bluuebunny/crossref_metadata_2025 huggingface dataset:
Post‐Shock Synchronized Pacing in Isolated Rabbit Left Ventricle: Evaluation of a Novel Defibrillation Strategy
Authors: TANG LIANG , HWANG GYO‐SEUNG , SONG JUAN , CHEN PENG‐SHENG , LIN SHIEN‐FONG
Published: March 2007

Introduction: A failed near‐threshold defibrillation shock is followed by an isoelectric window (IEW) and rapid repetitive responses that reinitiate ventricular fibrillation (VF). We hypothesized that properly timed (synchronized) postshock pacing stimuli (SyncP) may capture the recovered tissues during the repetitive responses and prevent postshock reinitiation of VF, resulting in improved defibrillation efficacy.

Methods and Results: We explored the effect of postshock SyncP on defibrillation efficacy in isolated rabbit hearts (n = 12). Optical recording‐guided real‐time detection and electrical stimulation (5 mA) of recovered tissues in anterior/posterior left ventricle (LV) were performed following IEW. The IEW duration was found to be 69 ± 13 ms. With the same shock strength, successful and failed defibrillation episodes were associated with 50% and 15% of the myocardium, respectively, captured by the SyncP (P < 0.001). Electrical stimulation from the posterior LV resulted in 75% of episodes capturing myocardium, as compared with anterior LV stimulation (55%; P < 0.01) and higher successful defibrillation rate (14%, posterior vs. 3%, anterior LV). The overall success in terminating VF by postshock SyncP was approximately 10%. The causes for failed myocardium capture by postshock SyncP included lack of IEW after low‐strength shock (42.9%), incorrect locations of reference site (25.7%) and pacing electrodes (17.9%), and others, such as wave breakthroughs (13.5%).

Conclusion: Postshock SyncP was feasible and the larger the myocardium captured area, the more likely was the successful defibrillation. Postshock SyncP delivered to the posterior LV was more effective than anterior LV to terminate VF.
A New Echocardiographic Index for Assessing Left Ventricular Function and Mechanism of Mitral Regurgitation and Its Relation to Other Echocardiographic Indices
Authors: Sag Cemal , Uzun Mehmet , Bolcal Cengiz , Yokusoglu Mehmet , Kucukarslan Nezihi , Koz Cem , Baysan Oben , Ozkan Mustafa , Karaeren Hayrettin , Genç Celal , Isik Ersoy
Published: March 2007

Objective: Mitral regurgitation (MR) is a progressive disease of the mitral valve, which can be primary or functional. The assessment of left ventricular function in MR is still troublesome. In this study, we evaluated the validity of a new parameter, total dt, in patients with MR. Methods: Forty patients with severe MR constituted the study group. According to the transesophageal echocardiographic evaluation, the patients were dichotomized into two groups: (1) Primary MR; n = 21, (2) Functional MR; n = 19. The total dt was defined as the sum of time intervals from 1 ms
to 3 ms (positive dt) and from 3 ms to 1 ms (negative dt) on the CW Doppler recording of MR jet. It was compared to other indices of left ventricular function and left ventricular geometry, including ejection fraction, fractional shortening, myocardial performance index, coaptation distance, left ventricular volume and diameter, sphericity index, and parameters of diastolic function. Result: The total dt correlated with myocardial performance index, coaptation distance, and sphericity index. It could differentiate between primary and functional MR with an area under curve of 0.878, followed by myocardial performance index with 0.860. The total dt > 104 ms was 79% sensitive and 81% specific for discrimination. Conclusion: The total dt is useful for assessing left ventricular function and also for differentiating primary MR from functional MR.
Reversal E/A Value at End‐Inspiration Might Be More Sensitive and Accurate for Diagnosing Abnormal Left Ventricular Diastolic Function
Authors: Yuan Lijun , Cao Tiesheng , Zang Yimin , Pei Jianming , Duan Yunyou , Gao Feng
Published: March 2007

Background: It is well known that left ventricular (LV) filling decreases on inspiration and increases on expiration; however, respiratory effects on diastolic function have not been fully investigated. Aim: This study attempted to provide further information on the precise diagnosis of LV diastolic dysfunction when taking respiration into account. Methods: Fifty‐one patients with systemic hypertension and impaired LV diastolic function and 33 normal subjects were recruited. Respiratory transmitral Doppler flow parameters and the early‐to‐late diastolic tissue velocity ratio of the mitral annulus (e/a ratio) of the septal wall were recorded. The validity of the reversal ratio of early‐to‐late peak flow velocity (E/A ratio) on inspiration and on expiration for diagnosis of diastolic dysfunction was compared. Results: The E velocity was much higher and its deceleration time was much shorter on expiration compared to that on inspiration, while the A velocity demonstrated no regular respiratory variations both in normal subjects and patients. Ten of the patients displayed a phenomenon characterized with an E/A ratio < 1 on inspiration and > 1 on expiration, eight of whom revealed abnormal LV filling by Tissue Doppler imaging. Conclusion: Respiratory effects on transmitral Doppler flow parameters raise the necessity of adjustment of the existing standard for precise diagnosis of diastolic dysfunction, while the characteristic phenomenon reported here indicates that reversal E/A value on end‐inspiration is a more sensitive and accurate indicator of abnormal LV diastolic function.
Associations Between Left Ventricular Myocardial Involvement and Endothelial Dysfunction in Systemic Sclerosis: Noninvasive Assessment in Asymptomatic Patients
Authors: D'Andrea Antonello , Stisi Stefano , Caso Pio , Uccio Fortunato Scotto di , Bellissimo Salvatore , Salerno Gemma , Scarafile Raffaella , Riegler Lucia , Cuomo Sergio , Citro Rodolfo , Scherillo Marino , Calabrò Raffaele
Published: March 2007

Objectives: Systemic sclerosis (SSc) is a multisystem disorder characterized by widespread vascular lesions and fibrosis of skin and distinct internal organs. Cardiac involvement is a common finding in SSc, but often clinically occult. Aim of the study: To analyze possible associations of left ventricular (LV) myocardial function with coronary flow reserve (CFR) and endothelial function in asymptomatic patients with SSc. Methods: 30 healthy patients and 33 age‐ and sex‐comparable asymptomatic patients classified as having either diffuse (18 patients) or limited form (15 patients) of SSc underwent standard Doppler Echo, Doppler myocardial imaging, Strain rate imaging of interventricular septum and LV lateral wall, transthoracic CFR of left anterior descending coronary vessel (after dipyridamole infusion), and brachial artery vasodilatation measurement (Vivid 7, GE Medical Systems Inc). Results: LV diameters and ejection fraction were comparable between the two groups, while systolic pulmonary pressure (P < 0.001) was increased in SSc. By chest‐CT, 15 SSc patients showed interstitial pulmonary fibrosis. Serological antibodies analysis detected anti‐centromere pattern in 14 SSc patients, and anti Scl‐70 in 19 patients. In SSc, LV myocardial early diastolic peak velocity, peak systolic strain rate and strain were both reduced in basal and middle interventricular septum, and in basal and middle LV lateral wall. Both CFR (P < 0.0001) and endothelial flow‐mediated dilatation (P < 0.001) were significantly lower in SSc patients. By stepwise forward multivariate analyses, CFR (P < 0.001) and endothelial function (P < 0.001) were powerful independent determinants of middle LV strain. Conclusions: Strain rate imaging, transthoracic CFR, and brachial artery flow‐mediated dilatation are valuable noninvasive and easily repeatable tools for detecting LV myocardial and vascular involvement caused by SSc. Their combined use may be therefore useful for early identifying patients with more diffused and severe form of SSc, ideally in asymptomatic cases prior to the development of severe vasculopathy, when it may be most feasible to modify the disease process by new potential therapies.
Assessment of Myocardial Velocities and Global Function of the Left Ventricle in Asymptomatic Patients with Moderate‐to‐Severe Chronic Aortic Regurgitation: A Tissue Doppler Echocardiographic Study
Authors: Sokmen Gulizar , Sokmen Abdullah , Duzenli Akif , Soylu Ahmet , Ozdemir Kurtulus
Published: March 2007

Objective: Asymptomatic patients with chronic aortic regurgitation (AR) have an excellent prognosis in the presence of preserved systolic function. It is a challenge to recognize patients with subclinical myocardial dysfunction in AR. Conventional parameters still have many drawbacks in predicting early left ventricular (LV) dysfunction. Pulsed‐wave tissue Doppler imaging (PW‐TDI) is a useful noninvasive technique for evaluating global and regional LV systolic function. In this study, we aimed to assess clinical usefulness of TDI in predicting early disturbance of myocardial contractility in asymptomatic patients with significant AR and preserved left ventricular systolic function. Methods and the Results: Echocardiograms were obtained in 32 AR patients and 33 healthy subjects. In addition to conventional parameters, regional myocardial velocities, isovolumetric contraction time (mICT), isovolumetric relaxation time (mIRT), and ejection time (mET) of left ventricle were obtained by TDI and modified LV myocardial performance index (MPI) was calculated. In AR, peak systolic velocity (Sm) of septal and anterior mitral annulus, and mean Sm was significantly lower, and LVMPI was significantly higher compared to control group. Conclusion: The data obtained by TDI show that LV MPI is lengthened, and systolic myocardial velocities are shortened in patients having chronic AR with normal LV systolic function according to conventional echocardiographic parameters. This suggests that LV long‐axis contraction and global LV performance are preciously and noticeably decreased in patients with moderate‐to‐severe chronic AR despite normal LV ejection fraction.
Abnormal Right Ventricular Myocardial Strain Generation in Mild Pulmonary Hypertension
Authors: López‐Candales Angel , Rajagopalan Navin , Dohi Kaoru , Gulyasy Beth , Edelman Kathy , Bazaz Raveen
Published: March 2007

Background: Although right ventricular (RV) dyssynchrony has been identified in patients with severe pulmonary hypertension due to significant RV enlargement and compromise in systolic function, a more clinically relevant question pertains to RV mechanical properties in patients with mild elevation in pulmonary artery systolic pressures (PASP). Methods: Several echocardiographic parameters and peak longitudinal strain were measured in 40 patients and divided into two groups of 20 patients based on their PASP. Results: Group I included 20 individuals (mean age 48 ± 16 years with a mean PASP of 27 ± 5 mmHg) and Group II included 20 patients (mean age 63 ± 14 years with a mean PASP of 49 ± 7 mmHg.) All time intervals were adjusted for heart rate. RV fractional area change and tricuspid annular plane systolic excursion for Group I (62 ± 12% and 2.74 ± 0.56 cm) and Group II (49 ± 14%; P < 0.02 and 2.09 ± 0.40; P < 0.002) were both normal. However, Group II had lower peak longitudinal RV free wall (RVF) strain (−27.3 ± 7.1 % vs. −31.9 ± 8.7%, P < 0.04), longer time to peak RVF strain (448 ± 57 ms vs. 411 ± 43 ms; P < 0.03) and evidence of significant RV dyssynchrony (−83 ± 55 ms vs. 1 ± 17 ms, P < 0.00001) in contrast to Group I. Conclusion: In conclusion, mild elevations in PASP affect the mechanical properties of the RV and result in RV dyssynchrony despite absence of gross abnormalities in RV size or function.
Carvedilol Therapy Is Associated with an Improvement in Left Atrial Appendage Function in Patients with Congestive Heart Failure
Authors: Sevimli Serdar , Yilmaz Mustafa , Gundogdu Fuat , Arslan Sakir , Gurlertop Yekta , Erol M. Kemal , Bozkurt Engin , Acikel Mahmut , Senocak Huseyin
Published: March 2007

Heart failure is one of the leading death reasons in the world. Left atrial appendage (LAA) is of great importance in maintaining cardiac function. We examined the effect of carvedilol therapy on left atrial appendage functions in patients with symptomatic congestive heart failure. Twenty patients with symptomatic congestive heart failure and resting ejection fraction ≤ 40% were included in this study. LAA was visualized by transesophageal echocardiography. LAA area change (LAAAC), LAA empty velocity (LAAEV) and LAA empty velocity time integral (LAAEVTI) were calculated as the average of five cardiac cycles. A minimum dose of carvedilol administered to each patient, was titrated up to maximal dose that the patients could tolerate, during an 8‐week period. After the third month of completing treatment, a second transthoracic and transesophageal echocardiographic study was performed. Heart rate (P < 0.001), systolic (P = 0.002) blood pressures were reduced by carvedilol therapy at the end of the third month. LAAEV (P < 0.001), LAAEVTİ (P < 0.001), and LAAAC (P < 0.001) were significantly increased at the end of the third month of carvedilol therapy. This study indicates that in patients with symptomatic congestive heart failure, carvedilol therapy is associated with an improvement in left atrial appendage function.
A Novel Finding to Assess Ischemia in Pacing Stress Echocardiography (PASE)
Authors: Naqvi Tasneem Z , Aslanian Noune G , Rafique Asim M , Siegel Robert J
Published: March 2007

Background: Normalization of heart rate post–pacing stress echocardiography (PASE) could enable evaluation of effect of ischemia on diastolic function. Methods: We examined the effect of pacing on left ventricular (LV) filling in 55 patients who underwent a transesophageal PASE. Pulse wave Doppler of mitral inflow was obtained at baseline and during transition from peak pacing to up to three beats immediate post pacing. Results: Thirty‐four patients (62%; 62 ± 12 years) had normal (NL) PASE, wall motion score index (WMSI) 1 ± 0 at baseline and during PASE. Sixteen patients (29%; 64 ± 12 years) had ischemic (ISCH) PASE, WMSI 1.07 ± 0.08 at baseline and 1.40 ± 0.21 during PASE. Five patients (9%; 81 ± 5 years) had abnormal (ABN) PASE, WMSI 1.55 ± 0.34 at baseline and 1.55 ± 0.34 during PASE. The ABN group had the most pronounced decrease in deceleration time (DT) seen in all three post‐PASE beats (221 ± 29 ms at baseline vs. 145 ± 46, 144 ± 26 and 144 ± 18 ms at beats 1, 2, and 3, P < 0.005 from baseline for all). The DT reduced significantly at post‐PASE beat 1 from baseline (234 ± 45 ms vs. 158 ± 36 ms, P = 0.02) in the ISCH group, whereas no significant change in DT occurred in the NL group (239 ± 74 ms vs. 222 ± 58 ms, P = 0.14) at beat 1. Conclusion: In ISCH and ABN ventricles the duration of early diastolic filling decreased post‐pacing. This new finding of a shortened deceleration time (DT) may be a marker of an ischemic response in PASE reflecting abnormal LV compliance.
Real Time Myocardial Contrast Echocardiography During Supine Bicycle Stress and Continuous Infusion of Contrast Agent. Cutoff Values for Myocardial Contrast Replenishment Discriminating Abnormal Myocardial Perfusion
Authors: Miszalski‐Jamka Tomasz , Kuntz‐Hehner Stefanie , Schmidt Harald , Hammerstingl Christoph , Tiemann Klaus , Ghanem Alexander , Troatz Clemens , Lüderitz Berndt , Omran Heyder
Published: March 2007

Background: Myocardial contrast echocardiography (MCE) is a new imaging modality for diagnosing coronary artery disease (CAD). Objective: The aim of our study was to evaluate feasibility of qualitative myocardial contrast replenishment (RP) assessment during supine bicycle stress MCE and find out cutoff values for such analysis, which could allow accurate detection of CAD. Methods: Forty‐four consecutive patients, scheduled for coronary angiography (CA) underwent supine bicycle stress two‐dimensional echocardiography (2DE). During the same session, MCE was performed at peak stress and post stress. Ultrasound contrast agent (SonoVue) was administered in continuous mode using an infusion pump (BR‐INF 100, Bracco Research). Seventeen‐segment model of left ventricle was used in analysis. MCE was assessed off‐line in terms of myocardial contrast opacification and RP. RP was evaluated on the basis of the number of cardiac cycles required to refill the segment with contrast after its prior destruction with high‐power frames. Determination of cutoff values for RP assessment was performed by means of reference intervals and receiver operating characteristic analysis. Quantitative CA was carried out using CAAS system. Results: MCE could be assessed in 42 patients. CA revealed CAD in 25 patients. Calculated cutoff values for RP‐analysis (peak‐stress RP >3 cardiac cycles and difference between peak stress and post stress RP >0 cardiac cycles) provided sensitive (88%) and accurate (88%) detection of CAD. Sensitivity and accuracy of 2DE were 76% and 79%, respectively. Conclusions: Qualitative RP‐analysis based on the number of cardiac cycles required to refill myocardium with contrast is feasible during supine bicycle stress MCE and enables accurate detection of CAD.
Neoplastic circulating endothelial‐like cells in patients with acute myeloid leukaemia
Authors: Rigolin Gian Matteo , Mauro Endri , Ciccone Maria , Fraulini Chiara , Sofritti Olga , Castoldi Gianluigi , Cuneo Antonio
Published: March 2007

Accumulating evidence suggests that angiogenesis may play a key role in the pathogenesis of leukaemic disorders. Several studies have shown that bone marrow‐derived endothelial cells (EC) may contribute to tumour angiogenesis and that in the peripheral blood of cancer patients there is an increased amount of circulating ECs (CECs) that may participate to new vessel formation. In this report, we showed that, in seven acute myeloid leukaemia (AML) patients with known cytogenetic abnormalities, CEC levels were significantly increased in comparison with controls and that a significant proportion of these CECs carried the same chromosomal aberration as blast cells (20–78%, mean value 42.1% of CECs). Most of CECs (mean value 74.4%) displayed immunophenotypic features of endothelial progenitor cells as they expressed CD133, a marker gradually lost during EC differentiation and absent on mature EC. These findings suggest a possible direct contribution of AML‐related CECs to tumour vasculogenesis and possibly to the spreading and progression of the disease.
Retrospective nationwide survey of Japanese patients with transfusion‐dependent MDS and aplastic anemia highlights the negative impact of iron overload on morbidity/mortality
Authors: Takatoku Masaaki , Uchiyama Takashi , Okamoto Shinichiro , Kanakura Yuzuru , Sawada Kenichi , Tomonaga Masao , Nakao Shinji , Nakahata Tatsutoshi , Harada Mine , Murate Takashi , Ozawa Keiya ,   the Japanese National Research Group on Idiopathic Bone Marrow Failure Syndromes
Published: March 2007

Objective:  Myelodysplastic syndromes (MDS) and aplastic anemia (AA) are the most common anemias that require transfusion therapy in Japan. This retrospective survey investigated relationships between iron overload, chelation practices, and morbidity/mortality in patients with these diseases.

Method:  Medical histories of transfusion‐dependent patients were assessed at transfusion onset, chelation onset, and study end.

Results:  Data were collected from 292 patients with MDS, AA, pure red cell aplasia, myelofibrosis, and other conditions. Patients received a mean of 61.5 red blood cell units during the previous year. Fewer than half (43%) of patients had previously received deferoxamine (DFO) therapy. Only 8.6% received daily/continuous DFO. In all, 75 deaths were reported, with cardiac and liver failure noted in 24.0 and 6.7% of cases. Of these, 97% had ferritin levels >1000 ng/mL. Abnormal cardiac and liver function was observed in 21.9% (14/64) and 84.6% (11/13) of all patients assessed. Effective chelation with DFO resulted in improved serum ferritin, liver enzymes, and fasting blood sugar.

Conclusions:  Mortality is higher in heavily iron‐overloaded patients, with liver and cardiac dysfunction being the primary cause. Daily/continuous chelation therapy was effective at reducing iron burden and improving organ function. Chelation therapy should be initiated once serum ferritin levels exceed 1000 ng/mL.
Redefining monosomy 5 by molecular cytogenetics in 23 patients with MDS/AML
Authors: Herry Angèle , Douet‐Guilbert Nathalie , Morel Frédéric , Bris Marie‐Josée Le , Braekeleer Marc De
Published: March 2007

Deletion of the long arm of chromosome 5 [del(5q)] or loss of a whole chromosome 5 (−5) is a common finding, arising de novo in 10% of patients with myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) and in 40% of patients with therapy‐related MDS or AML. We investigated by molecular cytogenetics 23 MDS/AML patients for whom conventional cytogenetics detected a monosomy 5. Monosomy 5 was redefined as unbalanced or balanced translocation and ring of chromosome 5. Loss of 5q material was identified in all 23 patients, but one. One copy of EGR1(5q31) or CSF1R(5q33–34) genes was lost in 22 of the 23 patients. Chromosome 5p material was a constant chromosomal component of derivative chromosomes or rings in all patients, but one. Sequential fluorescent in situ hybridization studies with whole chromosome paints and region‐specific probes, used as a complement to conventional cytogenetic analysis, allow a better interpretation of karyotypes in MDS/AML patients.
The miniature pig: a useful large animal model for dental and orofacial research
Authors: Wang S , Liu Y , Fang D , Shi S
Published: March 2007

Compared with small animal models such as rodents, large animal models are superior in many aspects for the study of human diseases and pre‐clinical therapies. Since the development of the Minnesota miniature pig in 1949 at the Hormel Institute (USA), miniature pigs have been used as a large animal model in medical studies for scientific, economic, and ethical reasons. The oral maxillofacial region of miniature pigs is similar to that of humans in anatomy, development, physiology, pathophysiology, and disease occurrence. In this review, we describe the anatomical characteristics of the oral maxillofacial system of the miniature pig, established models of oral diseases in this animal, and other uses of the miniature pig in orofacial research.
Purine catabolic enzymes and nitric oxide in patients with recurrent aphthous ulceration
Authors: Gurel A , Altinyazar HC , Unalacak M , Armutcu F , Koca R
Published: March 2007

Objectives:  Recurrent aphthous ulceration (RAU) is one of the most common oral mucosal disorders found in humans. Although the exact etiology of RAU is unkown, local and systemic conditions, and genetic, immunologic, and infectious factors all have been identified as potential etiopathogenic agents. The aim of our study was to compare serum xanthine oxidase (XO) and adenosine deaminase (AD) activities, and malondialdehyde (MDA), nitric oxide (NO) and uric acid (UA) levels in a group of patients affected by RAU and in a group of healthy controls.

Subjects and methods:  A total of 26 patients with minor RAU were included in the study. Twenty‐six healthy volunteers were selected to form the control group. AD and XO activities, and UA, NO, and MDA levels were studied in the serum samples of all patients and controls.

Results:  Serum XO and AD activities, and MDA, NO, and UA levels were significantly higher in RAU patients than in controls.

Conclusion:  Increased XO and AD activities, NO and UA levels and lipid peroxidation were thought to take part in the pathogenesis of RAU. Hence the effects of XO inhibitors in the treatment of RAU should be evaluated in future studies.
A immunohistochemical study of the peripheral ameloblastoma
Authors: Kishino M , Murakami S , Yuki M , Iida S , Ogawa Y , Kogo M , Toyosawa S
Published: March 2007

Aim:  Peripheral ameloblastoma (PA) is a rare variant of ameloblastoma occurring in the extraosseous region. With regard to the histogenesis of the tumor, two major sources of origin are considered: odontogenic epithelial remnants and the gingival epithelium. In this study, we examined the immunohistochemical profiles of cytokeratins (CKs) and Ki‐67 labeling index (LI) of PAs, and discuss the histogenesis and the biologic behavior of the PA.

Materials and methods:  Eight cases of PA were retrieved from the pathology files of 212 cases of ameloblastoma that had been registered at our hospital. Immunohistochemical staining was performed in seven cases using monoclonal antibodies of six CKs (7, 8, 13, 14, 18, and 19) and Ki‐67.

Results:  All cases of PA expressed CK13, 14, and 19. CK18 was positive staining in six cases, and CK8 in five cases. This staining pattern was similar to that in intraosseous ameloblastomas (IAs). The mean of Ki‐67 LI of PAs (1.91%) was significantly lower than that of IAs (4.82%) (P = 0.002).

Conclusion:  We consider that the PA originates from odontogenic epithelial remnants rather than from the gingival epithelium, and the Ki‐67 LI of the tumor is a good prognostic indicator.
Halitosis and gastroesophageal reflux disease: a possible association
Authors: Moshkowitz M , Horowitz N , Leshno M , Halpern Z
Published: March 2007

Objective:  Previous reports have suggested that gastrointestinal (GI) diseases may cause halitosis. The aim of this study was to evaluate the relationship between upper GI conditions, especially gastroesophageal reflux disease (GERD), and halitosis.

Patients and methods:  One hundred and thirty two consecutive patients complaining of upper GI symptoms were included in the study. All the patients completed a validated questionnaire that was designed to characterize and measure the severity of their symptoms. The questionnaire also contained questions about awareness and severity of oral bad breath. Following the filling of the questionnaire, the patients were physically examined and subjected to an upper GI endoscopy.

Results:  The final diagnosis among the 132 patients (M/F = 70/62, mean age 45.2 years, range 20–87 years) was GERD in 72 patients (55%), Functional dyspepsia in 52 (39%), Peptic ulcer in seven patients (5%) and gastric cancer in one patient (1%). Halitosis was significantly associated with the occurrence and severity of heartburn (P = 0.027), regurgitation (P = 0.002) sour taste (P < 0.001), belching (P = 0.001) and burburigmus (P = 0.006). Halitosis was not associated with upper abdominal pain, bloating, early satiety and chest pain. In relation to the final diagnosis, halitosis was significantly associated only with GERD (P = 0.002) but not with functional dyspepsia (P = 0.855) and peptic ulcer disease (0.765). No correlation was found between Helicobacter pylori infection status and halitosis occurrence and severity (analysis of variance F = 0.001, P = 0.977).

Conclusions:  Halitosis is a frequent symptom of GERD and may be considered as an extra‐esophageal manifestation of GERD. On the other hand, we did not find an association between functional dyspepsia, peptic ulcer disease and H. pylori infection with halitosis occurrence or severity.
Histological and ultrastructural evaluation of bone around Bio‐Oss® particles in sinus augmentation
Authors: Orsini G , Scarano A , Degidi M , Caputi S , Iezzi G , Piattelli A
Published: March 2007

Aim:  The aim of the present study was to evaluate histological and ultrastructural features of bone surrounding Bio‐Oss® particles retrieved, in the same patient, 20 months and 7 years after sinus augmentation.

Materials and Methods:  A 54‐year patient who needed sinus elevation before implant rehabilitation participated in this study. Two bone cores at two different times were harvested from a Bio‐Oss® regenerated sinus and processed for examination under light and transmission electron microscopy.

Results:  Under light microscopy, in the 20‐month specimen, most of the particles were surrounded by a thin layer of newly formed bone; in the 7‐year specimen there was mainly compact bone in direct contact with the particles. Under transmission electron microscopy, it was possible to characterize the bone–biomaterial interface; in the 20‐month specimen an electron‐dense layer was seen, whereas, almost no electron‐dense lines were seen at the interface in the 7‐year specimen.

Conclusions:  Bio‐Oss® particles did not interfere with bone‐healing processes after sinus augmentation procedures and promoted new bone formation. This study can help clinicians to understand better the morphological characteristics of bone regeneration processes using Bio‐Oss® after 20 months and, most importantly, after a longer time of interaction with surrounding tissues.
Oral carriage of yeasts and coliforms in stroke sufferers: a prospective longitudinal study
Authors: Zhu HW , McMillan AS , McGrath C , Li LSW , Samaranayake LP
Published: March 2007

Aim:  To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke.

Materials and methods:  In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later.

Results:  The oral carriage of yeasts increased significantly during acute stroke (P < 0.05), whereas coliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6‐month assessment (P < 0.05). Candida albicans and Klebsiella pneumoniae were the predominant yeast and coliform respectively. Stroke‐related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage (P < 0.05). We also report here for the first time that the use of aspirin was associated with lower oral yeast carriage in people suffering from stroke.

Conclusion:  Oral yeast carriage was closely linked to the level of stroke‐related functional disability that improved over time but had not totally resolved 6 months after hospital discharge. The oral reservoir of yeasts and coliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.
The mass function of high-redshift seed black holes
Authors: Lodato Giuseppe , Natarajan Priyamvada
Published: March 2007

In this Letter we derive the mass function of seed black holes that result from the central mass concentrated via disc accretion in collapsed haloes at redshift z ≈ 15. Using standard arguments including stability, we show that these pregalactic discs can assemble a significant mass concentration in the inner regions, providing fuel for the formation and initial growth of supermassive black holes. Assuming that these mass concentrations do result in central seed black holes, we determine the mass distribution of these seeds as a function of key halo properties. The seed mass distribution determined here turns out to be asymmetric and skewed to higher masses. Starting with these initial seeds, building up to 109 solar masses by z = 6 to power the bright quasars is not a problem in the standard Λ cold dark matter cosmogony. These seed black holes in gas-rich environments are likely to grow into the supermassive black holes at later times via mergers and accretion. Gas accretion on to these seeds at high redshift will produce miniquasars that likely play an important role in the reionization of the Universe. Some of these seed black holes, on the other hand, could be wandering in galaxy haloes as a consequence of frequent mergers, powering the off-nuclear ultra-luminous X-ray sources detected in nearby galaxies.
PRODUCTION AND CHARACTERIZATION OF ANTIBODY AGAINST AFLATOXIN G1
Authors: CHU FUN S. , STEINERT B. W. , GAUR P. K.
Published: April 2007

Antibody against aflatoxin G1 (AFG1) was obtained from rabbits after immunizing the animals with AFG1 hemiacetal (AFG2a) conjugated to bovine serum albumin. A direct heterogenous ELISA in which AFG2a was conjugated to horseradish peroxidase was used for monitoring the antibody titers and for toxin detection. Competitive ELISA assay revealed that the antibody was most specific for AFG2a and least for AFB2. The relative cross‐reactivity of this antiserum with aflatoxins G2a, G2, G1, M1, E1 and B2 was found to be 1, 7, 13, 47, 48, and 63, respectively. The lower detection limits for detection of AFG1 after derivatizing to AFG2a was around 15–25 pg per assay.
ATTACHMENT AND REMOVAL OF SALMONELLA SPP. ON MEAT AND POULTRY TISSUES
Authors: BENEDICT R. C. , SCHULTZ F. J. , JONES S. B.
Published: April 2007

Muscle pieces from beef, pork, and chicken were exposed to Salmonella strains in various aqueous solutions to determine mechanisms of microbial attachment and release. Binding was measured by scanning electron microscopy and by bacteriological methods. Bacteria appear to attach preferentially to connective tissue fibers, rather than to myofibrils. Muscle fiber swelling and shrinkage during processing permits some microbial entrapment between muscle bundles. Mannose and salt solutions were examined as potential inhibitors of attachment or as removal agents. Mannose inhibited attachment slightly and isotonic saline rinses removed some attached cells, but either method effected only about a one log reduction (90%). Application of 41 rinsings only effected a 4 log reduction. The apparent variety of attachment mechanisms by Salmonella hinders complete removal from meat tissues by simple rinsing procedures.
OCCURRENCE OF CLOSTRIDIUM PERFRINGENS IN GROUND BEEF AND GROUND TURKEY EVALUATED BY THREE METHODS1
Authors: ALI MOHAMMAD S. , FUNG DANIEL Y. C.
Published: April 2007

A rapid and effective method (Fung's Double‐tube method) for estimating low numbers of Clostridium perfringens from ground beef and ground turkey has been investigated and compared to Oxyrase Enzyme and Gas Pak Anaerobic System methods. C. perfringens was detected with one or more of the methods in 64 (54%) of 118 ground beef samples and 40 (73%) of 55 ground turkey samples. Fung's Double‐tube showed 94 (54%) out of 173, Oxyrase Enzyme 77 (45%) out of 173, and Gas Pak Anaerobic System 73 (42%) out of 173 ground beef and ground turkey samples to be positive for C. perfringens. Fung's doubletube showed significantly (p <0.05) higher number of samples positive for C. perfringens in these samples than other two methods. The results indicated a much higher occurrence of C. perfringens in ground turkey (73%) than in ground beef (54%). Furthermore in order to compare the efficiency of these methods in enumerating number of C. perfringens cells during storage, some samples were kept at room temperature (23°C) for 7 days. The number of C. perfringens increased from 44/g up to 1.3x109/g as enumerated by Fung's Double‐tube.
MICROBIOLOGICAL CONDITIONS OF SHEEP CARCASSES DURING THE SLAUGHTERING PROCESS
Authors: YALÇIN SUZAN , NIZAMLIOGLU MUSTAFA , GÜRBÜZ ÜMIT
Published: April 2007

This study was undertaken to determine the microbiological quality of sheep carcasses during different stages in the slaughtering process. A total of eleven carcasses were selected at random in an abattoir. The samples were taken by excision from four different sites; leg, brisket, shoulder and neck. The samples were collected from the same carcasses at four different stages in the slaughtering process; after dressing, after evisceration, after washing and chilling. The aerobic mesophilic bacteria, coliforms and Enterobacteriaceae recovered from each sample were enumerated. Chilling reduced the aerobic mesophilic and coliform counts of carcasses, significantly. Levels of carcass microbial load after chilling were 1.69, 0.11 and 0.11 log cfu/cm2 for aerobic mesophilic counts, coliform counts and Enterobacteriaceae counts, respectively. According to data obtained in the present study, chilling of carcasses was the most important step in improving the hygienic quality of carcasses. Processing stages changed significantly both aerobic mesophilic and coliform counts of neck, therefore, among different sites of carcass, neck should be the only critical site for microbiological sampling for sheep carcasses.
Physical Health, Illicit Drug Use, and Demographic Characteristics in Rural Stimulant Users
Authors: Garrity Thomas F. , Leukefeld Carl G. , Carlson Robert G. , Falck Russel S. , Wang Jichuan , Booth Brenda M.
Published: March 2007

ABSTRACT: 
Context: There is growing concern about illicit rural stimulant use, especially regarding methamphetamine use and its health consequences. Purpose: The present study describes associations between aspects of stimulant use and illness experience in rural areas, with additional focus on the role of demographic characteristics in these associations. Methods: The research participants were 710 stimulant drug users who were recruited from rural areas of Arkansas, Kentucky, and Ohio using Heckathorn’s respondent‐driven sampling method. Health was measured by self‐reports of perceived health and extent of current, recent, and lifelong health problems. Drug use was measured with self‐reports of type and frequency of use. Findings: Several associations were found between drug use and illness, controlling for demographics. Stimulant use pattern related significantly with the sum of health problems in the previous 6 months and the sum of lifetime illness diagnoses, after adjustment for demographic factors. Extent of illicit drug use in the past month and self‐perceived drug and alcohol problems were associated with several measures of health. Conclusions: In this sample of stimulant users, methamphetamine use was associated with fewer recent medical problems than crack cocaine, combined crack and powder cocaine use, and use of all 3 of these stimulants. These results, across the 3 sites, suggest that prevalent assumptions about the methamphetamine “plague” and its negative health consequences must be viewed cautiously and examined with additional research.
Predicting Rural Practice Using Different Definitions to Classify Medical School Applicants as Having a Rural Upbringing
Authors: Owen John A. , Conaway Mark R. , Bailey Beth A. , Hayden Gregory F.
Published: March 2007

ABSTRACT: 
Purpose: This study determines the relationship between a medical school applicant’s rural background and the likelihood of rural practice using different definitions of rural background. Methods: Cohort study of 599 physicians who entered the University of Virginia School of Medicine in 1990‐1995 and graduated in 1994‐1999. The “rurality” of the applicants’ backgrounds was assessed by coding applicants’ high school, college, and permanent addresses using 4 definitions of rural. In addition, most physicians responded to a survey question “Did you grow up in a rural area?” The same 4 definitions of rural were used to assess the rurality of practice locations. Logistic regression models were used to predict the simultaneous effect of different definitions of rural background, gender, and applicants’ career preference at matriculation on the probability of practicing in rural areas. Findings: In univariate analyses, the high school, college, and permanent addresses were all predictive of rural practice using 1 or more definitions of rural. In the multivariate analysis, only the “grew up rural” self‐description was predictive of rural practice location using 3 of the definitions of rural. In a secondary analysis, the grew up rural self‐description and applicants’ career preferences at matriculation were predictors of rural practice. Conclusions: Readily available addresses were predictive of rural practice. In a multivariate analysis, physicians’ self‐description about having grown up in a rural area was the best predictor of rural practice. Recruiting more applicants who match this definition of rural background should increase the number of rural physicians.
Fatal Passenger Vehicle Crashes With At Least 1 Driver Younger Than 15 Years: A Fatality Analysis Reporting System Study
Authors: Frisch Larry , Plessinger Alexander
Published: March 2007

ABSTRACT: 
Context: A small number of fatalities continue to occur due to motor vehicle crashes on highways in which at least 1 passenger vehicle (automobile, van, or small truck) is driven by a child younger than 15 years. Purpose: The purpose of this study was to extend previous work suggesting that such crashes occur frequently in the Southern states and have relatively high rates in rural areas in the South and Great Plains. Methods: This study utilizes data for the 5‐year period 1999‐2003 from the National Highway Transportation Safety Administration’s online Fatality Analysis Reporting System. All cases were identified in which at least 1 conventional passenger vehicle in a fatal crash was being driven by a child younger than 15 years. Findings: During the 5‐year period, 350 fatal crashes occurred with at least 1 driver younger than 15 years involved. Twenty‐one of these drivers were licensed (11) or driving with a learner’s permit (10). A total of 987 individuals in 419 vehicles were involved in these crashes, and 402 deaths resulted (1.16 deaths/crash). These crashes occurred primarily in Texas, Florida, Arkansas, and Arizona, but the highest rates per 100,000 children were found in North and South Dakota and predominantly in a band of Intermountain and Plains states. There was a strong correlation between crash rates and several measures of rurality. Conclusions: Crashes involving young, largely unlicensed, drivers account for about 70 deaths yearly.
Rural Versus Suburban Primary Care Needs, Utilization, and Satisfaction With Telepsychiatric Consultation
Authors: Hilty Donald M. , Nesbitt Thomas S. , Kuenneth Christina A. , Cruz Grace M. , Hales Robert E.
Published: March 2007

ABSTRACT: 
Context and Purpose: Rural and suburban populations remain underserved in terms of psychiatric services but have not been compared directly in terms of using telepsychiatry. Methods: Patient demographics, reasons for consultation, diagnosis, and alternatives to telepsychiatric consultation were collected for 200 consecutive, first‐time telepsychiatric consultations at rural and suburban clinics. Findings: Rural patients were more likely than suburban patients to be younger than 18 years, using Medicaid, and needing treatment planning (lest they be referred out of the community). Rural patient and primary care physician satisfaction was higher than that of suburban counterparts. Conclusion: Telepsychiatry programs may enhance access, satisfaction, and quality of rural care.
Improving Work Environment Perceptions for Nurses Employed in a Rural Setting
Authors: Teasley Susan L. , Sexton Kathleen A. , Carroll Cathryn A. , Cox Karen S. , Riley Michele , Ferriell Kathleen
Published: March 2007

ABSTRACT: 
Context: Effective recruitment and retention of professional nurses is a survival strategy for health care facilities, especially in rural areas. Purpose: This study examines the use of the Individual Workload Perception Scale to measure nurse satisfaction by a small rural hospital in order to make positive changes in the work environment for nurses. Methods: Baseline work environment perceptions of nurses employed in a rural Kentucky hospital were assessed using the Individual Workload Perception Scale, a validated 38‐item instrument. Nurses reviewed the results and brainstormed on potential interventions to address areas of concern. The 4 interventions selected for implementation by the nursing staff included (1) implementation of a shared decision making or governance model; (2) enhanced role of licensed practical nurses within the organization; (3) augmentation of administrative support on night and weekend shifts; and (4) utilization of wireless communication devices. After implementation of the interventions, staff nurse perceptions were reassessed using the same tool. Findings: The follow‐up survey revealed improvements in all areas measured by the Individual Workload Perception Scale, with the greatest improvement in the perception of the work environment noted among night nurses. The increase in positive work environment perception among these nurses, with greater than or equal to 11 years of professional experience, was statistically significant. Conclusions: Tools exist to support the development and evaluation of interventions to improve the work environment for nurses practicing in rural health care settings. By addressing issues of specific concern, both job satisfaction and retention of this talented pool of professionals can be enhanced.
Evaluation of a Medical School for Rural Doctors
Authors: Inoue Kazuo , Matsumoto Masatoshi , Sawada Tsutomu
Published: March 2007

ABSTRACT: 
Context: Jichi Medical School (JMS) is the first and only medical school in Japan that was founded exclusively to graduate/prepare rural doctors. Purpose: To evaluate the long‐term effect of JMS on the nationwide distribution of doctors. Methods: Data from the Japanese population census of 1995 and from the Japanese physician census of 1994 were combined for use in this study. We extracted the JMS graduates from the physician census and compared the distribution of JMS graduates to that of non‐JMS graduates. JMS graduates have an obligation to work in rural areas for 9 years after graduation. Therefore, we divided them into those doctors who were either “under rural duty” or “after rural duty.”Findings: JMS graduates were more likely than non‐JMS physicians to practice in rural municipalities. The percentage of JMS graduates practicing under rural duty in communities meeting at least 1 of 4 possible criteria for being considered rural was 2.7 times greater than the percentage of non‐JMS graduates in such communities. The percentage of JMS graduates practicing after rural duty in communities meeting at least 1 rural criterion was 2 times that of non‐JMS graduates. The JMS graduates accounted for only 0.7% of all the physicians in Japan. However, they accounted for 4.2%, 1.5%, 1.8%, and 3.0% of the physicians in small population, remote, mountain, and medically underserved municipalities, respectively. Conclusions: The goal of JMS to produce rural doctors in Japan has made an impact on doctor distribution nationwide.
Squid Protein Effect on Growth of Four Penaeid Shrimp
Authors: Cruz‐Ricque L. Elizabeth , Guillaume Jean , Cuzon Gérard ,   AQUACOP
Published: April 2007

The growth response to supplementation of mixed diets with a protein extracted from frozen squid (squid protein fraction: SPF) was tested at levels of 1.5, 3.0, 6.0 and 16.0% in the diet in four species of shrimp: Penaeus stylirostris, P. vannamei, P. monodon and P. indicus. In P. stylirostris and P. vannamei, growth rates were significantly improved by SPF even at the lowest level of supplementation. Improvement was obtained only with 6 and 16 percent in P. monodon, while no significant response was observed in P. indicus. The growth promoting effect of SPF at 16% of the diet could be explained by its nutritional value, particularly by its amino acid content, although all diets were supposed to be well balanced in all known nutrients. However, at lower levels the results obtained seemed to be due to the unknown growth factor (UGF) already mentioned in previous reports.