bluuebunny/crossref_metadata_2025 huggingface dataset:
ADMINISTRATION OF EXOGENOUS TISSUE PLASMINOGEN ACTIVATOR REDUCES OEDEMA IN MICE LACKING THE TISSUE PLASMINOGEN ACTIVATOR GENE
Authors: Stringer Kathleen A , Dunn John S , Gustafson Daniel L
Published: May 2004

1. It has recently become apparent that tissue plasminogen activator (tPA) modulates inflammation in diseases such as rheumatoid arthritis (RA) and acute respiratory distress syndrome (ARDS).

2. We have shown previously that tPA has anti‐inflammatory activity in in vivo models of oedema or inflammation.

3. The present study investigated the ability of exogenous recombinant tPA (rtPA) to reduce carrageenan‐mediated oedema in mice lacking the tPA gene, testing the hypothesis that rtPA treatment may be beneficial in diseases such as RA and ARDS in which there is a paucity of endogenous tPA.

4. Knockout mice deficient in the tPA gene and matching wild‐type mice received an intraplantar injection (25 µL) of carrageenan (1.5%, w/v) following either vehicle (sterile water for injection) or tPA (12 mg/kg).

5. Footpad oedema was measured, an oedema index was calculated and tissue myeloperoxidase (MPO) activity was determined. Mean oedema indices were higher in untreated tPA (–/–) mice than untreated wild‐type mice. Pretreatment with rtPA in either tPA (–/–) or wild‐type mice reduced the mean measured peak footpad oedema index by 63 and 48%, respectively. Tissue MPO activity was not different between treatment groups.

6. We conclude that exogenous rtPA has the ability to reduce acute oedema without altering neutrophil infiltration into the site of injury in both tPA (–/–) and wild‐type mice and that endogenous tPA may participate in the inflammatory process, as evidenced by higher oedema indices in untreated tPA (–/–) mice. These data provide support for the potential clinical utility of exogenous rtPA in the treatment of inflammatory diseases, such as RA and ARDS, in which there is a paucity of tPA.
ACTIVATION OF RENAL CALCIUM AND WATER EXCRETION BY NOVEL PHYSIOLOGICAL AND PHARMACOLOGICAL ACTIVATORS OF THE CALCIUM‐SENSING RECEPTOR
Authors: Conigrave Arthur D , Lok Hiu Chuen
Published: May 2004

1. Activated Ca2+‐sensing receptors (CaR) play key roles in the regulation of whole‐body calcium metabolism by inhibiting the secretion of the key calcitropic hormone parathyroid hormone and promoting urinary calcium excretion.

2. We have now examined the effects of intravenous administration of novel calcium receptor activators on renal function in anaesthetized female Wistar rats.

3. The type II calcimimetic NPS R‐467 and the CaR‐active amino acids l‐Phe and l‐Ala, which act at distinct binding sites on the receptor, all activated urinary flow rate, calcium and osmolar excretion and suppressed urinary osmolality.

4. The effects of l‐Phe and NPS R‐467 on urine flow rate and calcium excretion were stereoselective, consistent with the idea that these effects were mediated by calcium‐sensing receptors.

5. However, d‐Phe also suppressed urinary osmolality and promoted osmolar excretion, possibly by exceeding the transport maximum in the proximal tubule.

6. The data indicate that novel activators of CaR, including l‐amino acids at physiologically relevant serum concentrations, play a significant role in the regulation of urinary calcium and water excretion.
NEURAL CONTROL OF RENAL MEDULLARY PERFUSION
Authors: Eppel Gabriela A , Malpas Simon C , Denton Kate M , Evans Roger G
Published: May 2004

1. There is strong evidence that the renal medullary circulation plays a key role in long‐term blood pressure control. This, and evidence implicating sympathetic overactivity in development of hypertension, provides the need for understanding how sympathetic nerves affect medullary blood flow (MBF).

2. The precise vascular elements that regulate MBF under physiological conditions are unknown, but likely include the outer medullary portions of descending vasa recta and afferent and efferent arterioles of juxtamedullary glomeruli, all of which receive dense sympathetic innervation.

3. Many early studies of the impact of sympathetic drive on MBF were flawed, both because of the methods used for measuring MBF and because single and often intense neural stimuli were tested.

4. Recent studies have established that MBF is less sensitive than cortical blood flow (CBF) to electrical renal nerve stimulation, particularly at low stimulus intensities. Indeed, MBF appears to be refractory to increases in endogenous renal sympathetic nerve activity within the physiological range in all but the most extreme cases.

5. Multiple mechanisms appear to operate in concert to blunt the impact of sympathetic drive on MBF, including counter‐regulatory roles of nitric oxide and perhaps even paradoxical angiotensin II‐induced vasodilatation. Regional differences in the geometry of glomerular arterioles are also likely to predispose MBF to be less sensitive than CBF to any given vasoconstrictor stimulus.

6. Failure of these mechanisms would promote reductions in MBF in response to physiological activation of the renal nerves, which could, in turn, lead to salt and water retention and hypertension.
BRIEF EXPOSURE TO ETHANOL AUGMENTS VASCULAR CONTRACTILITY IN HUMAN CHORIONIC PLATE ARTERIES
Authors: Hong Eun Hui , Kang Na Young , Kim Jee Ahn , Koo Tae Bon , Kang Bong‐Seok , Kim In Kyeom
Published: May 2004

1. Heavy alcohol consumption has been known as a risk factor for hypertension, although the mechanism by which alcohol intake causes hypertension remains elusive.

2. We tested the hypothesis that brief exposure to ethanol augments vascular contractility through the stress response in human chorionic plate arteries.

3. Human chorionic plate arteries were mounted in organ baths and exposed to 5% ethanol for 15, 30 or 45 min.

4. Brief exposure for 45 min, but not 15 min, not only augmented contractility to KCl and 5‐hydroxytryptamine 5 h after the end of exposure, but also increased the expression of heat shock protein (HSP) 70 in the tissues.

5. Reverse transcription–polymerase chain reaction showed gradual increases of hsp70 mRNA expression, but not heat shock cognate 70 (hsc70), hsp90α or glucose regulatory protein 78 (grp78) mRNA expression, in an exposure time‐dependent manner 3 h after the end of exposure.

6. These results indicate that ethanol augments vascular contractility through the stress response.
EFFECTS OF RILMENIDINE ON PROXIMAL TUBULAR FLUID ABSORPTION IN RATS
Authors: Jovanovska Valentina , Eitle Eveline , Harris Peter J
Published: May 2004

1. The antihypertensive agent rilmenidine has threefold higher affinity for I1 imidazoline receptors compared with α2‐adrenoceptors and acts on the central nervous system by reducing sympathetic activity and in the kidney by inhibiting Na+/H+ exchange activity.

2. In the present study, we examined: (i) the effects of luminal and peritubular administration of rilmenidine on fluid absorption in superficial proximal tubules; and (ii) the nature of the receptors involved in mediating the action of this drug in the presence of specific antagonists (efaroxan, idazoxan and 2‐methoxy‐idazoxan). Studies were performed in anaesthetized Sprague‐Dawley rats using shrinking split‐drop micropuncture.

3. Luminal administration of rilmenidine (10−5 and 10−13 mol/L) inhibited proximal tubular fluid absorption. Peritubular rilmenidine at 10−12 and 10−13 mol/L also inhibited fluid uptake, whereas rilmenidine at 10−11 mol/L had a significant stimulatory action.

4. In the presence of the I2 > I1/α2‐adrenoceptor antagonist idazoxan (10−5 mol/L), luminal rilmenidine (10−5 mol/L) stimulated fluid absorption. Stimulation of fluid uptake was also observed when rilmenidine (10−5 mol/L) and the I1 imidazoline receptor antagonist efaroxan (10−5 mol/L) were added together in the luminal fluid. Luminal administration of the selective α2‐adrenoceptor antagonist 2‐methoxy‐idazoxan (10−5 mol/L) resulted in significant attenuation of the inhibitory action of luminal rilmenidine (10−5 mol/L). This indicates that both I1 imidazoline receptors and α2‐adrenoceptors are involved in the luminal actions of rilmenidine.

5. The effects of luminal and peritubular administration of α‐methylnoradrenaline (an α2‐adrenoceptor agonist) were compared with those of rilmenidine. Luminal α‐methylnoradrenaline, at higher concentrations (10−7 and 10−5 mol/L), inhibited fluid absorption, as was seen with peritubular rilmenidine, but, in contrast with rilmenidine, no stimulatory action was observed. Peritubular α‐methylnoradrenaline inhibited fluid uptake at higher concentrations (10−5 and 10−7 mol/L), whereas rilmenidine at these concentrations had no effect. The differences in the concentration‐dependent responses for rilmenidine and α‐methylnoradrenaline indicate that both imidazoline receptors and α2‐adrenoceptors are involved in the actions of these compounds on proximal fluid uptake.
ANTI‐APOPTOTIC EFFECT OF ATORVASTATIN, A 3‐HYDROXY‐3‐METHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR, ON CARDIAC MYOCYTES THROUGH PROTEIN KINASE C ACTIVATION
Authors: Tanaka Koichi , Honda Masaaki , Takabatake Toshikazu
Published: May 2004

1. Pleiotropic effects of statins, which are independent of lipid lowering, have been reported. In the present study, we examined the effect of a statin on apoptosis of adult rat cultured cardiac myocytes. We used the protein kinase C (PKC) inhibitors staurosporine (1 µmol/L), chelerythrine (10 µmol/L) and rottlerin (5 µmol/L) to induce myocyte apoptosis. The effect of atorvastatin (10−7 g/mL), a statin, on myocyte apoptosis induced by these PKC inhibitors was examined.

2. All these PKC inhibitors markedly increased the percentage of terminal deoxyribonucleotidyl transferase‐mediated dUTP–digoxigenin nick end‐labeling (TUNEL)‐positive myocytes. This increase was significantly suppressed by atorvastatin treatment. Both chelerythrine and rottlerin induced subcellular translocation of PKCδ and elevated caspase‐3 activity in myocytes. The changes in the subcellular distribution of PKCδ and caspase‐3 activity induced by these PKC inhibitors were suppressed by atorvastatin treatment.

3. The results of the present study suggest that the inhibitory effect of atorvastatin on apoptosis of adult rat cardiac myocytes induced by the PKC inhibitors is through activation of PKCδ pathway.
Is the Government Failure Theory Still Relevant? A panel analysis using US state level data
Authors: Matsunaga Yoshiho , Yamauchi Naoto
Published: June 2004

Abstract The purpose of this paper is to empirically examine the robustness of the government failure theory. A core feature of the government failure theory is demand heterogeneity. Previous studies have brought into question the robustness of the government failure theory, due to inconsistent results concerning the explanatory power of demand heterogeneity. Therefore, in this paper we revisit this important research agenda using US state level panel data. We find the two‐way fixed effects model a suitable model for testing the government failure theory's robustness and present findings which indicate that observable demand heterogeneity has a positive effect on the size of the nonprofit sector. This paper also empirically examines the relevance of the complementary financing hypothesis in terms of the cooperative nature of the governmental and nonprofit sector relationship; that is where governments delegate the production of quasi‐public goods to the nonprofit sector.
Constitutional Design and Investment in Cooperatives and Investor‐Owned Enterprises
Authors: Bacchiega Alberto , De Fraja Gianni
Published: June 2004

Abstract This paper studies the role of the corporate governance system in cooperatives and in investor‐owned enterprises. We abstract from all possible differences between the two systems except the type of majority needed to take decisions: this is one‐head‐one‐vote for cooperatives and proportional to capital invested in investor‐owned firms. We show that the institutional form chosen matters for the initial investment decision of the agents: in particular we find that members of a cooperative invest less than they would in an investor‐owned enterprise.
Switching Order Statistics through Random Power Contractions
Authors: WesoŁowski Jacek , Ahsanullah Mohammad
Published: June 2004

This paper investigates a new random contraction scheme which complements the length‐biasing and convolution contraction schemes considered in the literature. A random power contraction is used with order statistics, leading to new and elegant characterizations of the power distribution. In view of Rossberg's counter‐example of a non‐exponential law with exponentially distributed spacings of order statistics, possibly the most appealing consequence of the result is a characterization of the exponential distribution via an independent exponential shift of order statistics.
Screening and Human Capital in the Australian Labour Market of the 1990s
Authors: Lee Yew Liang , Miller Paul W.
Published: June 2004

This paper presents tests of the screening hypothesis using data on adult males from the 1996 Australian Census of Population and Housing. These tests are based on comparisons of wage and salary earners and the self‐employed, and public and private sector workers, as examples of screened and unscreened employments. The first test compares the mean levels of schooling, income and labour market experience in screened and unscreened sectors, while the second examines the returns to schooling and the goodness of fit of the earnings models for both wage and salary earning (separated into public and private sector employees) and self‐employed groups. The results are equivocal, but suggest screening could be part of the earnings determination process in the Australian labour market.
Another Look at Wage Distortion in a Developing Dual Economy
Authors: Basu Bharati
Published: June 2004

The paper focuses on an endogenous wage distortion in a developing dual economy where an efficiency wage in the urban sector triggers rural‐urban migration. Because of the endogenous nature of the distortion, this migration reduces the severity of distortion by creating more jobs and reducing the actual wage differential between the sectors. These results are in sharp contrast to the outcomes of an exogenous wage distortion (minimum wage) where rural‐urban migration increases the severity of unemployment and calls for costly policy mechanisms that might be either politically or economically difficult to implement. Furthermore, in contrast to the case of an exogenous distortion, interregional migration with endogenous wage distortion increases urban industrial output and structural transformation works its way into the development process. This structural transformation is maintained even when this dual economy engages in the production of non‐traded goods. Although this paper does not engage in policy ranking to bring in zero unemployment equilibrium, it shows that it is possible to achieve socially desirable level of migration by influencing detection rate of shirking or disutility of work effort instead of using costly distributive parameters such as taxes and subsidies.
Commodity Rates of Interest and Intertemporal Substitution in Commodity Demand and Consumption
Authors: Kim H. Youn
Published: June 2004

This paper examines the role of commodity own rates of interest in intertemporal analysis of consumer behaviour and presents a disaggregate analysis of intertemporal substitution in commodity demand and consumption. Commodity rates of interest are defined from the Euler equations implied by the intertemporal consumer choice problem. The relationship between commodity own rates and the real interest rate is derived, and the conditions for equality of commodity own rates are discussed. The intertemporal commodity substitution elasticities are characterised using commodity rates of interest, and the intertemporal substitution elasticity of consumption is derived from its constituent commodity demands. Evidence from estimation of the demand system and the consumption function reveals high intertemporal substitution for consumer goods as well as consumption.
International Factor Mobility, Government Size and Welfare
Authors: Anwar Sajid , Zheng Mingli
Published: June 2004

An examination of the available data reveals that the size of government varies considerably across time and countries. By making use of a simple general equilibrium model, this paper demonstrates that size of government is affected by the availability of capital and labour within an economy. Specifically, this paper utilises a model of a closed economy that produces one‐private and one‐public good. Both goods are produced by means of capital and labour. Production functions are subject to constant returns to scale and perfect competition prevails in all markets. The elasticity of substitution between the public and the private good is greater than unity and there is no international factor mobility in the initial equilibrium. The size of government is measured by total spending on the public good as a proportion of the total expenditure on the private and public goods. It is shown that capital (labour) inflow can decrease (increase) the size of government. Capital inflow increases welfare if the private good is relatively capital intensive whereas labour inflow increases welfare if the public good is relatively capital intensive.
Do (Some) Canadian Voters Punish a Prime Minister for Calling a Snap Election?
Authors: Blais André , Gidengil Elisabeth , Nevitte Neil , Nadeau Richard
Published: May 2004

Are voters willing to punish a prime minister for calling an ‘unnecessary’ snap election for purely opportunistic reasons? This paper examines voters' reactions to the Canadian prime minister's decision to call a snap election in November 2000. The decision provoked limited resentment, and that resentment was strongest among partisans of the opposition parties and among those who follow politics closely. Those who do not keep up with politics, it seems, either did not realize that the election was precipitous or simply did not care. The paper shows that resentment about the election call was a consideration in vote choice, but it was a decisive consideration for a very small group of voters. We estimate that the electoral cost to the incumbent Liberal Party was one percentage point. Some voters are prepared to punish prime ministers for opportunistically calling a snap election, but in this case the electoral penalty was small.
Center Parties, Party Competition, and the Implosion of Party Systems: A Study of Centripetal Tendencies in Multiparty Systems
Authors: Green-Pedersen Christoffer
Published: May 2004

Centripetal party competition is traditionally associated with the need to capture the median voter in a two-party system, whereas the existence of center parties is associated with centrifugal party competition. This article argues that the existence of a ‘pivotal center party’ leads to centripetal party competition in multiparty systems. A pivotal center party is so strong in electoral terms that forming a majority either to the left or to the right of it is unrealistic. Therefore, office-seeking political parties are forced on to a centrist course. This dynamic can be so forceful that the major parties to the left and to the right of the center party decide to govern in a broad coalition, and we may speak of an ‘implosion’ of the party system. The theoretical argument can explain party system developments in the Netherlands and Finland.
Making a Crisis Out of a Drama: The Political Analysis of BSE Policy-Making in the UK
Authors: Forbes Ian
Published: May 2004

Political analysis presents the episode of BSE (bovine spongiform encephalopathy) as a crisis, a policy failure and a policy disaster, revealing fundamental problems with the political and administrative system in the UK. Associated with this finding is the view that trust in government has been damaged by the failure to communicate fully the potential risks to the public of eating beef. These conventional judgements are challenged here, on the basis of an exploration of the episode, the findings of the official inquiry into BSE, and the relationship between risk and trust. I conclude that the drama over BSE and variant Creutzfeldt-Jakob disease does not amount to a crisis, a failure or a disaster, and cannot serve as a critique of the UK political system. Instead, the complexity of the case suggests that it is an intractable policy problem.
The Rhetorical Strategy of George H. W. Bush during the Persian Gulf Crisis 1990–91: How to Help Lose a War You Won
Authors: Hurst Steven
Published: May 2004

Public perceptions of the relative failure of the first Bush administration's policy in the Persian Gulf crisis of 1990–91 can be attributed in large part to its failure both to remove Saddam Hussein from office and to eliminate Iraq's nuclear weapons programme. Those objectives were not, in fact, among those that the administration initially set out to achieve. Midway through the crisis, however, it altered its rhetorical strategy in a fashion that helped to emphasize their significance in the public mind. This rhetorical shift resulted from a belief that its primary objectives were failing to maintain public support for its policies. However, the evidence for such a decline in public support is ambiguous at best, and there is no evidence that the change of rhetoric had any effect upon public support. The Bush administration unnecessarily drew attention to objectives that it could not achieve and helped to ensure public disillusion with the eventual outcome of the conflict.
THE RISE AND DECLINE OF THE TUTANKHAMUN‐CLASS CHARIOT
Authors: SANDOR BELA I.
Published: June 2004

Summary.  The Tutankhamun‐class chariot, the earliest high‐performance machine, existed in its refined form for about five centuries. Eight complete vehicles have survived and support the argument that they surpass all monumental structures of the pharaohs in engineering sophistication. There is no evidence of chariot racing from that era, but these chariots have many technical features that imply a pedigree based on racing. Several elements hint of thoughtful invention, advanced physical modelling and experimentation, with results that sometimes drastically and favourably differ from our concepts of vehicle design. It is difficult for us to envision a substantially better chariot made with the ancient materials of construction even if we were to apply our most advanced formulas and methods. There are two major areas of chariot analysis from an engineering standpoint, and both are accessible to non‐specialists. The complex suspension system of springs and shock absorbers has advantages in structural dynamics, ride quality and safety. An example of the latter is a dual‐purpose anti‐roll device. The chariots’ wheels have aircraft‐like damage tolerance, and have fundamentally more perfect spokes and joints for carrying multi‐axial loads than the wooden spokes of any classic car. This paper covers the essential technical features and historical perspectives of these chariots for archaeologists.
CONTEXTUALISING THE LARNAX: TRADITION, INNOVATION AND REGIONALISM IN COFFIN USE ON LATE MINOAN II–IIIB CRETE
Authors: PRESTON LAURA
Published: June 2004

Summary.  This paper analyses coffin use in the tombs of Late Bronze Age Crete in terms of both mortuary traditions on the island and regional variations in cultural practices. It argues that the revival of coffin use in the Final and Post‐palatial periods (in ceramic terms, Late Minoan II–IIIB) constituted a recourse to an earlier burial custom within negotiations of rapidly changing mortuary practices across the island. However, this ‘re‐invention’ involved significant modifications to the form and significance of the coffin. The paper then explores spatial variations in choices of coffin types, as one potential window onto the issue of intra‐island regionalism in social and cultural practices.
TOWARDS REALISING THE FULL ARCHAEOENVIRONMENTAL POTENTIAL OF RAISED (OMBROTROPHIC) MIRES IN THE BRITISH ISLES
Authors: GEAREY BENJAMIN R. , CHAPMAN HENRY P.
Published: June 2004

Summary.  Raised mires represent a unique resource for the study of past peoples within their changing landscape context. However, present palaeoecological and archaeological approaches to these landscapes within the British Isles have followed largely separate agendas. Palaeoecological study has generally been focused on themes of climate change, using a range of techniques to derive information relating to changes in surface wetness of raised mires over time. In contrast, archaeological study has been broadly limited to themes of preservation and site recovery. This paper argues that the integration of the methods employed within both disciplines can enable an investigation of context unattainable for the majority of archaeological sites. A case study illustrates the recursive nature of human‐environment relations in a raised mire system in Ireland.
A GREEK METROLOGICAL KOINE: A LEAD WEIGHT FROM THE WESTERN BLACK SEA REGION IN THE ASHMOLEAN MUSEUM, OXFORD
Authors: MEYER H.‐C. , MORENO A.
Published: June 2004

Summary.  A unique commercial lead weight from the western Black Sea region is examined in its metrological and historical context. The style and combination of relief symbols on the object (Athenian owl and Kyzikene tunny) suggest a quarter mina in a market weight system used equivalently at Athens and Kyzikos by the last quarter of the fifth century BC, and developed within a long‐term process of broad commercial integration of the Aegean and Black Seas in Classical times. The authors consider such a process to have been caused by the economic motivations of individual city‐states, not the direct Athenian imperialism expressed in the so‐called Standards Decree.
The Narrative Approach in Art Education: A Case Study
Authors: Esser‐Hall Gabriele , Rankin Jeff , Ndita Dumile Johannes
Published: June 2004

This case study takes as its focus the work of the Fine Art graduate Dumile Johannes Ndita, who visually narrates his experience of life in contemporary South Africa. The artist graduated from Border Technikon, East London, an institution which teaches the narrative approach. It is the aim of the authors to illustrate how this method enables students to transfer lived experience into image. The three voices in this paper come from different backgrounds. The artist will explain the meaning of his drawings, the teacher will give background information on the community and culture in which he himself and the artist operate and outline teaching methods. Students taught by this method create work that has impact and meaning beyond the confines of the art school. To argue this point, the theoretician will add her voice and reflect on meta‐narratives presented in Dumile Johannes Ndita's drawings. Intricate inter‐textual patterns, shared and interconnecting institutional narratives tie our individual voices to those of the wider community and culture of present‐day South Africa and beyond.
The Assessment of GCSE Art: Criterion‐Referencing and Cognitive Abilities
Authors: Rayment Trevor , Britton Brian
Published: June 2004

In this paper Cognitive Abilities Test scores are compared directly with moderated GCSE scores awarded to the same group of pupils. For ease of interpretation the comparisons are presented in a graphical form. Whilst some provisional and tentative conclusions are drawn about the reliability of GCSE art, questions are raised about the general validity of criterion‐referenced assessment in this area.
Open Minds and a Sense of Adventure: How Teachers of Art & Design Approach Technology
Authors: Wood Joyce
Published: June 2004

How does the use of technology in Art and Design differ from its use in other subjects? What uses do art teachers make that might seem noteworthy to their colleagues in other subject areas? And are there respects in which ICT affects art teaching uniquely?

The following report is drawn from two national, qualitative studies, carried out over four years and involving over two hundred skilled computer users in the UK teaching force [1]. The studies explored good practice in use of ICT in twelve separate curriculum subjects. Research addressed the following questions:

How does ICT help teachers convey the central concepts of their subjects? What can be learned with the aid of ICT that might not be learned as readily in any other way?

The study found that each curriculum subject uses ICT distinctively, has singular hardware requirements and is treated differently in terms of resourcing and access.
Comparison of the Dimensional Accuracy of Injection‐Molded Denture Base Materials to that of Conventional Pressure‐Pack Acrylic Resin
Authors: Parvizi Ali , Lindquist Terry , Schneider Robert , Williamson Derrick , Boyer Daniel , Dawson Deborah V.
Published: May 2004

Purpose: This study compared the linear dimensional changes of 3 injection‐molded denture base materials to that of conventionally processed polymethylmethacrylate (PMMA) resin.

Materials and Methods: An impression of an aluminum maxillary edentulous arch was made with a condensation silicone impression material (Denture Elasticon) to fabricate a gypsum master cast that was replicated as a silicone mold. A maxillary complete denture with acrylic teeth was waxed to full contour on the master cast and replicated to make 40 wax dentures. ERA attachments cast in metal (Rexillium) with indices milled into the centers were waxed into 3 positions in each denture for recording dimensional measurements of the wax denture. Ten dentures were allocated to each of 4 groups; Group 1 was processed using conventionally processed PMMA (Microlon), Group 2 used injection‐molded PMMA (SR‐lvocap), Group 3 employed injection‐molded nylon (Valplast), and Group 4 used injection‐molded styrene (Northern). All processed specimens were stored at room temperature (25°C, ambient humidity) for 1 week (while still on the master cast) before anteroposterior and cross‐arch measurements were made using the ERA reference points with a digital caliper. After separation from the master cast and following water storage at 37°C for 7 days additional measurements were made.

Results: An analysis of the results showed that the effect of processing was not the same for the 3 dimensions studied, regardless of which dimension was considered (p < 0.0001). The pattern of dimensional changes associated with the material type was not the same between the wax and processing stages as it was for the change between the processing and decasting stages (p < 0.0001).

Conclusions: Processing the denture base materials produced unequal deformation in different dimensions (anterior‐posterior and cross‐arch). Each material tested also responded differently to the processing stages.
Fabrication of a Custom Eyelid Implant Prosthesis: A Clinical Report
Authors: Choi Mijin , Driscoll Carl F.
Published: May 2004

Patients with lagophthalmos are often treated with a stock gold weight that has been implanted in the upper eyelid. This relatively simple surgical technique does not, however, always produce the desired result. This article describes a technique for the fabrication of a custom eyelid implant prosthesis for patients who present with a non‐functioning and unaesthetic eyelid implant.
Promoting Esthetic Procedures in the Prosthodontic Practice
Authors: Priest George , Priest Judy
Published: May 2004

The demand for esthetic services is large and growing. Emphasis on enhancing personal appearance is demonstrated in patients' increased demands for elective esthetic procedures. The techniques that have fueled this Esthetic Cultural Revolution fall under the expertise of prosthodontists. Prosthodontists, therefore, are in a position to establish themselves as the most qualified providers of these services. Prosthodontists must leverage their technical and treatment planning strengths with effective marketing strategies to address the esthetic expectations of today's patients. Marketing techniques with specific relevance to prosthodontists and esthetic dentistry are detailed.
Classification System for the Completely Dentate Patient
Authors: McGarry Thomas J. , Nimmo Arthur , Skiba James F. , Ahlstrom Robert H. , Smith Christopher R. , Koumjian Jack H. , Guichet Gregory N.
Published: May 2004

The American College of Prosthodontists (ACP) has developed a classification system designed for use by dental professionals in the diagnosis and treatment of completely dentate patients. This classification is the third in a series and is similar to the Classifications for Complete Edentulism and Partial Edentulism previously developed by the ACP. These guidelines are intended to aid practitioners in the systematic diagnosis of each patient which, in turn, should lead to an appropriate treatment. Four categories of a completely dentate situation are defined (Class I–IV), differentiated by specific diagnostic criteria, with Class I representing an uncomplicated clinical situation and Class IV representing the most complex clinical situation. Potential benefits of the system include (1) improved intraoperator consistency, (2) improved professional communication, (3) insurance reimbursement commensurate with complexity of care, (4) an improved screening tool for dental school admission clinics, (5) standardized criteria for outcomes assessment and research, (6) enhanced diagnostic consistency, and (7) a simplified aid in the decision‐making process associated with referral.
Complex Regional Pain Syndrome (CRPS): Survey of Current Practices
Authors: Burton Allen W. , Hassenbusch Samuel J. , Warneke Carla , Racz Gabor , Stanton‐Hicks Michael
Published: June 2004

Background and Objectives:  There are numerous treatments for complex regional pain syndrome (CRPS). These treatments are varied in scope and include pain management therapies, psychological therapies, and physiotherapy. Treatment guidelines have been published in the past, but little information exists as to how clinicians utilize these guidelines. Moreover, there has been a paradigm shift from the older “reflex sympathetic dystrophy” (RSD) nomenclature, with largely sympathetic block driven diagnosis and therapy to more recent trends towards more inclusive “CRPS” diagnostic criteria and multidisciplinary treatment. There remains controversy regarding the selection of various techniques, and the timing of advancement through the treatment algorithm to the more aggressive, interventional techniques. We set out to determine current CRPS treatment practices of interventional pain specialists.

Methods:  The authors developed a 36‐item, 15–20‐minute questionnaire. This questionnaire was sent to 453 interventional pain specialists.

Results:  One‐hundred‐five surveys were returned, with 100 being complete. Eighty‐three percent of our respondents were practicing anesthesiology pain specialists who on average treat 14.9 (SD = 16.8) CRPS patients per month.

Conclusions:  Our survey results revealed the use of a treatment algorithm for CRPS that consists of treatment using medical therapies (pharmacologic, blocks, catheters, and implantable devices), psychological therapies, and physiotherapy in a coordinated fashion. The trend among our survey respondents is to utilize increasingly interventional techniques after a failed 2‐ to 4‐week trial of any one particular therapy.
Evaluation of PR, RR, QT Intervals and QT Dispersion Following Stellate Ganglion Block in Chronic Shoulder–Hand Pain Patients
Authors: Saxena Ashok K. , Aggarwal Bhavna , Nakra Dhiraj , Sethi Ashok K. , Aggarwal Aditya N.
Published: June 2004

Abstract:  Right stellate ganglion block (SGB) can increase QT interval, rate‐corrected QT interval (QTc), QT dispersion (QTD), rate‐corrected QTD (QTcD), and RR interval while left SGB can decrease these intervals in healthy volunteers. No such studies have been conducted in patients with chronic pain, hence this study was designed to investigate the effects of left and right SGB on these variables in chronic shoulder–hand pain patients. In this study, 28 patients with chronic shoulder–hand pain of at least 6 months duration were given right or left SGB depending on the shoulder affected. A 12‐lead electrocardiogram (ECG) was recorded before the block, 30 minutes and 60 minutes after the block. PR interval, RR interval, QT interval were recorded in all 12 leads while QTc, QTD, and QTcD were calculated. Right SGB was performed in 21 patients. A significant decrease (P < 0.05) in PR interval and a significant increase (P < 0.05) in RR interval, QT interval, and QTc interval were observed. QTD showed a significant increase (P < 0.05) only at 30 minutes after right SGB. Left SGB was performed in seven patients. A significant decrease (P < 0.05) in QT interval was observed throughout the study period, while QTc showed a significant decrease (P < 0.05) only at 60 minutes after the block. We conclude that right SGB induces significant increase of QT interval, RR interval, QTc interval, QTD, and a significant decrease of PR interval while left SGB produces a significant decrease in QT and QTc intervals in patients with chronic shoulder–hand pain.
Pharmacokinetic Profile and Efficacy of a Fentanyl Transdermal Delivery System for Acute Postoperative Pain after Intra‐abdominal Gynecologic Surgery for Cancer
Authors: Siafaka I. , Rellia P. , Argyra E. , Iakovidou N. , Sykiotis C. , Vadalouka A.
Published: June 2004

Purpose:  This prospective, randomized, single‐blind study evaluated the efficacy and pharmacokinetic profile of a transdermal delivery system for fentanyl to provide relief of acute postoperative pain in patients undergoing intra‐abdominal gynecologic surgery for cancer.

Methods:  Forty female patients were randomized to either transdermal fentanyl 50 µg/hour (n = 20) or transdermal placebo (n = 20). Transdermal systems were placed 1 hour preoperatively and removed 25 hours later. Pain control was supplemented with a nonopioid drug, bupivacaine 0.125–0.25%, administered through an epidural catheter via patient‐controlled epidural analgesia. Serum fentanyl concentrations, bupivacaine consumption, pain scores [visual analog scale (VAS)], sedation rating score, adverse events, and physiological parameters were recorded for 48 hours postoperatively.

Results:  The minimum effective concentration of fentanyl in serum (0.63 ng/mL) was achieved at 11.3 ± 4.9 hours after application, and serum concentrations remained above this level until 13 hours after removal. The TTS‐F group had lower VAS pain scores and a significant 66% reduction in utilization of bupivacaine compared with placebo. Pain scores were significantly correlated with serum fentanyl concentration (P = 0.025). All physiological parameters fluctuated within normal range and no differences were observed between treatments. Adverse events were similar between the groups with only the incidence of local erythema significantly higher in the TTS‐F group (30% vs. 5%, P < 0.05), and sedation scores were significantly higher in the TTS‐F group during the immediate postoperative period.

Conclusion:  The transdermal therapeutic system for administration of fentanyl, combined with epidural administration of a nonopioid analgesic such as bupivacaine is effective in controlling postoperative pain after gynecologic surgery. Additionally, the safety/tolerability of this regimen was similar to placebo plus bupivacaine.
A Complication of Stellate Ganglion Block?
Authors: Lake Alfred Philip James , Puvanachandra Kathiravelpillai
Published: June 2004

Abstract:  Stellate ganglion block is commonly used to treat the sympathetically maintained pain which may occur in one‐third of patients with complex regional pain syndrome type 1. A complication that followed a single block and presented a diagnostic dilemma for the ophthalmologist is reported.
Permanent Neurologic Symptoms after Prolonged Epidural Analgesia
Authors: Diaz James H. , Gould Harry J.
Published: June 2004

Objective:  Although transient neurologic symptoms may occur after neuraxial anesthetics with lidocaine, permanent neurologic symptoms (PNS) are unusual after uncomplicated continuous epidural analgesia (CEA). This report demonstrates that PNS may follow CEA uncomplicated by paresthesias, dural puncture, spinal hemorrhage, or intravascular local anesthetic injection; and performed with bupivacaine alone administered at high dosages with vasoconstrictors over a prolonged time period.

Case Report:  An obstetrical patient developed fixed left L5‐S1 sensorimotor radiculopathy following L5‐S1 level CEA with bupivacaine alone administered at high doses (270 mg) with a vasoconstrictor (epinephrine, 225 mg) over a prolonged time period (62 hours).

Conclusions:  CEA should be administered at higher lumbar levels for labor analgesia rather than at lumbosacral levels that may require higher volumes and concentrations of local anesthetics with greater potential for local anesthetic neurotoxicity. Local anesthetics with vasoconstrictors should only be used as sentinel markers of unrecognized intravascular entry, rather than as primary local anesthetics during CEA to avoid any potential for ischemic neuropathy.
Development of neuropsychiatric symptoms in poststroke patients: a cross‐sectional study
Authors: Angelelli P. , Paolucci S. , Bivona U. , Piccardi L. , Ciurli P. , Cantagallo A. , Antonucci G. , Fasotti L. , Di Santantonio A. , Grasso M. G. , Pizzamiglio L.
Published: May 2004

Objective:  The study aimed to characterize neuropsychiatric symptomatology and its evolution in a large group of poststroke patients during their first year.

Method:  The Neuropsychiatric Inventory (NPI) was administered to a sample of 124 poststroke patients, divided into three independent groups on the basis of time from stroke (2, 6 and 12 months). The controls were 61 healthy subjects.

Results:  A wide range of neuropsychiatric symptoms was found significant in the poststroke population: mostly depression (61%), irritability (33%), eating disturbances (33%), agitation (28%), apathy (27%) and anxiety (23%). Modifications in terms of greater depression, anxiety, irritability and eating disturbances evolved in the year following stroke. Other symptoms were significantly present depending on time from stroke. Clear relations with other clinical and demographic variables were also found.

Conclusion:  Neuropsychiatric symptoms constitute an important part of comorbidity in stroke patients; thus, suitable assessment tools may improve clinical understanding of these patients.
A case study in the treatment of dementia with Lewy bodies
Authors: Kaufer Daniel I.
Published: May 2004

Objective: To describe the assessment and treatment of an elderly woman with parkinsonism, progressive memory and cognitive deficits, and visual hallucinations.

Method:  The patient presented with a 10‐year history of hand tremors, an 8‐year history of short‐term memory problems, and a 3–4‐year history of visual hallucinations. Treatment with donepezil and rivastigmine (successively) did not produce the desired benefits. Then she was started on galantamine 4 mg b.i.d. (escalated to 8 mg b.i.d.).

Results:  The patient's social interaction improved and cognitive decline appeared to be stabilized; hallucinations and agitation were also better controlled.

Conclusion:  By current criteria, this subject would be labeled as having Parkinson's disease with dementia, although she exhibited the core features of dementia with Lewy body disease. As suggested in previous studies, cholinesterase inhibitors may be effective in treating psychotic symptoms; however, all currently available agents may not be equally effective.
Patient and direct‐care staff body mass index in a state mental hospital: implications for management
Authors: Vieweg W. V. R. , Thomas M. , Janisko M. , Booth M. , Fernandez A. , Pandurangi A. , Silverman J. J.
Published: May 2004

Objective:  Obesity is a major problem among chronically psychotic patients.

Method:  We assessed body mass index (BMI) of chronically psychotic patients on admission to a state mental hospital and in follow‐up. We also compared patient BMI to staff BMI.

Results:  The initial patient BMI (26.4 ± 5.8 kg/m2) was in the overweight range. The patient BMI (29.1 ± 5.8 kg/m2) increased (P < 0.0001) on follow‐up and almost reached the level of obesity. Staff BMI (35.1 ± 8.6 kg/m2) was in the obese range with 64.9% meeting criteria of obesity and 29.9% meeting criteria of morbid obesity. African‐American women made up 84.5% of clinical‐care staff and constitute the race–sex mix most vulnerable to obesity in the US. Morbid obesity (BMI ≥ 40 kg/m2) was five times more common among these African‐American female clinical‐care staff than among African‐American women in the general US population.

Conclusion:  Our findings may have treatment implications for chronically psychotic patients at risk for obesity.
Relationships Between Older Men and Younger Women: Implications for STIs/HIV in Kenya
Authors: Longfield Kim , Glick Anne , Waithaka Margaret , Berman John
Published: May 2004

The aim of this study is to contribute to the understanding of motivations for cross‐generational relationships and how the perception of risk of acquiring sexually transmitted infections (STIs) including HIV affects condom use in Kenya. Eight focus‐group discussions were conducted with women and 28 interviews were held with men in four Kenyan towns. Ethnograph 5.0 computer software was used for the analysis of data. Women's primary incentive for engaging in such relationships is financial; men seek sexual gratification. Pressure from peers compels women to find older partners. Although some peers encourage such relationships, other groups, especially wives, same‐aged boyfriends, and parents, disapprove of them. Couples are preoccupied by the threat of discovery. STI/HIV risk perception is low, and couples rarely use condoms. Material gain, sexual gratification, emotional factors, and recognition from peers override concern for STI/HIV risk. Women's ability to negotiate condom use is compromised by age and economic disparities. Programmatic strategies include communicating information about such relationships' STI/HIV risk, promoting consistent condom use, decreasing peer pressure to pursue such relationships, and improving women's access to alternative sources of income.
How to create successful partnerships—a review of the literature
Authors: Wildridge Valerie , Childs Sue , Cawthra Lynette , Madge Bruce
Published: May 2004

This literature review covers a wide range of publications (articles, books, reports and government publications) that provide an overview of the wider topic of partnership working. It is not a systematic review, but the authors’ personal review, drawing largely on the resources available in the King's Fund Library. Partnership working is a key component of the UK government's modernization agenda, particularly in the health field. However, the principles of achieving successful partnership are generally applicable. The review therefore concentrates on literature that can provide guidance for people planning to set up a partnership, or re‐evaluating an existing partnership. The sections of this review comprise: definition of partnership working; types of partnership; partnership initiatives; drivers; critical success factors; barriers; benefits; the process of partnership working; evaluation and assessment tools; demolishing the Berlin Wall: government policy on partnership working; exemplars of library information service partnerships.
Community partnerships for health information training: medical librarians working with health‐care professionals and consumers in Tennessee
Authors: Stephenson Priscilla L. , Green Brenda F. , Wallace Richard L. , Earl Martha F. , Orick Jan T. , Taylor Mary Virginia
Published: May 2004

In Tennessee, several medical library outreach projects have involved collaborative work with health‐care professionals, public librarians, consumers, faith‐based organizations and community service agencies. The authors are medical librarians who worked as consultants, trainers and project directors to promote health literacy using PubMed medline and other health information resources in the several funding projects described here. We explain the programmes briefly, focusing on lessons learned and suggestions for those who follow us.