bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of normal and osteoarthritic canine cartilage mRNA expression by quantitative polymerase chain reaction
Authors: Clements Dylan N , Carter Stuart D , Innes John F , Ollier William ER , Day Philip JR
Published: October 2006

The molecular basis to mammalian osteoarthritis (OA) is unknown. We hypothesised that the expression of selected proteases, matrix molecules, and collagens believed to have a role in the pathogenesis of OA would be changed in naturally occurring canine OA cartilage when compared to normal articular cartilage. Quantitative (real-time) reverse transcriptase-polymerase chain reaction assays were designed measuring the expression of selected matrix molecules (collagens and small leucine-rich proteoglycans), key mediators of the proteolytic degradation of articular cartilage (metalloproteinases, cathepsins), and their inhibitors (tissue inhibitors of matrix metalloproteinases). All data were normalised using a geometric mean of three housekeeping genes, and the results subjected to power calculations and corrections for multiple hypothesis testing. We detected increases in the expression of BGN, COL1A2, COL2A1, COL3A1, COL5A1, CSPG2, CTSB, CTSD, LUM, MMP13, TIMP1, and TNC in naturally occurring canine OA. The expression of TIMP2 and TIMP4 was significantly reduced in canine OA cartilage. The patterns of gene expression change observed in naturally occurring canine OA were similar to those reported in naturally occurring human OA and experimental canine OA. We conclude that the expression profiles of matrix-associated molecules in end-stage mammalian OA may be comparable but that the precise aetiologies of OA affecting specific joints in different species are presently unknown.
Expression of tissue inhibitor of matrix metalloproteinases (TIMP)-3 protein in invasive breast carcinoma: Relation to tumor phenotype and clinical outcome
Authors: Mylona Eleni , Magkou Christina , Giannopoulou Ioanna , Agrogiannis George , Markaki Sofia , Keramopoulos Antonios , Nakopoulou Lydia
Published: October 2006

Introduction

Our aim was to study the expression pattern of tissue inhibitor of metalloproteinases (TIMP)-3 protein in invasive breast carcinoma, and its clinicopathological and prognostic value as well as its relation to markers indicative of the tumor phenotype.

Methods

Immunohistochemistry was performed on paraffin-embedded tissue specimens from 173 invasive breast carcinomas to detect the proteins TIMP-3, estrogen receptor (ER), progesterone receptor, p53, c-erbB-2, topoisomerase IIα and Bcl-2.

Results

TIMP-3 protein was immunodetected in the cytoplasm of the malignant cells and the peritumoral stroma, as well as in in situ carcinoma and normal epithelium. Reduced expression of TIMP-3 protein within cancer cells was correlated with carcinomas of high nuclear and histological grade (p = 0.032 and p = 0.015, respectively), and low ER expression (p = 0.053). Moreover, TIMP-3 immunopositivity was inversely correlated with the expression of p53 and topoIIα proteins (p = 0.002 and p = 0.008, respectively), whereas it was positively associated with Bcl-2 expression (p = 0.020). Reduced expression of TIMP-3 protein within cancer cells was found to have an unfavorable impact on disease-free survival (p = 0.052) in the entirety of the patient population, as well as in both subgroups of lymph-node-positive and mutant-p53-negative patients (p = 0.007 and p = 0.037, respectively). Stromal localization of TIMP-3 protein was found to have no clinicopathological or prognostic value.

Conclusion

This is the first immunohistochemical study to show that TIMP-3 protein within cancer cells is associated with tumor phenotype. Reduced expression of TIMP-3 protein within cancer cells was found to correlate with an aggressive tumor phenotype, negatively affecting the disease-free survival of both subgroups of lymph node-positive and mutant-p53-negative patients.
Dobutamine reverses the vasopressin-associated impairment in cardiac index and systemic oxygen supply in ovine endotoxemia
Authors: Ertmer Christian , Morelli Andrea , Bone Hans-Georg , Stubbe Henning Dirk , Schepers Ralf , Van Aken Hugo , Lange Matthias , Bröking Katrin , Lücke Martin , Traber Daniel L , Westphal Martin
Published: October 2006

Introduction

Arginine vasopressin (AVP) is increasingly used to treat sepsis-related vasodilation and to decrease catecholamine requirements. However, AVP infusion may be associated with a marked decrease in systemic blood flow and oxygen transport. The purpose of the present study was to evaluate whether dobutamine may be titrated to reverse the AVP-related decrease in cardiac index (CI) and systemic oxygen delivery index (DO2I) in an established model of ovine endotoxemia.

Methods

Twenty-four adult ewes were chronically instrumented to determine cardiopulmonary hemodynamics and global oxygen transport. All ewes received a continuous endotoxin infusion that contributed to a hypotensive-hyperdynamic circulation and death of five sheep. After 16 hours of endotoxemia, the surviving ewes (n = 19; weight 35.6 ± 1.5 kg (mean ± SEM)) were randomized to receive either AVP (0.04 Umin-1) and dobutamine (n = 8) or the vehicle (normal saline; n = 6) and compared with a third group treated with AVP infusion alone (n = 5). Dobutamine infusion was started at an initial rate of 2 μg kg-1min-1 and was increased to 5 and 10 μg kg-1 min-1 after 30 and 60 minutes, respectively.

Results

AVP infusion increased mean arterial pressure (MAP) and systemic vascular resistance index at the expense of a markedly decreased CI (4.1 ± 0.5 versus 8.2 ± 0.3 l min-1 m-2), DO2I (577 ± 68 versus 1,150 ± 50 ml min-1 m-2) and mixed-venous oxygen saturation (SvO2; 54.5 ± 1.8% versus 69.4 ± 1.0%; all p < 0.001 versus control). Dobutamine dose-dependently reversed the decrease in CI (8.8 ± 0.7 l min-1 m-2 versus 4.4 ± 0.5 l min-1 m-2), DO2I (1323 ± 102 versus 633 ± 61 ml min-1 m-2) and SvO2 (72.2 ± 1.7% versus 56.5 ± 2.0%, all p < 0.001 at dobutamine 10 μg kg-1 min-1 versus AVP group) and further increased MAP.

Conclusion

This study provides evidence that dobutamine is a useful agent for reversing the AVP-associated impairment in systemic blood flow and global oxygen transport.
Relating tissue specialization to the differentiation of expression of singleton and duplicate mouse proteins
Authors: Freilich Shiri , Massingham Tim , Blanc Eric , Goldovsky Leon , Thornton Janet M
Published: October 2006

Background

Gene duplications have been hypothesized to be a major factor in enabling the evolution of tissue differentiation. Analyses of the expression profiles of duplicate genes in mammalian tissues have indicated that, with time, the expression patterns of duplicate genes diverge and become more tissue specific. We explored the relationship between duplication events, the time at which they took place, and both the expression breadth of the duplicated genes and the cumulative expression breadth of the gene family to which they belong.

Results

We show that only duplicates that arose through post-multicellularity duplication events show a tendency to become more specifically expressed, whereas such a tendency is not observed for duplicates that arose in a unicellular ancestor. Unlike the narrow expression profile of the duplicated genes, the overall expression of gene families tends to maintain a global expression pattern.

Conclusion

The work presented here supports the view suggested by the subfunctionalization model, namely that expression divergence in different tissues, following gene duplication, promotes the retention of a gene in the genome of multicellular species. The global expression profile of the gene families suggests division of expression between family members, whose expression becomes specialized. Because specialization of expression is coupled with an increased rate of sequence divergence, it can facilitate the evolution of new, tissue-specific functions.
Highly Ordered Mesoporous Organosilica Hybrid Materials
Authors: Kapoor Mahendra P , Inagaki Shinji
Published: October 2006

The latest developments in periodic mesoporous organosilicas (PMO) have been compiled. The discovery of mesoporous hybrid organosilicas with molecular scale periodicity resulting from alternating hydrophilic and hydrophobic layers, and a cost effective solution showing the use of allyl derivatives of the bis-silyl precursors are discussed. Relevant uses of the periodic mesoporous materials in diverse applications are summarized. For example, the metal-incorporated periodic mesoporous organic frameworks are likely to offer an advantage in catalytic transformations, while the functionalized PMOs show promise in fascinating catalytic applications via enhancing the physical properties of guest molecules and clusters. In general, the advancement in PMOs have showed great promise and are expected to deliver exciting achievable future findings.
Photocatalytic Electron-Transfer Oxidation of Triphenylphosphine and Benzylamine with Molecular Oxygen via Formation of Radical Cations and Superoxide Ion
Authors: Ohkubo Kei , Nanjo Takashi , Fukuzumi Shunichi
Published: October 2006

Photooxygenation of triphenylphosphine (Ph3P) to triphenylphosphine oxide (Ph3P=O) with molecular oxygen (O2) occurs under photoirradiation of 9-mesityl-10-methylacridinium perchlorate ([Acr+–Mes]ClO4−) which acts as an efficient electron-transfer photocatalyst. Photooxidation of benzylamine (PhCH2NH2) with O2 also occurs efficiently under photoirradiation of Acr+–Mes to yield PhCH2N=CHPh and hydrogen peroxide (H2O2). Each photocatalytic reaction is initiated by intramolecular photoinduced electron transfer from the Mes moiety to the singlet excited state of the Acr+ moiety to produce the electron-transfer state (Acr•–Mes•+). The Mes•+ moiety oxidizes Ph3P and PhCH2NH2 to produce the radical cations (Ph3P•+ and PhCH2NH2•+, respectively), whereas the Acr• moiety reduces O2 to O2•−. The produced Ph3P•+ binds with O2•− as well as O2, leading to the oxygenated product (Ph3P=O). On the other hand, proton transfer from PhCH2NH2•+ to O2•− occurs, followed by hydrogen transfer, leading to the dehydrogenated dimer product, PhCH2N=CHPh. In each case, the radical intermediates were detected by laser flash photolysis and ESR measurements to clarify the photocatalytic mechanism.
Analysis of Short-Time Transient Dynamics of a Diffusion-Controlled Reaction in a Hard-Sphere Fluid Based on Fokker–Planck–Kramers Equation
Authors: Ibuki Kazuyasu , Ueno Masakatsu
Published: October 2006

Molecular dynamics (MD) simulations are performed for a simple diffusion-controlled reaction in a hard-sphere fluid. The short-time transient rate constants are compared with the Markovian Langevin dynamics (LD), two theories based on the Fokker–Planck–Kramers equation (FPKE), and the Smoluchowski–Collins–Kimball (SCK) theory based on the diffusion equation. At n* = 0.7856, where n* is the total number density reduced by the diameter of the molecules, molecular motions are diffusive and Markovian, and the MD results agree well with the LD results. At n* = 0.9428, the MD results are much larger than the LD ones at short times, and the discrepancy can be explained by non-Markovian effects. Also at n* = 0.2000, where inertia effects are important, the time profile of the MD rate constant is satisfactorily explained by LD, while the MD rate constant shows a smaller decay than at higher densities. FPKE theory with a continuous velocity distribution reproduces the LD results under all conditions indicating that the theory is valid over a wide density range. FPKE theory with a discontinuous velocity distribution cannot explain the simulation results at the lowest density despite taking into account inertia effects. Although SCK theory is expected to be valid only at high densities, the predicted rate constant is close to that from the simulation even at the lowest density, if the intrinsic rate constant is chosen to reproduce the exact value of the initial rate constant.
Synthesis of Peduncularine
Authors: Kitamura Mitsuru , Ihara Yuichiro , Uera Kazuyoshi , Narasaka Koichi
Published: October 2006

Peduncularine, the principal alkaloid of the Tasmanian shrub Aristotelia peduncularis, was synthesized via the radical cyclization of 7-oxabicyclo[2.2.1]hept-2-en-5-yl ketone oxime 9 forming the 6-azabicyclo[3.2.1]octane skeleton.
Synthesis of 1-Aryl-1H-indole Derivatives by Iodine-Mediated Cyclization of 2-(Arylamino)styrene Derivatives
Authors: Kobayashi Kazuhiro , Miyamoto Kazuna , Yamase Tohru , Nakamura Daizo , Morikawa Osamu , Konishi Hisatoshi
Published: October 2006

A convenient synthetic method for 1-aryl-1H-indole derivatives has been developed. 2-(Arylamino)-α-methylstyrene derivatives were treated with iodine in the presence of sodium hydrogencarbonate to give 1-aryl-3-methyl-1H-indole derivatives in fair to good yields. 3-Ethyl-2-methyl-1-phenyl-1H-indole and 3,3′-dimethyl-1,1′-(p-phenylene)diindole were also prepared from the respective 2-(phenylamino)styrene derivatives under the same conditions in reasonable yields.
Deamination of 1-Alkyl-9-aminomethyltriptycenes. Participation of a Neighboring 1-Alkyl Substituent
Authors: Yamamoto Gaku , Koseki Ai , Sugita Jun , Mochida Hisashi , Minoura Mao
Published: October 2006

Deamination reactions of 1-alkyl-9-aminomethyltriptycenes (alkyl = Me, Et, i-Pr, and t-Bu) and 9-(1-aminoethyl)-1-methyltriptycene were performed in CHCl3 and in AcOH, and product distributions were studied. The results suggest that the loss of N2 from a primary alkanediazonium ion predominantly takes place concomitantly with participation of a C–H bond of the neighboring 1-alkyl group to form a nonclassical cationic species with a three-center two-electron bonding, while the loss of N2 from a secondary alkanediazonium ion occurs spontaneously to form a secondary carbocation. Solvent effects (CHCl3 vs AcOH) are explained in terms of lower nucleophilicity/basicity of the AcO− in AcOH than in CHCl3 due to solvation.
Systematic Studies on Chain Lengths, Halide Species, and Well Thicknesses for Lead Halide Layered Perovskite Thin Films
Authors: Takeoka Yuko , Asai Keisuke , Rikukawa Masahiro , Sanui Kohei
Published: October 2006

Two-dimensional layered perovskite compounds, (CnH2n+1NH3)2(CH3NH3)m−1PbmX3m+1 (n = 2, 3, 4, 6, and 10; X = Cl, Br, and I; m = 1, 2, and 3) were systematically prepared. The influences of the barrier-size, halide species, and well thickness of the perovskite thin films on the quantum confinement structures were investigated. The layered perovskite films showed a strong and clear absorption peak due to excitons confined in inorganic quantum-wells. The exciton peak shifted to lower energy as the halide species was changed from Cl to Br and I. Furthermore, fine multilayer perovskite compound films were prepared by varying the spin-coating conditions.
Vendor Certification and Appraisal: Implications for Supplier Quality
Authors: Hwang Iny , Radhakrishnan Suresh , Su Lixin (Nancy)
Published: October 2006

We examine the buyer's problem of inducing the supplier's quality effort using two arrangements: the appraisal regime and the certification regime. In the appraisal regime, the buyer inspects the units supplied and either charges a penalty for defective units identified during inspection or pays the unit price for good units. In the certification regime, the supplier obtains vendor certification and the buyer pays the unit price for all units supplied. The inspection technology and the certification process provide noisy information on the supplier's quality effort. In the appraisal regime, the buyer implements the supplier's high-quality and low-inspection. The supplier's expected profit is greater than his reservation profit because of an additional agency cost: The buyer has to prevent the supplier from performing unwanted/preemptive inspection (which gives rise to indirect costs from delay, etc.). This additional agency cost arises precisely when the effectiveness of inspection is high. This provides a moral-hazard-based rationale for the increasing use of certification (such as ISO 9000) in spite of (in fact, because of) the increasing effectiveness of inspection. The potential for additional agency cost incurred by the buyer in the appraisal regime highlights an indirect cost associated with inspection.
Transshipment of Inventories Among Retailers: Myopic vs. Farsighted Stability
Authors: Sošić Greys
Published: October 2006

The author considers a model of a decentralized distribution system consisting of n retailers selling an identical product. Retailers face a stochastic demand and must order their initial inventory before this demand is realized. After demand realization, retailers decide how much of their unsold inventory or unsatisfied demand they want to share with other retailers. This is followed by a transshipment of leftover inventories and distribution of the additional profit generated through inventory sharing.

The author addresses the following issue: Suppose that the retailers distribute the profit from inventory sharing according to an allocation rule that induces retailers to share their residuals in a way that maximizes the additional profit, such as the Shapley value, but may not belong to the core. Is it likely that, in this framework, all retailers will jointly share their residuals and not form subcoalitions? Previous research has looked at this problem from a myopic viewpoint and concluded that the grand coalition is not stable. Unlike the prior work, the author looks at stability in a farsighted sense. That is, retailers do not consider only their immediate payoffs but are also concerned with reactions of other retailers to their actions. In a symmetric setting, with identical additional unit revenues from transshipments generated by all retailers, farsighted retailers always maximize their allocations by not defecting from the grand coalition. The author also provides conditions when the same is true for nonidentical additional unit revenues.
Coordinating Supply Chains with Simple Pricing Schemes: The Role of Vendor-Managed Inventories
Authors: Bernstein Fernando , Chen Fangruo , Federgruen Awi
Published: October 2006

We characterize supply chain settings in which perfect coordination can be achieved with simple wholesale pricing schemes: either retailer-specific constant unit wholesale prices or retailer-specific volume discount schemes. We confine ourselves to two-echelon supply chains with a single supplier servicing a network of retailers who compete with each other by selecting sales quantities. We identify a key sufficient condition, in terms of interdependencies between chain members' operational decisions, under which perfect coordination via simple schemes is feasible, under general cost and demand functions. This condition, which we refer to as echelon operational autonomy (EOA), states that the costs incurred by the supplier for a given vector of sales volumes depends only on operational decisions she controls herself. At the same time, the costs incurred by the retailers may depend on operational decisions controlled by the supplier, in which case, the supplier's operational decisions are made to minimize chainwide costs. We show how vendor-managed inventory (VMI) partnerships create EOA and compare the resulting coordinating pricing schemes with those required in a traditional decentralized setting (without EOA). We also discuss compliance issues with the coordinating schemes in view of the Robinson-Patman act and provide remedies to overcome these issues.
An experimental study of the neural mechanism hearing
Authors: Hughson Walter , Thompson Eva , Witting E. G.
Published: October 2006

The technical difficulties involved in an investigation of this kind invariably make the information obtained rather insignificant in relation to the amount of time and effort put forth. Experiments must be repeated many times before a dependable method can be developed, and even then an inevitably high mortality in the experimental animals persists Before consistent success can normally be achieved. The data upon which the following observations are based represents a series of chronic experiments carried out in the Laboratory of Otological Research at the Johns Hopkins in 1934, 14 in number, and a subsequent extensive investigation during the past year in the Otological Research Laboratory of the Abington Memorial Hospital. In the first group, partial and graded division of the auditory nerve was carried out under high binocular magnification. In all experiments partial or complete division of the nerve was considered successful only if the blood supply of the cochlea remained intact.
The diagnosis op nerve deafness
Authors: Crowe S.J.
Published: October 2006

This will be a valuable meeting if it does nothing more than direct your attention to the extent and complexity of the auditory apparatus and leads you to think of the ear as something more than the tympanic membrane, Eustachian tube, ossicles, mastoid and cochlea. The otologist is the expert who is depended on to recognize and treat the disorders of the ear; we are reasonably successful with the acute and chronic suppurations but know very little about the cause, the recognition or the treatment of impaired hearing. Hearing acuity plays an important part in economic and social life, and the fact that so little is known about deafness should fire every otologist with the ambition and determination to aid in the advance of this branch of his profession. Before the otologist can do his part, however, he must have special instruction in the embryology, anatomy, physiology and pathology of the ear and its central pathways. A national move in this direction is indicated by the higher standards imposed each year by the American Board of Otolaryngology. We, as otologists, must be able to visualize and think of the hearing apparatus as a whole: the structures in the temporal bone, the auditory pathways in the brain stem and cortex, the relation of these pathways to other nerves and, finally, the association fibres which connect the temporal lobe with other parts of the brain. As our scientific knowledge advances, new methods for clinical examination will be devised. Advance will come more rapidly if the young otologist is properly trained; if he is encouraged to show an interest in deaf patients and the cause of deafness; if he will keep himself informed about the newer instruments of precision and employ standardized methods for testing the hearing, so that his results may be compared and pooled with the experiences of others. A move toward the standardization of tests was made by this Society, in 1936, when the report on Methods of Testing the Hearing by Bone Conduction was presented at the Detroit meeting. The electrical method of study, introduced by Wever and Bray, and the experiments on conditioned animals are most important and stimulating. The ultimate object of all experimental work on the ear, however, is to suggest new ideas to the clinician, who, after all, is the most important link in the chain.
Middle fossa vestibular nerve section in the management of menifire's disease
Authors: Glasscock Michael E. , Miller Gale W.
Published: October 2006

The triad of fluctuating hearing loss, tinnitus, and episodic attacks of vertigo known as Meniere's disease can be a frustrating therapeutic problem. While most patients respond to a medical regime consisting of a low salt diet, diuretics, diazepam, and propantheline bromide, there is a significant group who remain refractory to conservative management. These individuals either continue to experience their distressing symptoms or undergo some type of surgical procedure in an attempt to seek relief.

There are a multitude of such techniques available to the otologic surgeon and he must make the decision as‐ to which procedure is best for any given individual. The authors' employ three surgical approaches for the management of Meniere's disease. These are the translabyrinthine laby‐rinthectomy, the endolymphatic subarachnoid shunt, and the middle fossa vestibular nerve section.

In this paper the indications for surgery, technique, results and complications are covered in detail. Thirty‐one patients are reviewed who have been followed from one to four years postoperatively. Seventeen had total and 14 had superior vestibular nerve sections. The results were much better in the total group, as 94 percent had complete relief of vertigo and 76 percent were able to maintain their preoperative hearing level.

The authors feel the middle fossa vestibular nerve section is a valuable addition to the otologist's armamentarium in the treatment of the patient who is refractory to medical management
The case for elective prophylactic neck dissection
Authors: Nahum Alan M. , Bone Robert C. , Davidson Terence M.
Published: October 2006

The possibility of improving the cure rate of cancer of the head and neck by radical neck dissection of the clinically negative neck (elective neck dissection) continues to pose a therapeutic dilemma. This paper seeks to review the available information, analyze relevant aspects of the issue and attempt to draw conclusions which will be helpful both to physicians and their patients. The discussion is confined to squamous carcinoma of the larynx, pharynx, and oral cavity
Influence of caldwell‐luc operation on developing permanent teeth
Authors: Paavolainen Mikko , Paavolainen Riitta , Tarkkanen Jorma
Published: October 2006

The influence of Caldwell‐Luc operation on the permanent teeth of school children was studied in a material of 21 six to 14‐year‐old children, who had undergone, altogether, 30 Caldwell‐Luc operations. Ten of the children had also undergone 23 endonasal antrostomies. The control material consisted of a class of 27 healthy school children, their mean age being 10.2 years.

Total anesthesia was found in five teeth on the operated side and in one tooth on the non‐operated side. Additionally, the operation had caused slight hypesthesia in part of the teeth, mostly in the first incisors. All sensory disturbances were caused by nerve lesion only, and no tooth had died as a result of the operation. The operation could not be shown to be conducive to caries. Correctly performed, Caldwell‐Luc operation does not cause serious dental injuries in school children, and is indicated especially in chronic sinobronchitis when conservative methods of treatment fail
Palato‐pharyngeal cine photography: A Technique For Developing Continuing Education Films
Authors: Smith Howard W.
Published: October 2006

A method of Cine photography has been developed to record a variety of plastic and reconstructive surgical procedures in the oral cavity and pharynx.

Effective classroom teaching of surgical closure of the cleft palate and the various palatal lengthening procedures including pharyngeal flaps, has been hampered by the lack of quality teaching films demonstrating surgical techniques in color.

The small size of the structures involved and the delicate nature of the surgery requires that the surgeon work at close range and directly in front of the mouth.To avoid the shadows cast by the sides of the oral cavity, the surgeon's hands and frequent change of position by the professional photographic team, a head‐mounted Cine camera was employed.

A “through the surgeon's eye” view for the camera was accomplished by using a parallelogram of beam‐splitting mirrors. The resulting photographic film provides the classroom audience with a sense of being in the surgeon's operating position thus having a view superior to that obtained by the surgeon's first assistant.

An elaborate system of counter‐balancing provides the surgeon with a weightless camera, mirror, and light complex mounted on a football helmet. The football helmet merely served as an interlocking unit enabling the surgeon to compose his own movie while operating
Twenty years experience with intranasal transseptal dacryocystorhinostomy
Authors: Berryhill Bruce H. , Dorenbusch A. A.
Published: October 2006

The intranasal transeptal approach for treating chronic dacryocystitis has been utilized by the authors since 1959. A total of 305 operations have been performed with a high success rate and very low complication rate. The intranasal approach is preferred since it allows good visualization of the lacrimal sac, avoids a facial scar, and is most successful.

Two hundred and eighty‐four primary operations were performed with an 89% success. Of 29 failures, 25 were re‐operated on with only 2 failures. Counting patients who required a revision operation, the overall success rate was 99%. Most revisions had to be performed because of scar formation in the nose or bony re‐growth over the nasal opening. Complications were few with two patients having postoperative bleeding requiring nose to be repacked, two small septal perforations, one periorbital abscess and one case in which there was severe scar formation in the nose.
Lateral tarsal strip procedure for the correction of paralytic ectropion
Authors: Becker Ferdinand F.
Published: October 2006

Otolaryngologists are frequently confronted with patients suffering from permanent facial paralysis. This condition often results in a severe cosmetic and functional deformity of the lower eyelid called paralytic ectropion. Conservative measures ore often unsatisfactory and surgical correction is needed. Tarsorrhaphy and cautery have been advocated in the past, but are usually unsatisfactory. The most standard surgical procedure in use at the present time is a modification of the Kuhnt‐Szymanowski procedure which is useful in repositioning the lax eyelid and allowing for lid shortening. This procedure involves removal of a portion of the midtarsal plate, but does not correct the lax lateral canthal tendon which is the cause of the pathology in paralytic ectropion. In 1979, in the ophthalmologic literature, Anderson and Gordy reported the tarsal strip procedure for the correction of paralytic and senile ectropion.

This paper describes the lateral tarsal strip procedure which involves a lateral canthotomy, division of the lateral portion of the lower eyelid into musculocutaneous and tarsoconjunctival layers, removal of a portion of the conjunctiva and suturing the resulting tarsal strip to the periosteum of the inner aspect of the orbital rim laterally to shorten and elevate the lower eyelid. The procedure is presented in diagrams and close‐up operative photographs. Before and after photographic documentations of two clinical cases ore also presented. Since this procedure has been employed for only about two years, long‐term results are not yet available; however, the author feels that this procedure will offer a significant improvement in the surgical treatment of paralytic ectropion.
The prosthetic management of oral commissure burns
Authors: Richard Holt G. , Parel Stephen , Richardson David S. , Kittle Paul E.
Published: October 2006

The complications of electrical burn to the oral cavity include microstomia and cosmetic deformity. Surgical burn excision and repair by primary closure, skin grafts, or tongue flaps have recognized disadvantages. The use of intraornl fixed or removable appliances, or the extraoral facemask prosthesis, serves to maintain adequate commissure spacing and allows normal skin and mucosal healing to occur. Secondary commissuroplasties may be required after prosthetic management of the burn.
Anatomical routes for cancer invasion of laryngeal cartilages
Authors: Yeager Vernon L. , Archer Carol R.
Published: October 2006

The larynx is separated into compartments bounded by connective tissue membranes and cartilages. The membranes and cartilages affect the localization and spread of cancer for a while, but invasion eventually occurs. Histological study of the cartilages in the earliest stages of invasion shows cancer cells growing between the collagen bundles where the connective tissue membranes attach to the cartilages. At these points, the collagen bundles pass obliquely through the perichondrium to anchor into the cartilage and bone like Sharpey's fibers. As the cancer cells multiply, they separate the collagen bundles, forming linear passageways through the perichon‐drum. This appears to be the mechanism for cartilage invasion. Thus the sites of attachment of the strongest membranes are also the most frequent sites of invasion, i.e., the anterior commissure tendon and the cricothyroid membrane.
Impact of cervical disease and its definitive radiotherapeutic management on survival: Experience in 2013 patients with squamous cell carcinomas of the oropharynx and pharyngolarynx
Authors: Bataini J. P. , Bernier J. , Jaulerry C. , Brunin F. , Pontvert D.
Published: October 2006

Two thousand thirteen patients with squamous cell carcinoma of oropharynx and pharyngolarynx were reviewed with regard to neck disease presentation and disease‐free survival after radical radiotherapy. All patients were staged according to both the AJCC1976 and the UICC1978 classifications. Causes of failure, disease‐free survival, and complication rates were assessed. Sixty percent had a clinically positive neck. The 3‐year disease‐free survival rates were 58%, 44%, 38%, and 25% for AJCC NO, Nl, N2, and N3 cases, respectively. Corresponding UICC figures were 58%, 46%, 26%, and 29%. Analyzed parameters were nodal stage, size, site and fixity, and location of primary. Complications attributed to neck disease did not exceed 3%. A critical appraisal of the nodal staging systems is derived from these sets of data.
Morphological aspects of the human vestibular nerve
Authors: Lee Won Sang , Suárez Carlos , Honrubia Vicente , Gómez Justo
Published: October 2006

A quantitative study was made of the number of fibers, their diameters, and distribution in the nerves innervating individual vestibular receptor organs of three human temporal bones. The specimens were obtained from autopsies conducted within 4 hours postmortem. The temporal bones containing the nerves were fixed in 3% glutaraldehyde and decalcified with EDTA until they were soft enough to allow dissection of the nerve branches to the individual receptors. The nerve branches were processed for osmium staining, embedded in plastic, and cut serially in 1‐μm‐thick sections for light‐microscopic histologic evaluation of their fiber composition. Quantitative evaluation of nerve‐fiber characteristics was made with the aid of a laboratory computer and programs for graphic representation and statistical analysis.

In the nerves to the individual cristae the number of fibers ranged between 1416 and 2335. Fibers with diameters between 2.5 μm and 3 μm were the most numerous. The number of fibers decreased exponentially with increased size. The thickest fibers had diameters up to 11.5 μm. The distribution of fibers in the nerve of each crista was different for the central and intermediate areas of the crista than it was for the ends. Thin fibers with diameters less than 2.5 μm, which represented 36% of the population, projected to the ends of the receptor area. Thick fibers with diameters greater than 4.5 μm, which represented 8% of the fibers, were distributed relatively uniformly except for the extreme ends of the crista, where they were nearly absent. Fibers with intermediate diameters were distributed throughout the crista, although they were more concentrated at the ends.

In the nerves to three maculae, the number of fibers ranged from 3744 to 5538. The percentage of fibers of each size, however, was similar to that in the cristae. The greater portion of fibers had diameters between 3.0 μm and 3.5 μm. Because of the anatomical configuration of the maculae, it was not possible to compare fiber diameters from one area
Laryngeal obstruction and obstructive sleep apnea syndrome
Authors: Anonsen Cynthia
Published: October 2006

Obstructive sleep apnea syndrome has been studied intensively since it was introduced in the 1970's; these studies have shown that the site of upper airway obstruction appears to vary among patients. Snoring is typically defined as the sound created by rhythmic oscillations of the soft palate in the inspiratory air stream during sleep. Snoring occurs in 100% of patients with obstructive sleep apnea and, for selected patients, is treatable by surgery. Snoring can, however, mean different things to different patients and physicians. Five atypical cases of obstructive sleep apnea syndrome are presented in which laryngeal dysfunction played a role in producing symptoms of obstructive sleep apnea syndrome. Recording nocturnal sounds during sleep and examining the entire upper respiratory tract may be important in determining appropriate medical or surgical management.
Family cancer syndrome: A study of the kindred of a man with osteogenic sarcoma of the mandible
Authors: Gardner Glendon M. , Steiniger Joseph R.
Published: October 2006

Several familial cancer syndromes have been identified. The syndrome of sarcomas, breast cancer and other neoplasms, known as Li‐Fraumeni syndrome, is characterized by several different neoplasms presenting at young ages with autosomal dominant transmission and a high incidence of second primaries.

In this paper, we studied six generations (51 people) of the family of a 24‐year‐old man with osteogenic sarcoma of the mandible. Twelve malignancies in 11 people, including several rare tumors, were revealed. Mean age of presentation was 24 years old. Nine of the 11 patients died of disease. One developed a second primary. Two tumors presented in the head and neck. Transmission was autosomal dominant. The karyotypes of two family members were normal.

Identification of Li‐Fraumeni syndrome in a family is important in determining appropriate follow‐up for the patient and family. Such families are models for studying carcinogenesis.
The surgical management of chronic parotitis
Authors: Arriaga Moises A. , Myers Eugene N.
Published: October 2006

Chronic parotitis is a disorder characterized by recurrent painful swelling of the gland with purulent sialorrhea. Occasionally, the condition fails to respond to medical management and definitive surgical therapy is necessary. Sialolithiasis is the usual etiology in cases of parotitis, although occasionally severe recurrent parotid infections are superimposed on underlying Sjögren's disease. Total parotidectomy with facial nerve dissection has been used in such cases in our department and has proved to be an excellent way to manage this disease. A summary of our results indicate that the recurring infections were eradicated and that the complication rate is tolerable, considering the magnitude of the problem. We feel that it is better to use surgical management early rather than wait for the formation of fistulae or abscesses.
Small fenestra stapedotomy using a fiberoptic hand‐held argon laser in obliterative otosclerosis
Authors: Gherini Stuart G. , Horn Karl L. , Bowman Carol A. , Griffin Gus
Published: October 2006

Obliterative otosclerosis has been a challenge since the advent of stapes surgery. “Drill‐out” procedures have had a generally poorer prognosis than conventional stapes surgery because of excessive bleeding, acoustic trauma from the burr, and reclosure of the oval window by otosclerosis.

In this report, we describe our early experience using a hand‐held fiberoptic argon laser for small fenestra stapedotomy in 10 cases of obliterative otosclerosis. Closure of the air‐bone gap to within 10 dB was seen in 100% of the patients. There was no significant sensorineural hearing loss, vertigo, or facial weakness. Argon‐laser stapedotomy using a hand‐held fiberoptic system is a safe and effective alternative to drill‐out stapedotomy in cases of obliterative otosclerosis.
Avoiding a wrapped endotracheal tube in laser laryngeal surgery: Experiences with apneic anesthesia and metal laser‐flex endotracheal tubes
Authors: Hawkins Donald B. , Joseph Mary M.
Published: October 2006

Ninety‐one laser laryngeal procedures using the apneic technique of anesthesia were performed in 28 patients between 2 months and 64 years of age. Seventy‐two procedures (79%) were performed on children and 19 on adults. There were no complications. Eight laser laryngoscopies were performed using a new metal Laser‐Flex® endotracheal tube. Obstruction of the endotracheal tube with a mucous plug occurred in one case. The apneic technique described in this paper provides a laser operative field free of an endotracheal tube, virtually eliminating the danger of a laser fire. It is a relatively safe and effective means of performing laser laryngeal surgery. In addition, the Laser‐Flex endotracheal tube appears to be an acceptable alternative to a metallic tape‐wrapped endotracheal tube.
Chondrogenic potential of tragal perichondrium: A cause of hearing loss following stapedectomy
Authors: Benecke James E. , Gadre Arun K. , Linthicum Fred H.
Published: October 2006

Tragal perichondrium is a widely used tissue seal in the oval window following stapes surgery. Autogenous and easily accessible, it is a suitable substance to cover the vestibule in total stapedectomy, and to seal around the prosthesis in small‐fenestra stapedotomy. The incidence of complications from the use of perichondrium in this manner is exceedingly low.

We report a case where tragal perichondrium in the oval window resulted in the proliferation of cartilage. The cartilage displaced the stapes prosthesis, resulting in a conductive loss. Although the chondrogenic potential of perichondrium is known, we are not aware of other reports implicating this as a cause of failure in stapes surgery. The pertinent clinical and experimental literature regarding chondrogenesis is reviewed. This information suggests that the formation of cartilage from perichondrium in the oval window might be influenced by mechanical trauma and tissue orientation.
Long-Term Control of Bone Turnover in Paget's Disease With Zoledronic Acid and Risedronate
Authors: Hosking David , Lyles Kenneth , Brown Jacques P , Fraser William D , Miller Paul , Curiel Manuel Diaz , Devogelaer Jean-Pierre , Hooper Michael , Su Guoqin , Zelenakas Ken , Pak Judy , Fashola Taiwo , Saidi Youssef , Eriksen Erik Fink , Reid Ian R
Published: October 2006

A single 5-mg infusion of zoledronic acid restores biochemical markers of bone turnover into the reference range in the majority of patients with Paget's disease and maintains biochemical remission for at least 2 years. This effect is largely independent of pretreatment disease activity and prior bisphosphonate therapy.

Introduction: Zoledronic acid (ZOL) is a potent bisphosphonate that produces a rapid and complete control of the increased bone turnover of Paget's disease. Long-term control of disease activity is an important aim of treatment in the hope that this will reduce the risk of complications such as deformity, fracture, and degenerative joint disease.

Materials and Methods: This study compares the ability of ZOL 5 mg given as a 15-minute intravenous infusion with risedronate (RIS) 30 mg daily by mouth for 60 days to maintain long-term control of bone turnover. No bisphosphonate was given during the extension study. All patients (n = 296) who achieved a therapeutic response, defined as normalization or a >75% reduction in the total alkaline phosphatase (total ALP) excess above the midpoint of the reference range, were eligible for inclusion.

Results: ZOL maintained the mean level of total ALP at the middle of the reference range, whereas those treated with risedronate showed a linear increase in total ALP from the 6-month post-treatment time-point. Both treatments resulted in a linear relationship between the 6-month nadir and 24-month total ALP. The relationship for RIS was shifted upward, showing that for a given level of post-treatment biochemical activity, bone turnover increased with time. This was in contrast to the ZOL-treated patients where total ALP generally remained unchanged over this 18-month extension period. A similar pattern of response was seen with the other bone turnover markers.

Conclusions: ZOL maintains bone turnover within the reference range over 24 months from the initiation of treatment. A reduction in the incidence and severity of long-term complications may require persistent normalization of bone turnover over many years, and this now seems a realistic possibility with ZOL.
TGF-β Promotes the Establishment of Renal Cell Carcinoma Bone Metastasis
Authors: Kominsky Scott L , Doucet Michele , Brady Kelly , Weber Kristy L
Published: October 2006

Bone metastases develop in ˜30% of patients with RCC, and the mechanisms responsible for this phenomenon are unknown. We found that TGF-β1 stimulation of RCC bone metastasis cells promotes tumor growth and bone destruction possibly by stimulating paracrine interactions between tumor cells and the bone.

Introduction: Bone metastasis is a frequent complication and causes marked morbidity in patients with renal cell carcinoma (RCC). Surprisingly, the specific mechanisms of RCC interaction with bone have been scarcely studied despite the inability to prevent or effectively treat bone metastasis. Bone is a reservoir for various growth factors including the pleiotropic cytokine TGF-β1. TGF-β1 has been shown to have tumor-supportive effects on advanced cancers and evidence suggests its involvement in promoting the development of breast cancer bone metastasis. Here, we studied the potential role of TGF-β1 in the growth of RCC bone metastasis (RBM).

Materials and Methods: To inhibit TGF-β1 signaling, RBM cells stably expressing a dominant-negative (DN) TGF-βRII cDNA were generated. The in vivo effect of TGF-β1 on RBM tumor growth and osteolysis was determined by histological and radiographic analysis, respectively, of athymic nude mice after intratibial injection of parental, empty vector, or DN RBM cells. The in vitro effect of TGF-β1 on RBM cell growth was determined after TGF-β1 treatment by MTT assay.

Results: TGF-β1 and the TGF-β receptors I and II (TGF-βRI/II) were consistently expressed in both RBM tissues and cell lines. Inhibition of TGF-β1 signaling in RBM cells significantly reduced tumor establishment and osteolysis observed in vivo after injection into the murine tibia, although no effect on tumor establishment was observed after injection of RBM cells subcutaneously or into the renal subcapsule. Treatment of five RBM cell lines with TGF-β1 in vitro either had no effect (2/5) or resulted in a significant inhibition (3/5) of cell growth, suggesting that TGF-β1 may promote RBM tumor growth indirectly in vivo.

Conclusions: TGF-β1 stimulation of RBM cells plays a role in promoting tumor growth and subsequent osteolysis in vivo, likely through the initiation of tumor-promoting paracrine interactions between tumor cells and the bone microenvironment. These data suggest that inhibition of TGF-β1 signaling may be useful in the treatment of RBM.
Multiplexed testing in the autoimmunity laboratory
Authors: González-Buitrago José M.
Published: October 2006

A variety of technologies for autoantibody profiling have been developed. The main techniques are line-blot immunoassays, bar-coded nanoparticle immunoassays, and bead-based assays with flow cytometry detection and antigen microarrays. Some of these technologies are only able to measure a limited number of autoantibodies, while others can detect elevated numbers. Assays for antinuclear antibody specificities using line-blot immunoassays and bead-based assays with flow cytometry detection are already commercialised. Antigen microarrays for autoantibody measurement are only in the development phase, although in the not too distant future these assays will probably appear on the market. Multiplexed testing in the autoimmunity laboratory appears to have a promising future, since this technique permits a reduction in analytical time, with a shorter turnaround time.

Clin Chem Lab Med 2006;44:1169–74.