bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized Study Evaluating Recombinant Human Bone Morphogenetic Protein‐2 for Extraction Socket Augmentation
Authors: Fiorellini Joseph P. , Howell T. Howard , Cochran David , Malmquist Jay , Lilly Leslie C. , Spagnoli Daniel , Toljanic Joseph , Jones Archie , Nevins Myron
Published: April 2005

Background: Conventional dentoalveolar osseous reconstruction often involves the use of grafting materials with or without barrier membranes. The purpose of this study was to evaluate the efficacy of bone induction for the placement of dental implants by two concentrations of recombinant human bone morphogenetic protein‐2 (rhBMP‐2) delivered on a bioabsorbable collagen sponge (ACS) compared to placebo (ACS alone) and no treatment in a human buccal wall defect model following tooth extraction.

Methods: Eighty patients requiring local alveolar ridge augmentation for buccal wall defects (≥50% buccal bone loss of the extraction socket) of the maxillary teeth (bicuspids forward) immediately following tooth extraction were enrolled. Two sequential cohorts of 40 patients each were randomized in a double‐masked manner to receive 0.75 mg/ml or 1.50 mg/ml rhBMP‐2/ACS, placebo (ACS alone), or no treatment in a 2:1:1 ratio. Efficacy was assessed by evaluating the amount of bone induction, the adequacy of the alveolar bone volume to support an endosseous dental implant, and the need for a secondary augmentation.

Results: Assessment of the alveolar bone indicated that patients treated with 1.50 mg/ml rhBMP‐2/ACS had significantly greater bone augmentation compared to controls (P ≤0.05). The adequacy of bone for the placement of a dental implant was approximately twice as great in the rhBMP‐2/ACS groups compared to no treatment or placebo. In addition, bone density and histology revealed no differences between newly induced and native bone.

Conclusion: The data from this randomized, masked, placebocontrolled multicenter clinical study demonstrated that the novel combination of rhBMP‐2 and a commonly utilized collagen sponge had a striking effect on de novo osseous formation for the placement of dental implants. J Periodontol 2005;76:605‐613.
Maintenance of Osseointegration Utilizing Insulin Therapy in a Diabetic Rat Model
Authors: Kwon Peter T. , Rahman Suraiya S. , Kim David M. , Kopman Jeffrey A. , Karimbux Nadeem Y. , Fiorellini Joseph P.
Published: April 2005

Background: Normal wound healing processes have been shown to be altered in diabetes, and the effect of the diabetes on bone‐to‐implant contact (BIC) once osseointegration has been established is still unknown. The purpose of this study was to histologically evaluate the bone‐to‐implant contact in uncontrolled and insulin‐controlled rats in which diabetes was induced following the establishment of osseointegration.

Methods: Thirty‐two rats were assigned to eight different treatment groups of four each. Titanium plasma‐sprayed (TPS) implants were placed in the femora of each animal, and allowed to osseointegrate for 28 days before diabetic induction. Daily insulin injections were given to four groups of rats and the other four groups received no insulin (uncontrolled). The rats were sacrificed at 1, 2, 3, and 4 months following diabetic induction.

Results: The results indicated that at 1, 2, 3, and 4 months, there was more BIC in the insulin‐controlled groups compared to the uncontrolled groups. The differences were significantly greater at 2, 3, and 4 months (P ≤0.001).

Conclusions: This study demonstrated that osseointegrated dental implants in insulin‐controlled diabetic rats maintained bone‐to‐implant contacts over a 4‐month period. However, boneto‐ implant contact appears to decrease with time in uncontrolled diabetic rats. J Periodontol 2005;76:621‐626.
Intraoral Autogenous Block Onlay Bone Grafting for Extensive Reconstruction of Atrophic Maxillary Alveolar Ridges
Authors: Schwartz‐Arad Devorah , Levin Liran
Published: April 2005

Background: Endosseous implants require sufficient bone volume for complete bone coverage. Alveolar defi‐ ciency can prevent ideal implant placement. Local bone grafts are a convenient source of autogenous bone in alveolar reconstruction. The aim of this study was to describe a technique, and to evaluate the success of extensive bone reconstruction of atrophic maxillary alveolar ridges using only intraoral block bone grafts prior to dental implantation.

Methods: Files of 10 healthy patients with extensive bone reconstruction of the maxillary alveolar ridge using intraoral block bone graft operations were reviewed. Medical history, smoking status, bone origin (donor sites), number of bone blocks, and complications were recorded.

Results: Of the 10 extensive bone maxillary reconstructions, four were uneventful, two required additional bone augmentation at the time of dental implant placement, two had a minimal graft exposure, one had a minor adverse effect (temporary paresthesia), and one operation partially failed and required partial graft removal.

Conclusion: Intraoral bone block grafting is a predictable operation with a high success rate for longspan augmentation, up to complete jaw augmentation/ extensive bone reconstruction of the maxillary alveolar ridge. J Periodontol 2005;76:636‐641.
Interdental Papilla Augmentation Procedure Following Orthodontic Treatment in a Periodontal Patient
Authors: Cardaropoli Daniele , Re Stefania
Published: April 2005

Background: The absence of the interdental papilla is a situation that may alter patients' esthetics. Recession of interproximal gingival tissues may be a consequence of periodontal disease, but in some cases it may also be a consequence of periodontal therapy, as a result of surgical or non‐surgical procedures.

Methods: The authors present a new multidisciplinary approach for the treatment of migrated maxillary incisors presenting infrabony defects, extrusion, and loss of the interdental papilla.

Results and Conclusion: The proposed clinical protocol may reconstruct the interproximal soft tissue, with esthetic improvement of the papillary level, together with resolution of the periodontal defects. J Periodontol 2005;76:655‐661.
Evaluation of an Occupational Therapy Mentorship Program
Authors: Milner Tracy , Bossers Ann
Published: April 2005

Background. It was identified that there is a lack of evidence for the effectiveness of formal mentorship programs, no evidence supporting mentor groups and little research in mentorship specific to occupational therapy. Purpose. The following quantitative study evaluates the mentorship program offered within the occupational therapy curriculum at The University of Western Ontario. Methods. One hundred and seventy nine surveys were analyzed to evaluate participants' perceptions of the program's strengths, weaknesses, changes needed, effectiveness, and whether it should continue to be offered. Results. In general, mentors and mentees reported that the mentorship program should continue to be offered and that it was effective in developing professionalism. However, the structure of the program, clarification of its requirements, and more support for the mentors were identified as some areas for change. Implications. Results can impact further program development at this university and other occupational therapy programs which may have a similar program or are interested in developing a mentorship program.
Prise en charge cognitive de la mémoire dans le vieillissement normal, les troubles cognitifs légers et la démence de type Alzheimer
Authors: Bier Nathalie , Desrosiers Johanne , Gagnon Lise
Published: April 2005

Description. Depuis les dernières années, les ergothérapeutes sont amenés à travailler davantage avec la clientèle gériatrique et doivent donc utiliser des interventions qui permettent de favoriser un maintien de l'autonomie et l'amélioration de la qualité de vie. Dans ce contexte, l'intervention cognitive, qui cible plus spécifiquement les troubles de la mémoire, est une intervention prometteuse dans le domaine du vieillissement et de l'ergothérapie. But. Le but de cette recension des écrits est de faire un survol de ce type d'intervention en présentant ses fondements, ses objectifs et ses procédures et ce, auprès de chacune des populations suivantes: les personnes âgées présentant des troubles de la mémoire liés au vieillissement normal, des troubles cognitifs légers ou une démence de type Alzheimer. Conséquences pour la pratique. La prise en charge cognitive de la mémoire est ainsi présentée et discutée en fonction des caractéristiques cognitives de chacune de ces clientèles.
Using Occupation to Facilitate Self-Awareness in People who have Acquired Brain Injury: A Pilot Study
Authors: Fleming Jennifer M. , Lucas Sarah E. , Lightbody Sue
Published: April 2005

Background. Impaired self-awareness in people who have had an acquired brain injury (ABI) is a complex phenomenon that impedes rehabilitation progress and outcome. Purpose. This pilot study investigated the effect of an occupation-based intervention program on the self-awareness and emotional status of people after ABI. Four male adults with impaired self-awareness following ABI participated in this study. Each received a 10-week individualized program that focused on the performance of three occupations for 1 to 2 hours per week. A facilitative approach was taken, using techniques to improve self-awareness described in the literature. Repeated measures of participants' self-awareness and emotional status were taken pre- and post-intervention, and analyzed descriptively. Results. Results indicated preliminary support for the effectiveness of the program in facilitating participants' self-awareness. However, consideration of baseline and follow-up data indicated a complex picture. Increased anxiety was found to accompany improvements in participants' self-awareness in all four cases. Practice Implications. This study will assist occupational therapists with program development for clients who have had an acquired brain injury.
Continuing Professional Education and the Internet: Views of Alberta Occupational Therapists
Authors: Pui M. Violet , Liu Lili , Warren Sharon
Published: April 2005

Background. Occupational therapists have identified barriers to accessing continuing professional education (CPE) in the traditional face-to-face formats. One alternative to traditional, centrally located, face-to-face CPE is course delivery through the Internet. Purpose. This study examined Alberta occupational therapists' perceptions of Internet-based CPE. Method. A questionnaire was mailed to 800 randomly sampled Alberta occupational therapists (response rate = 35.5%; n = 281). Results. Respondents pursued CPE to increase skills, knowledge and maintain clinical competency. They reported that a face-to-face CPE course was more useful than distance courses. Although almost 90% of respondents had access to computers with an Internet connection at home or at work, and nearly 65% thought that their computer knowledge was sufficient, only 2.9% had previously taken Internet-based CPE. Practice Implications. In order for the Internet to be accepted as a common, useful and alternative delivery tool for CPE in occupational therapy, the perceived barriers such as the lack of personal time, cost, and limited interaction with other learners and instructors will need to be addressed.
Single‐column simulated‐moving‐bed process with recycle lag
Authors: Mota José P. B. , Araújo João M. M.
Published: April 2005

It is shown that the periodic state of the simulated‐moving‐bed (SMB) process is reproduced by a single‐column chromatographic process with a recycle lag of (N − 1)τ time units, where N is the number of columns of the equivalent SMB unit and τ is the switching time. The operation of this ideal single‐column process is formulated by selecting an arbitrary column of the SMB and following its operation over a complete cycle. To implement the recycle lag in practice, a special type of plug‐flow tube has been designed. It includes internal elements to make the flow as close as possible to plug flow, and a piston to compensate for the difference between the inlet and outlet flow rates. This is necessary because the recycle lag is not a multiple of the overall cycle duration. The proposed system is a more compact, less‐expensive, and simpler‐to‐operate alternative to the SMB. It avoids the problem of packing reproducibility and the total pressure drop is 1/Nth of that of the equivalent SMB. Depending on the efficiency of the recycle tube, our single‐column process can achieve the same purities as the analogous SMB unit while keeping the specific productivity constant. © 2005 American Institute of Chemical Engineers AIChE J, 2005
Physicians' communication with a cancer patient and a relative
Authors: Delvaux Nicole , Merckaert Isabelle , Marchal Serge , Libert Yves , Conradt Sandrine , Boniver Jacques , Etienne Anne‐Marie , Fontaine Ovide , Janne Pascal , Klastersky Jean , Mélot Christian , Reynaert Christine , Scalliet Pierre , Slachmuylder Jean‐Louis , Razavi Darius
Published: April 2005

BACKGROUND

Although patients with cancer are often accompanied by a relative during medical interviews, to the authors' knowledge little is known regarding the efficacy of communication skills training programs on physicians' communication skills in this context. The objective of the current study was to assess the efficacy of 6 consolidation workshops, 3 hours in length, that were conducted after a 2.5‐day basic training program.

METHODS

After attending the basic training program, physicians were assigned randomly to consolidation workshops or to a waiting list. Training efficacy was assessed through simulated and actual interviews that were recorded on an audio tape at baseline, after consolidation workshops for the consolidation‐workshops group, and 5 months after the end of basic training for the waiting‐list group. Communication skills were assessed according to the Cancer Research Campaign Workshop Evaluation Manual. Patients' and relatives' perceptions of and satisfaction with physicians' communication performance were assessed using a 15‐item questionnaire.

RESULTS

Sixty‐two physicians completed the training program. Compared with physicians who participated to the basic training program, when addressing the patient, physicians who were randomized to the consolidation workshops used more open, open directive, and screening questions (P = 0.011 in simulated patient interviews and P = 0.005 in actual patient interviews) and elicited and clarified psychologic concerns more often (P = 0.006 in simulated patient interviews and P < 0.001 in actual patient interviews). When they addressed the relative, physicians who were randomized to the consolidation workshops gave less premature information (P = 0.032 in simulated patient interviews and P < 0.001 in actual patient interviews). When they addressed the patient and the relative simultaneously, physicians who were randomized to the consolidation workshops used more empathy, educated guesses, alerting to reality, confronting, negotiating, and summarizing (P = 0.003 in simulated patient interviews and P = 0.024 in actual patient interviews). Patients, but not relatives, who interacted with physicians in the consolidation‐workshops group were more satisfied globally with the interviews (P = 0.022).

CONCLUSIONS

Six 3‐hour consolidation workshops resulted in improved communication skills addressed to patients and to relatives. The current results showed that the transfer of skills addressing relatives' concerns remained limited and that consolidation workshops should focus even more systematically on the practice of three‐person interviews. Cancer 2005. © 2005 American Cancer Society.
Structure‐breaking effects of solvated Rb(I) in dilute aqueous solution—An ab initio QM/MM MD approach
Authors: Hofer Thomas S. , Randolf Bernhard R. , Rode Bernd M.
Published: April 2005

Structural properties of the hydrated Rb(I) ion have been investigated by ab initio quantum mechanical/molecular mechanical (QM/MM) molecular dynamics (MD) simulations at the double‐zeta HF quantum mechanical level. The first shell coordination number was found to be 7.1, and several other structural parameters such as angular distribution functions, radial distribution functions and tilt‐ and θ‐angle distributions allowed the full characterization of the hydration structure of the Rb(I) ion in dilute aqueous solution. Velocity autocorrelation functions were used to calculate librational and vibrational motions, ion–ligand motions, as well as reorientation times. Different dynamical parameters such as water reorientation, mean ligand residence time, the number of ligand exchange processes, and rate constants were also analyzed. The mean ligand residence time for the first shell was determined as τ = 2.0 ps. © 2005 Wiley Periodicals, Inc. J Comput Chem 26: 949–956, 2005
Nonaqueous capillary electrophoresis for rapid and sensitive determination of fangchinoline and tetrandrine in Radix Stephaniae tetrandrae and its medicinal preparations
Authors: Gao Wenhua , Lin Shaoyu , Chen Yaowen , Chen Anjia , Li Yuqin , Chen Xingguo , Hu Zhide
Published: April 2005

A simple, rapid, and sensitive non‐aqueous capillary electrophoresis procedure with head‐column field‐amplified sample stacking concentration for the analysis of fangchinoline and tetrandrine is established. Optimum separation and stacking conditions were obtained when the sample was injected at 8 kV for 50 s after preliminary pressure injection of ethanol (16.9 kPa) for 0.6 s and separated with the buffer containing 50 mM ammonium acetate, 0.5% (v/v) acetic acid, and 50% (v/v) acetonitrile in methanol medium at 24 kV applied voltage. The analytes were detected by UV at 214 nm. The two bisbenzylisoquinoline alkaloids can be separated within 6 min and quantified with high sensitivity. The detection limits were 0.30 ng mL–1 for fangchinoline and 0.34 ng mL–1 for tetrandrine, which indicated that the sensitivities were at least 1000‐fold enhanced over those reported in the literature as obtained by UV detection. The method was applied to the analysis of fangchinoline and tetrandrine in Radix Stephaniae tetrandrae and its medicinal preparations with good results.
Clinical and genetic study of a large SPG4 Italian family
Authors: Orlacchio Antonio , Kawarai Toshitaka , Gaudiello Fabrizio , Totaro Antonio , Schillaci Orazio , Stefani Alessandro , Floris Roberto , St. George‐Hyslop Peter H. , Sorbi Sandro , Bernardi Giorgio
Published: April 2005

A novel SPG4 906delT frame‐shift mutation in exon 6 was identified in a large Italian family with an autosomal dominant form of hereditary spastic paraplegia (ADHSP). Intrafamilial phenotypic variations observed in the pedigree included spasticity and additional clinical features, such as peripheral sensory–motor neuropathy, cognitive impairment, and urological dysfunction. Severe clinical features were found predominantly in the men who were affected, and there was no statistically significant correlation of disability and time since onset of symptoms, suggesting the existence of other genetic/nongenetic modifier(s), including gender. © 2005 Movement Disorder Society
Classification conundrums in paroxysmal dyskinesias: A new subtype or variations on classic themes?
Authors: Pourfar Michael H. , Guerrini Renzo , Parain Dominique , Frucht Steven J.
Published: April 2005

Paroxysmal movement disorders are a group of heterogeneous entities that have been categorized based on their most salient features. The four classic categories of paroxysmal dyskinesias are kinesigenic, nonkinesigenic, hypnogenic, and exercise‐induced. The phenotypic variability of these disorders, coupled with new insights into their possible etiologies, has made the task of classification increasingly problematic. We describe 4 cases that do not fit easily into the current classification scheme, compare them with four others recently described in the literature, and raise the question as to whether they constitute a new subtype. © 2005 Movement Disorder Society
Bilateral internuclear ophthalmoplegia in progressive supranuclear palsy with an overriding oculocephalic maneuver
Authors: Flint Alexander C. , Williams Olajide
Published: April 2005

We present a patient with progressive supranuclear palsy (PSP) who had a bilateral internuclear ophthalmoplegia (INO) that could be fully overcome by the oculocephalic maneuver. In addition to being an unusual finding in the clinical setting of PSP, this phenomenon has interesting implications for the functional control of conjugate horizontal gaze. © 2005 Movement Disorder Society
Episodes of hypoxemia during synchronized intermittent mandatory ventilation in ventilator‐dependent very low birth weight infants
Authors: Firme Steve R.E. , McEvoy Cindy T. , Alconcel Celia , Tanner Jason , Durand Manuel
Published: April 2005

Distinct patterns of asynchrony, and episodes of hypoxemia, may occur in a spontaneously breathing preterm infant during conventional intermittent mandatory ventilation (IMV) on traditional time‐cycled, pressure‐limited ventilators. Synchronized IMV (SIMV) and assist/control ventilation are frequent modes of patient‐triggered ventilation used with infant ventilators. The objective of this study was to use computerized pulse oximetry to quantify the occurrence of episodes of hypoxemia (oxygen desaturation) during SIMV vs. IMV, in preterm infants ≤1,250 g who required mechanical ventilation at ≥14 days of age. We performed a randomized, crossover study with each infant being randomized to IMV or SIMV (Infant Star ventilator) for initial testing for a 1‐hr period. Patients were subsequently tested on the alternate modality after a stabilization period of 10 min at the same ventilator and fractional inspired oxygen concentration (FiO2) settings. Pulse oximetry data were obtained with a Nellcor N‐200 monitor, a microcomputer, and a software program (SatMaster). An investigator blinded to the randomized assignment evaluated all measurements. Eighteen very low birth weight (VLBW) infants with a birth weight of 777 ± 39 g (mean ± SEM) and gestational age 25.1 ± 0.3 weeks were studied. The average pulse oximeter oxygen saturation (SaO2) was higher on SIMV than IMV (P < 0.01). During SIMV, these infants had significantly fewer episodes of hypoxemia (duration of episodes of oxygen desaturation as a percentage of scorable recording time) to 86–90% SaO2 (P < 0.01), 81–85% SaO2 (P < 0.01), and 76–80% SaO2 (P < 0.05) when compared to IMV. There was also a significant decrease in percentage of time of desaturation to SaO2 < 90% (P = 0.002), < 85% SaO2 (P = 0.003), and <80% SaO2 (P = 0.02) during SIMV vs. IMV. Our preliminary findings indicate that the use of SIMV in a population of VLBW ventilator‐dependent infants (≥14 days of age) results in better oxygenation and decreased episodes of hypoxemia as compared to IMV. © 2005 Wiley‐Liss, Inc.
Solving Virasoro constraints in matrix models
Authors: Alexandrov A. , Mironov A. , Morozov A.
Published: April 2005

This is a brief review of recent progress in constructing solutions to the matrix model Virasoro equations. These equations are parameterized by a degreenpolynomialWn(x), and the general solution is labeled by an arbitrary function ofn− 1 coefficients of the polynomial. We also discuss in this general framework a special class of (multi‐cut) solutions recently studied in the context of 𝒩 = 1 supersymmetric gauge theories.
Higher spin holography and string states on AdS5 × S5
Authors: Morales J.F. , Samtleben H.
Published: April 2005

We review the recent proposal for the full string spectrum on AdS5 × S5 at the higher spin symmetry enhancement point and its agreement with the free SYM spectrum. The spectrum exhibits a hidden symmetry structure larger than expected, with bosonic subgroup SO(10,2) and thirty‐two supercharges. A similar correspondence is found between the spectra on warped AdSd + 1 × S9−d compactifications and d‐dimensional SYM theories.
Topological G2 strings
Authors: de Boer J. , Naqvi A. , Shomer A.
Published: April 2005

We review the recently found map that takes any static and neutral
Kaluza‐Klein black hole, i.e.
any static and neutral black hole on Minkowski‐space times a circle
ℳ︁d × S1, and maps it to a corresponding solution
for
a non‐ and near‐extremal brane on a circle.
This gives a precise connection between phases of Kaluza‐Klein
black holes and the thermodynamic behavior of the
non‐gravitational theories dual to near‐extremal branes on a circle. In
particular, for the thermodynamics of strongly‐coupled
supersymmetric Yang‐Mills theories on a circle we predict the
existence of a new non‐uniform phase and find new information
about the localized phase. We also find evidence for the existence
of a new stable phase of (2,0)
Little String Theory in the canonical ensemble
for temperatures above its Hagedorn temperature.
Three‐loop test of the dilatation operator and integrability in 𝒩 = 4 SYM
Authors: Eden B. , Jarczak C. , Sokatchev E.
Published: April 2005

We report on a three‐loop calculation of the anomalous dimension of the Konishi operator and of the BMN operator of dimension three. Our results confirm the unique form of the 𝒩 = 4 SYM dilatation operator compatible with BMN scaling.
Inhibition of neuronal nitric oxide synthase attenuates the development of morphine tolerance in rats
Authors: Santamarta María Teresa , Ulibarri Isabel , Pineda Joseba
Published: April 2005

Our previous results have shown the involvement of nitric oxide in acute opioid desensitization of μ‐opioid receptors in vitro. In the present study, we investigated the effect of repeated administration of 7‐nitroindazole (7‐NI; 30 mg/kg/12 h, i.p., 3 days), an inhibitor of neuronal nitric oxide synthase in vivo, on μ‐opioid receptor tolerance induced by subchronic treatment with morphine in rats. The inhibitory effect of the opioid agonist Met5‐enkephalin (ME) on the cell firing rate was evaluated by single‐unit extracellular recordings of noradrenergic neurons in the locus coeruleus from brain slices, and the antinociceptive effect of morphine was measured by tail‐flick techniques. In morphine‐treated animals, concentration‐effect curves for ME in the locus coeruleus were shifted by 5‐fold to the right as compared to those in sham‐treated animals, which confirmed the induction of μ‐opioid receptor tolerance. However, tolerance to ME in morphine‐treated rats was fully prevented by co‐administration of 7‐NI when compared to the vehicle‐morphine group. Likewise, the antinociceptive effect of morphine was reduced in morphine‐treated animals as compared to the sham group, whereas the antinociceptive tolerance was partially prevented by co‐administration of 7‐NI in morphine‐treated rats (when compared to the vehicle‐morphine group). Finally, 7‐NI administration in sham‐treated rats failed to change the effect induced by ME on the locus coeruleus or by morphine in the tail‐flick test as compared to vehicle groups. These results demonstrate that subchronic administration of a neuronal inhibitor of nitric oxide synthase attenuates the development of morphine tolerance to the cellular and analgesic effects of μ‐opioid receptor agonists. Synapse 57:38–46, 2005. © 2005 Wiley‐Liss, Inc.
Ultrastructural alterations in hippocampal mossy fiber synapses in schizophrenia: A postmortem morphometric study
Authors: Kolomeets Natalya S. , Orlovskaya Diana D. , Rachmanova Valentina I. , Uranova Natalya A.
Published: April 2005

Synapses formed between mossy fibers, the axons of hippocampal dentate granular cells, and the dendrites of CA3 pyramidal neurons are important links within the trisynaptic circuitry. Abnormalities in this circuitry are associated with the failure of schizophrenics to integrate affective experience with higher cognitive function, and with disturbances in memory and spatial learning processes. The abnormalities include reduced size and altered dendritic arborization of CA3 pyramidal neurons. In addition, decreased expression and binding activity of glutamate receptors have been reported, predominantly in the CA3 region of the hippocampus. These findings suggest that there are disturbed neuronal processes and connections in the hippocampus of schizophrenics. An electron microscope morphometric study of synaptic contacts between mossy fiber axon terminals (MFT) and branched dendritic spines of pyramidal neurons in stratum lucidum of the CA3 region of the hippocampus was performed in 10 normal controls and 9 age‐matched chronic schizophrenics (postmortem delay 3–9 h). Schizophrenic cases with predominantly positive symptoms had a significantly reduced volume fraction of spines (−35%, P < 0.05), total number of invaginated spines (−47%, P < 0.01), and number of spines forming synapses (−32%, P < 0.05) per MFT compared with the control group. No effects of postmortem delay, age, duration of disease, or neuroleptic exposure were found. These data may reflect decreased efficacy of mossy fiber synapses in the CA3 hippocampal region in schizophrenics with predominantly positive symptoms. These data are in line with the neurodevelopmental hypothesis of schizophrenia. Synapse 57:47–55, 2005. © 2005 Wiley‐Liss, Inc.
Ketamine and amphetamine both enhance synaptic transmission in the amygdala–nucleus accumbens pathway but with different time‐courses
Authors: Kessal Karima , Chessel Aline , Spennato Guillaume , Garcia René
Published: April 2005

Excitatory glutamatergic fibers from limbic structures, such as the hippocampus and the basolateral amygdala, are known to converge on the same neurons in the nucleus accumbens. We have recently shown that ketamine, at a dose (25 mg/kg) that produces psychosis‐like behaviors in rats, decreases glutamatergic transmission between the hippocampus and the nucleus accumbens. Here we investigated whether ketamine also affects glutamatergic transmission between the basolateral amygdala and the nucleus accumbens. We also studied the effects of amphetamine (1.5 mg/kg), known to evoke psychosis‐like behaviors in rats. We found that each drug produced a long‐lasting (at least 30 min) potentiation of synaptic efficacy in the projection from the basolateral amygdala to the nucleus accumbens. However, while this synaptic potentiation developed shortly after ketamine injection (within 4 min), it occurred after a 30‐min delay in rats injected with amphetamine. These data reveal, in freely behaving rats, that ketamine has a more rapid and powerful effect on projection targets of the basolateral amygdala than does amphetamine. Synapse 57:61–65, 2005. © 2005 Wiley‐Liss, Inc.
Immunotherapy of human malignancies with immune RNA
Authors: Dekernion Jean B. , Ramming Kenneth P. , Pilch Yosef H.
Published: April 2005

Immune RNA (I‐RNA) is an RNA‐rich nucleic acid preparation extracted from lymphoid cells or tissues following exposure to specific antigens in vitro or sensitization to specific antigens in vivo. It has been shown to induce normal, nonimmune lymphoid cells to mediate specific cellular and humoral immune responses in vitro and in vivo. Previous studies have demonstrated that I‐RNA preparations extracted from the lymphoid organs of animals immunized with tumor cells mediate specific immune responses against tumor associated antigens in both animal models and human tumor systems. Based on this work, preliminary clinical trials of I‐RNA immunotherapy were initiated 3 years ago. Cancer patients were treated with I‐RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. I‐RNA was administered weekly, intradermally, at doses of 4 to 8 mg/week without any significant local or systemic toxicity. The results of these preliminary trials suggest increased survival in patients with metastatic hypernephroma and possible benefit in the form of decreased recurrence rate in the adjuvant immunotherapy of patients with malignant melanoma. A prospectively randomized trial of adjuvant immunotherapy with I‐RNA in patients with Dukes' classes B2 and C colorectal cancer has been recently undertaken.
Studies on the release of extra‐antral gastrin evidence of vagal inhibition in the dog
Authors: Wheeler M. H. , Bhattacherjee S. , Psaila J. V. , McLeish A. R. , Poxom V. , Owens C. , Clendinnen B. G. , Alexander‐Williams J.
Published: April 2005

Serum gastrin concentration was measured in 3 dogs after a meat meal; basal levels rose significantly after 10 minutes. After antrectomy with a Billroth I, and later a Billroth II anastomosis, the tests were repeated. Basal gastrin levels were unchanged but the rise after meat feeding was abolished. Four antrectomized dogs with a BII anastomosis and cannulae in both the duodenum and stomach were used to examine the effect of duodenal perfusion on serum gastrin. Whether the perfusate was 150 mM NaCl, 150 mM HCl or 0.1% acetylcholine, the mean serum gastrin levels did not differ significantly from basal levels. Transthoracic vagotomy in antrectomized dogs produced a significant rise in basal gastrin levels, but did not restore the response to a meat meal or duodenal perfusion.

Parallel studies were conducted in 6 antrectomized, vagotomized patients who had undergone Roux‐en‐Y conversion for postgastrectomy bilious vomiting, and in 2 patients after total gastrectomy. Duodenal perfusion via duodenostomy tubes with 150 mM NaCl, 150 mM HCl, fat emulsion, and an amino acid mixture did not raise serum gastrin above basal levels.

Since meat feeding and duodenal perfusion in antrectomized dogs and humans failed to stimulate a rise in serum gastrin, we conclude that the intestinal phase of gastric secretion is unlikely to be mediated by gastrin. The results following vagotomy in the dog suggest that extragastric basal gastrin release is vagally inhibited or that vagotomy interferes with the catabolic destruction of gastrin.
Upper dorsal sympathectomy for palmar primary hyperhidrosis by the supraclavicular approach
Authors: Kurchin A. , Zweig A. , Adar R. , Mozes M.
Published: April 2005

This report provides a detailed description of the operative technique, anatomical variations, and surgical pitfalls of supraclavicular upper dorsal sympathectomy for palmar hyperhidrosis, based on experience with performance of a simultaneous bilateral operation in 155 patients between 1971 and 1976. The denervation is preganglionic and is confined to removal of T2 and T3 ganglia. Frozen section examination of the specimen is useful in preventing technical failure. Persistent Horner's syndrome occurred in 8% of the patients and is the main complication of the procedure. The advantages of the supraclavicular approach are ease of performing a bilateral procedure, few pulmonary complications because of the extrapleural approach, minimal overall morbidity, and good results in relieving palmar hyperhidrosis.
Saphenous vein loop fistula in the thigh for maintenance hemodialysis
Authors: Kinnaert P. , Vereerstraeten P. , Toussaint C. , Van Geertruyden J.
Published: April 2005

Thirty patients with 31 saphenous vein loop fistulas (SVLF) constructed in the thigh were followed up for 1–31 months. The predicted patency rates for these blood access devices were 75% at 1 year and 43% at 2 years. For 277 patients with direct arteriovenous (A‐V) fistulas located in the forearm (FF), these percentages were 85% and 83%, respectively. There were several differences between the 2 groups, including a higher percentage (84%) of women in the SVLF group than in the FF group (39%,p < 0.0005). In addition, 19% of SVLF patients had polycystic kidney disease, while only 10% of the FF patients suffered from this disease. The incidence of false aneurysms was significantly higher with SVLF (16%) than with FF (2%,p < 0.0005).
Effects of gastric resection and vagotomy on blood and bone mineral content
Authors: Blichert‐Toft Mogens , Beck Anne , Christiansen Claus , Transbøl Ib.
Published: April 2005

This investigation evaluates the effects of the Billroth II and I gastric resections and of vagotomy on blood and bone minerals in comparable groups of male patients with peptic ulcer who had no other potentially demineralizing conditions. The series includes 153 patients divided into 3 subgroups according to the type of gastric operation that had been carried out on an average of 5 years earlier (range 1–10 years).

A definite trend towards hypocalcemia (p < 0.001) and a modest loss of bone mineral as judged by photon absorptiometry (p < 0.05) occurred in the groups subjected to gastric resection, while changes of statistical significance were not observed following vagotomy. Significant hypomagnesemia, hypophosphatemia, or hyperphosphatasia did not occur in any group. The observations in the vagotomy group suggest that the amount of gastric acid secreted may be unimportant for the maintenance of blood and bone mineral normality. We were unable to establish the true nature of the bone disease that follows gastric resection. On the other hand, there was no substantial evidence indicating that osteomalacia was the only disorder involved.

We conclude that in patients without conditions predisposing to disturbed mineral metabolism, none of the surgical procedures evaluated in this study seem to carry an appreciable risk of bone demineralization of clinical importance. With regard to mineral metabolism, vagotomy is preferable to gastric resection.
The value of early surgery and routine operative cholangiography in the management of acute cholecystitis
Authors: Reiss Raphael , Pikelnie Serge , Engelberg Moshe
Published: April 2005

Acute cholecystitis remains one of the most frequent abdominal emergencies, and yet many aspects of its management remain controversial. This prospective study of 182 consecutive operations for acute cholecystitis was conceived to assess the value of early surgery and routine operative cholangiography in the improvement of both immediate and long‐term results.

The patients ranged from 26 to 82 years of age, with about 1/3 of them above 60 years. Gangrenous changes were encountered in 21% of patients, and perforated cholecystitis occurred in 2%. No biliary calculi were found in 6%. Cholecystectomy was performed in all patients. A technically successful operative cholangiography via the cystic duct was performed in 94% of patients. No complications due to cholangiography were encountered, and the procedure was 93% accurate (11 false positives, 0 false negatives). The common bile duct was explored in 48 patients (26%) and found to be diseased in 75% of them. There was one postoperative death (0.5%), caused by sepsis and gastrointestinal bleeding. Clinical and x‐ray follow‐up, ranging from 2–6 years, disclosed 4 residual stones (2%). We conclude that a therapeutic policy combining early surgery with routine operative cholangiography improves results and decreases the incidence of residual ductal abnormalities.
Surgical treatment of malignant melanoma of the skin
Authors: Veronesi Umberto , Cascinelli Natale
Published: April 2005

Surgery is the primary therapeutic modality in the treatment of primary melanomas and metastases to lymph nodes. Surgery also plays an important role in the therapy of locally recurrent tumors and distant metastases in selected cases. Wide excision of the primary tumor in stage I malignant melanoma results in a recurrence rate of about 2%. Surgical techniques for lymph node dissection are the same for melanoma as those performed for other malignancies. There is little question that dissection is necessary in obviously involved nodal areas, but controversy remains regarding the value of lymph node dissection of clinically uninvolved regional nodes. A prospective, randomized study by the World Health Organization has shown no improvement in survival for patients who underwent elective regional node dissection.

Surgery is the treatment of choice when melanoma recurs locally as a single cutaneous or subcutaneous nodule. Surgery may also result in long‐term, disease‐free survival in patients with a solitary distant metastasis after treatment of a primary lesion.
The use of regional chemotherapy in the management of malignant melanoma
Authors: Krementz Edward T. , Carter R. Davilene , Sutherland Carl M. , Campbell Marilyn
Published: April 2005

From 1957 through 1977, a total of 714 patients with malignant melanoma were treated by chemotherapy administered by isolated regional perfusion of the limbs, and 56 patients were treated by intra‐arterial infusion.

Excisional surgery and adjunctive perfusion in 286 patients with stage I disease resulted in cumulative survival rates of 87% at 5 years and 75% at 10 and 15 years. With recurrent or metastatic regional disease treated by perfusion alone or in combination with surgical excision, the survival rates were 36%, 34%, and 31% at 5, 10, and 15 years, respectively. Even in the least favorable group, those with nodal and soft tissue involvement, the survival rates were 27% at 5 years and 22.5% at 10 and 15 years. Analysis of 121 patients with stage I melanoma according to level of dermal invasion showed recurrence in 2 of 42 (4%) patients with level III lesions, 11 of 75 (15%) with level IV tumors, and 2 of 4 (50%) with level V lesions. Recurrence rates by pathologic type were 2 of 49 (4%) patients with superficial spreading melanoma, 6 of 30 (20%) with nodular melanoma, and 5 of 14 (36%) with acral lentiginous melanoma, the latter including subungual, plantar, or palmar lesions.

Chemotherapy by intra‐arterial infusion is a technique useful in treating regional disease not amenable to isolation‐perfusion. Of 36 patients having measurable lesions, there were 4 complete responses. Objective responses occurred in 50–80% of patients treated, depending on the agent used.

As an adjunct to surgical treatment, chemotherapy by isolation‐perfusion offers improved survival rates without prolonged treatment or the risks associated with systemic chemotherapy. As primary therapy for advanced regional disease, chemotherapy by perfusion produces survival rates superior to those obtained by surgery alone or systemic chemotherapy.
The role of immunotherapy in the management of patients with malignant melanoma
Authors: Goodnight James E. , Morton Donald L.
Published: April 2005

Immunotherapy using a variety of agents may be beneficial in controlling accessible cutaneous melanoma metastases and may have potential for limiting the growth of systemic disease when used in the adjuvant setting. Approximately 20% of patients with metastases limited to the skin can be brought into complete remission with local, intralesional BCG immunotherapy. Dinitrochlorobenzene (DNCB), vaccinia virus,C. parvum,and transfer factor have also been tested for activity in local immunotherapy. BCG, DNCB, and vaccinia virus appear to be the most effective. Adjuvant immunotherapy has shown some promise, particularly with regard to improvement in survival. In a study of adjuvant immunotherapy with BCG in patients with stage II disease, recurrence rates were similar, but of those patients who developed recurrences, those who received BCG lived significantly longer. Immunotherapy, used either alone or in combination with chemotherapeutic agents, has shown little or no activity in the treatment of metastatic malignant melanoma.
Combined modality therapy of malignant melanoma
Authors: Hersh Evan M. , Gutterman Jordan U. , McBride Charles M.
Published: April 2005

The major modalities of therapy, namely, surgery, radiotherapy, chemotherapy, and immunotherapy, are each of value in selected cases of malignant melanoma. However, because none of these therapies, alone, is capable of curing or controlling some subgroups of melanoma patients, combined modality therapy needs to be used more extensively. Surgery is of particular value in the treatment of primary tumors and in recurrent or regional metastatic disease. Chemotherapy for malignant melanoma has been disappointing. The most active single agent, DTIC, induces only about a 20% response rate, and little or no significant improvement is seen when DTIC is combined with other agents. However, chemotherapeutic agents when utilized by isolation perfusion in the treatment of primary or recurrent melanoma of the extremities, in conjunction with surgical excision of the primary tumor, produce cure rates of approximately 85% in patients with stage I disease and 50% in those with stage II disease. Immunotherapy appears to be of significant value in primary melanoma, and intra‐lesional BCG immunotherapy of cutaneous or subcutaneous metastatic lesions has yielded a 50% response rate.

Successful combined modality therapy would take into account the natural history and course of the disease. Conventional therapy consists of surgery as primary therapy, followed by chemo‐ or immunotherapy. Further research is needed to determine if better results can be achieved by altering the sequence of utilization of the various treatment modalities.
Diagnostic methods in breast cancer
Authors: Johnsén Christer , Bjurstam Nils
Published: April 2005

The curability of breast cancer can be increased by efforts at early diagnosis using mammography, self‐examination of the breast and periodic examinations in a cancer screening program. We have studied a triple diagnostic approach that combines clinical examination, mammography and fine needle aspiration biopsy in women with breast symptoms and have found that diagnostic accuracy is increased, breast cancer is diagnosed earlier, treatment is better planned, radical surgery is usually possible without preliminary open biopsy, precancerous lesions are detected, high risk groups of patients are identified, and surgical biopsy of benign lesions can be avoided in many patients.
The role of skeletal scintigraphy in detection of metastatic breast cancer
Authors: Galasko C. S. B.
Published: April 2005

The most common site of metastases from breast cancer is the skeleton. Conventional methods of detecting skeletal metastases are not very sensitive. Substantial evidence indicates that skeletal scintigraphy is the most accurate method of demonstrating metastases to bone, particularly in patients with “early” breast cancer who have no manifestations of metastatic disease. In a study of 50 patients with advanced mammary carcinoma, skeletal metastases were demonstrated by scintigram (and later confirmed) in 84%, but by conventional x‐rays in only 50%. More important, in 50 patients with “early” breast cancer who had negative skeletal x‐rays, lesions were found by scintigraphy in 24%. All of these patients developed disseminated carcinoma and 83% of them died within 5 years. In contrast, only 34% of patients with a negative scintigram developed disseminated carcinoma within 5 years.
“Superstaging” in breast cancer—A correlation of lymph node histology and investigations designed to detect occult metastatic disease
Authors: Cant E. L. , Smith A. F. , Sumerling M. D. , Forrest A. P. M.
Published: April 2005

In an effort to detect occult metastases in women with “early” breast cancer and no evidence of metastatic disease by conventional criteria, 50 women with “early” breast cancer were subjected to a battery of tests that included skeletal scintiscanning, liver scintiscanning, and measurements of urinary hydroxyproline, serum alkaline phosphatase of bone origin, serum alkaline phosphatase of liver origin and serum gamma glutamyl transpeptidase. One or more abnormalities suggestive of occult metastatic disease in the skeleton and/or the liver were found in 44% of patients. There was no correlation between positive test results and the finding of positive pectoral lymph nodes (found in 42% of patients). Short‐term follow‐up suggests a correlation between positive test results and development of recurrent disease. It appears that the performance of these tests preoperatively and the histological evaluation of pectoral and axillary lymph nodes are complementary approaches to the staging of breast cancer.