bluuebunny/crossref_metadata_2025 huggingface dataset:
Building Research Competence in Nursing Through Mentoring
Authors: Byrne Mary W. , Keefe Maureen R.
Published: April 2004

Purpose: To explore how mentoring can be used to build research competence in nursing in various professional and geographic settings.

Organizing construct: The traditional concept of mentoring in interdisciplinary health professions and its application to nursing research.

Methods: Literature review of MEDLINE and CINAHL databases 1990–2001 and personal reflections on mentoring and mentored experiences.

Findings: Mentoring relationship models identified include: traditional mentor and protégé, team, peer, inclusive, and mentoring forward. E‐mentoring strategies facilitate interactions for long‐distance relationships. Discrete projects, multiple mentor sources, and mutually beneficial peer relationships can enable mentoring across one's career. Psychosocial dimensions of mentoring support creative work. When scholarly productivity with funded research is the desired outcome, intense involvement of a protégé with an expert researcher is essential.

Conclusion: Choices among mentoring models can be made in accordance with resources, priorities, and objectives congruent with a given nursing setting and time, but optimum scholarly productivity requires experts and sustained support.
Validation of the Spanish Life Support Preference Questionnaire (LSPQ)
Authors: Froman Robin D. , Owen Steven V.
Published: April 2004

Purpose: To translate and validate the Life Support Preference Questionnaire (LSPQ) for use with Spanish‐speaking adults, and to further validate the English version of the LSPQ.

Methods: Two samples were included: community‐dwelling Hispanic and non‐Hispanic adults who were monolingual or bilingual Spanish speakers, and an English‐speaking sample, all living in south‐central United States. Validation included calculation of internal consistency, stability, and alternate forms reliability estimates for two language versions of the LSPQ. Factorial validity was studied for both language versions and regression and t test analyses were done to explore ethnic differences in selection of the life support choices in the scale.

Findings: Both language versions of the LSPQ showed strongly supportive measurement properties. Differences were found between ethnic groups on four of the item choices, indicating that Hispanics in this sample preferred interventions to actively support life more than did the non‐Hispanic adults.

Conclusions: Both the English and Spanish versions of the LSPQ have been validated for use in research and practice. Additional validation will be necessary in other samples.
Teaching Philosophy of Science in Nursing Doctoral Education
Authors: Butts Janie Bond , Lundy Karen Saucier
Published: April 2004

Purpose: To explore the teaching and learning process regarding philosophy of science and to offer creative recommendations based on classroom experience.

Conceptual Framework: Dewey's writings about intelligence, deliberation, and critical reflection; Freire's writings about active knowers provide the foundation for the teaching and learning environment for doctoral students.

Methods: A case example is presented. Creative strategies and assignments are used, such as classroom exploration and connections between nursing, philosophy, philosophy of science, and students' personal lives; classroom deliberation; journaling; philosophical thinking; development of a philosophical topic such as determinism, freedom, or the mind; and presentation of a philosophical book.

Conclusions: The philosophy of science course is critical content for doctoral students.
Psychosocial Factors Related to Nausea, Vomiting, and Fatigue in Early Pregnancy
Authors: Chou Fan‐Hao , Lin Li‐Ling , Cooney Ann T. , Walker Lorraine O. , Riggs Mark W.
Published: April 2004

Purpose: To test whether nausea and vomiting or fatigue correlated with psychosocial variables.

Design: Descriptive, using secondary data from a prenatal database of 113 women in prenatal care in Texas. Mean gestational duration was 59 days at the time of data collection.

Methods: Psychosocial factors, frequency of nausea and vomiting and of fatigue were determined by use of questionnaires. Psychosocial measures had reliability and validity and included the Personal Resources Questionnaire and Center for Epidemiologic Studies Depression Scale. A checklist was used for measuring nausea and vomiting and fatigue.

Findings: Of 113 participants, 30 (26.5%) reported no, 43 (38.1%) occasional, and 40 (35.4%) frequent nausea and vomiting. Depressive symptoms had the highest correlation with nausea and vomiting. Social support was negatively related to nausea and vomiting. Four (3.5%) women reported no fatigue, 49 (43.4%) reported occasional fatigue, and 60 (53.1%) reported frequent fatigue in the past month. Depressive symptoms had the highest correlation with fatigue. The chi‐square statistic showed that fatigue was significantly related to employment. Fatigue was not significantly associated with work hours or stressfulness of jobs.

Conclusions: Only a limited number of psychosocial factors were associated with nausea and vomiting and fatigue in early pregnancy. Depression was related to physical symptoms, but unclear was whether depression preceded or resulted from the symptoms. Many women experienced symptoms, and better understanding of causality is needed to ameliorate the effects on women's well‐being.
Comparing Various Short‐Form Geriatric Depression Scales Leads to the GDS‐5/15
Authors: Weeks Sandra Kenney , McGann Paul E. , Michaels Teresa King , Penninx Brenda W.J.H.
Published: April 2004

Purpose: To compare three published short GDS scales and to identify a valid and reliable short‐form alternative to the 15‐item Geriatric Depression Scale.

Design: Comparative validation study via retrospective chart review of 816 acute care patients in an 830‐bed academic medical center in the USA in 2001.

Methods: Data of the 15‐item Geriatric Depression Scale, the Mini‐Mental State Examination, and demographic data were extracted from medical records after patient discharge. Three scales: the D'Ath GDS‐4, van Marwijk GDS‐4, and Hoyl GDS‐5, were compared to the 15‐item Geriatric Depression Scale.

Results: The Hoyl 5‐item version showed the highest sensitivity (97.9%). Concern for GDS‐5 false positives when compared to the 15‐item GDS (specificity 72.7%) led to re‐ordering the 15 GDS items into a new two‐tiered instrument, the GDS‐5/15. In this study of 816 older adult inpatients, 60% were screened as “not depressed” using the first 5 items on the GDS‐5/15, leaving 40% for continued screening and completion of all 15 GDS items.

Conclusions: A shorter screening tool might encourage more providers to add depression screening to routine health care visits. The GDS‐5/15 is an alternative screening tool.
The Relationship of Violence and Trichotillomania
Authors: Boughn Susan , Holdom Julie Jaarsma
Published: April 2004

Purpose: To examine the relationship between violence and the development of trichotillomania (TTM) in women.

Design and methods: Semistructured interviews were conducted with a convenience sample of 44 women with trichotillomania from 21 American states and Canada. The participants were asked to describe how they live and cope with TTM. The data were subjected to content analysis and were quantified for presentation. Checks were instituted to establish reliability of the content analysis using the criteria of reproducibility and stability.

Findings: Forty of the 44 women (91%) reported some form of trauma or violence occurring during their lives and 38 (86%) reported a history of violence concurrent with the onset of TTM. Events ranged from repetitive and moderate to severe abuse (including sexual assault, rape, and gang rape) by family members, acquaintances, and strangers.

Conclusions: These women with trichotillomania experienced a disproportionate number of traumatic or violent episodes in childhood. In most cases, the onset of TTM was correlated with specific episodes of violence. Of special interest is the possible relationship between family chaos experienced during childhood and the onset of TTM.
Increasing Perceptions of Self‐Worth in Preadolescents Diagnosed with ADHD
Authors: Frame Kathleen , Kelly Lynn , Bayley Elizabeth
Published: April 2004

Purpose: To test the effectiveness of a school‐based, nurse‐facilitated support group in increasing perceptions of scholastic competence, social acceptance, behavioral conduct, perceived athletic competence, perceived physical appearance, and perceived global self‐worth in preadolescents diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD).

Design: A quasi‐experimental design with 65 preadolescents diagnosed with ADD or ADHD in an upper‐middle class community in the United States.

Methods: Participants randomly assigned to either the control or experimental group completed Harter's Self‐Perception Profile for Children instrument at the beginning of the study and 4 weeks later. Students in the experimental condition participated in a school‐nurse facilitated support group which met twice weekly for 4 weeks.

Findings: Participants in the support group had increased scores on each of the six subscales, with significant increases on four of the subscales, including perceived social acceptance, perceived athletic competence, perceived physical appearance, and perceived global self‐worth.

Conclusion: Participation in a school‐based, nurse‐led support group was positively associated with perception of self‐worth in preadolescents diagnosed with ADD or ADHD.
The Effects of an Educational Intervention on Antipsychotic‐Induced Weight Gain
Authors: Littrell Kimberly H. , Hilligoss Nicole M. , Kirshner Carol D. , Petty Richard G. , Johnson Craig G.
Published: April 2004

Purpose: To assess the effect of an educational intervention on antipsychotic‐induced weight gain among patients with schizophrenia.

Design and Methods: Quasi‐experimental. Seventy patients with a DSM‐IV diagnosis of schizophrenia or schizoaffective disorder entered this 6‐month study condicted in the United States. All participants began receiving olanzapine treatment when they entered the study. The patients were then randomly assigned to an intervention group or a standard care group. Over the next 4‐months, the intervention group participated in weekly psychoeducation classes focused on nutrition, exercise, and living a healthy lifestyle. Patients were followed for an additional 2 months to assess weight change.

Findings: A statistically significant difference in weight change between the two groups was observed post‐treatment and at endpoint. At endpoint, the mean weight change of the intervention group was ‐.06 pounds, while the mean weight change in the standard care group was 9.57 pounds. In both groups, men gained significantly more weight than did women.

Conclusions: The results indicate that a structured educational intervention might have a positive effect on antipsychotic‐induced weight gain among patients with schizophrenia.
Social Capital, Health, and Health Disparities
Authors: Carlson Elizabeth D. , Chamberlain Robert M.
Published: April 2004

Purpose: To synthesize the empirical evidence that links social capital to population health with the aim of identifying implications for health disparities research.

Methods: A literature search of PubMed and CINAHL databases from January 1990 to June 2002 was done using the search term ‘social capital.’ In addition, tables of contents of applicable journals from January 1997 to June 2002 were searched. Reference lists were examined for additional empirical and theoretical articles related to social capital and health. Eighty‐four articles were retrieved for review and 19 articles met inclusion criteria.

Findings: Although most researchers concluded that their findings supported an association between social capital and health, all research was descriptive, without conceptual development. This gap resulted in (a) lack of distinction of the concept as an attribute of a geographic space or as an individual attribute, (b) problematic use of operational variables, and (c) limited theoretical exploration of causal linkage. These deficits limit the usefulness of the concept for health disparities research.

Conclusions: The lack of conceptual development diminishes the usefulness of social capital as a variable for public health research. However, the empirical evidence is sufficient to warrant further work to advance the concept in relation to population health and health disparities.
Testing an Intervention for Preventing Osteoporosis in Postmenopausal Breast Cancer Survivors
Authors: Waltman Nancy L. , Twiss Janice J. , Ott Carol D. , Gross Gloria Jean , Lindsey Ada M. , Moore Timothy E. , Berg Kris
Published: April 2004

Purpose: To test a 12‐month multicomponent intervention for preventing or treating osteoporosis in 21 postmenopausal women who had completed treatment (except Tamoxifen) for breast cancer, and for whom hormone replacement therapy (HRT) was contraindicated.

Design: Pilot intervention study.

Methods: The intervention consisted of home‐based strength and weight training exercises, 5 or 10 mg alendronate per day, 1500 mg calcium per day, 400 IU vitamin D per day, education on osteoporosis, and facilitative strategies to promote adherence to the intervention. Outcome measures were: adherence to the intervention, dynamic balance, muscle strength, and bone mineral density (BMD) of the hip, spine, and forearm.

Findings and Conclusions: Adherence to calcium, vitamin D, and alendronate therapy was above 95%, and adherence to strength training exercises was above 85%. Over the 12 months, the 21 participants had significant improvements in dynamic balance, muscle strength for hip flexion, hip extension, and knee flexion, and BMD of the spine and hip. Participants had a significant decrease in BMD of the forearm. Three of the 21 women who had measurable bone loss at baseline had normal BMD after 12 months of the intervention.
Contrasts in Patients' and Providers' Explanations of Rheumatoid Arthritis
Authors: Fair Betty Samford
Published: April 2004

Purpose: To investigate explanations of rheumatoid arthritis (RA) from young women's perceptions of the illness experience and providers' understanding of the disease.

Design and Methods: This ethnographic study included 17 women from age 26 to 40 years who were under medical care for RA, and five health care providers of these participants.

Findings: Two main themes were identified: (a) having RA ‘is a pain’ and (b) it changed me. The first theme represented the participants' physical and emotional suffering, interferences in their everyday lives, and aggravations in receiving health care. The second theme represented the life and lifestyle changes the women experienced as a result of having RA. The providers' explanations included two themes: (a) functioning in a normal manner and (b) controlling the disease. The first theme was keeping the women's physical functioning as normal as possible. The second theme was the providers' goal to control the disease, which they believed would lead to the preservation of joint function and manageable pain levels. Regarding results of health care, the participants and providers had comparable beliefs about decreasing the physical pain and improving joint function but they had disparate notions about the participants' being active partners in communication and negotiation processes of their health care.

Conclusions: The findings indicated the importance of discovering potential disparities in patients' and providers' explanations of RA, and revealed the participants' desire for clinical support in becoming partners in their own health care.
Challenging the Myths About Parents' Adjustment After the Sudden, Violent Death of a Child
Authors: Murphy Shirley A. , Johnson L. Clark , Lohan Janet
Published: April 2004

Purpose: To examine three commonly held myths: (a) a child's death by suicide results in the worst parental outcomes compared with other causes of violent death, (b) divorce is not only more common among bereaved than nonbereaved married couples, it might be inevitable, and (c) ‘letting go and moving on’ is an essential bereavement task needed for a satisfactory adjustment following the violent death of a child.

Design and Methods: Review of empirical evidence and critical reviews, review of Internet resources available to the general public, and the inclusion of original data obtained from a longitudinal, prospective study conducted by the authors.

Findings: Conclusive evidence was found to dispel two of the three myths, but sufficient evidence was not found to draw conclusions about the third myth regarding parents' adjustment to a child's suicidal death.

Conclusions: Myths in regard to parental bereavement are resistant to disconfirming evidence and they appear to persist among professional practitioners and the general public despite contrary empirical evidence.
Cancer Patients' Demographic Characteristics and Ratings of Patient‐Centered Nursing Care
Authors: Radwin Laurel E.
Published: April 2004

Purpose: To examine relationships between patients' demographic characteristics and patients' reports of patient‐centered care.

Design: Secondary analysis of data (N=423) from a study in the northeastern United States focused on the psychometric properties of the Oncology Patients' Perceptions of the Quality of Nursing Care Scale (OPPQNCS).

Methods: The quality of four interpersonal nursing interventions, representing patient‐centered nursing care, was measured with the OPPQNCS subscales. Patients' characteristics included race (White or non‐White), sex, age, education, income, and hospitalization for cancer. Four separate ordinary least squares regression models were constructed.

Findings: Hospitalization was inversely related to intervention quality in each model. Income was the only statistically significant characteristic for nonhospitalized patients, and only in the coordination model. For hospitalized patients, education was statistically significant in the coordination model, and income in the proficiency model. An interaction term for education and income was statistically significant in the responsiveness model, and a term for gender and education in the individualization model.

Conclusions: Hospitalized patients' exposure to nursing care may indicate a wider range of care quality than for nonhospitalized patients, possibly accounting for the inverse relationship between hospitalization and patient‐centered care. Groups identified at risk for lower quality care—minorities, women, elders, and people in low‐income groups—did not report a lower level of patient‐centered nursing care. Nurses' contributions to patient‐centered care and care equity are important components of care quality, particularly for hospitalized cancer patients.
Experiences of Pioneer Nurse Practitioners in Establishing Advanced Practice Roles
Authors: Brown Marie Annette , Draye Mary Ann
Published: April 2004

Purpose: To describe pioneers' experience of establishing the nurse practitioner (NP) role, and their experiences in maintaining and building the NP role in the contemporary practice environment.

Design: The study sample included 50 middle‐aged women currently practicing in Washington State as licensed advanced practice nurses, who began the NP role during 1965–1979.

Methods: This descriptive study included interviews and focus groups to gather data about the nurses' early experiences. Interpretative methods of grounded theory were used in data collection and analysis.

Findings: The central organizing theme, Advancing Autonomy to Make a Difference, was manifested through six broad themes: Breaking Free, Molding the Clay, Encountering Obstacles, Surviving the Proving Ground, Staying Committed, and Building the Eldership.

Conclusions: Autonomy was requisite to practice to one's full potential and maintain commitment over time. The data findings show the evolution of advanced nursing practice in the United States and provide guidance for nurses who are working to establish advanced practice nursing in other countries.
Impact of random soil properties on stressstrain response
Authors: Stolle Dieter , Guo Peijun , Sedran Gabriel
Published: April 2004

This paper analyzes the impact of natural random variation of soil properties on the constitutive modelling of geomaterial behaviour. A theoretical framework for accommodating variation in soil properties is presented. The framework is then used to examine the consequence of parameter variability on stressstrain relations. An important observation is that average soil parameters from a series of tests on small specimens, in which density of the specimens varies randomly, do not necessarily reflect the average constitutive behaviour of soil. Model predictions are shown to be consistent with the experimental data.Key words: random variability, deterministic analysis, soil parameters, constitutive model.
Behaviour of tire shred  sand mixtures
Authors: Zornberg Jorge G , Cabral Alexandre R , Viratjandr Chardphoom
Published: April 2004

Tire shreds and tire shred  soil mixtures can be used as alternative backfill material in many geotechnical applications. The reuse of tire shreds may not only address growing environmental and economic concerns, but also help solve geotechnical problems associated with low soil shear strength. In this study, an experimental testing program was undertaken using a large-scale triaxial apparatus with the goal of evaluating the optimum dosage and aspect ratio of tire shreds within granular fills. The effects on shear strength of varying confining pressure and sand matrix relative density were also evaluated. The tire shred content and tire shred aspect ratio were found to influence the stressstrain and volumetric strain behaviour of the mixture. The axial strain at failure was found to increase with increasing tire shred content. Except for specimens of pure tire shreds and with comparatively high tire shred content, the test results showed a dilatant behaviour and a well-defined peak shear strength. The optimum tire shred content (i.e., the one leading to the maximum shear strength) was approximately 35%. For a given tire shred content, increasing the tire shred aspect ratio led to increasing overall shear strength, at least for the range of tire shred aspect ratios considered in this study. The shear strength improvement induced by tire shred inclusions was found to be sensitive to the applied confining pressure, with larger shear strength gains obtained under comparatively low confinement.Key words: tire shreds, shear strength, reinforcement, triaxial testing, stressstrain behaviour.
Brains, Innovations and Evolution in Birds and Primates
Authors: Lefebvre Louis , Reader Simon M. , Sol Daniel
Published: April 2004

Several comparative research programs have focused on the cognitive, life history and ecological traits that account for variation in brain size. We review one of these programs, a program that uses the reported frequency of behavioral innovation as an operational measure of cognition. In both birds and primates, innovation rate is positively correlated with the relative size of association areas in the brain, the hyperstriatum ventrale and neostriatum in birds and the isocortex and striatum in primates. Innovation rate is also positively correlated with the taxonomic distribution of tool use, as well as interspecific differences in learning. Some features of cognition have thus evolved in a remarkably similar way in primates and at least six phyletically-independent avian lineages. In birds, innovation rate is associated with the ability of species to deal with seasonal changes in the environment and to establish themselves in new regions, and it also appears to be related to the rate at which lineages diversify. Innovation rate provides a useful tool to quantify inter-taxon differences in cognition and to test classic hypotheses regarding the evolution of the brain.
Reading Ability and Central Visual Field after Photodynamic Therapy
Authors: Krebs Ilse , Binder Susanne , Stolba Ulrike , Brunner Simon
Published: April 2004

Purpose: We examined whether photodynamic therapy (PDT) can prevent severe loss of reading acuity and further depression of the visual field in cases of predominantly classic subfoveal neovascularization due to age-related macular degeneration. Patients and Methods: Sixty eyes of 52 patients underwent biomicroscopy, assessment of reading and distance acuity, 10° static threshold perimetry, distance acuity, and fluorescein angiography at baseline, after 6 weeks, 3 months and then every 3 months after therapy. Results: After 18 months only 16.7% had lost more than 3 levels of reading acuity, 23.3% had lost less than 3 levels, 6.7% had remained unchanged and 53.3% had gained reading acuity, 18.7% of these more than 3 levels. 81.7% of the eyes lost less than 3 lines of distance acuity. 78.3% did not show any increase of the mean defect in the central visual field. Conclusion: PDT can prevent severe loss of distance and reading acuity and further deterioration of the central visual field in about 80% of the eyes. The baseline reading acuity was poor and the patients should be aware of the fact that loss of reading acuity cannot be regained even after successful PDT.
Changes in Antioxidant Enzyme Activity and Malondialdehyde Level in Patients with Age-Related Macular Degeneration
Authors: Yildirim Özlem , Ateş Nurcan Aras , Tamer Lülüfer , Muşlu Necati , Ercan Bahadır , Atik Uğur , Kanık Arzu
Published: April 2004

Age-related macular degeneration is the leading cause of legal blindness in the developed world, and yet its pathogenesis remains poorly understood. Oxidative stress may play a major role in the etiology and pathogenesis of age-related disorders such as age-related macular degeneration. Catalase is an antioxidant enzyme which plays an important role in the detoxification of free oxygen radicals. Malondialdehyde is a marker that shows free radical damage. We have measured the erythrocyte activity of catalase and the serum level of malondialdehyde in 30 patients with age-related macular degeneration and 60 healthy subjects. Patients with age-related macular degeneration showed significantly lower catalase activity compared to healthy subjects (p = 0.002). Plasma malondialdehyde level of the patient group was significantly higher than that of the controls (p = 0.038).
The Effects of Adenoidectomy and Tonsillectomy on Speech and Nasal Resonance
Authors: Maryn Youri , van Lierde Kristiane , De Bodt Marc , van Cauwenberge Paul
Published: April 2004

This article presents a review of literature concerning speech and nasal resonance following adenoidectomy and/or tonsillectomy. In order to comprehend speech-related postoperative changes, the role of the adenoid and the tonsils in speech is discussed as well as the concept of veloadenoidal closure separating oral and nasal cavities. Moreover, the effects of adenoidal and tonsillar hypertrophy on speech and nasal resonance are debated.
The Role of Laryngeal Electromyography in Vocal Fold Immobility
Authors: Mostafa Badr Eldin , Gadallah Naglaa Ali , Nassar Nagwa Mohammad , Al Ibiary Hassan Mohammad , Fahmy Hanan Ahmed , Fouda Nevine Mahmoud
Published: April 2004

Aim of Study: To assess the utility of laryngeal electromyography (EMG) as a diagnostic method for patients with immobile vocal folds and to evaluate its possible role as a prognostic indicator in the management of those cases. Methodology: The study included 35 patients with unilateral vocal fold immobility (VFI) and 10 normal controls. All patients were subjected to full history taking and thorough clinical examination and radiological investigations. Laryngeal EMG was performed for all the patients and controls. Results: The specificity of EMG was 100%, while the sensitivity was 65.7% in detecting VFI. Seventeen cases (74%) with abnormal EMG data had a combined lesion of recurrent and superior laryngeal nerves and 6 cases (26%) had isolated recurrent laryngeal nerve lesion. In both groups there was no statistical difference as regards the position of the paralyzed vocal fold in either paramedian or lateral positions. Clinical follow-up with indirect laryngoscopy, 6 months later, revealed recovery in 10 of the 25 cases (40%). None of the recovered patients showed abnormal EMG data at presentation, while 13 out of 15 cases of non-recovered patients showed abnormal EMG data, i.e. the specificity of EMG was 100%, while the sensitivity was 86.6% in predicting recovery in patients with VFI. The quantitative analysis of the interference pattern was more sensitive (65.7 and 86.6%) than the conventional methods of analysis (60 and 80%) in detecting and predicting recovery in patients with immobile vocal folds, respectively. Conclusion: The clinical use of laryngeal EMG is an efficient and objective test in the study of patients with immobile vocal folds and in predicting recovery of those cases. It is also a useful tool in the diagnostic algorithm in vocal fold paralysis.
Benign Paroxysmal Positional Vertigo and Comorbid Conditions
Authors: Cohen Helen S. , Kimball Kay T. , Stewart Michael G.
Published: April 2004

Purpose: To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety. Procedures: Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography. Results: Subjects had high rates of diabetes, mild head trauma, and probable sinus disease. Balance was generally impaired, worse in diabetics and subjects with significant vestibular weakness. Subjects who smoked or had had mild head trauma had higher levels of anxiety. Conclusions: Comorbid conditions, particularly diabetes, mild head trauma, and sinus disease, are unusually prevalent in BPPV patients. Message: Patients with comorbid disease are at risk for having increased vertigo, anxiety, and disequilibrium compared to other patients.
Sympathetic Innervation of the Tongue in Rats
Authors: Wang Hsing-Won , Chiou Wen-Yaw
Published: April 2004

We employed a glyoxylic catecholaminergic histofluorescence method to study the sympathetic innervation present in the rat tongue. One percent neutral red was used as a counterstain. Many noradrenergic fibers were demonstrated around the blood vessels, muscles, glands and submucosa of the tongue, but not in the epithelium or papilla. In a group of rats following neurectomy, the superior cervical ganglia (SCG) were removed unilaterally or bilaterally. Changes in sympathetic innervation of the tongue were examined 14 days after SCG ganglionectomy. In those animals after unilateral SCG ganglionectomy, we found no noradrenergic histofluorescence in the ipsilateral anterior 2/3 of the tongue, although some scant fluorescence was found in the ipsilateral posterior 1/3 of the tongue. However, no noradrenergic histofluorescence could be observed in animal’s bilateral SCG ganglionectomies. Our results indicate that sympathetic innervation of the tongue in rats originates in the SCG, with some cross-innervation of the sympathetic fibers occurring in the posterior 1/3 of the tongue.
Pharmacodiagnostic Value of the HER Family in Head and Neck Squamous Cell Carcinoma
Authors: Schartinger Volker Hans , Kacani Laco , Andrle Jan , Schwentner Ilona , Wurm Martin , Obrist Peter , Oberaigner Wilhelm , Sprinzl Georg Mathias
Published: April 2004

Two protooncogene products, EGFR (Her-1, c-erbB-1) and HER2 (Her-2/neu, c-erbB-2), have been reported to be frequently overexpressed in head and neck squamous cell carcinoma (HNSCC). In order to identify patients who may benefit from targeted cancer treatment for these two molecules, we determined the expression status of EGFR and HER2 in 129 HNSCC tumor specimens. Two pharmacodiagnostic kits (EGFR pharmDx™ and HercepTest™) were used to identify HNSCC tumors that overexpress EGFR or HER2. Overexpression of EGFR was detected in 42.6% of the tumor specimens, while HER2 was only rarely expressed (overexpression was observed in just 3.1% of all cases). Given the necessity of new therapeutic modalities for patients suffering from HNSCC, treatment EGFR signaling inhibitors appears to be warranted, whereas therapeutic intervention with HER2 inhibitors seems to be inappropriate in this tumor type.
Lacrimal Intubation with the Ritleng System in Recurrent Congenital Nasolacrimal Duct Obstruction in Children
Authors: Yalaz Muslime , Ozcan Altan A. , Akcalı Cağatay , Soylu Levent
Published: April 2004

Purpose: To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. Methods: Twenty-six patients (29 eyes) with congenital nasolacrimal duct obstruction, who ranged in age from 2 to 12 years (mean, 4.85 ± 2.9 years), underwent silicone intubation with the Ritleng lacrimal intubation system. The Ritleng lacrimal intubation system is composed of a Ritleng probe, a monofilament guide thread and a silicone tube. The prolene tip was removed from the inferior meatus with nasal endoscopy in 26 eyes, whereas this was done by using a Ritleng hook in 3. Clinical success was defined by the relief from symptoms and signs of obstruction. The tubes were left in place for an average of 6 months. The patients were followed up between 6 and 25 months (mean, 8.3 months). Results: All cases were successfully intubated with the Ritleng system. Two cases underwent reintubation because of tube dislocation during the first week. Granuloma developed at the edge of the inferior punctum in 1 case. We observed relief from symptoms in all cases. Conclusion: The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction.
Immunohistochemical Studies in the Identification of Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Head and Neck
Authors: Rinaldo Alessandra , Devaney Kenneth O. , Ferlito Alfio
Published: April 2004

In the prediction of likely disease-free and overall survival intervals in patients with squamous carcinomas of the head and neck, cervical lymph node status assumes a prime role, and patients with cervical node metastases have diminished survivals, as a group, compared with patients whose cervical nodes are reported as negative for metastatic carcinoma. Conventional means of pathologic examination of cervical node biopsy specimens include examination of a single section through each individual node identified on gross examination, a process which, of necessity, leaves a significant portion of the node unexamined by microscopy. Recently, it has become apparent that more exhaustive pathologic sampling techniques, such as examining multiple sections of each lymph node, or staining each lymph node with antibodies to keratin via immunohistochemistry, will reliably yield a greater incidence of positive cervical lymph nodes (‘micrometastases’) than do conventional pathologic techniques. This suggests that the next line of inquiry should answer this question: just because micrometastases can be detected, should they be? Does the identification of (otherwise likely to be overlooked) tiny microscopic foci of spread of tumor in regional nodes by more sophisticated techniques yield additional data of real import to the patients, or is such information of lesser value? Should a role be defined in the care of head and neck cancer patients for the use of such advanced inquiries in the structuring of therapies, then the best approach to finding such elusive micrometastases (intraoperative immunohistochemistry? immunohistochemistry using routinely fixed tissues? polymerase chain reaction?) may subsequently be established.
Positional Nystagmus Showing Neutral Points
Authors: Hiruma Kiyoshi , Numata Tsutomu
Published: April 2004

We encountered patients who had their static direction-changing positional nystagmus canceled at about 20–30° yaw head rotation from the supine position. This nystagmus was also canceled when the head was rotated 180° from this position. We call these head positions neutral points. At the neutral points, the cupula of the horizontal semicircular canal of the affected ear is positioned vertical to the gravitational plane and no deflection of the cupula occurs. The positional nystagmus observed (except the neutral points) was thought to occur due to a ‘heavy cupula’ or ‘light cupula’, which may be determined by the specific gravity of its endolymph.
Bioadhesive Transdermal Film Containing Caffeine
Authors: Nicoli S. , Amoretti V. , Colombo P. , Santi P.
Published: April 2004

The aim of this work was to investigate in vitro the transdermal permeation of caffeine from a new bioadhesive film, using rabbit ear skin as a barrier. The effects of film composition and of the presence of penetration enhancers in the formulation were studied. The obtained fluxes were compared with those shown by commercial formulations. The results obtained indicate that the bioadhesive film gave rise to a higher transdermal permeation compared to a commercial gel and to a saturated solution of caffeine in water. Additionally, the film did not present the typical time lag of solution and gel. Another peculiar feature of the film is that the percentage of permeated active substance is much higher than that obtained from commercial formulations. Finally, it was possible to modulate caffeine permeation from the film by adding different enhancers/solvents.
Matching the Neural Adaptation in the Rat Ventral Cochlear Nucleus Produced by Artificial (Electric) and Acoustic Stimulation of the Cochlea
Authors: Loquet Gérard , Pelizzone Marco , Valentini Gregory , Rouiller Eric M.
Published: April 2004

To investigate neural adaptive properties, near-field evoked potentials were recorded from a chronically implanted electrode in the ventral cochlear nucleus in awake Long-Evans rats exposed to acoustic stimuli or receiving intracochlear electric stimulation. Stimuli were 250-ms trains of repetitive acoustic clicks (10, 30 and 50 dB SPL) or biphasic electric pulses (30, 50 and 70 µA) with intratrain pulse rates ranging from 100 to 1000 pulses per second (pps). The amplitude of the first negative (N1) to positive (P1) component of the average evoked potentials was measured for each consecutive individual pulse in the train. While a progressive exponential decrease in N1–P1 amplitude was observed as a function of the position of the pulse within the train for both types of stimulation, the decrement of electric responses (adaptive pattern) was substantially less prominent than that observed for acoustic stimuli. Based on this difference, the present work was extended by modifying electric stimuli in order to try to restore normal adaptation phenomena. The results suggest the feasibility of mimicking acoustic adaptation by stimulation with exponentially decreasing electric pulse trains, which may be clinically applicable in the auditory implant field.
Large Vestibular Evoked Myogenic Potentials in Response to Bone-Conducted Sounds in Patients with Superior Canal Dehiscence Syndrome
Authors: Brantberg Krister , Löfqvist Lennart , Fransson Per-Anders
Published: April 2004

Dehiscence of the superior semicircular canal is a ‘new’ vestibular entity. Among these patients, the vestibular evoked myogenic potentials (VEMP) in response to air-conducted sounds are large. In the present study, VEMP in response to bone-conducted sounds were studied in 5 normal subjects, in 3 patients after (unilateral) labyrinthectomy and in 4 patients with (unilateral) superior canal dehiscence syndrome. The bone-conducted sound stimulus was a 250- and a 500- tone burst delivered monaurally on the mastoid using standard bone conductors. Among the normals, bone-conducted sounds delivered monaurally caused VEMP bilaterally. There was, however, a transcranial attenuation for the 500-Hz stimulus, but less so for the 250-Hz stimulus. Among the patients with labyrinthectomy there were VEMP on the healthy side, but not on the lesioned side, irrespective of whether the bone-conducted sounds were presented behind the healthy or the operated ear. Among the patients with superior canal dehiscence syndrome, the VEMP on the affected side were larger than on the healthy side. This suggests that there is also vestibular hypersensitivity for bone-conducted sounds in these patients.
Testosterone Cannot Activate an Adult-Like Stress Response in Prepubertal Male Rats
Authors: Romeo Russell D. , Lee Susan J. , Chhua Nara , McPherson Christina R. , McEwen Bruce S.
Published: April 2004

The pubertal maturation of the hypothalamic-pituitary-adrenal (HPA) axis has received relatively little experimental attention. The present set of experiments sought to extend our understanding of the pubertal stress response by measuring corticotropin (ACTH), corticosterone, and testosterone levels in prepubertal and adult male rats exposed to a single 30-min session of restraint stress. We show that ACTH and corticosterone levels in prepubertal males take significantly longer to return to baseline after termination of the stressor compared to adults. These data indicate that prepubertal males demonstrate a more prolonged stress response compared to adults after a single acute stressor with both psychogenic and neurogenic components. As testosterone has been shown to reduce the stress response in adulthood, we next investigated whether the relatively low levels of circulating testosterone in prepubertal males mediated their protracted stress response. Data collected from additional experiments revealed that prepubertal males treated with adult-like physiological levels of testosterone still exhibited an extended stress response compared to similarly treated adults. These results indicate that the stress response demonstrated by adult males cannot be mimicked or activated in prepubertal males by mere supplementation of testosterone. Thus, we conclude that the HPA neuroendocrine axis is further shaped during pubertal development to allow for the emergence of a more tightly regulated stress response in adulthood.
Ghrelin Inhibits Prolactin Secretion in Prepubertal Rats
Authors: Tena-Sempere Manuel , Aguilar Enrique , Fernandez-Fernandez Rafael , Pinilla Leonor
Published: April 2004

Ghrelin, a novel 28-amino-acid peptide primarily expressed in stomach and hypothalamus, has recently emerged as the endogenous ligand for the GH-secretagogue receptor with ability to stimulate GH secretion in humans and rats. In addition, ghrelin also stimulates prolactin (PRL) secretion in humans. However, its role in the regulation of PRL secretion in rats remains largely unknown. In this context, the present experiments were carried out to analyze the effects of ghrelin on PRL secretion in male and female rats. In detail, the ontogeny and potential sexual dimorphism in the PRL response to ghrelin was evaluated. In addition, the hypothalamic and/or pituitary site of primary action of ghrelin, as well as the possible interactions between ghrelin and other neurotransmitters, as nitric oxide, dopamine, serotonin or excitatory amino acids, in the precise control of PRL secretion were assessed. Experiments were conducted in prepubertal male and female animals. Systemic (i.p.) and central (i.c.v.) administration of ghrelin significantly inhibited PRL secretion. Such an inhibitory effect became evident after day 10 of age, was similar in males and females, and was also observed in hyperprolactinemic aged female rats. In contrast, however, challenge of pituitary samples in vitro with increasing doses of ghrelin (10–9–10–7M) failed to inhibit PRL secretion. Analysis of interactions between ghrelin and other systems involved in the control of PRL secretion revealed that neither blockade of dopaminergic receptors with domperidone, nor enhancement of serotoninergic tone with fluoxetine + 5-hydroxytryptophan altered the inhibitory response to ghrelin in terms of PRL secretion. Similarly, blockade of nitric oxide synthases with L-nitro-arginine-methyl ester failed to modify the magnitude of ghrelin-induced inhibition of PRL secretion, whereas ghrelin was unable to further decrease serum PRL levels after activation of ionotropic excitatory amino acid receptors by administration of NMDA or AMPA. In conclusion, our data indicate that ghrelin is able to inhibit PRL secretion in male and female rats, likely through an extrapituitary primary site of action that is independent of nitric oxide, dopamine, and serotonin systems.
Bone Marrow-Derived Cells Are Present in Mooren’s Ulcer
Authors: Ye Juan , Chen Jian , Kim Jae Chan , Yao Ke
Published: April 2004

To investigate whether bone marrow-derived cells are present in Mooren’s ulcer and involved in its destructive and regenerative disease course, tissue specimens were collected from 3 eyes of 3 patients with Mooren’s ulcer that underwent lamellar keratectomy. Three normal donor limbal corneoscleras served as controls. Immunohistochemical staining patterns were analyzed by using the following antibodies: CD34 (a marker of hematopoietic progenitor cells and endothelium), c-kit (a marker of hematopoietic and stromal progenitor cells) and STRO-1 (a differentiation antigen present on bone marrow fibroblast cells and on various nonhematopoietic progenitor cells). Strong positive CD34, c-kit and STRO-1 cells were revealed in Mooren’s ulcer specimens, especially in the superficial stroma. A few weakly expressed CD34 stromal cells were seen in normal limbal cornea, but no immunoreactivity for c-kit and STRO-1 was found. Bone marrow-derived cells are present in Mooren’s ulcer and contribute to its destructive and regeneration process by synergizing with other factors. Specific therapeutic strategies that target the role of these cells in Mooren’s ulcer are anticipated.
Comparison of Serum Nitric Oxide, Malondialdehyde Levels, and Antioxidant Enzyme Activities in Behçet’s Disease with and without Ocular Disease
Authors: Aydın Erdinç , Sogut Sadık , Özyurt Hüseyin , Ozugurlu Fikret , Akyol Ömer
Published: April 2004

Objective: The pathogenesis of Behçet’s disease (BD) may be related to excessive production of reactive oxygen species, activated neutrophils, and T lymphocytes. The goal of this prospective study was to investigate whether there is any relationship among the oxidant/antioxidant system and nitric oxide (NO) and malondialdehyde (MDA) levels in patients with BD and its subtypes: complete Behçet’s disease (CBD) and incomplete Behçet’s disease (ICBD), with or without ocular disease. Methods: Thirty-two patients and 26 age- and sex-matched healthy control subjects were evaluated for NO and MDA levels and antioxidant enzyme activities. The patients with BD were divided into two subgroups: those with and without ocular disease. Twelve patients with CBD and 4 patients with ICBD had ocular disease. The serum NO level was determined by Griess reaction. The MDA level was detected by thiobarbituric acid reaction. Superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in serum were analyzed with spectrophotometric methods. Results: Increased MDA levels but decreased GSH-Px activities in plasma were observed in BD patients with all subtypes, as compared with controls. Concerning the presence of ocular disease and the subtype (CBD or ICBD) compared with each other, there were no significant differences in MDA or NO serum levels and SOD or GSH-Px enzyme activities. Conclusions: Serum NO levels and SOD enzyme activities were not significantly changed in patients with BD and its subtypes; however, a remarkable decrease of GSH-Px enzyme activity and increase of MDA levels were found.