bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantum Logic Is Alive ∧ (It Is True v It Is False)
Authors: Dickson Michael
Published: February 2004

Is the quantum-logic interpretation dead? Its near total absence from current discussions about the interpretation of quantum theory suggests so. While mathematical work on quantum logic continues largely unabated, interest in the quantum-logic interpretation seems to be almost nil, at least in Anglo-American philosophy of physics.

This paper has the immodest purpose of changing that fact. I shall argue that while the quantum-logic interpretation faces challenges, it remains a live option. The usual objections either miss the mark, or admit a reasonable answer, or fail to decide the issue conclusively.
Realism and Underdetermination: Some Clues From the Practices-Up
Authors: Cordero Alberto
Published: February 2004

Recent attempts to turn Standard Quantum Theory into a coherent representational system have improved markedly over previous offerings. Important questions about the nature of material systems remain open, however, as current theorizing effectively resolves into a multiplicity of incompatible statements about the nature of physical systems. Specifically, the most cogent proposals to date land in effective empirical equivalence, reviving old anti-realist fears about quantum physics. In this paper such fears are discussed and found unsound. It is argued that nothing of global skeptical or agnostic significance follows from the kind of underdetermination presently encountered in fundamental quantum theory. The case is instructive, however, for what it shows about the characteristics and prospects of scientific realism as a perspective in contemporary philosophy of science.
Statistical Mechanics and the Asymmetry of Counterfactual Dependence
Authors: Elga Adam
Published: February 2004

In “Counterfactual Dependence and Time's Arrow”, David Lewis defends an analysis of counterfactuals intended to yield the asymmetry of counterfactual dependence: that later affairs depend counterfactually on earlier ones, and not the other way around. I argue that careful attention to the dynamical properties of thermodynamically irreversible processes shows that in many ordinary cases, Lewis's analysis fails to yield this asymmetry. Furthermore, the analysis fails in an instructive way: it teaches us something about the connection between the asymmetry of overdetermination and the asymmetry of entropy.
Infinite Systems in SM Explanations: Thermodynamic Limit, Renormalization (semi-) Groups, and Irreversibility
Authors: Liu Chuang
Published: February 2004

This paper examines the justifications for using infinite systems to ‘recover’ thermodynamic properties, such as phase transitions (PT), critical phenomena (CP), and irreversibility, from the micro-structure of matter in bulk. Section 2 is a summary of such rigorous methods as in taking the thermodynamic limit (TL) to recover PT and in using renormalization (semi-) group approach (RG) to explain the universality of critical exponents. Section 3 examines various possible justifications for taking TL on physically finite systems. Section 4 discusses the legitimacy of applying TL to the problem of irreversibility and assesses the repercussions for its legitimacy on its home turf.
Definition, Convention, and Simultaneity: Malament's Result and Its Alleged Refutation by Sarkar and Stachel
Authors: Rynasiewicz Robert
Published: February 2004

The question whether distant simultaneity (relativized to an inertial frame) has a factual or a conventional status in special relativity has long been disputed and remains in contention even today. At one point it appeared that Malament (1977) had settled the issue by proving that the only non-trivial equivalence relation definable from (temporally symmetric) causal connectability is the standard simultaneity relation. Recently, however, Sarkar and Stachel (1999) claim to have identified a suspect assumption in the proof by defining a non-standard simultaneity relation from causal connectability. I contend that their critique is based on a misunderstanding of the criteria for the definability of a relation, a misunderstanding that Malement's original treatment helped to foster. There are in fact a variety of notions of definability that can be brought to bear. They all, however, require a condition that suffices to secure Malament's result. The non-standard relation Sarkar and Stachel claim to be definable is not so definable, and, I argue, their proposal to modify the notion of “causal definability” is misguided. Finally, I address the relevance of Malament's result to the thesis of conventionalism.
The Principles of Gauging
Authors: Lyre Holger
Published: February 2004

The aim of this paper is twofold: First, to present an examination of the principles underlying gauge field theories. I shall argue that there are two principles directly connected to the two well-known theorems of Emmy Noether concerning global and local symmetries of the free matter-field Lagrangian, in the following referred to as “conservation principle” and “gauge principle.” Since both express nothing but certain symmetry features of the free field theory, they are not sufficient to derive a true interaction coupling to a new gauge field. For this purpose it is necessary to advocate a third, truly empirical principle which may be understood as a generalization of the equivalence principle. The second task of the paper is to deal with the ontological question concerning the reality status of gauge potentials in the light of the proposed logical structure of gauge theories. A nonlocal interpretation of topological effects in gauge theories and, thus, the non-reality of gauge potentials in accordance with the generalized equivalence principle will be favored.
Why Quantize Gravity (or Any Other Field for That Matter)?
Authors: Huggett Nick , Callender Craig
Published: February 2004

The quantum gravity program seeks a theory that handles quantum matter fields and gravity consistently. But is such a theory really required and must it involve quantizing the gravitational field? We give reasons for a positive answer to the first question, but dispute a widespread contention that it is inconsistent for the gravitational field to be classical while matter is quantum. In particular, we show how a popular argument (Eppley and Hannah 1997) falls short of a no-go theorem, and discuss possible counterexamples. Important issues in the foundations of physics are shown to bear crucially on all these considerations.
Singularities and Scalar Fields: Matter Theory and General Relativity
Authors: Mattingly James
Published: February 2004

Philosophers of physics should be more attentive to the role energy conditions play in General Relativity. I review the changing status of energy conditions for quantum fields—presently there are no singularity theorems for semiclassical General Relativity. So we must reevaluate how we understand the relationship between General Relativity, Quantum Field Theory, and singularities. Moreover, on our present understanding of what it is to be a physically reasonable field, the standard energy conditions are violated classically. Thus the singularity theorems are unavailable for classical General Relativity. Our understanding of singularities in General Relativity turns on delicate issues of what it is to be a matter field—issues distinct from the content of the theory.
Against the Excesses of Quantum Gravity: A Plea for Modesty
Authors: Curiel Erik
Published: February 2004

I argue that all current research programs in quantum gravity conform to the 17th century hypothetico-deductive model of scientific inquiry, perhaps of necessity given the current state of technology. In so far as they do not recognize and advertise the shortcomings of the research method they use, they do a disservice to the integrity of science, for the method admits of far less certainty accruing to its products than one would be led to believe by the pronouncements of researchers in the area.
Extrascientific Uses of Physics: The Case of Nonlinear Dynamics and Legal Theory
Authors: Kellert Stephen H.
Published: February 2004

This essay explores the metaphorical use of the area of nonlinear dynamics popularly known as “chaos theory,” surveying its use in one particular field: legal theory. After sketching some of the mistakes encountered in these efforts, I outline the possibility of the fruitful use of nonlinear dynamics for thinking about our legal system. I then offer some general lessons to be drawn from these examples—both cautionary maxims and a limited defense of cross-disciplinary borrowing. I conclude with some reflections on the nature of arguments that seek to establish intellectual authority or epistemic merit by analogical reasoning.
Science, Biases, and the Threat of Global Pessimism
Authors: Wray K. Brad
Published: February 2004

Philip Kitcher rejects the global pessimists' view that the conclusions reached in inquiry are determined by the interests of some segment of the population, arguing that only some inquiries, for example, inquiries into race and gender, are adversely affected by interests. I argue that the biases Kitcher believes affect such inquiries are operative in all domains, but the prevalence of such biases does not support global pessimism. I argue further that in order to address the global pessimists' concerns, the scientific community needs criticism from people with diverse interests and background assumptions.
Ecological Stability, Model Building, and Environmental Policy: A Reply to Some of the Pessimism
Authors: Odenbaugh Jay
Published: February 2004

Recently, there has been a rise in pessimism concerning what theoretical ecology can offer conservation biologists in the formation of reasonable environmental policies. In this paper, I look at one of the pessimistic arguments offered by Kristin Shrader-Frechette and E. D. McCoy (1993, 1994)—the argument from conceptual imprecision. I suggest that their argument rests on an inadequate account of the concepts of ecological stability and that there has been conceptual progress with respect to complexity-stability hypotheses. Such progress, I maintain, can supply important resources for conservation biologists in determining environmental policies.
Can a Historian of Science Be a Scientific Realist?
Authors: Arabatzis Theodore
Published: February 2004

In this paper I address some of the problems that the historical development of science poses for a realist and discuss whether a realist construal of scientific activity is conducive to historiographical practice. First, I discuss, by means of historical examples, Ian Hacking's defense of entity realism. Second, I try to show, drawing on Kuhn's recent work on incommensurability, that the realism problem is relevant to historiography and that a realist position entails a particular historiographical strategy, which faces problems. Finally, I suggest that for historiographical purposes an agnostic attitude with respect to scientifictheories and unobservable entities is the most appropriate.
Should the Empiricist Be a Constructive Empiricist?
Authors: Alspector-Kelly Marc
Published: February 2004

Van Fraassen does not argue that everyone should be a constructive empiricist. He claims only that constructive empiricism (CE) is a coherent post-positivist alternative to realism, notwithstanding the realist's charge that CE is arbitrary and irrational. He does argue, however, that the empiricist is obliged to limit belief as CE prescribes. Criticism of CE has been largely directed at van Fraassen's claim that CE is a coherent option. Far less attention has been directed at his claim that empiricists should be constructive empiricists. I consider his various attempts to support this claim, conclude that they are unsuccessful, and suggest that the empiricist who repudiates CE does not thereby abandon contemporary empiricism itself.
On Species Individualism: A New Defense of the Species-as-Individuals Hypothesis
Authors: Coleman Keith A. , Wiley E. O.
Published: February 2004

We attempt to defend the species-as-individuals hypothesis by examining the logical role played by the binomials (e.g.,“Homo sapiens,” “Pinus ponderosa”) in biological discourse about species. Those who contend that the binomials can be properly understood as functioning in biological theory as singular terms opt for an objectual account of species and view species as individuals. Those who contend that the binomials can in principle be eliminated from biological theory in favor of predicate expressions opt for a predicative account of species and view species as kinds. We contend that biologists' talk about species is talk about species as individuals, and we conclude that the most plausible account of species is an objectual account.
Science in a Democratic Republic
Authors: Jarvie I. C.
Published: February 2004

Polanyi's and Popper's defenses of the status quo in science are explored and criticized. According to Polanyi, science resembles a hierarchical and tradition-oriented republic and is necessarily conservative; according to Popper's political philosophy the best republic is social democratic and reformist. By either philosopher's lights science is not a model republic; yet each claims it to be so. Both authors are inconsistent in failing to apply their own ideals. Both underplay the extent to which science depends upon the wider society; and neither makes sufficient allowance for the ways it can disrupt the social order. Polanyi even demands extraterritorial exemption for science from the scrutiny of incompetent outsiders. In their different ways, each minimizes the problems of institutionalized science and fails to consider the value, even the long-term necessity, for science of democratic criticism and control. Transnational control of science is an open challenge for democratic polities.
SaRAD: a Simple and Robust Abbreviation Dictionary
Authors: Adar Eytan
Published: February 2004

Motivation: Due to recent interest in the use of textual material to augment traditional experiments it has become necessary to automatically cluster, classify and filter natural language information.

Results: The Simple and Robust Abbreviation Dictionary (SaRAD) provides an easy to implement, high performance tool for the construction of a biomedical symbol dictionary. The algorithms, applied to the MEDLINE document set, result in a high quality dictionary and toolset to disambiguate abbreviation symbols automatically.

Availability: The SaRAD tool, supplementary information and pseudo-code are available at http://www.hpl.hp.com/shl/projects/abbrev.html
A multi-algorithm, multi-timescale method for cell simulation
Authors: Takahashi Kouichi , Kaizu Kazunari , Hu Bin , Tomita Masaru
Published: February 2004

Motivation: Many important problems in cell biology require the dense nonlinear interactions between functional modules to be considered. The importance of computer simulation in understanding cellular processes is now widely accepted, and a variety of simulation algorithms useful for studying certain subsystems have been designed. Many of these are already widely used, and a large number of models constructed on these existing formalisms are available. A significant computational challenge is how we can integrate such sub-cellular models running on different types of algorithms to construct higher order models.

Results: A modular, object-oriented simulation meta-algorithm based on a discrete-event scheduler and Hermite polynomial interpolation has been developed and implemented. It is shown that this new method can efficiently handle many components driven by different algorithms and different timescales. The utility of this simulation framework is demonstrated further with a ‘composite’ heat-shock response model that combines the Gillespie–Gibson stochastic algorithm and deterministic differential equations. Dramatic improvements in performance were obtained without significant accuracy drawbacks. A multi-timescale demonstration of coupled harmonic oscillators is also shown.

Availability: An implementation of the method is available as part of E-Cell Simulation Environment Version 3 downloadable from http://www.e-cell.org/software. Benchmark models are included in the package, and also available upon request.

Supplementary information: Complete lists of reactions and parameters of the heat-shock model, and more results are available at http://www.e-cell.org/bioinfo/takahashi03-1-supp.pdf
Translational polymorphism as a potential source of plant proteins variety in Arabidopsis thaliana
Authors: Kochetov Alex V. , Sarai Akinori
Published: February 2004

Motivation: According to scanning model, 40S ribosomal subunits can either initiate translation at start AUG codon in suboptimal context or miss it and initiate translation at downstream AUG(s), thereby producing several proteins. Functional significance of such a protein translational polymorphism is still unknown.

Results: We compared predicted subcellular localizations of annotated Arabidopsis thaliana proteins and their potential N-terminally truncated forms started from the nearest downstream in-frame AUG codons. It was found that localizations of full and N-truncated proteins differ in many cases: 12.2% of N-truncated proteins acquired sorting signals de novo and 5.7% changed their predicted subcellular locations (mitochodria, chloroplast or secretory pathway). It is likely that the in-frame downstream AUGs may be frequently utilized to synthesize proteins possessing new functional properties and such a translational polymorphism may serve as an important source of cellular and organelle proteomes.

Availability: Detailed description of arabidopsis mRNAs potentially producing novel functional protein forms is available by request.
Predicting subcellular localization of proteins using machine-learned classifiers
Authors: Lu Z. , Szafron D. , Greiner R. , Lu P. , Wishart D.S. , Poulin B. , Anvik J. , Macdonell C. , Eisner R.
Published: February 2004

Motivation: Identifying the destination or localization of proteins is key to understanding their function and facilitating their purification. A number of existing computational prediction methods are based on sequence analysis. However, these methods are limited in scope, accuracy and most particularly breadth of coverage. Rather than using sequence information alone, we have explored the use of database text annotations from homologs and machine learning to substantially improve the prediction of subcellular location.

Results: We have constructed five machine-learning classifiers for predicting subcellular localization of proteins from animals, plants, fungi, Gram-negative bacteria and Gram-positive bacteria, which are 81% accurate for fungi and 92–94% accurate for the other four categories. These are the most accurate subcellular predictors across the widest set of organisms ever published. Our predictors are part of the Proteome Analyst web-service.

Availability:  http://www.cs.ualberta.ca/~bioinfo/PA/Sub, http://www.cs.ualberta.ca/~bioinfo/PA

Supplementary information:  http://www.cs.ualberta.ca/~bioinfo/PA/Subcellular
Enrichment of transcriptional regulatory sites in non-coding genomic region
Authors: Xue Wen , Wang Jin , Shen Zhirong , Zhu Huaiqiu
Published: February 2004

Motivation: Over-represented k-mers in non-coding genomic regions often lead to identification of potential transcriptional regulatory sites (TRS). This phenomenon has been employed by many algorithms to predict TRS in silico. Yet, the improvement of these algorithms should be based on deeper understanding of the enrichment feature. To obtain a general distributional profile of TRS in different regions of genomes as well as in different genomes, we here performed a systematic analysis on the over-representation of TRS in intergenic regions and gene upstream regions of yeasts and viral genomes, and the distributional pattern of TRS in intergenic and intron regions of the Drosophila genome. We also explored the way to evaluate the accuracy of TRS consensus sequences by measuring their enrichment.

Results: To measure enrichment, a statistical background model was introduced by comparing TRS frequency in certain regions of genome to either the frequency in the whole genome or the frequency in exon region. This model was applied to different classes of non-coding genomic regions in four genomes. Most of the TRS were observed to be over-represented in the intergenic regions of the Saccharomyces cerevisiae, Schizosaccharomyces pombe and Epstein-Barr virus (EBV) genomes. The enrichment of S.cerevisiae TRS in the 600 bp upstream region of genes was also significant. In Drosophila genome, TRS did not show enrichment in intergenic and intron regions when TRS frequency in the whole genome was taken as background, as we did in other genomes. However, when we took TRS frequency in exon region as background, over 70% TRS are over-represented in those two classes of non-coding regions. This fact indicates the existence of transcriptional regulatory signals in introns. The analysis of some S.cerevisiae TRS, which have inconsistent consensus sequences with different levels of enrichment in intergenic region, suggests the possibility of evaluating the accuracy of experimentally determined TRS by measuring their enrichment in non-coding genomic regions.

Availability: Free programs are available at http://dii.nju.edu.cn/~xuewen/enrichment/
A simple fold with variations: the pacifastin inhibitor family
Authors: Gáspári Zoltán , Ortutay Csaba , Perczel András
Published: February 2004

Summary: Members of the pacifastin family are small, ∼35-residue serine protease inhibitors isolated from arthropod species. Several locust inhibitors exhibit intriguing taxon specificity while others do not. The structural basis of this phenomenon may lie in the different dynamical properties of the proteins originating from different stabilizing interactions. In this study, we identify new members of the family to confirm the universal role of these interactions in the family. Structural investigations show that both the disulfide pattern and the stabilizing interactions are unique among small all-beta proteins.

Availability: Detailed description of the results can be found at http://www.chem.elte.hu/departments/protnmr/pif
Support vector machine classification on the web
Authors: Pavlidis Paul , Wapinski Ilan , Noble William Stafford
Published: February 2004

Summary: The support vector machine (SVM) learning algorithm has been widely applied in bioinformatics. We have developed a simple web interface to our implementation of the SVM algorithm, called Gist. This interface allows novice or occasional users to apply a sophisticated machine learning algorithm easily to their data. More advanced users can download the software and source code for local installation. The availability of these tools will permit more widespread application of this powerful learning algorithm in bioinformatics.

Availability: Web interface at svm.sdsc.edu. Binaries and source code at microarray.cpmc.columbia.edu/gist.
Safety of Modified Radical Neck Dissection for Differentiated Thyroid Carcinoma
Authors: Kupferman Michael E. , Patterson D. Michael , Mandel Susan J. , LiVolsi Virginia , Weber Randal S.
Published: February 2004

Objectives/Hypothesis The management of cervical metastases from differentiated thyroid carcinoma (DTC) remains controversial. Most surgeons perform a neck dissection (ND) for clinically apparent disease. The extent of nodal dissection varies from regional to comprehensive. Morbidity from ND in the setting of DTC remains high, particularly when performed in the setting of a thyroidectomy (TT). To determine complications from ND for DTC, we retrospectively reviewed our surgical experience of modified radical neck dissection for nodal metastases.

Study Design Retrospective chart review.

Methods Between 1997 and 2002, 39 consecutive patients (31 females and 8 males) underwent 44 comprehensive NDs of levels II–V for DTC. Central compartment dissection (CCD) (levels VI and VII) was also performed during 23 of these procedures. Twenty (45.5%) patients had prior treatment elsewhere. Preoperative pathology revealed papillary carcinoma in 22 patients (56.4%), tall cell variant in 11 (28.2%), and follicular variant in 6 (15.4%).

Results Ten patients (20%) underwent ND alone, whereas 6 (14%) underwent simultaneous ND and TT. Fifteen patients underwent simultaneous ND, TT, and CCD (30%). Temporary hypocalcemia occurred after 21% of NDs that were performed in the setting of either TT or CCD or both. There were no cases of permanent hypoparathyroidism. Transient regional lymph node (RLN) paresis occurred in two patients and was associated with a concomitant central compartment nodal dissection; there were no permanent RLN palsies. Transient spinal accessory nerve paresis developed after 27% of NDs performed. Two patients developed chyle leaks.

Conclusions When ND is necessary for the treatment of thyroid malignancies, the procedure can be performed safely with acceptable morbidity.
Endoscopic Neck Surgery: Resection of the Submandibular Gland in a Cadaver Model
Authors: Terris David J. , Haus Brian M. , Gourin Christine G.
Published: February 2004

Objectives/Hypothesis The objective was to evaluate the feasibility of performing a totally endoscopic resection of the submandibular gland in a cadaver model.

Study Design Prospective, nonrandomized experimental investigation in a cadaver model.

Methods A modified endoscopic surgical approach (representing a hybrid of balloon dissection and low‐pressure carbon dioxide insufflation) previously developed in a porcine model was implemented in fresh cadavers. Once a reliable protocol was achieved, eight procedures were performed in six cadavers. Data collected prospectively included the operative time, inadvertent neurovascular injury, and size of the glands.

Results All eight endoscopic submandibular gland resections were successfully performed in six consecutive cadavers (no conversions to open resection were necessary). The duration of the procedures ranged from 50 to 150 minutes, with a median duration of 65.5 minutes and a steady trend toward a shorter duration. Histological examination confirmed the presence of normal glandular architecture without evidence of excessive trauma or thermal injury. The optimal spacing of the instrument ports was 4 cm from the camera port. There were no cases of neurovascular injury. In two cadavers, a minimal amount of subcutaneous emphysema could be appreciated, which was limited to the skin overlying the dissection.

Conclusion Totally endoscopic resection of the submandibular gland is possible by combining balloon dissection with low‐pressure carbon dioxide insufflation. The excellent visualization afforded by the endoscope provided a safe operative approach. Ultimately, a number of endoscopic neck procedures may be possible, and clinical trials are under way.
Factors Predictive of Local Disease Control after Intra‐arterial Concomitant Chemoradiation (RADPLAT)
Authors: Robbins K. Thomas , Doweck Ilana , Samant Sandeep , Vieira Francisco , Kumar Parvesh
Published: February 2004

Objectives To determine the relative risk of prognostic factors for local disease control following RADPLAT.

Study Design Prospective study, academic medical center.

Methods Analyses of nine categories of risk factors among 240 patients with Stage II‐IV carcinoma consecutively treated with RADPLAT (cisplatin 150 mg/m2 IA and sodium thiosulfate 9 g/m2 IV, weekly ×4; radiotherapy 2 Gy/fraction/d, 5× weekly, 68–74 Gy over 6 to 7 weeks). Median follow‐up: 58 months (range, 12–96 mo).

Results The percentage of patients who had local disease control was 87.5%. Univariant analysis showed T classification (P = .01), laterality of neck disease (P = .026), number of neck levels involved (P = .008), total dose of radiation greater versus less than 60 Gy (P = .027), and presence of pathologically positive lymph nodes following chemoradiation (P = .01) to be significant. Logistic regression analysis showed total dose of radiation (P = .03) and the presence of pathologically positive lymph nodes following chemoradiation (P = .05) to be significant. For Kaplan‐Meier estimates of local disease control at 5 years, T classification (P = .038), number of levels with nodal disease (P = .006), and total dose of radiation therapy (P = .0001) were significant. The log‐rank test identified as significant the total dose of radiation therapy (P < .0001), the presence of pathologically positive lymph nodes following chemoradiation (P = .005), and the number of neck levels with positive nodes (P = .006). The Cox regression model showed significance for the total dose of radiation (P = .001), the presence of pathologically positive lymph nodes following chemoradiation (P = .007), and the T classification (P = .029).

Conclusion Risk factors significantly associated with local disease control after RADPLAT appears to differ from more traditional therapy and is suggestive of a paradigm shift.
Clinical Results with the Med‐El Compressed and Split Arrays in the United States
Authors: Bauer Paul W. , Roland Peter S.
Published: February 2004

Objective To determine the indications for which the Med‐El compressed and split arrays have been used in the United States, to assess the success achieved in insertion, to determine hearing outcomes, and assess complications associated with using these arrays.

Study Design Retrospective review of data gathered during the US clinical trial.

Methods Data were extracted concerning indications for use, depth of insertion, number of electrodes in use, 3 and 6 month performance outcomes, and complications. The results obtained in postmeningitic patients using the compressed array were compared with results of patients using the split array.

Results Six adults and 22 children have been implanted with the compressed array. The principal indications have been postmeningitis or congenital cochlear malformations. The average improvement seen in the Meaningful Auditory Integration Scale scores was 17.6 for the compressed array group and 13.9 for the split array group. The same number of electrodes was inserted on average for both groups, with comparable numbers of electrodes in use.

Conclusions The Med‐El compressed array is an alternative to a standard or split array in managing patients with postmeningitic deafness or congenital cochlear malformations. Benefits to these patients are most clearly seen in subjective measures.
Octreotide Scintigraphy in the Head and Neck
Authors: Bustillo A. , Telischi F. , Weed D. , Civantos F. , Angeli S. , Serafini A. , Whiteman M.
Published: February 2004

Objectives/Hypothesis Octreotide is a somatostatin analogue that, when coupled to a radioisotope, produces a scintigraphic image of neuroendocrine tumors (NET) expressing somatostatin type 2 receptors (SSR 2). Octreotide scintigraphy (OS) may be useful in confirming the preoperative diagnosis of certain head and neck NET. Paragangliomas (PG), like many NET, have been found to have a high density of SSR 2 on the cell surfaces. Other NET of the head and neck include merkel cell carcinomas (MCC), medullary thyroid carcinomas (MTC), and esthesioneuroblastomas.

Study Design A retrospective study that compared the results of OS with the histopathologic diagnosis in 74 patients with head and neck NET.

Results Of the 60 patients undergoing evaluation for suspected paraganglioma, OS was correctly positive in 36 of the 37 patients with PG. OS was correctly negative in 19 of the 23 patients that did not exhibit PG. For PG, this yielded a sensitivity of 97% and a specificity of 82%. There were 14 patients in the nonparaganglioma group. OS detected or diagnosed all metastases in three patients with MTC, locoregional recurrences in two patients with esthesioneuroblastoma, an extrapituitary adenoma in one patient, and metastasis in two patients with MCC. It failed to detect a paraspinal metastasis in the third patient with MCC.

Conclusion On the basis of this series of patients, OS appears to be a reliable test to detect PG and may be helpful in detecting primary and metastatic disease for NET.
Staging of Obstructive Sleep Apnea/Hypopnea Syndrome: A Guide to Appropriate Treatment
Authors: Friedman Michael , Ibrahim Hani , Joseph Ninos J.
Published: February 2004

Objective Early studies by Friedman et al. have demonstrated the value of staging obstructive sleep apnea/hypopnea syndrome (OSAHS) patients for the prediction of success for uvulopalatopharyngoplasty (UPPP) on the basis of short‐term follow up. The goal of this study is to test the value of this staging system in a prospective study.

Study Design This is a prospective study of two cohorts of patients: one was treated with the benefit of a clinical staging system and the other without.

Methods Patients with symptoms of OSAHS were assessed by polysomnography and were staged according to a previously described staging system. The staging system is based on palate position, tonsil size, and body mass index (BMI). The control group was treated without the benefit of staging. All patients in the control group were treated with UPPP only. Patients in the experimental group were treated based on their clinical stage. Patients with stage I disease, regardless of the severity of disease, were treated with UPPP only. Selected patients with stage II and stage III disease were treated with UPPP in addition to a staged tongue‐base reduction using a radiofrequency technique (TBRF).

Results Follow‐up at 6 months showed significant improvement compared with a group of patients treated without the benefit of a staging system. Successful treatment of patients with stage II disease improved from 37.9% to 74.0%. The overall success rate improved from 40% to 59.1%.

Conclusion Clearly, patients with stage I disease had the best success rate, but a selective protocol based on clinical staging improves the overall success rate. In addition, it can eliminate as surgical candidates those patients with whom the procedure is likely to fail.
Hospital Use in the Treatment of Sleep Apnea
Authors: Petersen Erik J. , Reiter Evan R.
Published: February 2004

Objectives Evaluate hospital use for treatment of sleep apnea.

Study Design Retrospective database review.

Materials and Methods The 1998 to 2000 National Inpatient Sample (NIS) was searched for admissions with a diagnosis of sleep apnea. Records were examined for demographics, diagnoses, procedures, and complications. Data were analyzed to identify factors affecting length of stay (LOS) and charges.

Results There were 5,864 (0.03% NIS) admissions for sleep apnea. The sleep apnea group had lower mean age (43.1 vs. 47.2 years), higher percentages of males (71.6% vs. 41.0%) and African Americans (18.7% vs. 13.7%), and higher rates of obesity, hypertension, and anatomic airway diagnoses than the NIS population. Of sleep apnea group adults, 77.1% underwent a mean 2.3 procedures, whereas of those patients under 18 years of age, 60.8% underwent a mean of 1.2 procedures. Tracheotomy and procedures for hypopharyngeal airway compromise were used infrequently. Within the sleep apnea group, there were significant differences in LOS and charges on the basis of age, sex, race, payment method, procedures, and number of secondary diagnoses (all P < .05). Patients over 18 admitted for other diagnoses, but with secondary diagnosis of sleep apnea, had longer LOS (5.38 vs. 4.95 days) and higher charges ($16,562 vs. $13,928) than patients without sleep apnea.

Conclusions Hospital use for sleep apnea remains largely for surgical treatment of the disease. Procedures directed at hypopharyngeal obstruction are seldom used. Multiple factors including patient age, number of secondary diagnoses, and procedures affect LOS and charges. The presence of sleep apnea also increases charges and LOS in patients admitted for other diagnoses.
Effectiveness of Laser‐Assisted Myringotomy for Otitis Media in Children
Authors: Cotter Cheryl S. , Kosko James R.
Published: February 2004

Objective To evaluate the effectiveness of OtoScan CO2 laser‐assisted myringotomy (OtoLAM ESC/Sharplan) for acute otitis media and chronic otitis media with effusion (COME) in children.

Study Design Retrospective review of 47 children with refractory acute otitis media (RAOM) or COME more than 3 months in duration in a pediatric otolaryngology practice.

Methods Laser‐assisted myringotomy was performed on 47 patients (79 ears) using the OtoLAM device. There were 28 children (ages 0.50–3 years) with RAOM and 19 children (ages 0.58–15 years) with COME.

Results A total of 57.4% of procedures were considered treatment failures. Failures occurred in 53.6% of patients with RAOM on average ±SD 3.89 ± 2.16 weeks after the procedure and in 63.2% of patients with COME on average ±SD 7.25 ± 5.57 weeks after the procedure. Age, sex, microorganism isolated, myringotomy size, wattage, and laterality did not predict outcome. Ventilation tube insertion was performed in 27 (57.4%) patients. Two patients have persistent tympanic membrane perforations at 2 years.

Conclusions Laser‐assisted myringotomy in children with RAOM and COME was associated with a high incidence of recurrence or persistence of disease and with perforation of the tympanic membrane. Recommendations for use of the OtoLAM should include discussion of high failure rates and the strong likelihood of subsequent ventilation tube insertion. The OtoLAM remains an option for office‐based ventilation of the middle ear for families and patients where general anesthesia is a concern.
Silent Functional Magnetic Resonance Imaging (fMRI) of Tonotopicity and Stimulus Intensity Coding in Human Primary Auditory Cortex
Authors: Yetkin F. Zerrin , Roland Peter S. , Christensen William F. , Purdy Phillip D.
Published: February 2004

Objectives The aims of this study were to determine the feasibility of obtaining auditory cortex activation evoked by pure tones presented at threshold and suprathreshold hearing levels, to evaluate tonotopicity of the primary auditory cortex, and to determine the effect of stimulus intensity on auditory cortex activation using silent functional magnetic resonance imaging (fMRI).

Methods Sixteen subjects with normal hearing underwent silent fMRI. An audiometer was used to deliver pure tones of 1,000, 2,000, and 4,000 Hz to the left ear. Two levels of acoustic stimulation were used: 1) threshold, hearing level determined in the scanner room and 2) suprathreshold, 70 dB hearing loss (HL). Tonotopicity and stimulus intensity coding was assessed on the basis of the location, extent, and amount of the auditory cortex activation.

Results The localization of activation moved to more medial and posterior regions of the primary auditory cortex as the frequency of the pure tone increased. Compared with a threshold stimulus, a suprathreshold stimulus evoked the same regions with increased spatial extent. The average increase in the right auditory cortex activation in response to suprathreshold stimulus was 57% at 1,000, 51% at 2,000, and 45% at 4,000 Hz compared with that activated by the threshold stimulus.

Conclusions Silent fMRI can be used to evaluate auditory cortex activation using low‐intensity stimuli. The level of stimulus intensity increases the amount of auditory cortex activation and influences the fMRI mapping of the tonotopic organization of the primary auditory cortex.
Supporting Cells As a Target of Cisplatin‐Induced Inner Ear Damage: Therapeutic Implications
Authors: Ramírez‐Camacho Rafael , García‐Berrocal José Ramón , Buján Julia , Martín‐Marero Alejandro , Trinidad Almudena
Published: February 2004

Objectives/Hypothesis Cisplatin induces adverse effects such as ototoxicity and nephrotoxicity. Unexplained hearing improvement in sudden deafness and fluctuating hearing loss suggests the presence of some mechanisms other than the primary lesion of the outer hair cell. The authors' aim was to study the functional and morphological lesions induced in the cochlea of the rat after cisplatin injection.

Study Design Prospective experimental morphological and functional study.

Methods Forty‐eight Wistar rats were given intraperitoneal injections of 5 mg/kg cisplatin. After short‐, medium‐, and long‐term survival, animals were studied by means of auditory brainstem response testing and scanning electronic microscopy.

Results An increased hearing loss was observed in animals with long‐term survival compared with animals with short‐term survival after a single dose of cisplatin. These findings correlated with a more intense injury of the supporting cells, continuing with the late deterioration of the hair cells.

Conclusion The study suggested that the initial damage of the supporting cells could be responsible for the late injury of the hair cells. This hypothesis was supported by the late increase in hearing loss after a single dose of cisplatin, emphasizing the role of the supporting cells in the cochlear changes induced by cisplatin.
Measuring the in Vivo Binding Parameters of [18F]-Fallypride in Monkeys Using a PET Multiple-Injection Protocol
Authors: Christian Bradley T , Narayanan Tanjore , Shi Bing , Morris Evan D , Mantil Joseph , Mukherjee Jogeshwar
Published: February 2004

The goal of this work was to quantify the in vivo transport and binding parameters of [F-18]fallypride and the D2/D3 receptor density (B′max) in both the striatal (putamen, caudate, ventral striatum) and extrastriatal regions (thalamus, amygdala, cerebellum, temporal and frontal cortices) of the rhesus monkey brain. Multiple-injection PET experimental protocols with injections of radiolabeled and unlabeled doses of fallypride were used to estimate the K1, k2, kon/VR, koff and B′max kinetic parameters. The experimental design was chosen using the D-optimal criterion to maximize the precision of the estimated binding parameters for the various brain regions. There was a significant range in B′max for the putamen (27pmol/mL), caudate (23pmol/mL), ventral striatum (14pmol/mL), thalamus (1.8pmol/mL) and amygdala (0.9pmol/mL). Significant receptor binding was also found in the cortical regions. Knowledge of these in vivo rate constants serves as a necessary step in using [F-18]fallypride PET to measure D2/D3 receptor density and drug occupancy in clinical research applications. We believe the precise parameter estimates derived from these complicated experimental protocols are necessary for proper application of drug occupancy and clinical research studies with [F-18]fallypride, which often rely on the validity of assumptions regarding the model parameters.
Up-Regulation of Endothelial Nitric Oxide Synthase via Phosphatidylinositol 3-Kinase Pathway Contributes to Ischemic Tolerance in the CA1 Subfield of Gerbil Hippocampus
Authors: Hashiguchi Akihito , Yano Shigetoshi , Morioka Motohiro , Hamada Junichiro , Ushio Yukitaka , Takeuchi Yusuke , Fukunaga Kohji
Published: February 2004

We here investigated endothelial nitric oxide synthase (eNOS) expression after 10 minutes of forebrain ischemia. Real-time polymerase chain reaction, immunoblots and immunohistochemical studies revealed up-regulation of eNOS expression in the hippocampal CA1 subfield of gerbil. Immunoreactivity of eNOS significantly increased in endothelium but neither in neurons nor astrocytes after 6 to 168 hours of reperfusion. An increased Akt activity preceded the postischemic eNOS up-regulation. Intracerebroventricular injection (i.c.v.) of wortmannin, an inhibitor of phosphatidylinositol 3-kinase (PI-3K), significantly inhibited the increases in both eNOS mRNA and its protein with concomitant inhibition of Akt activation. The significant increase in the eNOS expression was also evident following preconditioning 2-minute ischemia. Both eNOS up-regulation and acquisition of ischemic tolerance observed at 3 days after preconditioning ischemia were significantly inhibited by pretreatment with wortmannin. Administration (i.c.v.) of NG-nitro-L-arginine methyl ester, but not 7-nitroindazole, 30 minutes prior to lethal 10-minute ischemia, significantly abolished the acquired tolerance. Intraperitoneal injections of aminoguanidine at immediately after, 24, and 48 hours after preconditioning had no effects on the tolerance. These results suggest that eNOS expression is up-regulated in the endothelium via PI-3K pathways after transient forebrain ischemia, and that preconditioning-induced eNOS expression plays an important role in neuroprotection in the ischemic tolerance.
Endothelial Nitric Oxide Synthase Gene Polymorphisms Predict Susceptibility to Aneurysmal Subarachnoid Hemorrhage and Cerebral Vasospasm
Authors: Khurana Vini G , Sohni Youvraj R , Mangrum Wells I , McClelland Robyn L , O'Kane Dennis J , Meyer Fredric B , Meissner Irene
Published: February 2004

Rupture of an intracranial aneurysm (subarachnoid hemorrhage) is a potentially devastating condition frequently complicated by delayed cerebral ischemia from sustained contraction of intracranial arteries (cerebral vasospasm). There is mounting evidence linking the formation of intracranial aneurysms and the pathogenesis of post-subarachnoid hemorrhage vasospasm to aberrant bioavailability and action of the vasodilator molecule nitric oxide generated by isoforms of nitric oxide synthase. In humans, the gene encoding the endothelial isoform of nitric oxide synthase (eNOS) is known to be polymorphic, with certain polymorphisms associated with increased cardiovascular disease susceptibility. In this prospective clinical study involving 141 participants, we used gene microarray technology to demonstrate that the eNOS gene intron-4 27-base pair variable number tandem repeat polymorphism (eNOS 27 VNTR) predicts susceptibility to intracranial aneurysm rupture, while the eNOS gene promoter T-786C single nucleotide polymorphism (eNOS T-786C SNP) predicts susceptibility to post-subarachnoid hemorrhage vasospasm. We believe that genetic information such as this, which can be obtained expeditiously at the time of diagnosis, may be used as a helpful adjunct to other clinical information aimed at predicting and favorably modifying the clinical course of persons with intracranial aneurysms.
The Future of the ‘Radical Centre’ in Northern Ireland after the Good Friday Agreement
Authors: Evans Jocelyn A. J. , Tonge Jonathan
Published: February 2004

The 1998 Good Friday Agreement has provided a new political dispensation in Northern Ireland. Through the management of the competing aims of unionism and nationalism, the Agreement hopes to promote cross-community consensus and forge a new, moderate centre. However, the segmental autonomy evident under the consociationalism of the Agreement poses questions of the existing political centre in Northern Ireland. Traditionally, the centre, as represented by the Alliance Party, has rejected unionism and nationalism, believing either to be ideologies to be overcome, rather than accommodated. Under the post-Agreement political arrangements, Alliance has already been obliged to bolster pro-Agreement unionism, through the temporary tactical redesignation of three of its Assembly members as Unionist and through tacit support for selected unionist election candidates. Using the first ever membership survey of the existing centre party in Northern Ireland, this article examines whether its vision of a radical third tradition is sustainable in a polity in which unionist and nationalist politics are legitimised.