bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Tisseel and FloSeal on Primary Ischemic Time in a Rat Fasciocutaneous Free Flap Model
Authors: Partsafas Aaron W. , Bascom Daphne A. , Jorgensen Scott A. , Wax Mark K.
Published: January 2004

Objectives: Free flaps are the technique of choice for reconstruction of defects resulting from extirpation of tumors of the head and neck. Advances in microsurgical technique have resulted in success rates of greater than 95%. Numerous intraoperative factors, ranging from technical issues to topically applied agents, can complicate the outcome of microsurgical free tissue transfer. Synthetic tissue adhesives and hemostatic agents are playing an ever‐increasing role in reconstructive surgery. The safety of these factors in free flap surgery has not been ascertained.

Study Design: Animal Care Committee live rat model.

Methods: Male Sprague‐Dawley rats were divided into three groups: group I, Control; group 2, FloSeal; group 3, Tisseel. In each group, a 3 × 6 cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated and the experimental material applied beneath the flap and around the flap pedicle prior to suturing of the flap back to the wound bed. The experimental materials consisted of 0.2 mL saline in the control group, 0.5 mL FloSeal, and 0.2 mL Tisseel. In phase I of this study, the effect of each treatment on flap survival was assessed by survival at postoperative day 4. In phase II of the study, the effects of these agents on ischemic tolerance was investigated. Five rats in each treatment group were exposed to ischemic times of 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time (CIT50) were calculated.

Results: All flaps survived the 2‐hour period of ischemia and were viable at postoperative day 4. Flap survival from group 1 (Control), group 2 (FloSeal), and group 3 (Tisseel) at the various ischemic times was as follows: at 6 hours, 80%, 80%, and 80%, respectively; at 8 hours, 80%, 80%, 60%; at 10 hours, 60%, 33%, 40%; at 12 hours, 20%, 20%, 0%. The CIT50 for the Control, FloSeal, and Tisseel groups was 9.4, 9.0, and 7.0 hours, respectively.

Conclusions: FloSeal, a thrombin‐based hemostatic agent, and Tisseel, a fibrin glue, displayed no adverse effect on flap survival in this model.
Cochlear Implantation in Children with Congenital Inner Ear Malformations
Authors: Buchman Craig A. , Copeland Benjamin J. , Yu Kathy K. , Brown Carolyn J. , Carrasco Vincent N. , Pillsbury Harold C.
Published: January 2004

Objective/Hypothesis: To assess the audiologic and surgical outcomes for pediatric cochlear implant patients with inner ear malformations.

Study Design: Retrospective review of 315 pediatric cochlear implant cases from 1994 to 2002.

Methods: Twenty‐eight pediatric cochlear implant patients with known inner ear malformations determined on high‐resolution computed tomography (HRCT) of the temporal bone were the subjects of review. Results ofHRCTfindings, intraoperative findings, postoperative complications, and objective measures of both closed‐ and open‐set testing of speech perception were analyzed.

Results: Patients with the constellation of an incompletely partitioned (IP) cochlea, enlarged vestibular aqueduct (EVA), and a dilated vestibule (i.e., Mondini's malformation) as well as those with an isolated EVA or partial semicircular canal aplasia have relatively good levels of speech perception. Patients with total semicircular canal aplasia, isolated IP, cochlear hypoplasia, or common cavity demonstrated lower levels of performance. Poor performance may be related to associated developmental delays rather than labyrinthine anatomy alone. Complications of surgery were relatively limited.

Conclusions: Cochlear implantation can be successfully performed in children with inner ear malformations. These children and their parents can expect significant auditory benefits from this intervention. The various types of inner ear malformations may have quite different prognoses for good auditory performance.
Surgical Management of Complications after Hearing Aid Fitting
Authors: Kohan Darius , Sorin Alexander , Marra Stephen , Gottlieb Marc , Hoffman Ronald
Published: January 2004

Objectives: Standard procedures for hearing aid fitting performed in accordance with established guidelines are well tolerated, safe, and effective. In this article, we present unusual complications after hearing aid fitting that required surgical management.

Methods: Four otologists at a major university center with a combined 65 years of experience performed a retrospective analysis of their surgical practice. Six patients were identified that had encountered severe complications from improper earmold fitting that required surgical intervention.

Results: One patient had a perforation of the tympanic membrane with earmold material found to have migrated into the middle ear cleft. The tympanic membrane healed spontaneously, resulting in persistent otalgia and a maximum air‐bone gap. The earmold cast was successfully removed by means of a tympanomastoidectomy. Two patients with presbycusis and normal ear canals developed eardrum perforations and conductive hearing deficits. In both patients, earmold material was found partially occupying the middle ear cleft and removed by way of a transcanal approach. Three patients with prior canal wall down mastoidectomy defects and narrow external ear canals required microtoscopy under general anesthesia or canaloplasty for removal of impacted material.

Conclusion: Proper fitting of hearing aids performed by well‐trained medical professionals results in a very low incidence of significant complications. Perforation of the tympanic membrane with impaction of earmold material in the middle ear or mastoid bowl may occur and can be successfully managed by standard otologic surgical techniques.
Vertebrobasilar Occlusive Disorders Presenting as Sudden Sensorineural Hearing Loss
Authors: Sauvaget E , Kici S , Petelle B , Kania R , Chabriat H , Herman Ph , Huy P Tran Ba
Published: January 2004

Background: Isolated sudden sensorineural hearing loss (SSHL) has been rarely related to vertebrobasilar occlusive disorders (VBOD). This is an important issue for both neurologists and otolaryngologists, since the management and prognosis of this type of hearing loss widely differs from that of hearing loss from other causes.

Objectives: To describe the clinical characteristics and report the incidence of SSHL related to VBOD.

Methods: Retrospective analysis of clinical charts from 333 patients admitted for SSHL in a large ear, nose, and throat emergency tertiary care center from 1999 to 2002.

Results: Four cases (1.2%) of VBOD as the unique cause of SSHL were diagnosed among 333 patients. The most typical features of these cases were the presence of one of the following characteristics: (1) bilateral SSHL, (2) associated occipital or posterior nuchal pain, and (3) the occurrence of delayed neurologic deficits. The underlying vascular disease affected the vertebral arteries: dissection in two cases and atherosclerosis in two other cases. The audiometric features of hearing loss were endocochlear in one case, of both types in one case, and unknown in two cases. Hearing recovered partially or completely.

Conclusions: Our results confirm the low incidence of SSHL related to VBOD and show that the observation of endocochlear audiometric features cannot preclude a central cause in SSHL. The clinical presentation of our cases related to VBOD emphasize that a careful follow‐up of any patient with SSHL is warranted and that the presence of nuchal pain suggestive of arterial dissection in younger subjects, a past history of atherosclerosis or embolism in older patients, or the occurrence of delayed associated neurologic symptoms should be considered with particular caution in this situation.
Multicenter Initiative Seeking Critical Genes in Respiratory Papillomatosis
Authors: Buchinsky Farrel J. , Derkay Craig S. , Leal Suzanne M. , Donfack Joseph , Ehrlich Garth D. , Post J Christopher
Published: January 2004

Objectives: To determine the host genes that govern susceptibility to recurrent respiratory papillomatosis (RRP). RRP is caused by human papillomavirus (HPV) 6 and 11. Millions of babies are exposed during the birthing process, but relatively few develop the disease and the aggressiveness of the course is highly variable. Genetically encoded host susceptibility is postulated. Determining the host genes that govern susceptibility will enhance our understanding not only of RRP but also of host‐viral interaction in general.

Study Design: A genome‐wide association study on familial triads consisting of an RRP‐affected child and his or her parents. Using the HapMap data from the human genome project, we will identify those alleles that are over‐transmitted by the parents to their affected offspring as compared to those alleles that are under‐transmitted.

Methods: Approximately 400 patients and their parents will be recruited through a collaboration between the Center for Genomic Sciences and the RRP Task Force. DNA will be extracted from blood specimens and viral typing will be performed on biopsy specimens. Patients will be genotyped using single nucleotide polymorphism (SNP) markers and compared to their respective parents' genotype using the transmission disequilibrium test. Both a genome scan and a candidate gene approach will be utilized.

Results: Institutional Review Board authorization has been obtained at three hospitals and the process is underway at 18 more. Patient and parent recruitment has begun. Specimens have been forwarded to Pittsburgh, Pennsylvania, where the DNA has been extracted and is being stored.

Conclusions: A novel approach combining a nationwide patient resource and the mapping power of the subcentimorgan human haplotype map has been developed to elucidate the biological mechanisms of RRP by determining the genetically encoded susceptibilities of host‐virus interaction.
Clinical Predictors of Difficult Laryngeal Exposure
Authors: Hsiung Ming‐Wang , Pai Lu , Kang Bor‐Hwang , Wang Bing‐Long , Wong Chih‐Shung , Wang Hsing‐Won
Published: January 2004

Purpose: Although difficult laryngeal exposure (DLE) is a common problem encountered after procedures using a rigid laryngoscope, to date, no anticipatory physical indicators have been formally noted as reliable predictors of DLE. The purpose of this paper is to identify useful and reliable indicators by which to predict, with acceptable accuracy, the occurrence of DLE following rigid laryngoscopy.

Study Design: Fifty‐six patients, each of whom had undergone a rigid laryngoscope procedure, were classified as belonging to either the DLE group (n = 19) or the control group (n = 37) for purposes of this prospective study.

Methods: All patients were given a physical examination, which encompassed the following nine measures: age, sex, modified Mallampati index (MMI), body mass index (BMI), hyoid‐mental distance (HMD), thyroid‐mental distance (TMD), thyroid‐mandible angle (TMA), horizontal thyroid distance (HTD), and vertical thyroid distance (VTD). Stepwise regression was employed on patient data to identify those with DLE.

Results: The ages of patients in the DLE group ranged from 35 to 79 years, with a mean of 51.3 years. Among the nine variables, we found sex (P = .045, odds ratio = 69.159) and TMA (P = .004, odds ratio = 1.510) to be “reliable” DLE predictors. Using these two variables, 94.6% of study case patients could have been correctly classified preoperatively. Based on our comparison of case results, we found that a TMA value greater than 120 degrees in men and 130 degrees in women indicates a strong likelihood of DLE.

Conclusions: TMA is a sensitive, reliable, and useful predictor of DLE in both men and women. The combination of sex and TMA provide important initial clinical indicators that can alert a clinician regarding DLE probability.
Effects of Insulin‐Like Growth Factor‐1 Gene Transfer on Myosin Heavy Chains in Denervated Rat Laryngeal Muscle
Authors: Flint Paul W. , Nakagawa Hideki , Shiotani Akihiro , Coleman Michael E. , O'Malley Bert W.
Published: January 2004

Objectives/Hypothesis: To determine whether the myotrophic activity of human insulin‐like growth factor (hIGF)‐1 promotes restoration of normal myosin heavy chain (MHC) composition after nerve injury, MHC composition was analyzed after hIGF‐1 gene transfer in denervated rat laryngeal muscle.

Study Design: Animal model to study effects of gene transfer on laryngeal paralysis.

Methods: In anesthetized rats, the left recurrent and superior laryngeal nerves are cut and suture ligated. A midline thyrotomy is performed, and the thyroarytenoid muscle is injected with a polyvinyl‐based formulation containing a muscle specific expression system and hIGF‐1 DNA (treatment group) or saline (control group). After 30 days, animals were killed, and the thyroarytenoid muscle was removed and processed for sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDSPAGE). Densitometric measurements were obtained to determine composition of MHCs.

Results: As previously described, MHC composition in denervated laryngeal muscle was characterized by a decrease in type IIB and IIL and up‐regulation of IIA/IIX. Compared with controls, hIGF‐1 treated animals demonstrated a significant increase in expression of type IIB and IIL and a significant decrease in expression of type IIA/X.

Conclusions: These findings suggest that the myotrophic effect of hIGF‐1 gene transfer results in normalization of MHC composition in denervated muscle, with suppression of type IIA/X MHC and promotion of type IIL expression.
Inspiratory Activation of the Vocal Cord Adductor, Part II: Animal Study in the Cat
Authors: Sekita Yasuko , Shiba Keisuke , Nakazawa Ken , Numasawa Tamaki , Isono Shiroh
Published: January 2004

Objectives/Hypothesis: The authors have shown previously that the vocal cord adductor is activated during inspiration in patients with vocal cord abduction impairment and that this adductor inspiratory activity is abolished by relief from inspiratory tracheal negative pressure by opening the tracheostoma. (Shiba K. Isono S, Sekita Y, Tanaka A. Inspiratory activation of the vocal cord adductor, Part I: human study in patients with restricted abduction of the vocal cords. Laryngoscope 2004;114:372–375). The authors hypothesized that insufficient opening of the glottis during inspiration generates strong negative pressure in the trachea and that this negative pressure triggers an airway reflex that activates the adductor.

Study Design: Experimental study of the mechanism of laryngeal obstruction using an animal model of restricted abduction of the vocal cords.

Methods: To identify such an airway reflex, the authors recorded the adductor electromyogram in anesthetized cats whose vocal cords were mechanically adducted by stitching both cords together. To determine whether this reflex modulation of adductor activity is induced through afferents from the larynx or from the lower airway, the authors applied negative pressure to the subglottic space and lower airway separately.

Results: The adductor was activated during inspiration with powerful negative pressure in the trachea. Negative pressure in the subglottic space had a more marked effect on the adductor activity than did pressure in the lower airway. The adductor inspiratory activity was virtually abolished by laryngeal deafferentation.

Conclusion: Glottal narrowing during inspiration reflexly activates the vocal cord adductor. This paradoxical inspiratory‐related adductor activation is induced by an airway reflex triggered mainly through afferents from the larynx and probably contributes to stridor and dyspnea in patients with laryngeal obstruction.
A Model of Global Cerebral Ischemia in C57 BL/6 Mice
Authors: Yonekura Ichiro , Kawahara Nobutaka , Nakatomi Hirofumi , Furuya Kazuhide , Kirino Takaaki
Published: January 2004

A reproducible model of global cerebral ischemia in mice is essential for elucidating the molecular mechanism of ischemic neuronal injury. Such a model is particularly important in the mouse because many genetically engineered mutant animals are available. In C57BL/6 and SV129/EMS mice, we evaluated a three-vessel occlusion model. Occlusion of the basilar artery with a miniature clip was followed by bilateral carotid occlusion. The mean cortical cerebral blood flow was reduced to less than 10% of the preischemic value, and the mean anoxic depolarization was attained within 1 minute. In C57BL/6 mice, there was CA1 hippocampal neuronal degeneration 4 days after ischemia. Neuronal damage depended upon ischemic duration: the surviving neuronal count was 78.5 ± 8.5% after 8-minute ischemia and 8.4 ± 12.7% after 14-minute ischemia. In SV129/EMS mice, similar neuronal degeneration was not observed after 14-minute ischemia. The global ischemia model in C57BL/6 mice showed high reproducibility and consistent neuronal injury in the CA1 sector, indicating that comparison of ischemic outcome between wild-type and mutant mice could provide meaningful data using the C57BL/6 genetic background. Strain differences in this study highlight the need for consideration of genetic background when evaluating ischemia experiments in mice.
Defining Ischemic Burden after Traumatic Brain Injury Using 15O PET Imaging of Cerebral Physiology
Authors: Coles Jonathan P , Fryer Tim D , Smielewski Peter , Rice Kenneth , Clark John C , Pickard John D , Menon David K
Published: January 2004

Whereas postmortem ischemic damage is common in head injury, antemortem demonstration of ischemia has proven to be elusive. Although 15O positron emission tomography may be useful in this area, the technique has traditionally analyzed data within regions of interest (ROIs) to improve statistical accuracy. In head injury, such techniques are limited because of the lack of a priori knowledge regarding the location of ischemia, coexistence of hyperaemia, and difficulty in defining ischemic cerebral blood flow (CBF) and cerebral oxygen metabolism (CMRO2) levels. We report a novel method for defining disease pathophysiology following head injury. Voxel-based approaches are used to define the distribution of oxygen extraction fraction (OEF) across the entire brain; the standard deviation of this distribution provides a measure of the variability of OEF. These data are also used to integrate voxels above a threshold OEF value to produce an ROI based upon coherent physiology rather than spatial contiguity (the ischemic brain volume; IBV). However, such approaches may suffer from poor statistical accuracy, particularly in regions with low blood flow. The magnitude of these errors has been assessed in modeling experiments using the Hoffman brain phantom and modified control datasets. We conclude that this technique is a valid and useful tool for quantifying ischemic burden after traumatic brain injury.
Intracerebral Hirudin Injection Attenuates Ischemic Damage and Neurologic Deficits without Altering Local Cerebral Blood Flow
Authors: Karabiyikoglu Murat , Hua Ya , Keep Richard F. , Ennis Steven R. , Xi Guohua
Published: January 2004

There has been considerable interest in the use of thrombin inhibitors to reduce the occurrence of stroke or to potentiate tissue plasminogen activator-induced reperfusion. However, there is growing evidence that thrombin may also have extravascular effects that influence ischemic brain injury. Male Sprague-Dawley rats were subjected to either 90 minutes of temporary middle cerebral artery (MCA) occlusion or sham operation to examine thrombin and protease activated receptor-1 (PAR-1) expression. In another set of rats, the MCA was occluded for 90 minutes and 10 U of hirudin or the same volume of vehicle was injected into the caudate followed by reperfusion for up to 28 days, to test the effects of local thrombin inhibition on ischemic damage, neurologic outcome and cerebral blood flow (CBF). Thrombin immunoreactivity was increased in the ischemic caudate at 4 and 24 hours, whereas PAR-1 expression was unchanged. Hirudin reduced infarct volume in the caudate at 24 hours (79 ± 41 vs. 115 ± 20 mm3, P < 0.05) and resulted in a larger residual tissue volume in the caudate at 28 days (17.6 ± 3.9 vs. 11.8 ± 6.3 mm3, P < 0.05). Hirudin treatment also had a beneficial effect on body weight and ameliorated neurologic deficits tested by forelimb placing and forelimb use asymmetry during 28 days survival. These beneficial effects of hirudin were not associated with improved regional CBF during reperfusion. These results suggest that, in addition to their effects on coagulation and circulation, thrombin inhibitors also have direct neuroprotective properties and may be considered in stroke therapy.
Task Repetition Can Affect Functional Magnetic Resonance Imaging-Based Measures of Language Lateralization and Lead to Pseudoincreases in Bilaterality
Authors: Lohmann Hubertus , Deppe Michael , Jansen Andreas , Schwindt Wolfram , Knech Stefan
Published: January 2004

Repeated functional magnetic resonance imaging (fMRI) during learning and recovery can inform us about functional reorganization in the brain. We examined how, in the absence of reorganization, simple task repetition affects measures of fMRI activation. We studied fMRI activation over 10 consecutive sessions of silent word generation in a healthy subject. Additionally, we performed functional transcranial Doppler sonography (fTCD) to learn about the temporal pattern of corresponding changes in cerebral blood flow velocity (CBFV) and pulsatility. With repetition, word generation-associated increases in heart rate diminished steadily. Task repetition also led to a net increase in CBFV bilaterally and to a bilateral increase in the number of activated voxels on fMRI. As a result, whereas the absolute interhemispheric difference of activated voxels remained constant, there was a decrease in the standard fMRI index for language lateralization [LIfMRI = 100 (activated voxels in left hemisphere - voxels in right)/(voxels in left + voxels in right)]. Thus task repetition can lead to changes in task-related autonomic drive and an augmentation of bihemispheric blood flow. This can mimic increasing bilaterality of brain activation.
Incidence and Mechanisms of Cerebral Ischemia in Early Clinical Head Injury
Authors: Coles Jonathan P. , Fryer Tim D. , Smielewski Piotr , Chatfield Doris A. , Steiner Luzius A. , Johnston Andrew J. , Downey Stephen P. M. J. , Williams Guy B. , Aigbirhio Franklin , Hutchinson Peter J. , Rice Kenneth , Carpenter T. Adrian , Clark John C. , Pickard John D. , Menon David K.
Published: January 2004

Antemortem demonstration of ischemia has proved elusive in head injury because regional CBF reductions may represent hypoperfusion appropriately coupled to hypometabolism. Fifteen patients underwent positron emission tomography within 24 hours of head injury to map cerebral blood flow (CBF), cerebral oxygen metabolism (CMRO2), and oxygen extraction fraction (OEF). We estimated the volume of ischemic brain (IBV) and used the standard deviation of the OEF distribution to estimate the efficiency of coupling between CBF and CMRO2. The IBV in patients was significantly higher than controls (67 ± 69 vs. 2 ± 3 mL; P < 0.01). The coexistence of relative ischemia and hyperemia in some patients implies mismatching of perfusion to oxygen use. Whereas the saturation of jugular bulb blood (SjO2) correlated with the IBV ( r = 0.8, P < 0.01), SjO2 values of 50% were only achieved at an IBV of 170 ± 63 mL (mean ± 95% CI), which equates to 13 ± 5% of the brain. Increases in IBV correlated with a poor Glasgow Outcome Score 6 months after injury (ρ = −0.6, P < 0.05). These results suggest significant ischemia within the first day after head injury. The ischemic burden represented by this “traumatic penumbra” is poorly detected by bedside clinical monitors and has significant associations with outcome.
Mechanisms of Erythropoietin-induced Brain Protection in Neonatal Hypoxia-Ischemia Rat Model
Authors: Sun Yun , Zhou Changman , Polk Paula , Nanda Anil , Zhang John H.
Published: January 2004

Erythropoietin, a hemotopoietic growth factor, has brain protective actions. This study investigated the mechanisms of Recombinant Human EPO (rhEPO)-induced brain protection in neonates. An established rat hypoxia-ischemia model was used by ligation of the right common carotid artery of 7-day-old pups, followed by 90 minute of hypoxia (8% 02 and 92% N2) at 37°C. Animals were divided into three groups: control, hypoxia-ischemia, and hypoxia-ischemia plus rhEPO treatment. In rhEPO treated pups, 300 units rhEPO was administered intraperitoneally 24 hours before hypoxia. rhEPO treatment (300 units) was administered daily for an additional 2 days. ELISA and immunohistochemistry examined the expression of EPO and EPOR. Brain weight, morphology, TUNEL assay, and DNA laddering evaluated brain protection. rhEPO abolished mortality (from 19% to 0%) during hypoxia insult, increased brain weight from 52% to 88%, reduced DNA fragmentation, and decreased TUNEL-positive cells. Real-time RT-PCR, Western blot, and immunohistochemistry revealed an enhanced expression of heat shock protein 27 (HSP27) in ischemic brain hemisphere. Double labeling of TUNEL with HSP27 showed most HSP27 positive cells were negative to TUNEL staining. rhEPO reduces brain injury, especially apoptotic cell death after neonatal hypoxia-ischemia, partially mediated by the activation of HSP27.
Pathophysiology of Cerebral Ischemia and Brain Trauma: Similarities and Differences
Authors: Bramlett Helen M. , Dietrich W. Dalton
Published: January 2004

Current knowledge regarding the pathophysiology of cerebral ischemia and brain trauma indicates that similar mechanisms contribute to loss of cellular integrity and tissue destruction. Mechanisms of cell damage include excitotoxicity, oxidative stress, free radical production, apoptosis and inflammation. Genetic and gender factors have also been shown to be important mediators of pathomechanisms present in both injury settings. However, the fact that these injuries arise from different types of primary insults leads to diverse cellular vulnerability patterns as well as a spectrum of injury processes. Blunt head trauma produces shear forces that result in primary membrane damage to neuronal cell bodies, white matter structures and vascular beds as well as secondary injury mechanisms. Severe cerebral ischemic insults lead to metabolic stress, ionic perturbations, and a complex cascade of biochemical and molecular events ultimately causing neuronal death. Similarities in the pathogenesis of these cerebral injuries may indicate that therapeutic strategies protective following ischemia may also be beneficial after trauma. This review summarizes and contrasts injury mechanisms after ischemia and trauma and discusses neuroprotective strategies that target both types of injuries.
Roles of Bifocal, Homer, and F-actin in anchoring Oskar to the posterior cortex of Drosophila oocytes
Authors: Babu Kavita , Cai Yu , Bahri Sami , Yang Xiaohang , Chia William
Published: January 2004

Transport, translation, and anchoring of osk mRNA and proteins are essential for posterior patterning of Drosophila embryos. Here we show that Homer and Bifocal act redundantly to promote posterior anchoring of the osk gene products. Disruption of actin microfilaments, which causes delocalization of Bifocal but not Homer from the oocyte cortex, severely disrupts anchoring of osk gene products only when Homer (not Bifocal) is absent. Our data suggest that two processes, one requiring Bifocal and an intact F-actin cytoskeleton and a second requiring Homer but independent of intact F-actin, may act redundantly to mediate posterior anchoring of the osk gene products.
A survey of environmental health officers' views of food hygiene training
Authors: Worsfold Denise , Griffith Chris , Worsfold Philip
Published: February 2004

In both their enforcement and training role environmental health officers (EHOs) may influence businesses' attitudes to hygiene training. A survey was conducted to examine EHOs' experience and perceptions of the provision and effectiveness of food hygiene training in small food businesses. The results indicate that officers had concerns about the content and the delivery of hygiene courses and about the quality of other hygiene trainers. Officers use the industry guides to advise on training but receive limited guidance on the assessment of hygiene training in the workplace. The checking of training records was considered to be less important than the use of observation and questioning for assessing hygiene training effectiveness. Environmental factors, such as supervisor support and situational aids were judged by officers to be important factors in the implementation of workplace hygiene training. They reported low levels of formal refresher training and active support of training by management.
The desert generation
Authors: Baruch Yehuda
Published: February 2004

Building on lessons from a Biblical story, this paper analyzes and suggests mental frameworks and an innovative perspective for managing contemporary new psychological contracts, by drawing on a case of a nation which was found unfit for a new type of existence, a different life ethos, and philosophy. In that story, a strategic decision was made for that generation, which was to be consumed in the desert. From this story the paper projects onto contemporary career concepts and approaches. The paper acknowledges the difficulties employees face in today's turbulent labor markets. It concludes with offering a variety of options available to executives and a set of strategic approaches of managerial career systems that organizations can apply.
Developing logistics competencies through third party logistics relationships
Authors: Halldórsson Árni , Skjøtt‐Larsen Tage
Published: February 2004

This paper considers third party logistics (TPL) from a resource and competence perspective. New competencies are developed in the relationship between the shipper and the TPL provider. A typology of TPL relationships is developed going from market exchanges to joint logistics solutions. Here, the article will concentrate on the highest level – joint logistics solutions. The theoretical grounding of competence development will be outlined. Two case examples will illustrate the learning process in TPL arrangements. Finally, the article will discuss managerial implications and implications for future research in TPL.
Sources of first mover advantages in emerging markets – an Indian perspective
Authors: Rahman Zillur , Bhattacharyya S.K.
Published: January 2004

The order of entry of a firm in a market is associated with its ability to create value. This paper suggests that it pays to be a first mover in an emerging market, the darlings of 2001. It touches on the definition of an emerging market, discusses the importance of emerging markets in the global business and highlights how the infrastructure condition and consumer orientation in an emerging market favour a first mover. Finally, it recommends various strategies that a first mover should follow to have sustainable competitive advantages.
Enterprise systems and the supply chain
Authors: Davenport Thomas H. , Brooks Jeffrey D.
Published: January 2004

Early enterprise resource planning (ERP) systems or, more simply, enterprise systems (ES), were not primarily focused on the supply chain. Their initial focus was to execute and integrate such internally‐oriented applications that support finance, accounting, manufacturing, order entry, and human resources. Having got their internal operations somewhat integrated, many organizations have moved on to address the supply chain with their ES. The Internet has also brought about a revolution in supply chain thinking. Progress toward complete inter‐enterprise integration is measured in years and even decades. In this article, we discuss both the visions firms have for using enterprise systems for supply chain management, and the actual reality of current implementation. We conclude with projections of how enterprise systems will be used for supply chains in the future.
Aligning mySAP.com with the future logistics enterprise
Authors: Gulledge Thomas R. , Hayes Phil , Lotterer Alexander , Simon Georg
Published: January 2004

The US Department of Defense (DoD) is engaged in a multi‐year transformation of logistics planning and execution, known as the Future Logistics Enterprise (FLE). It is currently being defined in policy documents and an implementation plan known as the Future Logistics Architecture (FLA). The systems strategy for the FLE is still emerging, but it is anticipated that commercial standard software will play a significant role in the enablement of the new logistics business processes. A number of products are available for implementation, but this paper focuses on mySAP.com from SAP AG. We show the strategy for aligning the SAP reference hierarchy and the associated reference business process models with the FLA. The result of the mapping and associated analysis is an SAP reference model for the FLE, which can be used as a guide for the software vendor for future product development strategies. This paper reports on the development of the FLA, its alignment with mySAP.com and the development of the SAP reference model.
The integration of ERP into a logistics curriculum: applying a systems approach
Authors: Boykin Raymond F. , Benjamin Martz Wm.
Published: January 2004

The area of logistics and enterprise resource planning (ERP) have a natural bond in that both deal explicitly with identifying working with business processes. This also generates concerns. For example, typical education and training paradigms implementations are often task‐oriented (scientific management) not process‐oriented (systems management). This creates a paradoxical situation where those taught to work with logistics and ERP systems tend to focus only on and understand a limited role within the business. We examine the process‐oriented versus task‐oriented approach used in a high‐tech manufacturing organization to validate the conjecture. In addition, we propose that students exposed to the integration of ERP topics in their logistics coursework develop more process‐oriented thinking than do those students exposed to more traditional or functional area education. The foundations for a preferred model for ERP education and training are proposed.
A cutting sequencing approach to modular manufacturing
Authors: Yazgaç Tülin , Gürcan Özdemir Rifat
Published: January 2004

In this study, a two‐stage algorithm is developed for the cutting sequencing problem in a modular manufacturing system consisting of four basic workstations. Since the flexibility of the system is dependent upon the cutting stage of raw materials, the study focuses particularly on this workstation. In the first stage of the algorithm, an integer linear programming model is used to determine the number of hardboards that will be cut. The model is tested with two different objective functions. In the second stage, a heuristic which takes into account the due date of the products is developed to obtain the real‐time sequencing of these cutting patterns on the shop floor. The algorithm is further implemented in a furniture manufacturer that operates on a make‐to‐order basis. The results of the existing and proposed system are compared, and the proposed algorithm is found to provide a useful tool in such a real‐life planning problem.
An integrated method for designing modular products
Authors: Asan Umut , Polat Seçkin , Serdar Seyda
Published: January 2004

Many recent modular design methods and approaches have focused on the modularization process – decomposition and composition. This paper suggests an integrated methodology that includes additional tools and stages for a complete modular architecture design. The borders of the modular design process are expanded by adding strategic issues, appropriateness to modularity, degree of modularity and modularity strategies, in an operationalized manner. The methodology presents a “requirements analysis‐ decomposition‐composition‐design evaluation” structure. The “modularization process” is designed so as to choose from three different perspectives – customer‐based, function‐based and structure‐based design. To test and validate the methodology it was applied to a domestic gas detector product family. As a result, a new modular product architecture with eight modules was developed.
Decision support system: real‐time control of manufacturing processes
Authors: Terblanche Swanepoel Karel
Published: January 2004

Manufacturing industries are in the midst of a new technological revolution, characterised by the increasing advances and application of information and communication technology for both information processing and automatic control. A unique manufacturing methodology for non‐destructive, real‐time process optimization and quality certification has been developed. This includes the design of a decision support system (DSS) for controlling the optimized process. The DSS comprises the capability of supporting both the process operator and manager in the decision‐making process, allowing them to take advantage of the degrees of freedom of the physical system to make it work in a way where the optimized process control variables are under statistical control, resulting in optimized output factors that, in turn, secure higher productivity and improved quality.
Work load responsive adjustment of planned lead times
Authors: Enns S.T. , Suwanruji Pattita
Published: January 2004

Mechanisms to adjust planned lead times based on current work loads are desirable for time‐phased planning systems. This paper investigates the use of exponentially smoothed order flow time feedback in setting planned lead times dynamically. The system studied is a supply chain with capacity‐constrained processing stations and transit times between stations. Lot sizes are based on the minimization of flow times using queuing approximations. Both seasonal and level demand patterns with uncertainty are considered. Since both dependent and independent demands are assumed at each station, customer delivery performance depends on the distribution of inventory along the supply chain. Results show that dynamic planned lead time setting can be used effectively to control delivery performance along the supply chain. Performance is also influenced significantly by appropriate lot size selection.
A decision support system for machine tool selection
Authors: Çagˇdaç Arslan M. , Çatay Bu¨lent , Budak Erhan
Published: January 2004

Globalization of business, the worldwide competitive economy and the decrease in product life force companies to use new equipments that are continuously introduced to the market with the advances in technology. An improper selection can negatively affect productivity, precision, flexibility and company’s responsive manufacturing capabilities. Thus, selecting the most suitable machine from the increasing number of available machines can be highly demanding. A decision support system is developed for the selection of machine tools. It will guide the selection process and help a decision maker solve the selection problem. Multi‐criteria weighted average is used in decision‐making process to rank the machines evaluated with respect to several criteria. The method is demonstrated with an example.
Does double loop learning create reliable knowledge?
Authors: Blackman Deborah , Connelly James , Henderson Steven
Published: January 2004

This paper addresses doubts concerning the reliability of knowledge being created by double loop learning processes. Popper's ontological worlds are used to explore the philosophical basis of the way that individual experiences are turned into organisational knowledge, and such knowledge is used to generate organisational learning. The paper suggests that double loop learning may frequently create mistakes and fail to detect possible interesting lines of thought. Popper's work is used to suggest some solutions and an elaboration of the double loop learning process, but ultimately effective organisational learning is shown to depend on the undertaking of an epistemological burden by individuals above and beyond what is usually explicated in prescriptions for learning organisation and knowledge management.
Strategic positioning of HRM in knowledge‐based organizations
Authors: Thite Mohan
Published: January 2004

With knowledge management as the strategic intent and learning to learn as the strategic weapon, the current management focus is on how to leverage knowledge faster and better than competitors. Research demonstrates that it is the cultural mindset of the people in the organisation that primarily defines success in knowledge intensive organisations. This article highlights the importance of people management in the knowledge economy, explores major challenges to human resource management (HRM) in managing knowledge workers, and identifies some key HR strategies for effective people‐centric partnership in knowledge management, namely, trusting HR philosophy, institutionalising learning to learn, and fine tuning HR systems in recruitment, retainment, performance and reward management of intellectual capital in a multi‐national context. This article reflects the key themes from the author's recent book, Managing People in the New Economy, published by Sage.
Ultrasound estimates of gestational age among perinatally demised: a population‐based study
Authors: Olsen Øystein Erlend , Lie Rolv Terje , Rosendahl Karen
Published: February 2004

Background.  Correct estimation of gestational age may improve the quality of obstetric care. We hypothesize that significant differences between traditional and alternative estimates by ultrasound are evident among perinatal deaths.

Methods.  Population‐based case series with data linkage between autopsy records and The Medical Birth Registry of Norway, including perinatally demised singletons who were examined by autopsy and post‐mortem radiography, having antenatal estimates of gestational age both by the calendar method, as calculated from the first day of the last menstrual period preceding the pregnancy (GAlmp), and by mid‐second‐trimester ultrasound (GAus), N = 380. The main outcome measure was the distribution of GAlmp and GAus within weight strata.

Results.  Mean GAus was 1 week less than mean GAlmp (t‐test, p < 0.001). The degree of apparent growth restriction manifest after death, as expressed by both birthweight and by post‐mortem radiographic measurements, was fairly well correlated with the degree of downward adjustment of age by ultrasound in the early second trimester (Pearson's correlation, r = − 0.599, p < 0.001). The degree of discrepancy between the ultrasound and the calendar methods was associated both with placenta findings (Kruskal–Wallis test, χ2 = 20.95, p = 0.007) and with the main cause of death (Kruskal–Wallis test, χ2 = 27.65, p = 0.004).

Conclusion.  Among infants who died perinatally, gestational age seemed to be systematically downward adjusted by mid‐second‐trimester screening ultrasound, particularly among those who were the most growth retarded at the time of death.
Ovarian metastasis in women with clinical stage I endometrial carcinoma
Authors: Gemer Ofer , Bergman Marina , Segal Shmuel
Published: February 2004

Background.  The incidence of ovarian metastasis in women with clinical stage I endometrial carcinoma is generally reported to be 5%, leading to the practice of removing the ovaries at surgery even in young patients.

Methods.  A retrospective study of 84 patients with clinical stage I endometrial cancer was carried out. Patients were excluded if the pathologic study revealed any evidence of extrauterine, apart from adnexal, spread or if the peritoneal cytology was positive. Patients with serous papillary or clear cell tumor histology were also excluded.

Results.  Sixty‐seven patients fulfilled the inclusion criteria. Only three (4%) patients were found to be in surgical stage IIIA, all three had grade 3 tumors. Of these patients, two had uterine serosal involvement and one had a microscopic tumor implant in a fallopian tube; none had ovarian metastasis.

Conclusions.  The risk of ovarian metastasis in women with well to moderately differentiated endometrial cancer, myometrial invasion limited to less than one half of the myometrium, negative peritoneal cytology and no evidence of metastatic lymph node spread is negligible. Young patients with a preoperative histological diagnosis of well to moderately differentiated endometrial carcinoma may be surgically staged, leaving the final decision regarding removal of the ovaries pending a thorough pathological review of the surgical specimens.
Prevalence of female genital mutilation among African women resident in the Swedish county of Östergötland
Authors: Kangoum Abdul‐Almawla , Flodin Ulf , Hammar Mats , Sydsjö Gunilla
Published: February 2004

Objectives.  To establish the prevalence of female genital mutilation (FGM) among African women resident in the Swedish County of Östergötland and assess the types of FGM.

Material and methods.  Three hundred and four African women aged ≥ 18 years were domiciled in Östergötland by the end of 1998. The women were invited by letter. A socio‐cultural questionnaire designed to give an overall picture of FGM within a socio‐economic context, and also to invite the women to an interview and examination, was sent to all African women in the county of Östergötland. Women who gave their consent (n = 63) underwent a gynecologic examination.

Results.  The response rate was 84%. According to the questionnaire, 68% of all the African women were genitally mutilated. The clinical examination revealed that 39 women (62%) were mutilated, 17 of them (44%) had undergone removal of part or all external genitalia and stitching (‘infibulation’), 26% had undergone removal of the prepuce of the clitoris (‘prepucectomy’), 23% had undergone various cultural practices on the external genitalia, and 7.7% excision of the clitoris with partial or total removal of labia minora (‘clitoridectomy’).

Conclusion.  The influx of immigrants to Sweden and the other Scandinavian countries from cultures where FGM is practiced, requires that physicians and other health professionals familiarize themselves with the practice and the cultural beliefs underlying it. Sensitivity to the needs of these women as well as attention to the potential physical hazards posed by the practice are important factors in care.
Skeletal phenotype in patients with Shwachman–Diamond syndrome and mutations in SBDS
Authors: Mäkitie O , Ellis L , Durie PR , Morrison JA , Sochett EB , Rommens JM , Cole WG
Published: January 2004

Pancreatic exocrine and bone marrow dysfunctions are considered to be universal features of Shwachman–Diamond syndrome (SDS) whereas the associated skeletal dysplasia is variable and not consistently observed. The genetic defect in SDS has recently been identified; causative mutations have been shown in the SBDS gene. The aims of this study were to characterize the nature, frequency, and age‐related changes of radiographic skeletal abnormalities in patients with SBDS mutations and to assess genotype–phenotype correlation. Fifteen patients (mean age 9.7 years) with a clinical diagnosis of SDS and documented SBDS gene mutations were included. Review of their skeletal radiographs showed abnormalities in all patients. The skeletal changes were variable, even in patients with identical genotypes. The typical features were (1) delayed appearance of secondary ossification centers, (2) variable widening and irregularity of the metaphyses in early childhood, followed by progressive thickening and irregularity of the growth plates, and (3) generalized osteopenia. There was a tendency towards normalization of the epiphyseal maturation defect and progression of the metaphyseal changes with age. The results suggest that the characteristic skeletal changes are present in all patients with SDS and SBDS mutations, but their severity and localization varies with age. No phenotype–genotype correlation was observed.