bluuebunny/crossref_metadata_2025 huggingface dataset:
NEW KNOWLEDGE DERIVED FROM LEARNED KNOWLEDGE: FUNCTIONAL‐ANATOMIC CORRELATES OF STIMULUS EQUIVALENCE
Authors: Schlund Michael W. , Hoehn‐Saric Rudolf , Cataldo Michael F.
Published: October 2007

Forming new knowledge based on knowledge established through prior learning is a central feature of higher cognition that is captured in research on stimulus equivalence (SE). Numerous SE investigations show that reinforcing behavior under control of distinct sets of arbitrary conditional relations gives rise to stimulus control by new, derived relations. This investigation examined whether frontal‐subcortical and frontal‐parietal networks known to support reinforced conditional relations also support derived conditional relations. Twelve adult subjects completed matching‐to‐sample (MTS) training with correct/wrong feedback to establish four trained conditional relations within two distinct, three‐member stimulus classes: (1) A1→B1, B1→C1 and (2) A2→B2, B2→C2. Afterwards, functional neuroimaging was performed when MTS trials were presented involving matching two identical circles (a sensorimotor control condition), trained relations (A→B, B→C), and derived relations: symmetry (B→A, C→B), transitivity (A→C), and equivalence (C→A). Conditional responding to trained and derived relations was similarly correlated with bilateral activation in the targeted networks. Comparing trained to derived relations, however, highlighted greater activation in several prefrontal regions, the caudate, thalamus, and putamen, which may represent the effects of extended training or feedback present during imaging. Each derived relation also evidenced a unique activation pattern. Collectively, the findings extend the role of frontal‐subcortical and frontal‐parietal networks to derived conditional relations and suggest that regional involvement varies with the type of derived conditional relation.
Modernization of the API Recommended Practice on Rheology and Hydraulics: Creating Easy Access to Integrated Wellbore Fluids Engineering
Authors: Bern P. A. , Morton E. K. , Zamora M. , May R. , Moran D. , Hemphill T. , Robinson L. , Cooper I. , Shah S. , Flores D. V.
Published: October 2007

Tailoring drilling-fluid hydraulics is one important key to the success of a drilling operation. Failure to do so, can result in costly problems, negatively impact equipment longevity and performance, as well as ultimately jeopardize overall well objectives. In recent years, the industry methods have deviated from American Petroleum Institute (API) RP13D standard practice (2003, 2006). This departure has been driven primarily by the increasingly onerous demands of critical wells, coupled with readily accessible computer power.

In 2003, a task group was formed to modernize the existing API recommended practice (RP) bulletin on rheology and hydraulics. It comprised a cross-functional team of operators, suppliers, and academics that set an aggressive target to modernize the existing standard within 2 years. The focus was to develop simple, yet accurate, methods that could be implemented readily with basic spread-sheeting skills.

This paper describes improvements made to the existing procedures and provides an illustration of how these methods can be applied to complex well designs. The paper also serves to introduce the industry to a modernized API standard that offers an ideal foundation to inform new engineers of the fundamental concepts of hydraulic design and optimization.
Very Large Amounts of Radiation are Required to Produce Cancer
Authors: Brooks Antone L. , Hui T. Edmond , Couch Lezlie A.
Published: October 2007

The public fear of radiation is in part driven by the Linear No Threshold Hypothesis (LNTH), or the concept that each and every ionization increases the risk for cancer. Even if this were true, it is important to recognize that the increased risk is very small at low doses and cannot be detected. This paper demonstrates the large number of assumptions and extrapolations needed when using the LNTH to estimate low-dose cancer risk. The manuscript provides information at every level of biological organization suggesting that many of these linear assumptions do not hold. While the initial damage may be produced linearly with dose, the processing of that damage is very non-linear. Finally, the paper provides the unique prospective on radiation-induced cancer, demonstrating that it takes large amounts (total energy) of radiation delivered to large populations to detect an increase in cancer frequency. These observations are supported by both theoretical calculations and examples based on past human radiation exposure.
The application of tea tree essential oil in dentistry
Authors: Markovic D. , Mirkovic B. , Jovanovic T. , Knezevic A. , Nastovski T.
Published: October 2007

Essential oils are widely used in medicine, dentistry and cosmetology as flavour and odour corrigents in various substances for oral hygiene. The aim of this study was to present comprehensively the possibilities for application of Melaleuca Alternifolia essential oil in dentistry based on the analysis of contemporary scientific and professional publications. The application of Tea tree essential oil in the treatment of periodontal, fungal and viral diseases is very efficient. The study of antimicrobial potential of ten different essential oils confirmed the efficiency of Tea tree oil against numerous Gram+ and Gram- bacteria. In vitro studies of bacteriostatic, bactericidal and fungicidal effect of Tea tree oil solution against ten different microorganisms confirmed sensitivity of the following microorganisms: Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum and Porphyromonas gingivalis, and slightly weaker effect against Streptococcus Mutans and Prevotella intermedia. Tea tree is very effective in the treatment of various diseases and is an introduction and momentum for the application of plant substances in the treatment of numerous diseases in dentistry. .
Middle Turbinate Resection: Issues and Controversies
Authors: Giacchi Renato J. , Lebowitz Richard A. , Jacobs Joseph B.
Published: October 2007

Diversity of opinion continues to exist among otolaryngologists regarding the potential benefits of preservation or resection of the middle turbinate during endoscopic ethmoidectomy. Rhinologists in favor of middle turbinate preservation cite the potential loss of olfactory function as well as diminished humidification and filtration of inspired air following its resection. In addition, the middle turbinate remnant could lateralize, causing frontal recess obstruction and frontal sinusitis. In general, it is accepted that a diseased or flail middle turbinate should be resected during ethmoidectomy to create a marsupialized surgical bed. However, in the case of a structurally sound middle turbinate, indications for resection vary significantly. We are reporting on 100 primary endoscopic ethmoidectomies for chronic rhinosinusitis followed for at least 2 years. Of these 100 sides, 50 included conservative partial middle turbinectomy and 50 were performed with middle turbinate preservation. The postoperative clinical and endoscopic findings revealed no difference in the incidence of frontal sinusitis or frontal recess stenosis between groups. We compared additional data and present our technique of conservative middle turbinate resection, which preserves a portion of this structure as an important anatomic landmark.
Septal Deviation and Chronic Sinus Disease
Authors: Elahi Mohammed M , Frenkiel Saul
Published: October 2007

The introduction of computerized tomography in the identification of sinonasal pathology and associated anatomic variants has contributed to a greater understanding of the factors leading to ostiomeatal complex (OMC) obstruction and chronic sinus disease. The OMC and paranasal sinus regions were prospectively evaluated in 150 consecutive patients as a function of the degree of nasal septal deviation and compared with matched controls. These data were correlated with paranasal sinus disease, lateral nasal wall findings, and middle turbinate abnormalities. An increased incidence and severity of bilateral chronic sinus disease was present with increasing septal deviations (p < 0.05). Similarly, patients with increasing nasal septum deviations were noted to have a higher incidence of OMC obstruction (p < 0.05). Ostiomeatal complex obstruction in the direction of septal angulation was associated with nasal septal deformity; however, contralateral OMC obstruction was associated with middle turbinate and lateral nasal wall abnormalities (p < 0.05). The evaluation of the degree of septal angulation has helped better understand the factors contributing to chronic sinus disease and OMC obstruction.
Correlations among Mucociliary Transport, Ciliary Function, and Ciliary Structure
Authors: Jorissen Mark
Published: October 2007

Mucociliary transport is one of the most important defense mechanisms of the airway. Mucociliary transport time or rate, as measured using the saccharin test or the radioisotope technique, respectively, is clinically the most relevant parameter, although subject to large intra- and interindividual variability. There is no correlation between mucociliary transport in vivo and ciliary beat frequency ex vivo. Preliminary evidence demonstrates that mucociliary transport correlates with ciliary structure and orientation as investigated with transmission and scanning electron microscopy. A correlation is presented between ciliary beat frequency and secondary ciliary abnormalities. This correlation can best be described according to the logistic sigmoid model (r = 0.69). Based on these functional data, an ultrastructural distinction is proposed among normal (less than 5%), light (5 to 15%), moderate (15 to 25%), and severe (more than 25%) secondary ciliary dyskinesia.
Viral-Induced Rhinitis
Authors: Winther Birgit , Gwaltney Jack M. , Mygind Niels , Hendley J. Owen
Published: October 2007

Upper respiratory viruses cause self-limited illness characterized by acute rhinitis. In rhinovirus colds the symptoms are thought to be caused by the host response rather than viral damage of the nasal epithelium. Rhinovirus triggers an inflammatory cascade, evidenced by the presence of inflammatory mediators (e.g., IL-8) and proinflammatory cytokines (e.g., kinins) in nasal secretions, which results in symptomatic illness. In contrast to rhinovirus and coronavirus, which do not cause discernible epithelial damage, influenza virus and adenovirus do damage the nasal epithelium. Appropriate antiviral therapy will depend on the causative virus. Treatment of rhinovirus colds may require an antiviral agent (e.g., interferon a) in combination with antiinflammatory medication.
Nasal Mucosal Endorgan Hyperresponsiveness
Authors: Svensson Christer , Andersson Morgan , Greiff Lennart , Persson Carl G.A.
Published: October 2007

Nonspecific hyperresponsiveness of the upper and lower airways is a well-known characteristic of different inflammatory airway diseases but the underlying mechanisms have not yet been satisfactorily explained. In attempts to elucidate the relation of hyperresponsiveness to disease pathophysiology we have particularly examined the possibility that different airway endorgans may alter their function in allergic airway disease. The nose, in contrast to the bronchi, is an accessible part of the airways where in vivo studies of airway mucosal processes can be carried out in humans under controlled conditions. Different endorgans can be defined in the airway mucosa: subepithelial microvessels, epithelium, glands, and sensory nerves. Techniques may be applied further in the nose to determine selectively the responses/function of these endorgans. Topical challenge with methacholine will induce a glandular secretory response, and topical capsaicin activates sensory c-fibers and induces nasal smart. Topical histamine induces extravasation of plasma from the subepithelial microvessels. The plasma exudate first floods the lamina propria and then moves up between epithelial cells into the airway lumen. This occurs without any changes in the ultrastructure or barrier function of the epithelium. We have therefore forwarded the view of mucosal exudation of bulk plasma as a physiological airway tissue response with primarily a defense function. Since the exudation is specific to inflammation, we have also suggested mucosal exudation as a major inflammatory response among airway endorgan functions. Using a “nasal pool” device for concomitant provocation with histamine and lavage of the nasal mucosa we have assessed exudative responses by analyzing the levels of plasma proteins (e.g., albumin, α2-macroglobulin) in the returned lavage fluids. A secretory hyperresponsiveness occurs in both experimental and seasonal allergic rhinitis. This type of nasal hyperreactivity may develop already 30 minutes after allergen challenge. It is attenuated by topical steroids and oral antihistamines. We have demonstrated that exudative hyperresponsiveness develops in both seasonal allergic rhinitis and common cold, indicating significant changes of this important microvascular response in these diseases. An attractive hypothesis to explain airway hyperresponsiveness has been increased mucosal absorption permeability due to epithelial damage, possibly secondary to the release of eosinophil products. However, neither nonspecific nor specific endorgan hyperresponsiveness in allergic airways may be explained by epithelial fragility or damage since nasal absorption permeability (measured with 51Cr-EDTA and dDAVP) was decreased or unchanged in our studies of allergic and virus-induced rhinitis, respectively. Thus, the absorption barrier of the airway mucosa may become functionally tighter in chronic eosinophilic inflammation.
Neuropeptides
Authors: Baraniuk James N.
Published: October 2007

Sensory, parasympathetic, and sympathetic nerves innervate many structures in airways. The anatomy, histology, and function of these nerves and their varied neurotransmitters will be reviewed. Changes that may contribute to the pathophysiology of allergic, viral, and nonallergic rhinitis will be described.
Noninfectious, Nonallergic Rhinitis (NINAR): Considerations on Possible Mechanisms
Authors: Sanico Alvin , Togias Alkis
Published: October 2007

Most patients who suffer from chronic noninfectious, nonallergic rhinitis (NINAR) cannot be assigned to a syndrome of known etiology. The symptomatology may well resemble that of allergic rhinitis; however, NINAR has lower prevalence of sneezing, conjunctival symptoms, and pruritus and higher prevalence of symptoms compatible with sinus disease. The triggers for the symptoms of NINAR are mainly irritants and changes in atmospheric conditions. Among individuals who develop chronic rhinitis symptoms, the percentage of nonallergic etiology increases steadily with age and is more than 60% beyond the fifth decade of life. Our strategy regarding the pathophysiology of NINAR should be to identify functional abnormalities of nasal mucosa that can potentially result in the alleged nasal symptoms. In this respect, comparison of patients with NINAR to patients with allergic rhinitis and to healthy individuals could shed light into the cause(s) of NINAR. Three potential functional abnormalities are discussed in this article: those associated with the aging process of the nasal mucosa, those resulting in various forms of nasal hyperreactivity, and those reflecting imbalanced neuronal control of end organs of the nose. The most interesting development in the therapy of NINAR is the use of capsaicin. Although placebo-controlled studies are scarce and participants have not been adequately characterized, it is possible that abnormal nociceptor nerve endings play a role in the generation of the symptoms of NINAR. Alternatively, NINAR may represent a condition of increased perceptual acuity to irritants and to environmental changes. This problem may also benefit from defunctionalization of nociceptors.
Nasal Polyps and Their Relation to Polyps/Hypertrophic Polypoid Mucosa in the Paranasal Sinuses: A Macro-, Endo-, and Microscopic Study of Autopsy Materials
Authors: Larsen Per L. , Tingsgaard Peter K. , Harcourt Jonathan , Sofsrud Gitte , Tos Mirko
Published: October 2007

The present study comprised macro- and endoscopic screening of the nasosinusal complex in 56 autopsies, 24 with nasal polyps and 32 without. Seven had nasal polyposis (bilaterally more than two). Hypertrophic polypoid mucosa in the paranasal sinuses was not found in the cases with nasal polyposis and in only 2 (4%) of the total number (24) of cases with polyps. Microscopic examination of nine small polyps, the mucosa from which they originated, and control specimens showed accumulation of eosinophils in the mucosa from which the polyps originated, indicating localized inflammation.
Induction in Vivo of Cartilage Grafts for Craniofacial Reconstruction
Authors: Verwoerd-Verhoef Henriette L. , Bean Jim K. , Van Osch Gerjo J.V.M. , Ten Koppel Paul G.J. , Meeuwis Jaap A. , Verwoerd Caret D.A.
Published: October 2007

In the craniofacial region, defects of cartilage structures are preferably reconstructed with autologous cartilage. Donor-site morbidity related to the creation of a new defect elsewhere, and a lack of growth potential of the graft—mandatory in children—have stimulated investigators to find other ways to generate new “extra” cartilage. Several biomaterials have been tested as a matrix for the ingrowth of (peri)chondroblasts in experimental animals. In young (growing) rabbits we have developed a process of heterotopic cartilage induction with the use of a demineralized (bovine) bone matrix which is enfolded in a pedicled flap of ear perichondrium for at least three weeks. During this period the demineralized matrix is colonized by macrophages and polymorphonuclear cells which start a process of complete biodegradation of the material. Simultaneously, the collagen matrix is invaded by mesenchymal cells, originating from the perichondrium and differentiating into chondroblasts and later, into chondrocytes forming the intercellular substance. The developing, very young cartilage could be demonstrated as collagen type II, thus, hyaline cartilage. When applied with its adherent perichondrium as a graft, it merges easily with the more matured host cartilage and even appears to be capable of further growth. Therefore, it seems suitable for the reconstruction of a cartilaginous defect in growing cartilaginous structures like the nasal septum or the larynx.
Adenoid Cystic Carcinoma of the Paranasal Sinuses
Authors: Naficy Saman , Disher Michael J. , Esclamado Ramon M.
Published: October 2007

Adenoid cystic carcinoma of the paranasal sinuses is a rare neoplasm whose propensity for perineural spread frequently results in positive surgical margins at the skull base. Radiation therapy (RT) may be used to treat unresectable tumors or as an adjuvant for positive surgical margins after attempted resection. A retrospective review of the experience at the University of Michigan Medical Center was undertaken to study the factors influencing survival and to compare the efficacy of RT alone versus as an adjuvant treatment to surgical resection. All patients selected for review (n = 17) had a histologically confirmed diagnosis of adenoid cystic carcinoma arising from the paranasal sinuses with an average follow-up of 6 years. The choice of treatment modality was based upon the resectability of the tumor by clinical and radiologic parameters. This was therefore not a randomized study and there was a clear bias against the radiation only group, which contained the more advanced and locally aggressive tumors. The 6-year survival for the combined surgery + RT group was 73% compared with 50% for the radiation only group (p = NS). The overall local recurrence rate was 76% and the rate of distant metastases was 18%. Of the 10 patients who underwent surgical resection eight (80%) had positive surgical margins at the skull base.
A Treatment Algorithm for the Management of Epistaxis in Hereditary Hemorrhagic Telangiectasia
Authors: Lund Valerie J. , Howard David J.
Published: October 2007

We examined the management options used for epistaxis of varying severity in patients with hereditary hemorrhagic telangiectasia (HHT) to develop a treatment algorithm. Fifty patients with HHT were studied from 1991 to 1997 to consider various treatment options and their relative efficacy. There were 28 females and 22 men; their ages ranged from 15 to 85. Follow-up ranged from 6 months to 6 years. A wide variety of treatments had been used (including various forms of cautery, septal surgery, topical and systemic hormones, antifibrinolytic therapy, arterial ligation, laser therapy, and closure of the nostrils). Treatments used during the follow-up period were argon laser therapy (40), systemic estrogen or progesterone (17), septodermoplasty (12), or closure of the nostrils (14). Patients were divided into those with mild to moderate disease (requiring one or no blood transfusions during the course of their illness) and those with severe disease (requiring more than one blood transfusion). Using this broad categorization, those with mild to moderate disease did well with sequential argon laser therapy with or without the adjunct of septodermoplasty or hormone therapy. Those with severe disease did not find argon laser therapy beneficial but found their epistaxis completely stopped with closure of the nasal cavities. Based on these findings, a simple treatment algorithm defines the optimum treatment options for epistaxis in this difficult-to-treat group of patients.
The Forgotten Turbinate: The Role of the Superior Turbinate in Endoscopic Sinus Surgery
Authors: Orlandi Richard R. , Lanza Donald C. , Bolger William E. , Clerico Dean M. , Kennedy David W.
Published: October 2007

The fate of the middle turbinate in endoscopic sinus surgery has been a subject of debate for some time. The superior turbinate's role, however, has been largely passed over. Past anatomic descriptions and illustrations have given surgeons the incorrect impression that this structure is well superior and out of the field of dissection. Injury to the superior turbinate may account for postoperative hyposmia. The superior turbinate also serves as a constant landmark for the sphenoethmoidal recess, and a limited resection allows the surgeon to identify and include the natural ostium of the sphenoid sinus in the sphenoidotomy. The embryology and anatomy of the superior turbinate are reviewed. An approach to the natural ostium of the sphenoid sinus from the lateral side of the middle turbinate, using the superior turbinate as a guide, is described.
Post-Functional Endoscopic Sinus Surgery Methicillin-Resistant Staphylococcus aureus Sinusitis
Authors: Jiang Rong-San , Jang Jinq-Wen , Hsu Chen-Yi
Published: October 2007

Methicillin-resistant Staphylococcus aureus (MRSA) is a highly virulent bacterium that is difficult to eradicate. It has become a common nosocomial pathogen, but it also causes sporadic infections in some outpatients. Among 358 chronic sinusitis patients who received functional endoscopic sinus surgery (FESS) for treatment between July 1995 and June 1997 in our department, 18 were infected postoperatively by MRSA by the end of August 1997. One patient was excluded because she received another nasal surgery, partial turbinectomy, and submucous resection of the nasal septum, after FESS. Most of 17 MRSA infected patients presented themselves with mucopurulent nasal discharge and/or nasal crust. The treatment was generally difficult because MRSAs were resistant to multiple antibiotics. When quinolone antibiotics were used to treat most patients, the improvement rate was 76.5%. We conclude that MRSA infections in post-FESS patients might affect the outcome of FESS.
Sinus Surgery in Bone Marrow Transplantation Patients
Authors: Sterman Bruce M.
Published: October 2007

Bone marrow transplantation (BMT) is used in the treatment of a wide range of malignancies. It involves immunosuppression and increased risk of infections such as sinusitis. However, the risk of infection is much higher in allogeneic transplants than those who are replaced with their own bone marrow (autologous). Immunodeficient patients may develop fungal sinusitis with a high mortality rate. An aggressive approach to evaluation and surgical intervention for fungal sinusitis in BMT patients at the Indiana University Medical Center was used for 2 years (from 1991 through 1992). This approach encouraged surgery on any BMT patient who was clinically septic or had any changes on a sinus CT scan. In 1993, a more medically oriented approach with radiologic and nasal endoscopic monitoring was adopted. During 1991 to 1992, 12 of the 21 allogeneic transplant patients (57%) who had sinus surgery died. The four autologous BMT patients operated on during this period all survived. Three allogeneic transplant recipients had surgery in 1993 and survived. No autologous cases had sinus procedures in 1993. No fungal sinus infection occurred in any BMT patient during the 3-year review. Careful patient selection, evaluation, and preventative measures can be successful in dealing with this rare but potentially fatal complication without performing unnecessary surgery on patients who have a poor prognosis unrelated to their sinuses.
Reproducibility of Acoustic Rhinometry and Rhinomanometry in Normal Subjects
Authors: Silkoff Philip E. , Chakravorty Shobha , Chapnik Jerry , Cole Philip , Zamel Noe
Published: October 2007

The reproducibility of nasal patency measurements was assessed by acoustic rhinometry and active rhinomanometry using previously described Toronto methodologies. Six subjects with normal upper airways were tested with both procedures on six separate occasions within a 2-month period. Topical decongestant was applied to minimize the effects of mucosal variation on the nasal airway. The mean coefficients of variation (mean ± s.d; %) over time of the measurements were 8.1 ± 4.1 and 9.7 ± 5.2 for minimal unilateral cross-sectional area and 4.8 ± 1.8 and 5.5 ± 3.5 for nasal volume (0–5 cm) of the right and left sides, respectively. For active rhinomanometry, the mean coefficients of variation (mean ± s.d.; %) over time of the measurements were 15.9 ± 7.3, 12.9 ± 4.6, and 8.5 ± 2.8 for right, left and combined nasal airflow resistance. The intraclass correlation coefficient was 0.76, 0.70, and 0.96 for right, left, and combined nasal resistance, 0.91 and 0.87 for right and left minimal cross sectional area, and 0.86 and 0.69 for right and left nasal volumes, respectively, also confirming a high level of reproducibility for both methods. In conclusion, performed by an experienced operator under controlled circumstances, the reproducibility of both methods of nasal patency assessment compared favorably with many widely accepted clinical tests.
Accuracy of Measurement of Acoustic Rhinometry Applied to Small Experimental Animals
Authors: Kaise Toshihiko , Ukai Kotaro , Pedersen Ole F. , Sakakura Yasuo
Published: October 2007

Nasal obstruction is one of the major symptoms of allergic rhinitis. In the study of the mechanism of nasal obstruction, experiments on animal are useful. In adult humans, acoustic rhinometry has been used to evaluate nasal obstruction by determining nasal cavity dimensions in terms of cross-sectional areas as a function of the distance from the nostril. We modified the equipment used on humans to assess dimensions of nasal airway geometry of small experimental animals. The purpose of this study was to investigate the accuracy of measurement of the modified acoustic rhinometry applied to small experimental animals using nasal cavity models and guinea pigs. Measurement of the nasal cavity models (made of cylindrical silicone tubes) showed that the acoustic rhinometry estimated 85.5% of actual area and 79.0% of actual volume. In guinea pigs, nasal cavity volume determined by the acoustic rhinometry was 73.7 ± 20.0% of actual volume. The actual volume was estimated by impression material instilled into the nasal cavity of the animals (IM volume), and volume determined by acoustic rhinometry significantly correlated with IM volume. Furthermore, there was a significant negative correlation between the volume and nasal airway resistance in guinea pigs. Measurement of the nasal airway resistance is the method frequently used in the evaluation of the nasal obstruction in guinea pigs. These results suggest that acoustic rhinometry is useful in evaluating nasal obstruction in small experimental animals.
Endoscopic Resection of Fibro-Osseous Lesions of the Paranasal Sinuses
Authors: Brodish Brian N. , Morgan Charles E. , Sillers Michael J.
Published: October 2007

Fibro-osseous tumors, including osteomas, ossifying fibro-mas, and fibrous dysplasia, are not uncommon benign lesions arising in the paranasal sinuses. Conventional wisdom advocates resection when these lesions are symptomatic, or when they exhibit rapid growth. Traditionally, resection has been performed via a variety of open approaches. With the advent of sinonasal endoscopy in the mid 1980s, and subsequent advances in technology and surgical techniques, endoscopic management of some of these lesions is now feasible. To date, a search of the literature reveals only three case reports of osteomas resected with endoscopic guidance. We present a series of 10 symptomatic fibro-osseous lesions (nine osteomas and one fibrous dysplasia) occurring in nine patients in which endoscopic techniques were used. Nine ethmoid and frontal recess osteomas were resected transnasally and one sphenoid sinus fibrous dysplasia was resected using a transseptal transsphenoidal approach with endoscopic visualization. There were two anticipated CSF leaks, which were recognized and repaired at the time of surgery. There were no other complications and no tumor recurrence. All patients noted improvement in preoperative symptoms. We discuss patient selection, operative techniques and strategies, and the advantages and disadvantages of the endoscopic approach in the management of paranasal sinus fibro-osseous lesions.
The Role of the Crista Ethmoidalis in Endoscopic Sphenopalatine Artery Ligation
Authors: Bolger William E. , Borgie Roderick C. , Melder Patrick
Published: October 2007

Posterior epistaxis is a significant medical problem that can be challenging to treat. Endoscopic surgery could potentially reduced operative time and patient risk; however, surgeons report difficulty in endoscopically isolating the major offending artery, the sphenopalatine. These difficulties could be reduced if a recognizable anatomic structure marked the region of the artery. The study objective is to characterize the relationship of a relatively unknown anatomic structure, the crista ethmoidalis, to the sphenopalatine foramen/artery, in an effort to facilitate location of the sphenopalatine artery during endoscopic ligation. Using 22 human cadaveric sagitally sectioned heads and standard gross anatomic dissection techniques, the presence of the crista ethmoidalis was sought and recorded as well as its relative location to the sphenopalatine foramen/artery. The crista ethmoidalis was present and closely related to the sphenopalatine foramen and artery in all specimens. In 21/22 specimens, the crista was located just anterior to the sphenopalatine foramen, whereas in one specimen it was located 3 mm directly inferior to the foramen. Our investigation indicates that the crista ethmoidalis is a helpful and reliable landmark for endoscopically locating the sphenopalatine artery and foramen. Using this landmark, the initial problems reported with endoscopic ligation, i.e., locating the foramen and artery, should be greatly reduced. We offer our observations regarding the crista ethmoidalis to assist endoscopic surgeons in the care of their difficult epistaxis patients.
2007 Presidential Address—The End(s) of Testing
Authors: Baker Eva L.
Published: October 2007

This expanded version of the 2007 Presidential Address for the American Educational Research Association approaches changes in assessment and accountability from the perspective of achieving balance. The author identifies unresolved conceptual and practical issues in the use of assessment in the schools and describes approaches intended to mitigate problems or improve practice. An example is given from formative assessment research that integrates some of these approaches (Center for Research on Evaluation, Standards, and Student Testing, at the University of California, Los Angeles). International examples of performance and assessment are also reviewed. The author suggests that secondary school assessment be modified to focus students on acquiring concrete Qualifications that certify important accomplishments, with a wide choice of Qualification areas. She argues that using concrete accomplishments and restructuring tests will help schools and their students to regain needed balance.
Effects of perindopril in hypertensive patients with or without type 2 diabetes mellitus, and with altered insulin sensitivity
Authors: Marre Michel , Leye Abdoulaye
Published: October 2007

Impaired insulin sensitivity and hypertension are risk factors for atherosclerosis, which in turn leads to a variety of cardiovascular diseases. In both conditions, the risks of morbidity and mortality appear to be further increased. Impaired insulin sensitivity is also a precursor for diabetes. The renin-angiotensin-aldosterone system (RAAS) is implicated in the development of both hypertension and insulin resistance. Antihypertensive agents that act by blocking the RAAS, such as angiotensin-con-verting enzyme (ACE) inhibitors, may improve insulin sensitivity and therefore prevent the deleterious consequences of insulin resistance, including type 2 diabetes. ACE inhibitors appear to improve insulin sensitivity in patients with hypertension and insulin resistance, including diabetes. This review assesses the literature surrounding the use of the ACE inhibitor perindopril in patients with hypertension and varying degrees of insulin resistance, including the effects of perindopril in preventing the development of diabetes and subsequent cardiovascular morbidity and mortality.
Improvement of postprandial lipid handling and glucose tolerance in a non-diabetic population by the dual PPARα/γ agonist, tesaglitazar
Authors: Fagerberg Bjorn , Schuster Herbert , Birketvedt Grethe Støa , Tonstad Serena , Öhman Karl Peter , Gause-Nilsson Ingrid
Published: October 2007

This study examined the effect of tesaglitazar (GALIDATM), a dual peroxisome proliferator-activated receptor (PPAR)α/γ agonist, on postprandial metabolism.

This investigation was part of the Study in Insulin Resistance (SIR) (SH-SBT-0001), a randomised, double-blind, placebo-controlled study that reported improvements in fasting lipid and glucose values with tesaglitazar (0.1, 0.25, 0.5 or 1 mg once daily for 12 weeks) in hypertriglyceridaemic, abdominally obese, non-diabetic patients. A subgroup of 222 patients underwent postprandial lipid and glucose testing at baseline and treatment end.

Tesaglitazar 0.25, 0.5 and 1 mg reduced postprandial area under the curve (AUC) for triglycerides by 20% (p=0.003), 30% (p<0.0001) and 41% (p<0.0001), respectively. Free fatty acid (FFA) levels were reduced by 17% with tesaglitazar 0.5 mg (p=0.002) and by 29% with tesaglitazar 1 mg (p<0.0001). Tesaglitazar significantly improved glucose tolerance and increased the proportion of patients with normal glucose tolerance as measured by the oral glucose tolerance test (OGTT).

To conclude, postprandial dyslipidaemia and hyper-glycaemia, indicators of increased vascular risk, were significantly improved by tesaglitazar treatment in these non-diabetic, hypertriglyceridaemic, abdominally obese subjects.
A double-blind, randomised trial of tesaglitazar versus pioglitazone in patients with type 2 diabetes mellitus
Authors: Bays Harold , McElhattan Jennifer , Bryzinski Brian S
Published: October 2007

The efficacy and safety of tesaglitazar (0.5 and 1 mg) and pioglitazone (15, 30 and 45 mg) were compared in a 24-week, randomised, double-blind study in 1, 707 patients with type 2 diabetes mellitus.

Tesaglitazar 1 mg was non-inferior to pioglitazone 45 mg for change from baseline in glycosylated haemoglobin (HbA1C) at 24 weeks (difference: −0.056 [95% confidence intervals −0.161, 0.049], pNI<0.001 for non-inferiority hypothesis). Tesaglitazar 1 mg improved triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and non-HDL-C levels compared with all pioglitazone doses at 24 weeks (p<0.001). Low-density lipoprotein cholesterol (LDL-C) was lower with tesaglitazar for all pioglitazone comparisons (p<0.05), except for tesaglitazar 0.5 mg versus pioglitazone 15 mg. Tesaglitazar 1 mg decreased LDL particle number, when compared with all pioglitazone doses (p<0.01). Both agents increased body weight and peripheral oedema in a dose-dependent manner, but only tesaglitazar increased serum creatinine.

In summary, tesaglitazar provided similar glycaemic control to pioglitazone, was associated with significant improvement in lipid and lipoprotein variables, and increased serum creatinine in a dose-dependent manner.
Efficacy, safety and tolerability of tesaglitazar when added to the therapeutic regimen of poorly controlled insulin-treated patients with type 2 diabetes
Authors: Ratner Robert E , Parikh Shamik , Tou Conrad
Published: October 2007

This randomised, double-blind, parallel-group study assessed the effects of addition of the dual peroxisome proliferator-activated receptor (PPAR) α/γ agonist, tesaglitazar, for 24 weeks to the therapeutic regimen of 392 poorly controlled (glycosylated haemoglobin [HbA1C] 7.5-10%) insulin-treated, type 2 diabetes patients.

At 24 weeks, tesaglitazar 0.5 mg resulted in a 0.66% (95% confidence intervals: −0.85, −0.47; p<0.0001) reduction from baseline in HbA1C, and reduced fasting plasma glucose (p<0.0001) and daily insulin dose (p=0.014) versus placebo. After 24 weeks, tesaglitazar caused greater improvements from baseline in triglyc-erides (p<0.0001), high-density lipoprotein cholesterol (HDL-C) (p<0.001), non-HDL-C (p<0.05), apolipopro-tein (apo)A-I (p<0.05) and apoB levels (p<0.01) than placebo. Tesaglitazar was generally well tolerated but was associated with a greater increase in serum creatinine level than placebo.

The clinical development of tesaglitazar is no longer continuing; its effects on the glucose and lipid abnormalities of type 2 diabetes suggest that the concept of dual PPARα/γ agonism is worthy of further investigation.
Effect of glucose-insulin-potassium (GIK) infusion on biomarkers of cardiovascular risk in ST elevation myocardial infarction (STEMI): insight into the failure of GIK
Authors: Parikh Shailja V , Abdullah Shuaib M , Keeley Ellen C , Cigarroa Joaquin E , Addo Tayo A , Warner John J , Khera Amit , De Lemos James A , McGuire Darren K
Published: October 2007

Glucose-insulin-potassium (GIK) infusion favourably affects several biomarkers associated with risk in the setting of myocardial infarction (MI). In the context of a recent trial demonstrating no benefit of GIK, we assessed the impact of GIK on inflammation, neurohormonal activation and myonecrosis in ST elevation myocardial infarction (STEMI).

In a local substudy of an international randomised trial, 25 patients with STEMI were randomised to receive a 24-hour infusion of GIK vs. no GIK. C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) were assayed at baseline and at 24 hours.

The two groups were well matched for baseline characteristics and infarct location. There were no statistically significant differences at baseline or at 24 hours in levels of hs-CRP, NT-proBNP or cTnT, with similar and significant increases in all three biomarkers by 24 hours in both groups.

In conclusion, GIK had no discernible effect on biomarkers associated with inflammation, neurohormonal activation or myonecrosis, three pathways associated with adverse outcomes in STEMI.
Long-term effects of pioglitazone versus gliclazide on hepatic and humoral coagulation factors in patients with type 2 diabetes
Authors: Perriello Gabriele , Pampanelli Simone , Brunetti Paolo , Pietro Cinzia Di , Mariz Segundo
Published: October 2007

This study compared the long-term effects of pioglitazone and gliclazide on the production of coagulation factors in patients with type 2 diabetes. Patients (n=283) with glycosylated haemoglobin > 7.5% were randomised to receive either pioglitazone (30–45 mg/day) or gliclazide (80–320 mg/day) for one year. Coagulation factors were measured at baseline and at six and 12 months. While both pioglitazone and gliclazide induced a comparable improvement in glycaemic control, only pioglitazone improved insulin sensitivity. Pioglitazone significantly (p<0.001) decreased circulating levels of von Willebrand factor (-9.7%, −9.4%) and plasminogen activator inhibitor-1 (-16.8 ng/ml, −12.3 ng/ml), and increased levels of antithrombin-III (+1.3 mg/dL, +1.5 mg/dL) after six and 12 months, respectively. The beneficial effects of pioglitazone on glycaemic control, lipid homeostasis, and coagulation and thrombosis, may improve vascular outcomes in patients with type 2 diabetes.
Association of the T54 allele of the FABP2 gene with cardiovascular risk factors in obese Mexican subjects
Authors: Martínez-López Erika , Ruíz-Madrigal Bertha , Hernández-Cañaveral Iván , Panduro Arturo
Published: October 2007

Genetic predisposition to cardiovascular risk may vary between different ethnic groups. We studied the effect of the FABP2 A54T polymorphism on biochemical and anthropometric cardiovascular risk factors in 114 obese Mexican subjects. The mean age of the patients studied was 36.8±13.3 years. Insulin resistance was present in 47%, hypercholesterolaemia in 49% and hyper-triglyceridaemia in 45%.

Frequency of the FABP2 genotype was 39% AA, 54.8% AT and 6.2% TT. The AT/TT group showed an increase in body mass index (34±7.1 vs. 31±4.8 kg/m2), waist circumference (101±15.7 vs. 96.5±15.8 cm), triglycerides (145±60.8 vs. 127±79.4 mg/dL; 1.64±0.67 vs. 1.43±0.89 mmol/L), total cholesterol (176±39.4 vs. 164±38.2 mg/dL; 4.55±1.02 vs. 4.24±0.99 mmol/L), LDL (121±24.2 vs. 111±25.9 mg/dL; 3.13±0.62 vs. 2.88±0.67 mmol/L) and VLDL (28.8±12.1 vs. 25.1±16.1 mg/dL; 0.74±0.31 vs. 0.64±0.41 mmol/L) compared to the AA group (p<0.05). The AT/TT group had greatly increased cardiovascular risk, with an OR of 7.56 (95% CI, 1.82-36.24; p<0.001) compared to the AA group. Our results suggest that A54T polymorphism of the FABP2 gene is associated with cardiovascular disease risk in obese subjects.
Efficacy and tolerability of candesartan cilexetil/hydrochlorothiazide and amlodipine in patients with poorly controlled mild-to-moderate essential hypertension
Authors: Fogari Roberto , Mugellini Amedeo , Derosa Giuseppe
Published: October 2007

The antihypertensive efficacy and tolerability of combination therapy with candesartan cilexetil, 16 mg plus hydrochlorothiazide (CC/HCTZ), 12.5 mg was compared with that of amlodipine, in a multicentre, double-blind, randomised, parallel-group study in patients with mild-to-moderate essential hypertension inadequately controlled by monotherapy.After a two week run-in period on existing therapy, patients with a sitting diastolic blood pressure (DBP) of 90—110 mmHg and a sitting systolic blood pressure (SBP) < 180 mmHg were switched to either CC/HCTZ (n=101) or amlodipine (n=102), once-daily by mouth. After eight weeks of AA treatment, both regimens reduced mean trough blood pressure (BP) by a similar amount: mean sitting SBP/DBP reductions were -15.4/-11.9 mmHg for CC/HCTZ, and -15.7/-12.0 mmHg for amlodipine (group differences, p=0.835/0.963). The BP of 84.2% of patients on CC/HCTZ and 84.5% on amlodipine was controlled (sitting DBP < 90 mmHg and sitting SBP < 140 mmHg) (p=1.00). Six (5.9%) patients on CC/HCTZ and 18 (17.6%) on amlodipine discontinued treatment, including one (1% O ) and 12 (11.8%) owing to ad C verse events R (p<0.001).The most common adverse event was peripheral oedema, which occurred in two patients on CC/HCTZ and 19 on amlodipine. In conclusion, CC/HCTZ and amlodipine were equally effective in reducing BP in hypertensive patients not controlled by monotherapy, but CC/HCTZ was much better tolerated.Tolerance is an important clinical consideration in the chronic treatment of an asymptomatic disease.
An adaptive controller–observer scheme for temperature control of non‐chain reactions in batch reactors
Authors: Caccavale F. , Iamarino M. , Pierri F. , Tufano V.
Published: September 2007

In this paper an adaptive controller–observer temperature control scheme is developed for a class of irreversible non‐chain reactions taking place in batch reactors. The scheme is based on a nonlinear observer for the estimation of the heat released by the reaction, where the heat transfer coefficient is adaptively estimated. Tracking of the desired reactor temperature is achievedviaa two‐loop control scheme, where an independent adaptive estimate of the heat transfer coefficient is used as well. Remarkably, the observer and the controller can be designed and tuned separately. The convergence of both the nonlinear observer and of the overall controller–observer scheme is analyzed by resorting to a Lyapunov‐like argument. A comparative simulation case study is developed to test the performance of the proposed scheme and compare it with other approaches already known in the literature. Copyright © 2007 John Wiley & Sons, Ltd.
Review and evaluation of the approximations to the temperature integral
Authors: Órfão José J. M.
Published: September 2007

The kinetics of processes involving solids may be determined from experiments under non‐isothermal conditions. On analyzing data by integral methods, it is necessary to calculate the temperature integral, which does not have an analytical solution. Instead of performing the numerical integration, most of the researchers prefer to circumvent the problem by using approximate expressions, not always adequate. The widespread use of inaccurate approximations does not contribute to a coherent growth of scientific knowledge. In the present article, a critical review of the known approximations is carried out and a clear ranking is established. Moreover, the deviations of the calculated activation energies relatively to the numerical solution are discussed, and some recommendations are proposed. Namely, it is shown that a “novel” expression, previously presented in another form in the well known “Handbook of Mathematical Functions”, approximates very accurately the temperature integral and allows to obtain correct values of the activation energy. © 2007 American Institute of Chemical Engineers AIChE J, 2007
Large and rapid temperature reduction of organic solutions with subcritical CO2
Authors: Dalvi Sameer V. , Mukhopadhyay Mamata
Published: September 2007

The production of ultra‐fine solid particles with narrow size distribution requires creation of a very large, rapid, and uniform supersaturation in the solution of the solid substance. This is facilitated by a rapid, uniform, and large reduction of the solid solubility in the solution and can be achieved either by drastically reducing the temperature of solution or by drastically increasing the CO2 solubility for achieving the antisolvent effect. As these processes have some disadvantages, a simple technique is reported in this work for imparting the large, uniform, and rapid reduction of temperature in the solution for the required supersaturation. This entails pressure reduction over the gas‐expanded liquids utilizing subcritical CO2 at a relatively low pressure in the range of 40–70 bar and near ambient temperature of 303 K for creating a temperature drop of 30–70 K in the solution within seconds. The present article enunciates the principle of this new technique and analyses the effects of various process parameters on the reduction of temperature of the CO2‐expanded organic solutions. © 2007 American Institute of Chemical Engineers AIChE J, 2007