual environments destined for real-world organizations, yet it is frequently absent from accounts of the design of such applications. We describe how contextual requirements have influenced the design of a collaborative virtual environment (CVE) to support the delivery of safety-critical training, and suggest how context and purpose of use may be a significant factor in the sense of presence and engagement in both virtual and physical simulated environments.
A Conceptual Framework for Mixed Reality Environments: Designing Novel Learning Activities for Young Children
Authors: Rogers Yvonne , Scaife Mike , Gabrielli Silvia , Smith Hilary , Harris Eric
Published: January 2003

How do we conceptualize and design mixed reality environments (MREs)? Here we describe a first pass at a conceptual framework and use it to inform the design of different kinds of activities for children to experiment with. Our aim was to investigate how different MRE setups affected children's exploratory behavior and their understanding of them. The familiar activity of color mixing was used: different setups were provided, where paint or light colors could be mixed, by using either physical tools, digital tools, or a combination of these. The findings of our study showed that novel mixes of physical and digital “transforms” engendered much exploration and reflection.
Airway pathology in asthma: Fig. 1.—
Authors: Saetta M. , Turato G.
Published: January 2003

This review focuses on the major cellular and structural changes present in the airways and lung parenchyma in asthma in comparison with chronic obstructive pulmonary disease (COPD) in an attempt to underline the possible mechanisms contributing to airflow limitation in these two diseases.

Both asthma and COPD are characterized by a thickening of the airway wall and by the presence of an inflammatory process, but the inflammatory cells infiltrating the airway wall differ between the two diseases.

In asthma, the most striking feature is the eosinophilic infiltration, whereas, in COPD, it is the CD8 T‐lymphocytic infiltration of the airway wall. In the lung parenchyma, both diseases are characterized by an inflammatory process, whereas destruction and fibrosis of the alveolar walls occur in COPD but not in asthma.

These cellular and structural changes may contribute to the development of airflow limitation (that characterizes both asthma and chronic obstructive pulmonary disease) by inducing either an increase in resistance or a decrease in driving pressure.
Cytokines in asthma
Authors: Kips J.C.
Published: January 2003

The airway inflammation underlying asthma is regulated by a network of mutually interacting cytokines. The exact functional role of each individual cytokine in the pathogenesis of the disease remains to be fully established.

Type 2 T‐helper cells are currently considered to play a crucial role in this process.In vivoanimal data suggest a sequential involvement of interleukin (IL)‐4 and IL‐5 in the induction of allergen-induced airway changes. The potential role of other type 2 T‐helper cell-like cytokines in asthma is increasingly being recognized. In particular, IL‐4 and -13 display a large degree of redundancy. Whereas IL‐4 seems to be crucial in the primary allergen sensitization process, IL-13 might be more important during secondary exposure to aerosolized allergen. Animal models also indicate that T‐cell-derived cytokine production, rather than eosinophil influx or immunoglobulin‐E synthesis, is causally related to altered airway behaviour.

An important aspect when evaluating the functional role of cytokines in a complex disease such as asthma is the interaction with other cytokines in the microenvironment. Increased expression of pro-inflammatory cytokines such as tumour necrosis factor‐α can further enhance the inflammatory process, and is increasingly linked to disease severity. In addition, decreased expression of immunoregulatory cytokines, including interleukin-12, interleukin-18 or interferon gamma could also strengthen the type 2 T‐helper cell-driven inflammatory process.
Cytokines in chronic obstructive pulmonary disease
Authors: Chung K.F.
Published: January 2003

Chronic obstructive pulmonary disease (COPD) is characterized by chronic obstruction of expiratory flow affecting peripheral airways, associated with chronic bronchitis (mucus hypersecretion with goblet cell and submucosal gland hyperplasia) and emphysema (destruction of airway parenchyma), together with fibrosis and tissue damage, and inflammation of the small airways. Cytokines are extracellular signalling proteins. Increased levels of interleukin (IL)‐6, IL‐1β, tumour necrosis factor‐α (TNF‐α) and IL‐8 have been measured in sputum, with further increases during exacerbations, and the bronchiolar epithelium over-expresses monocyte chemotactic protein (MCP)‐1 and IL‐8. IL‐8 can account for some chemotactic activity of sputum, and sputum IL‐8 levels correlate with airway bacterial load and blood myeloperoxidase levels. The expression of chemokines such as regulated on activation, normal T‐cell expressed and secreted (RANTES) may underlie the airway eosinophilia observed in some COPD patients. Cytokines may be involved in tissue remodelling. TNF‐α and IL‐1β stimulate macrophages to produced matrix metalloproteinase‐9 (MMP‐9), and bronchial epithelial cells to produce extracellular matrix glycoproteins such as tenascin. Increased expression of transforming growth factor‐β (TGFβ) and of epidermal growth factor (EGF) occurs in the epithelium and submucosal cells of patients with chronic bronchitis. TGFβ and EGF activate proliferation of fibroblasts, while activation of the EGF receptor leads to mucin gene expression.

The cytokine profile seen in chronic obstructive pulmonary disease is different from that observed in asthma. The role of these cytokines needs to be defined and there is a potential for anticytokine therapy in chronic obstructive pulmonary disease.
Modern treatment of chronic obstructive pulmonary disease
Authors: Calverley P.M.A.
Published: January 2003

Chronic obstructive pulmonary disease (COPD) is a major cause of ill health and medical expenditure worldwide. Despite recent increases in the knowledge about the nature of the disease process and recognition of cytokine-mediated pathways of inflammation, current management is focussed on patient outcomes that relate to physiological measures of dysfunction.

The new Global initiative in Obstructive Lung Disease (GOLD) management guidelines are evidence-based and stress both pharmacological and nonpharmacological therapy. Effective drug therapy can help smoking cessation in motivated patients (nicotine replacement, bupropion). Bronchodilator therapy is best given by inhaler, can use either beta-agonists or anticholinergics and is more effective if long acting. Health status and exercise performance can improve without parallel changes in forced expiratory volume in one second. Inhaled corticosteroids are indicated if there is a significant bronchodilator response or the patient has more severe disease with frequent exacerbations.

Antioxidant therapy remains controversial but may reduce exacerbation number. Acute exacerbations require higher doses of bronchodilators and short courses of oral corticosteroids. New drug treatment is a major priority for chronic obstructive pulmonary disease research.
Cytokine modulators as novel therapies for airway disease
Authors: Barnes P.J.
Published: January 2003

Cytokines play a critical role in orchestrating and perpetuating inflammation in asthma and chronic obstructive pulmonary disease (COPD), and several specific cytokine and chemokine inhibitors are now in development for the future therapy of these diseases.

Anti-interleukin (IL)‐5 is very effective at reducing peripheral blood and airway eosinophil numbers, but does not appear to be effective against symptomatic asthma. Inhibition of IL‐4 with soluble IL‐4 receptors has shown promising early results in asthma. Inhibitory cytokines, such as IL-10, interferons and IL-12 are less promising, as systemic delivery causes side-effects. Inhibition of tumour necrosis factor‐α may be useful in severe asthma and for treating severe COPD with systemic features.

Many chemokines are involved in the inflammatory response of asthma and COPD and several low-molecular-weight inhibitors of chemokine receptors are in development. CCR3 antagonists (which block eosinophil chemotaxis) and CXCR2 antagonists (which block neutrophil and monocyte chemotaxis) are in clinical development for the treatment of asthma and COPD respectively.

Because so many cytokines are involved in asthma, drugs that inhibit the synthesis of multiple cytokines may prove to be more useful; several such classes of drug are now in clinical development and any risk of side-effects with these nonspecific inhibitors may be reduced by the use of inhalational route of delivery.
Disease of the airways in chronic obstructive pulmonary disease
Authors: Cosio Piqueras M.G. , Cosio M.G.
Published: January 2003

The pathological hallmarks of chronic obstructive pulmonary disease (COPD) are inflammation of the small airways (bronchiolitis) and destruction of lung parenchyma (emphysema). The functional consequence of these abnormalities is airflow limitation.

Airway abnormalities and emphysema interact in a complex fashion in the development of airflow limitation in COPD. In an attempt to improve understanding of the role of the airways in COPD, the morphological counterparts of airflow limitation, the cellular inflammatory infiltrate in the airways and the relationship between emphysema type and airway abnormalities are reviewed.

Significant correlation between airway remodelling and functional measurements are found in earlier stages of COPD. In advanced COPD, airflow limitation is reflected by airway narrowing, airway deformity and extent of emphysema. The cellular inflammatory infiltrate is mainly composed of neutrophils in early stages of COPD. However, the presence of CD8+ T‐cells seems to differentiate smokers with COPD from smokers that would not develop the disease. The inflammatory changes and remodelling found in the airways and their contribution to airflow obstruction might be modulated by the type of emphysema smokers develop, with centrilobular emphysema showing more severe inflammatory changes and narrower airways than panlobular emphysema.

In conclusion, the degree of airway involvement in chronic obstructive pulmonary disease can vary greatly for the same degree of airflow obstruction, depending on the type of emphysema smokers develop. If the underlying lung abnormalities in chronic obstructive pulmonary disease vary, as the evidence suggests, the study of cigarette-induced lung disease as a single entity will further delay understanding of chronic obstructive pulmonary disease.
Pharmacological treatment of asthma today: Table 1
Authors: Rabe K.F. , Schmidt D.T.
Published: January 2003

The current concept of asthma therapy is based on a stepwise approach, depending on disease severity, and the aim is to reduce the symptoms that result from airway obstruction and inflammation, to prevent exacerbations and to maintain normal lung function.

β2‐Adrenoceptor agonists and glucocorticoids are at present the most effective drugs for the treatment of airway obstruction and inflammation, with theophylline, leukotriene receptor antagonists and anticholinergics as second- or third-line therapy. There are, to date, no additional or newly developed drugs available that add substantially to the current strategies or even replace β2‐adrenoceptor agonists or glucocorticoids. New approaches in asthma therapy recommend drug combinations of inhaled steroids, primarily with long-acting β2‐adrenoceptor agonists, based on their improved efficacy and the potential for a steroid-sparing effect.

Although existing drug entities are able to control the vast majority of patients with mild and moderate asthma, patients' (and doctors') adherence to guidelines and treatment strategies falls well short of the desired standards.

Treatment choices, however, differ between countries and should take into account convenience to the patient and the occurrence of side-effects. Additionally, the cost of therapy and reimbursement policies also influences therapeutic strategies.
Cytokines and the lung
Authors: Toews G.B.
Published: January 2003

Cytokines are signal molecules that induce movement, differentiation, growth and death of many cell types. Cytokines generate these effects through interactions with receptors, which relay a signal into the cell triggering a response.

Cytokine-receptor interactions are promiscuous; a combining site of any receptor can bind many ligands. Promiscuity allows for the generation of agonists, alternative ligands that activate a receptor in a way similar to the normal ligands and antagonists, ligands that bind to a receptor, but neutralize the effects of an agonist. Cytokine-receptor interactions induce many diverse (pleiotropic) effects. Cytokine-receptor interactions are redundant; several cytokines can perform the same function.

Mammalian hosts use cytokines to maintain homeostasis and to provide signals crucial to host responses to invading microbes and other injurious agents. Cytokines are the molecular messages, which: 1) initiate and amplify inflammatory and immune responses by recruiting and activating cells; 2) regulate the activation and differentiation of T‐ and B‐lymphocytes, whose functions are crucial to specific cell-mediated immunity; and 3) initiate and regulate local repair processes critical to the resolution of inflammatory responses.

Further studies of cytokines and their receptors should provide a framework for therapeutic interventions in patients with dysregulated inflammatory responses.
A PIT-1 Homeodomain Mutant Blocks the Intranuclear Recruitment Of the CCAAT/Enhancer Binding Protein α Required for Prolactin Gene Transcription
Authors: Enwright John F. , Kawecki-Crook Margaret A. , Voss Ty C. , Schaufele Fred , Day Richard N.
Published: January 2003

The pituitary-specific homeodomain protein Pit-1 cooperates with other transcription factors, including CCAAT/enhancer binding protein α (C/EBPα), in the regulation of pituitary lactotrope gene transcription. Here, we correlate cooperative activation of prolactin (PRL) gene transcription by Pit-1 and C/EBPα with changes in the subnuclear localization of these factors in living pituitary cells. Transiently expressed C/EBPα induced PRL gene transcription in pituitary GHFT1–5 cells, whereas the coexpression of Pit-1 and C/EBPα in HeLa cells demonstrated their cooperativity at the PRL promoter. Individually expressed Pit-1 or C/EBPα, fused to color variants of fluorescent proteins, occupied different subnuclear compartments in living pituitary cells. When coexpressed, Pit-1 recruited C/EBPα from regions of transcriptionally quiescent centromeric heterochromatin to the nuclear regions occupied by Pit-1. The homeodomain region of Pit-1 was necessary for the recruitment of C/EBPα. A point mutation in the Pit-1 homeodomain associated with the syndrome of combined pituitary hormone deficiency in humans also failed to recruit C/EBPα. This Pit-1 mutant functioned as a dominant inhibitor of PRL gene transcription and, instead of recruiting C/EBPα, was itself recruited by C/EBPα to centromeric heterochromatin. Together our results suggest that the intranuclear positioning of these factors determines whether they activate or silence PRL promoter activity.
Determination of Nuclear Receptor Corepressor Interactions with the Thyroid Hormone Receptor
Authors: Makowski Anita , Brzostek Sabrina , Cohen Ronald N. , Hollenberg Anthony N.
Published: January 2003

The thyroid hormone receptor (TR) recruits the nuclear corepressors, nuclear receptor corepressor (NCoR) and silencing mediator of retinoid and thyroid hormone receptors (SMRT), to target DNA elements in the absence of ligand. While the TR preferentially recruits NCoR, the mechanism remains unclear. The corepressors interact with the TR via interacting domains (IDs) present in their C terminus which contain a conserved motif termed a CoRNR box. Despite their similarity, the corepressor IDs allow for nuclear receptor specificity. Here we demonstrate that NCoR stabilizes the TR homodimer when bound to DNA by preventing its dissociation from thyroid hormone response elements. This suggests that NCoR acts to hold the repression complex in place on target elements. The TR homodimer recruits NCoR through two of its three IDs, one of which is not present in SMRT. This unique ID, N3, contains a CoRNR box but lacks the extended helical motif present in each of the other IDs. Instead, N3 contains an isoleucine just proximal to this motif. This isoleucine is also conserved in N2 but not in the corresponding S2 domain in SMRT. On thyroid hormone response elements and in mammalian cells this residue is critical in both N3 and N2 for high-affinity TR binding. In addition, this residue also controls specificity for the interactions of TR with NCoR. Together these data suggest that the specific recruitment of NCoR by the TR through a unique motif allows for stabilization of the repression complex on target elements.
Molecular Basis for the Subtype Discrimination of the Estrogen Receptor-β-Selective Ligand, Diarylpropionitrile
Authors: Sun Jun , Baudry Jerome , Katzenellenbogen John A. , Katzenellenbogen Benita S.
Published: January 2003

Although the two subtypes of the human estrogen receptor (ER), ERα and ERβ, share only 56% amino acid sequence identity in their ligand binding domain (LBD), the residues that surround the ligand are nearly identical; nevertheless, subtype-selective ligands are known. To understand the molecular basis by which diarylpropionitrile (DPN), an ERβ-selective ligand, is able to discriminate between the two ERs, we examined its activity on ER mutants and chimeric constructs generated by DNA shuffling. The N-terminal region of the ERβ LBD (through helix 6) appears to be fully responsible for the ERβ selectivity of DPN. In fact, a single ERα point mutation (L384M) was largely sufficient to switch the DPN response of this ER to that of the ERβ type, but residues in helix 3 are also important in achieving the full ERβ selectivity of DPN. Using molecular modeling, we found an energetically favorable fit for the S-DPN enantiomer in ERβ, in which the proximal phenol mimics the A ring of estradiol, and the nitrile engages in stabilizing interactions with residues in the ligand-binding pocket of ERβ. Our findings highlight that a limited number of critical interactions of DPN with the ERβ ligand-binding pocket underlie its ER subtype-selective character.
Guillotine tonsillectomy: a glimpse into its history and current status in the United Kingdom
Authors: Mathews J. , Lancaster J. , Sherman I. , Sullivan G. O.
Published: January 2003

Guillotine tonsillectomy was the widely practised technique of tonsillectomy in the late 19th century as it was considered a quick and reliable method of removing tonsils. It fell into disrepute in the early 20th century. This paper reviews the history of the origin of the tonsillotome and traces the various modifications over the last few centuries. The current practice of guillotine tonsillectomy is examined by means of a postal questionnaire surveyof all UK consultants.
Freud’s friend Fliess
Authors: Riddington Young Annie
Published: January 2003

Fliess, an ENT surgeon, was Freud’s closest friend and confidant. They both believed that sexual problems were the chief cause of neurosis. Fliess postulated that eflex nasal neurosis was based on the important physiological connection between the nose and the genitals. He described specific genital spots located on the nasal inferior turbinate. Fliess’ second preoccupation was with vital periodicities. He believed that the symptoms of his reflex nasal neurosis followed regular 28-day cycles as does menstruation. He further proposed a male 23-day menstrual cycle, that he centred specifically on the nasal turbinate. Clearly, Fliess’ fanciful theories of neurosis based on the turbinates have never held any scientific validity and are presented for their curiosity. This eccentric rhinolaryngologist, however,exerted a profound influence on Freud’s conception of human development, that is often undervalued.
Revision surgery for chronic otitis media: recurrent-residual disease and hearing
Authors: O’Leary Stephen , Veldman Jan E.
Published: January 2003

The aim of this study was to determine the effect of surgical approach, intact canal wall (ICW) or canal wall down (CWD), upon the success of revision surgery for chronicotitis media (COM). A retrospective analysis of 367 patients (including 65 children aged <15years) who underwent revision tympanoplasty because of persistent disease was performed. Single-staged tympanoplasty was performed, preserving the canal wall when present. Hearing was reconstructed with allograft incus. Follow-up ranged from one to 15 years. Hearing was determined by pre- and post-operative air-bone gaps.

Post-operative re-perforation, aural discharge and/or cholesteatoma rates were similar for CWD and ICW. Cholesteatoma could present following the revision, even though it was not apparentat surgery. Following tympanoplasty, the final hearing was not significantly affected by the surgical approach or presence of cholesteatoma. Improvement in hearing was adversely affected by cholesteatoma or an absent stapes suprastructure.

Revision ICW and CWD operations were both successful in controlling signs of COM. Cholesteatoma is a peripheral risk in COM and may become apparent after revision surgery.
Nasal septum buttons: symptom scores and satisfaction
Authors: Luff D. A. , Kam A. , Bruce I. A. , Willatt D. J.
Published: January 2003

Patients with symptomatic septal perforations require treatment, with many surgeons advocating primary treatment with an obturator if conservative measures fail. Twenty nasal Button Outcome Questionnaires were sent to patients who had undergone insertion of a septal button between 1990 and 2000 in our unit. Fourteen questionnaires were returned. This study reveals that despite a reduction in symptom score in nine patients, septal buttons are poorly tolerated by patients with only 45 per cent of obturators ultimately being in situ. In view of these findings, patients are now offered a choice between primary surgical and mechanical closure in our unit.
Rationale for osteotome selection in rhinoplasty
Authors: Lee Heung-Man , Kang Hee Joon , Choi Jin Ho , Chae Sung Won , Lee Sang Hag , Hwang Soon Jae
Published: January 2003

Proper selection of an osteotome for nasal osteotomy is important for minimizing soft tissue trauma. Radiographic analysis of the facial bony lateral wall thickness was performed to suggest a guideline for an appropriate osteotome size for Asians. Facial bone computed tomography (CT) of 100 patients (50 male, 50 female) were studied. The thickness of the facial bony lateral wall at three points along the track of a lateral osteotomy, and two points along the track of a medial osteotomy and intermediate osteotomy were measured. The average bony thickness along the track of a lateral osteotomy was 2.61 ± 0.66 mm at the low level, 2.75 ± 0.76 mm at the middle level, and 2.72 ± 0.53 mm at the high level in subjects. The average bony thickness along the track of an intermediate osteotomy were 1.26 ± 0.34 mm at the low level, and 1.31 ± 0.32 mm at the high level in the subjects. The average bony thickness along the track of the medial osteotomy were 2.54 ± 0.31 mm at the lowlevel, and 2.77 ± 0.30 mm at the high level in subjects. These results may provide a guideline for choosing an osteotome of appropriate size for the Asian population.
Computer imaging and patient satisfaction in rhinoplasty surgery
Authors: Sharp H. R. , Tingay R. S. , Coman S. , Mills V. , Roberts D. N.
Published: January 2003

The measurement and achievement of improved patient benefit following a particular medical or surgical intervention has become an increasingly relevant part of the provision of effective healthcare.

We have retrospectively analysed patient satisfaction in 56 patients following rhinoplasty via the Glasgow Benefit Inventory (GBI), 25 of whom underwent pre-operative computer imaging planning. We have also audited patient reaction to this technique via a concurrent questionnaire in those subjects who underwent imaging, and correlated this with overall patient outcome.

Patient satisfaction with cosmetic rhinoplasty following computer imaging was significantly improved compared to those patients who did not receive imaging.
Endoscopic laser treatment in pre-malignant and malignant vocal fold epithelial lesions
Authors: Remijn E. E. G. , Marres H. A. M. , van den Hoogen F. J. A.
Published: January 2003

Endoscopic laser treatment was performed in 43 patients with pre-malignant or malignant vocal fold epithelial lesions, 10 were treated with endoscopic laser surgery for dysplasia, 12 for carcinoma in situ (CIS), five for verrucous carcinoma and 16 patients for squamous cell carcinoma (SCC). Thirty-two patients received laser therapy as their first therapy, whereas 11 patients had had previous radiation therapy for laryngeal carcinoma (n = 9) or CIS (n = 2).

Recurrence after initial laser therapy necessitating re-treatment (a second laser treatment or radiotherapy) occurred in nine out of 32 patients (28 per cent), thus 23 (72 per cent) were maintained free of disease during the follow-up period.

Besides the 32 patients without previous therapy, patients who had already undergone radiat on therapy were also included in this study. In this group there were nine patients with SCC, one patient with CIS and one with dysplasia. They all underwent laser therapy. Four were free ofdisease during follow-up (36 per cent) and seven developed recurrences. Six (58 per cent of allpatients with previous radiation therapy) underwent total laryngectomy.
Short-term complications of percutaneous tracheostomy: experience of a District General Hospital–Otolaryngology Department
Authors: Kumar Manoj , Jaffery Ali , Jones Mathew
Published: January 2003

Percutaneous tracheostomy is a procedure frequently carried out in a critical care setting. It is performed in the majority of cases by anaesthetists in the United Kingdom. The ENT surgeon is only called in situations where it is deemed by the intensivist that percutanous tracheostomy would prove too great a risk. In this situation the patient was taken to the operating theatre for a surgical tracheostomy. In our paper, a retrospective analysis was performed of all percutaneous tracheostomies carried out by ENT surgeons in the Royal Glamorgan Hospital, during a two-year period from July 1999 to July 2001, to assess whether percutaneous tracheostomy is a feasible option as a first line procedure in all elective tracheostomies. Thirty-six patients were included in the study. The mean age was 60.2 years. Haemorrhage was noted to be a problem in only one patient and two patients developed post-operative wound infection that was treated with systemic antibiotics. No other complications were encountered. We propose that all ENT surgeons should be trained in performing percutaneous tracheostomy and that it should be used as the gold standard in elective tracheostomy insertion. In cases where difficulties are likely to be anticipated, percutaneous tracheostomy can still be considered as the first option. This can be performed in the operating theatre setting with the knowledge that if any complication should occur then conversion to surgical tracheostomy can be done without delay.
A case of rhinolithiasis in Botswana: a mineralogical, microscopic and chemical study
Authors: Vink Bernard W. , van Hasselt Piet , Wormald Richard
Published: January 2003

A case of rhinolithiasis in Southeast Botswana was treated and after removal in hospital, the rhinolith was subjected to macroscopic and microscopic examination, X-ray diffraction analysis, electron microscope analysis and partial botanical analysis.

The rhinolith consists of a strongly elliptical core of calcium stearate (C36H70CaO4.H2O), surrounded by approximately 30 elongated concentric growth rings, consisting of sodium-containing whitlockite (Ca18Mg2(Na,H)(PO4)14). The different layers have various degrees of porosity and red staining, probably due to traces of amorphous iron oxide. The origin of the rhinolith started with a piece of plant material, lodged in the nose, which was replaced by calcium stearate, leaving some remnants of resistant epidermal plant tissue. During subsequent years, thin layers of whitlockite were deposited periodically around the core with the reddish brown bands representingdeposition during the dry season when atmospheric dust rich in amorphous iron oxide is at its highest in Botswana.
Cholesterol granuloma of the frontal sinus
Authors: Shykhon M. E. , Trotter M. I. , Morgan D. W. , Reuser T. T. Q. , Henderson M. J.
Published: January 2003

It is common to see cholesterol granuloma in the mastoid air cells, less common in the orbit, and uncommon in the paranasal sinuses. Cholesterol granuloma is thought to be due to an interruption to normal aeration with impaired lymphatic drainage, resulting in a closed cavity where it may form. These expanding cysts cause bone destruction and compression of the surrounding structures that lead to clinical symptoms. Diagnosis and management of cholesterol granuloma cysts can be challenging. Magnetic resonance imaging (MRI) and computed tomographic (CT) scans are usually diagnostic. We present a rare case of cholesterol granuloma in the frontal sinus, few cases have been reported in the literature.
Metachronous adenocarcinoma of the maxillary sinuses: a rare entity
Authors: Ang Annette H. C. , Pang Kenny Peter , Tan Luke K. S.
Published: January 2003

Malignant tumours of the nasal cavities and paranasal sinuses are uncommon.They constitute less than one per cent of all tumours and less than three per cent of head and neck tumours. Although multiple primary carcinomas of the aerodigestive tract are commonly reported, metachronous maxillary sinus carcinomas are rare. To date, all of these cases reported are of squamous cell origin. The incidence of metachronous maxillary carcinoma involving both sinuses is in the range of 1.4 per cent amongst patients with maxillary carcinoma. We present the first reported case, to our knowledge, of a patient with metachronous adenocarcinoma of the maxillary sinus.
Familial vocal fold paralysis
Authors: Ali Raza S. , Mahendran S. , Rahman Nazneen , Williams R. G.
Published: January 2003

Familial clustering of congenital bilateral abductor vocal fold paralysis has been reported very rarely. So far, only a handful of cases have been reported, mostly with the autosomal dominant of X-linked recessive mode of inheritance. We describe the cases of a brother and sister, who presented with neonatal stridor due to bilateral abductor vocal fold paralysis. First-degree parental consanguinity suggests an autosomal recessive mode of inheritance. Karyotype analysis revealed a paracentric balanced inversion of chromosome 13 in both cases, that was also present in the unaffected mother. An updated review of the literature on this interesting but rare condition is also presented.
A solitary neurofibroma of the palatine tonsil
Authors: Surwald C. J. , Salam M. A. , Rowe R. C. G.
Published: January 2003

A rare case of a tonsillar neurofibroma in a 28-year-old Caucasian male is presented. Benign tumours of the tonsils are rare and of those reported, only a few are benign peripheral nerve sheath tumours (BPNSTs). This is the first report of a solitary neurofibroma of the palatine tonsil in the English literature.
Tongue ischaemia in a patient with external carotid artery stenosis
Authors: Amen Furrat , Amen Amer A.
Published: January 2003

We report the case of a 75-year-old man who presented with an ischaemic tongue. He was known to have external carotid artery stenosis and a history of a transient ischaemic attack. He was treated with a heparin infusion and the tongue healed well.
A base of skull fracture presenting as haematemesis
Authors: Cruise A. S. , Bryson J. , Solomons N.
Published: January 2003

In a patient presenting with haematemesis, known to have oesophageal varices, the bleeding would be expected to be from those varices. This case demonstrates an unusual presentation of a base of skull fracture; blood from a fracture of the temporal bone had run from the middle ear through the eustachian tube to the pharynx. It demonstrates the need to remainvigilant even when the diagnosis appears to be obvious.
Evaluation of Elasto-Plastic Buckling Strength of Two-Way Grid Shells Using Continuum Analogy
Authors: Kato Shiro , Yamashita Tetsuo
Published: January 2003

The present paper aims to propose a method to evaluate elasto-plastic buckling strength of two-way grid shells, using mathematical formulas for linear buckling derived based on the continuum shell analogy. The paper is organised from two principal points of view. In the first discussion, we derive two formulas for linear buckling of two-way grid shells by substituting the equivalent continuum rigidity into the buckling formulas for orthotropic shells. The applicability of the formulas is verified using several structural examples by comparison with the other proposed formulas and FEM results. In the second discussion, based on the concept of column buckling, an effective approach to estimate elasto-plastic buckling strength of two-way grid shells is demonstrated. In the estimation procedure, the buckling formulas derived in the first discussion are effectively applied to obtain the generalised slenderness.
Arch-Supported Reticulated Shell Structures and Their Static Mechanical Behaviour
Authors: Li Yuan-Qi , Shen Zu-Yan
Published: January 2003

Based on the structural features of reticulated shells, arch structures, etc., arch-supported reticulated shell structures have been developed as a new large-span space structural system. In the paper, the acceptability of this hybrid structural system and the reasonable combination of arch structures and reticulated shells with different Gaussian curvatures are discussed. Several ideas on using arch-supported reticulated shell structures to form openable structures are also mentioned. Compared to single-layer reticulated shells, the mechanical behaviour of the hybrid structures, especially the influence of initial geometrical imperfection, was investigated through nonlinear analysis and experimental research on three typical models. Analysis indicates that hybrid structures can efficiently decrease the geometrical imperfection sensitivity and improve their integral mechanical behaviour, which proves that this type of hybrid structures can be used widely.
Effect of Geometric Imperfections on Single-Layer Barrel Vaults
Authors: El-Sheikh Ahmed
Published: January 2003

It is almost impossible to produce a barrel vault assembly with complete precision. With the hundreds of members and joints these structures typically contain, assuming precise manufacturing throughout is unrealistic. It is, therefore, inevitable that some of these components will have some geometric imperfections, primarily in the form of member lack of fit and joint misplacement. This paper presents a study on the effects of geometric imperfections on single-layer barrel vaults. Imperfections are considered in different vault zones in order to identify the critical areas in which imperfection is most damaging. The conclusions of this study could be beneficial to barrel vault design and construction.
A Direct Method for Buckling Analysis of Single Layer Lattice Structures
Authors: Loureiro Alfonso , Goñi Rufino , Bayo Eduardo
Published: January 2003

Numerous authors have studied the buckling behaviour of single layer lattice structures. Issues such as the buckling analysis in the elastic and plastic ranges, and the effects of imperfections in the failure mechanism of the structure have been investigated. However, there is still an uncertainty at the time of performing the buckling design of individual elements within the structure. This uncertainty stems from the need to approximate the effective length of each individual member. In addition, the approximate design criteria established by the different codes, and in particular Eurocode 3, are generally applicable to planar frames, but uncertain for spatial structures. This paper presents a direct one-step method for the buckling analysis of single layer lattice structures. The method avoids the use of the effective length factor of each individual element. The key point is to perform a non-linear analysis of the structure starting from an initial deformation state that includes the initial imperfections of the elements. Such an initial deformation state is obtained from the first buckling mode of the structure by a suitable scaling procedure based on an energy approach. The resulting initial deformed shape is introduced along with the external loads in a fully non-linear structural analysis that yields the resulting element stresses including the buckling effects. The performance of the method is checked by means of a series of numerical examples. The stiffness characteristics of the connections have been obtained, and included in the analysis, thus showing their influence on the behaviour of the structure.
Heritability and anthropometric influences on human fertility
Authors: Madrigal Lorena , Relethford John H. , Crawford Michael H.
Published: January 2003

This study researched the impact of anthropometrics and size‐of‐family of orientation on women's fertility by using path analysis. The data were collected as part of the anthropological study conducted in Ireland by Harvard University personnel before the Second World War. The women included in this analysis were all over age 49 and were either married or widowed at the time of the survey. Our results indicate that the heritability of fertility is moderate in this sample and that there is a tendency for heavy women to have a higher fertility. However, when anthropometrics and size‐of‐family of orientation were entered as independent variables in a path diagram, an insignificant portion of the variation of fertility was explained. In this Irish population, the main cause of differential fertility was cultural rather than biological. A large portion of women never married and no unmarried woman reported producing a child. Am. J. Hum. Biol. 15:16–22, 2003. © 2002 Wiley‐Liss, Inc.
Effect of the bubonic plague epidemic on inbreeding in 14th century Britain
Authors: Pattison John E.
Published: January 2003

The purpose of the study reported here was to further investigate a new method of estimating inbreeding in large, relatively isolated populations over historic times, as reported by Pattison (1999, 2001). The method is based on modeling the genealogical “paradox” and produces values of Pearl's coefficients of inbreeding as a function of time for any given population curve. In particular, this study demonstrates that the new method of estimating inbreeding may be used to examine the effect of unusual features in population curves on levels of inbreeding in that population. As an example, the medieval population “bump” that spans the 13th and 14th centuries in the population of Britain, which terminated abruptly with the outbreak of bubonic plague in 1348 AD, is examined. It is first assumed that the whole population was the adult (breeding) population, corresponding to minimum inbreeding. For this case it is found that, for distant generations, about 90% of the whole population occurs in any present‐day British pedigree. This value compares favorably with the values of 85% and 80% reported by Wachter (1980) and Derrida et al. (1999, 2000), respectively. The population bump causes the curves for Pearl's coefficient, for minimum inbreeding, to have a plateau of about 96% over the period from about 1220 AD to 1380 AD. The effect of introducing a single known estimate of inbreeding into the model is to produce a more realistic situation where the adult (breeding) population is considerably less than the whole population. It is found that the maximum number of different ancestors in any generation, in the average British pedigree, is about 22,900 individuals and occurs about 1220 AD. More importantly, and possibly contrary to expectation, it is now found that the population bump had virtually no effect on the level of inbreeding. Am. J. Hum. Biol. 15:101–111, 2003. © 2002 Wiley‐Liss, Inc.
Facial dysgenesis: A novel facial syndrome with chromosome 7 deletion p15.1‐21.1
Authors: Hoover‐Fong Julie E. , Cai J. , Cargile C.B. , Thomas G.H. , Patel A. , Griffin C.A. , Jabs E.W. , Hamosh A.
Published: January 2003

We describe a female neonate with a unique constellation of features including anophthalmia and cryptophthalmos, temporal remnant “eye tags,” bilateral cleft lip, unilateral cleft palate, a proboscis with absent nasal septum, choanal atresia, micrognathia, square stoma, and bilateral external auditory canal atresia. Gross brain structure, pituitary function, limbs, trunk, and genitalia were normal. Skeletal survey, echocardiogram and abdominal viscera were unremarkable except for a split central sinus of the right kidney. BAER exam indicated she could hear and temporal CT confirmed the presence of cochlea and possible ossicles. Cytogenetic evaluation revealed an interstitial deletion at chromosome 7p15.1‐21.1. TWIST, a gene encoding a transcription factor involved in craniofacial development, is deleted by FISH analysis. The absence of a mutation on the non‐deleted allele of TWIST as determined by sequencing virtually eliminates complete loss of the TWIST gene as the cause of this patient's severe phenotype. The HOXA gene cluster also encodes transcription factors that are crucial for directing cephalad to caudad somatic fetal development. HOXA1, the most telomeric of the 13 members of the HOXA gene cluster, is located at the centromeric boundary of the patient's chromosome 7 deletion. By FISH analysis, neither allele of HOXA1 is deleted and sequencing reveals no mutations. Haploinsufficiency or complete loss of the HOXA1 gene also does not appear to cause this patient's severe phenotype. Previous reports of chromosome 7p15‐21 deletions do not have phenotypes similar to this patient. © 2003 Wiley‐Liss, Inc.