bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for local recurrence after breast-conserving surgery
Authors: Fredriksson I , Liljegren G , Palm-Sjövall M , Arnesson L-G , Emdin S O , Fornander T , Lindgren A , Nordgren H , Idvall I , Holmqvist M , Holmberg L , Frisell J
Published: August 2003

Background

It is not clear whether risk factors for local recurrence after breast-conserving surgery differ in women having surgery for in situ or invasive cancer. Furthermore, the Nottingham Prognostic Index (NPI) and Nottingham Histological Grade (NHG) have been little studied as determinants of local recurrence risk.

Method

In a case–control study (491 cases and 1098 controls) nested within a cohort of 7502 women who had surgery for in situ or invasive cancer of the breast, patient characteristics, tumour characteristics and treatment-related variables were evaluated as risk factors for local recurrence.

Results

Multivariate conditional logistic regression analyses showed that age below 40 years, tumour multicentricity and an unclear or unknown surgical margin were significant risk factors for local recurrence. Radiotherapy to the breast and adjuvant hormone therapy were protective. Cancer in situ was not associated with a higher risk of local recurrence than invasive cancer (odds ratio 1·0, 95 per cent confidence interval 0·8 to 1·3). NHG and NPI were not helpful in determining risk of local recurrence.

Conclusion

Margin status, age, tumour multicentricity, and use of radiotherapy and adjuvant hormone therapy were important determinants of risk of local recurrence. With the exception of surgical margin, variables related to the quality of surgical management did not predict risk of local recurrence.
Improved patient survival in recipients of simultaneous pancreas–kidney transplant compared with kidney transplant alone in patients with type 1 diabetes mellitus and end-stage renal disease
Authors: Mohan P , Safi K , Little D M , Donohoe J , Conlon P , Walshe J J , O'Kelly P , Thompson C J , Hickey D P
Published: August 2003

Background

There are emerging data that simultaneous pancreas–kidney transplant (SPK) prolongs life compared with kidney transplant alone (KTA) in type 1 diabetics with end-stage renal disease. This study was a retrospective comparison of SPK with KTA in patients with type 1 diabetes.

Methods

Between 1 January 1992 and 30 April 2002, 101 patients with type 1 diabetes were transplanted. Fifty-one of these patients received a KTA and 50 had a SPK. All patients underwent coronary angiography with surgical correction of any coronary artery disease before being listed. All patients who underwent SPK received quadruple immunosuppressive therapy consisting of antilymphocyte globulin, calcineurin inhibitor (tacrolimus or cyclosporin), azathioprine and steroids. Those who underwent KTA received calcineurin inhibitor (tacrolimus or cyclosporin), azathioprine and steroids.

Results

Patient survival at 1, 3, 5 and 8 years was 96, 93, 89 and 77 per cent respectively after SPK, and 93, 75, 57 and 47 per cent respectively after KTA (P = 0·018 at 8 years).

Conclusion

The addition of pancreatic transplantation prolongs life in type 1 diabetic patients with renal failure compared with renal transplantation alone.
Use of multidetector-row computed tomographic colonography before flexible sigmoidoscopy in the investigation of rectal bleeding
Authors: Taylor S A , Halligan S , Vance M , Windsor A , Atkin W , Bartram C I
Published: August 2003

Selective colonography may reduce need for colonoscopy
Attendance at a pain clinic with severe chronic pain after open and laparoscopic inguinal hernia repairs
Authors: Hindmarsh A C , Cheong E , Lewis M P N , Rhodes M
Published: August 2003

Background

The aim was to compare the frequency of severe chronic pain that required attendance at a pain clinic after open and laparoscopic inguinal hernia repairs.

Methods

This was a retrospective analysis of 7999 patients who underwent inguinal hernia repair between January 1994 and December 2001. The definition of severe chronic pain was pain related to inguinal hernia surgery that was bad enough for the patient to seek further medical help and be referred to the specialist pain clinic after exclusion of surgically correctable pathology such as hernia recurrence.

Results

During the study there were 7153 open repairs and 846 laparoscopic repairs. Sixty-nine patients (1·0 per cent) were referred to the pain clinic a median of 16·9 (range 5·1–69·4) months after open hernia repair. Three patients (0·4 per cent) were referred a median of 16·5 (range 7·3–21·5) months after laparoscopic hernia repair (P = 0·045).

Conclusion

Laparoscopic inguinal hernia repair was associated with a significantly lower frequency of attendance at the pain clinic with severe chronic pain.
Randomized clinical trial of suction versus standard clearance of the diathermy plume
Authors: Pillinger S H , Delbridge L , Lewis D R
Published: August 2003

Background

Diathermy smoke contains complex hydrocarbons and organic material, and may contain viable tumour cells or viral particles. These particles measure from 0·05 to more than 25 µm, and long-term exposure to such particles may have adverse effects on health. This study investigated whether a suction clearance device reduces the amount of smoke reaching the surgeon's mask.

Methods

This was a randomized clinical trial in which subjects were randomized to standard diathermy equipment (group 1) or a diathermy smoke extraction system (group 2). All patients underwent thyroid or parathyroid surgery with standard anterior cervical collar incision and division of the strap muscles. The difference in the amount of smoke reaching the level of the operator's mask was measured by means of an aerosol monitor.

Results

Fifteen patients were randomized to each group. The mean amount of smoke detected at the level of the operator's mask was 0·137 mg/m3 in group 1 and 0·012 mg/m3 in group 2 (P < 0·001). The maximum amount detected was 2·411 and 0·255 mg/m3 respectively (P < 0·001). There were no significant differences between the groups in terms of incision time or background particles measured before and after surgery. There was no correlation between gland weight and incision time or amount of smoke detected.

Conclusion

Suction clearance of the diathermy plume resulted in a significant reduction in the amount of smoke reaching the level of the operator's mask. Although the risk of diathermy smoke inhalation is currently unknown, use of such a system appears advisable.
Transplantation for diabetes mellitus
Authors: Mamode N , Sutherland D E R
Published: August 2003

Justifiably expanding
Cyclo-oxygenase 2 inhibition in colorectal cancer therapy
Authors: Church R D , Fleshman J W , McLeod H L
Published: August 2003

Background

Cyclo-oxygenase inhibition for the treatment of colorectal neoplasia has been studied with renewed interest since the discovery of cyclo-oxygenase (Cox) 2 and the introduction of specific Cox-2 inhibitors. These drugs have implications for both the prevention of colorectal carcinoma and the potential treatment of the disease.

Methods and results

A Medline database search was performed for articles using the keywords ‘colonic, colon or rectal and neoplasia or cancer’ and ‘cyclo-oxygenase or Cox-2.’ Cross-references of relevant historical papers were also included. There is substantial evidence that Cox-2 plays a role in the development and progression of colorectal cancer. The specific inhibition of this enzyme has been shown to inhibit cancer growth in in vitro and in vivo models. The mechanisms of action for these effects are poorly understood and potential clinical applications at present remain under investigation.

Conclusion

Cox-2 inhibitors have great promise as useful additions to current cancer treatments. There is a need for randomized clinical trials to define a role for these drugs in chemoprevention, recurrence prophylaxis, and adjuvant therapy for colorectal and other solid tumours.
The difference between laparoscopic and keyhole surgery
Authors: Mathur P , Seow-Choen F
Published: August 2003

The nomenclature needs to be sorted out
Interstitial laser thermotherapy for liver tumours
Authors: Nikfarjam M , Christophi C
Published: August 2003

Background

Primary hepatocellular carcinoma (HCC) and metastases from colorectal cancer are the most common malignant liver tumours. Surgical resection is the optimum treatment in suitable patients. Interstitial laser thermotherapy (ILT) is gaining acceptance for the treatment of irresectable liver tumours and as a potential alternative to surgery. An understanding of the principles of therapy and review of clinical outcomes may allow better use of this technology.

Method

An electronic search using the Medline database was performed for studies on the treatment of hepatic malignancy published between January 1983 and February 2003.

Results

Current information on the efficacy of ILT is based on prospective studies. ILT appears to be a safe and minimally invasive technique that consistently achieves tumour destruction. The extent of destruction depends on the fibre design, delivery system, tumour size and tumour biology. Real-time magnetic resonance imaging provides the most accurate assessment of laser-induced tumour necrosis. In selected patients with HCC and colorectal cancer liver metastases, ILT achieves complete tumour necrosis, provides long-term local control, and improves survival, compared with the natural history of the disease. In addition, ILT has survival benefits for patients with other tumour types, especially those with isolated liver metastases from a breast cancer primary.

Conclusion

ILT improves overall survival in specific patients with liver tumours. Advances in laser technology and refinements in technique, and a better understanding of the processes involved in laser-induced tissue injury, may allow ILT to replace surgery as the procedure of choice in selected patients with liver malignancies.
Peripheral parenteral nutrition
Authors: Anderson A D G , Palmer D , MacFie J
Published: August 2003

Background

Peripheral parenteral nutrition (PPN) currently accounts for almost 20 per cent of all parenteral nutrition administered in the UK. In the absence of consensus guidelines there is wide variation in practice. Heterogeneity of clinical trials has made direct comparisons difficult and meta-analysis impossible.

Methods

Medline, Embase and Cochrane databases were searched for all clinical trials relating to the use of PPN in adults. Relevant papers from the reference lists of these articles and from the authors' personal collections were also reviewed.

Results and conclusions

Effective PPN is possible in about 50 per cent of inpatients requiring parenteral nutrition. Evidence relating to optimal feed composition, choice of cannula, infusion technique and pharmacological manipulation is discussed, along with practical recommendations for the administration of PPN.
Screening for abdominal aortic aneurysm (Br J Surg 2003; 90: 515-516)
Authors: Muir Gray J A
Published: August 2003

The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses can be sent electronically via the BJS website (www.bjs.co.uk) or by post. All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Letters submitted by post should be typed on A4-sized paper in double spacing and should be accompanied by a disk.
Functional genomics via metabolic footprinting: monitoring metabolite secretion by Escherichia coli tryptophan metabolism mutants using FT–IR and direct injection electrospray mass spectrometry
Authors: Kaderbhai Naheed N. , Broadhurst David I. , Ellis David I. , Goodacre Royston , Kell Douglas B.
Published: August 2003

We sought to test the hypothesis that mutant bacterial strains could be discriminated from each other on the basis of the metabolites they secrete into the medium (their ‘metabolic footprint’), using two methods of ‘global’ metabolite analysis (FT–IR and direct injection electrospray mass spectrometry). The biological system used was based on a published study of Escherichia coli tryptophan mutants that had been analysed and discriminated by Yanofsky and colleagues using transcriptome analysis. Wild‐type strains supplemented with tryptophan or analogues could be discriminated from controls using FT–IR of 24 h broths, as could each of the mutant strains in both minimal and supplemented media. Direct injection electrospray mass spectrometry with unit mass resolution could also be used to discriminate the strains from each other, and had the advantage that the discrimination required the use of just two or three masses in each case. These were determined via a genetic algorithm. Both methods are rapid, reagentless, reproducible and cheap, and might beneficially be extended to the analysis of gene knockout libraries. Copyright © 2003 John Wiley & Sons, Ltd.
Development of computational tools for the inference of protein interaction specificity rules and functional annotation using structural information
Authors: Ferrè Fabrizio , Via Allegra , Ausiello Gabriele , Brannetti Barbara , Zanzoni Andreas , Helmer‐Citterich Manuela
Published: August 2003

Relatively few protein structures are known, compared to the enormous amount of sequence data produced in the sequencing of different genomes, and relatively few protein complexes are deposited in the PDB with respect to the great amount of interaction data coming from high‐throughput experiments (two‐hybrid or affinity purification of protein complexes and mass spectrometry). Nevertheless, we can rely on computational techniques for the extraction of high‐quality and information‐rich data from the known structures and for their spreading in the protein sequence space. We describe here the ongoing research projects in our group: we analyse the protein complexes stored in the PDB and, for each complex involving one domain belonging to a family of interaction domains for which some interaction data are available, we can calculate its probability of interaction with any protein sequence. We analyse the structures of proteins encoding a function specified in a PROSITE pattern, which exhibits relatively low selectivity and specificity, and build extended patterns. To this aim, we consider residues that are well‐conserved in the structure, even if their conservation cannot easily be recognized in the sequence alignment of the proteins holding the function. We also analyse protein surface regions and, through the annotation of the solvent‐exposed residues, we annotate protein surface patches via a structural comparison performed with stringent parameters and independently of the residue order in the sequence. Local surface comparison may also help in identifying new sequence patterns, which could not be highlighted with other sequence‐based methods. Copyright © 2003 John Wiley & Sons, Ltd.
Ab initio protein structure prediction using pathway models
Authors: Yuan Xin , Shao Yu , Bystroff Christopher
Published: August 2003

Ab initio prediction is the challenging attempt to predict protein structures based only on sequence information and without using templates. It is often divided into two distinct sub‐problems: (a) the scoring function that can distinguish native, or native‐like structures, from non‐native ones; and (b) the method of searching the conformational space. Currently, there is no reliable scoring function that can always drive a search to the native fold, and there is no general search method that can guarantee a significant sampling of near‐natives. Pathway models combine the scoring function and the search. In this short review, we explore some of the ways pathway models are used in folding, in published works since 2001, and present a new pathway model, HMMSTR‐CM, that uses a fragment library and a set of nucleation/propagation‐based rules. The new method was used for ab initio predictions as part of CASP5. This work was presented at the Winter School in Bioinformatics, Bologna, Italy, 10–14 February 2003. Copyright © 2003 John Wiley & Sons, Ltd.
Comparative modelling techniques: where are we?
Authors: Tramontano Anna
Published: August 2003

The enormous increase in data availability brought about by genomic projects is paralleled by an equally unprecedented increase in the expectations for new medical, pharmacological, environmental and biotechnological discoveries. Whether or not we will be able to meet (at least partially) these expectations will depend on how well we will be able to interpret the data and translate the mono‐dimensional information encrypted in genomes into a detailed understanding of its biological meaning at the phenotypic level. The process is far from being trivial, and the obstacles along the road are formidable: even the problem of identifying coding regions in eukaryotic genomes is not completely solved. Far more complex is identification of the function of the encoded proteins, and this will probably represent the most challenging problem for the next generations of scientists. Copyright © 2003 John Wiley & Sons, Ltd.
Microarray probe expression measures, data normalization and statistical validation
Authors: Saviozzi Silvia , Calogero Raffaele A.
Published: August 2003

DNA microarray technology is a high‐throughput method for gaining information on gene function. Microarray technology is based on deposition/synthesis, in an ordered manner, on a solid surface, of thousands of EST sequences/genes/oligonucleotides. Due to the high number of generated datapoints, computational tools are essential in microarray data analysis and mining to grasp knowledge from experimental results. In this review, we will focus on some of the methodologies actually available to define gene expression intensity measures, microarray data normalization, and statistical validation of differential expression. Copyright © 2003 John Wiley & Sons, Ltd.
Kainate‐induced endocytosis in retinal amacrine cells
Authors: Borsello Tiziana , Bressoud Raymond , Mottier Vincent , González Nicolas , Gomez Gabriel , Clarke Peter G.H.
Published: August 2003

Endocytosis is enhanced in some cases of neuronal death. We report for the first time that intraocular injections, in chick embryos, of excitotoxic doses of kainate induce strong endocytosis in retinal amacrine cells destined to die and that even subtoxic doses can induce some degree of endocytosis. That the uptake was due to endocytosis rather than passive diffusion through the plasma membrane was shown ultrastructurally. The endocytosis was demonstrated by using three unrelated tracers—horseradish peroxidase, microperoxidase, and 4.4‐kDa fluorescein isothiocyanate (FITC)‐labeled dextran—suggesting that it does not depend on the binding of the tracers to a particular receptor. However, it appears to be surprisingly sensitive to the size of the ligand, because a heavier (42‐kDa) FITC‐dextran was not endocytosed. The induction of endocytosis by kainate can occur even when protein synthesis is blocked. These results indicate that toxic or near‐toxic doses of kainate induce endocytosis, raising the question of whether this is mechanistically implicated in causing or preventing excitotoxic neuronal death. J. Comp. Neurol. 465:286–295, 2003. © 2003 Wiley‐Liss, Inc.
Effects of gustatory nerve transection and regeneration on quinine‐stimulated Fos‐like immunoreactivity in the parabrachial nucleus of the rat
Authors: King Camille Tessitore , Deyrup Leif D. , Dodson Sara E. , Galvin Katherine E. , Garcea Mircea , Spector Alan C.
Published: August 2003

The distribution of quinine‐stimulated Fos‐like immunoreactivity (FLI) in several subdivisions of the parabrachial nucleus (PBN) known to be responsive to gustatory stimulation was examined in rats in which the chorda tympani nerve (CT) and/or glossopharyngeal nerve (GL) was transected (Experiment 1) and in rats in which the GL was transected with regeneration promoted or prevented (Experiment 2). We confirmed previous findings in the literature by demonstrating that rats intraorally infused with 3 mM quinine showed a robust population of FLI in the waist area and the external lateral (EL) and external medial (EM) subdivisions of the PBN (Yamamoto et al. [1994] Physiol Behav 56:1197–1202; Travers et al., [ 1999] Am J Physiol 277:R384–R394). In the waist area, only GL transection significantly decreased the number of FLI‐neurons elicited by intraoral infusion of quinine compared with water‐stimulated controls. In the external subdivisions neither neurotomy affected the number of FLI‐neurons. The effect of GL transection in the waist area was enduring for rats in which the GL did not regenerate (up to 94 days), but regeneration of the GL after 52 days restored quinine‐stimulated FLI to control values. In these same GL‐transected animals, there were parallel decreases in the number of gapes elicited by intraoral quinine stimulation that recovered, but only subsequent to regeneration of the GL. These data provide support for the role of the waist area in the brainstem processing that underlies oromotor rejection behaviors and also help substantiate the hypothesis that the CT and GL are relatively specialized with regard to function. Moreover, when the quinine‐induced pattern of neural activity in the second central gustatory relay, as assessed by FLI, is substantially altered by the loss of peripheral gustatory input from the GL, it can be restored upon regeneration of the nerve. J. Comp. Neurol. 465:296–308, 2003. © 2003 Wiley‐Liss, Inc.
Specific innervation of aromatase neurons by substance P fibers in the dorsal horn of the spinal cord in quail
Authors: Evrard Henry C. , Willems Evelyne , Harada Nobuhiro , Balthazart Jacques
Published: August 2003

The enzyme aromatase catalyzes the production of estrogens in the dorsal horn of the spinal cord where most of the nociceptive primary afferent fibers terminate. Numerous estrogen receptors are present in this area and the control of spinal aromatase activity is thought to play an important role in the estrogenic control of nociception. The coexistence of aromatase and nociceptive terminals suggests a role for aromatase cells in pain‐related processes, but whether terminals releasing nociceptive neuropeptides (e.g., substance P) actually contact aromatase neurons is unknown and the factors that control spinal aromatase activity have not yet been identified. In the present study we analyzed by double‐label immunocytochemistry the distribution in the Japanese quail spinal cord, of aromatase and of substance P or its receptor (neurokinin 1 receptor). All antigens were mainly localized in laminae I and II as observed in mammals. Most aromatase neurons were colocalized with neurokinin 1 receptors and were in close apposition with substance P‐immunoreactive fibers. These results suggest that aromatase neurons are responsive to noxious stimulation and may participate in the control of nociception. Furthermore, spinal aromatase activity could be controlled by substance P through a regulation of the aromatase gene transcription as reported for the mouse diencephalon and/or through neurokinin 1 receptor‐dependent phosphorylation of the aromatase protein. J. Comp. Neurol. 465:309–318, 2003. © 2003 Wiley‐Liss, Inc.
Hprt(CAG)146 mice: Age of onset of behavioral abnormalities, time course of neuronal intranuclear inclusion accumulation, neurotransmitter marker alterations, mitochondrial function markers, and susceptibility to 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine
Authors: Tallaksen‐Greene Sara J. , Ordway Jared M. , Crouse Andrew B. , Jackson Walker S. , Detloff Peter J. , Albin Roger L.
Published: August 2003

We reported previously a model of polyglutamine repeat disorders with insertion of 146 CAG repeats into the murine hypoxanthine phosphoribosyl transferase locus (Hprt(CAG)146; Ordway et al. [1997] Cell 91:753–763), which does not normally contain polyglutamine repeats. These mice develop an adult‐onset neurologic phenotype of incoordination, involuntary limb clasping, seizures, and premature death. Histologic analysis demonstrates widespread ubiquinated neuronal intranuclear inclusions (NIIs). We now report characterization of the age of onset of behavioral abnormalities, correlated with the time course of occurrence of NIIs in several brain regions, and the occurrence of NIIs in non‐neuronal tissues. Onset of behavioral abnormalities occurred at approximately 22 weeks of age. There was variable time course of expression of NIIs in several brain regions. Assessment of several non‐neuronal tissues revealed nuclear inclusions in hepatocytes and choroid plexus epithelium. γ‐Aminobutyric acid (GABA)/benzodiazepine receptors, dopamine D1‐like and D2‐like receptors, and type 2 vesicular monoamine transporter (VMAT2) binding sites were assayed before and after the onset of behavioral abnormalities. GABA/benzodiazepine receptors were unchanged either before or after the onset of behavioral abnormalities in any region analyzed, whereas striatal D1‐like and D2‐like receptors were diminished after but not before the onset of symptoms. Dorsal striatal VMAT2 binding sites were decreased before the onset of behavioral changes. Mitochondrial electron transport chain components were assayed with histochemical methods before and after the onset of behavioral changes. There was no change in behaviorally presymptomatic or symptomatic animals. Hprt(CAG)146 mice did not exhibit increased susceptibility to the mitochondrial toxin 1‐Methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine. Hprt(CAG)146 mice are a useful model for studying polyglutamine repeat disorders. J. Comp. Neurol. 465:205–219, 2003. © 2003 Wiley‐Liss, Inc.
Large clusters of α7‐containing nicotinic acetylcholine receptors on chick spinal cord neurons
Authors: Roth Adelheid L. , Berg Darwin K.
Published: August 2003

Nicotinic acetylcholine receptors containing the α7 gene product are widely expressed in the nervous system and have high calcium permeabilities that allow them to influence numerous calcium‐dependent processes. Though often found at presynaptic locations, where they enhance transmitter release, the receptors can also occupy postsynaptic sites. Highest levels have been reported for chick ciliary ganglion neurons, where the postsynaptic receptors are concentrated on somatic spines arranged in clumps and appear as large receptor clusters. We show here that subpopulations of chick spinal cord neurons also express high levels of α7‐containing receptors and arrange them in large clusters. The populations include peripheral motoneurons, presumptive preganglionic neurons, neurons adjacent to the lateral motor column, and possible interneurons in the ventral horn. In many cases, the receptor clusters codistribute with filamentous actin, as do clusters on ciliary ganglion neurons, where the actin represents a somatic spine constituent. In other respects, the spinal cord clusters differ. Those on motoneurons codistribute with the actin‐associated component drebrin, as do the clusters on ciliary ganglion neurons, but the clusters on preganglionic neurons do not. Preganglionic neurons do, however, stain for lipid raft components as found for ciliary ganglion neurons, where the rafts embed the receptor‐enriched spines. The results demonstrate that CNS neurons can configure α7‐containing nicotinic receptors into large clusters but also suggest that the clusters are not likely to reflect a common molecular substructure on all neurons. J. Comp. Neurol. 465:195–204, 2003. © 2003 Wiley‐Liss, Inc.
Zonal organization of the vestibulocerebellum in pigeons (Columba livia): III. Projections of the translation zones of the ventral uvula and nodulus
Authors: Wylie Douglas R.W. , Brown Matthew R. , Winship Ian R. , Crowder Nathan A. , Todd Katherine G.
Published: August 2003

Previous electrophysiological studies in pigeons have shown that the complex spike activity of Purkinje cells in the medial vestibulocerebellum (nodulus and ventral uvula) is modulated by patterns of optic flow that result from self‐translation along a particular axis in three‐dimensional space. There are four response types based on the axis of preferred translational optic flow. By using a three axis system, where +X, +Y, and +Z represent rightward, upward, and forward self‐motion, respectively, the four cell types are t(+Y), t(–Y), t(–X–Z), and t(–X+Z), with the assumption of recording from the left side of the head. These response types are organized into parasagittal zones. In this study, we injected the anterograde tracer biotinylated dextran amine into physiologically identified zones. The t(–X–Z) zone projected dorsally within the vestibulocerebellar process (pcv) on the border with the medial cerebellar nucleus (CbM), and labeling was found in the CbM itself. The t(–X+Z) zone also projected to the pcv and CbM, but to areas ventral to the projection sites of the t(–X–Z) zone. The t(–Y) zone also projected to the pcv, but more ventrally on the border with the superior vestibular nucleus (VeS). Some labeling was also found in the dorsal VeS and the dorsolateral margin of the caudal descending vestibular nucleus, and a small amount of labeling was found laterally in the caudal margin of the medial vestibular nucleus. The data set was insufficient to draw conclusions about the projection of the t(+Y) zone. These results are contrasted with the projections of the flocculus, compared with the primary vestibular projection, and implications for collimotor function are discussed. J. Comp. Neurol. 465:179–194, 2003. © 2003 Wiley‐Liss, Inc.
On a finite element formulation for incompressible Newtonian fluid flows on moving domains in the presence of surface tension
Authors: Dettmer W. , Saksono P. H. , Perić D.
Published: August 2003

This work is concerned with the numerical modelling of incompressible Newtonian fluid flows on moving domains in the presence of surface tension. The solution procedure presented is based on the stabilized equal order mixed velocity‐pressure finite element formulation of the incompressible Navier–Stokes equations, which is adapted to a moving domain by means of an arbitrary Lagrangian–Eulerian (ALE) technique. The accurate and very robust integration in time is achieved by employing the generalized‐αmethod. The surface tension boundary condition is rephrased appropriately within the framework of linear finite elements. The solution procedure is verified by comparing numerical solutions with the corresponding analytical solutions and experimental data. The overall solution procedure proves to be accurate, robust and efficient. It allows the simulation of extensive deformation of the fluid domain without remeshing. Copyright © 2003 John Wiley & Sons, Ltd.
Pain perception in recovered bulimia nervosa patients
Authors: Stein Daniel , Kaye Walter H. , Matsunaga Hisato , Myers Daniel , Orbach Israel , Har‐Even Dov , Frank Guido , Rao Rhadika
Published: August 2003

Objective

Decreased pain sensitivity is found in individuals who are ill with bulimia nervosa (BN). The purpose of this study is to determine whether altered pain perception persists after recovery from bulimia nervosa (RBN).

Methods

Eleven women who were recovered from BN for more than 1 year were compared with 15 healthy volunteer women. The participants received two pain evaluations—thermal pain stimulation (TPS), which evaluates threshold and tolerance to heat, and the submaximal effort tourniquet test (SETT), which assesses threshold and tolerance to ischemic pain induced by inflation of a blood pressure cuff.

Results

Compared with the controls, the RBN women showed elevated pain threshold as measured with the SETT and a tendency to elevated pain threshold on the TPS.

Discussion

Decreased pain sensitivity persists after recovery from BN and may reflect altered modulatory function in this illness. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 331–336, 2003.
Predicting the outcome of eating disorders using structural equation modeling
Authors: Fichter Manfred M. , Quadflieg Norbert , Rehm Jürgen
Published: August 2003

Objective

There is a need for models that predict accurately the course of mental disorders.

Method

Eating‐disordered female inpatients were assessed longitudinally at the beginning of treatment (t1), at the end of treatment (t2), at 2 or 3‐year follow‐up (t3), and at 6‐year follow‐up (t4). The sample consisted of 196 women with bulimia nervosa (BN) purging type, 103 women with anorexia nervosa (AN), and 68 women with binge eating disorder (BED; N = 367). Confirmatory factor analysis and path analysis were used to predict the women's status at 6‐year follow‐up.

Results

The results for BN and BED show that the specific eating disorder pathology was influenced mainly by specific eating disorder pathology at earlier time points and not by non–eating‐specific (general) psychopathology. Similarly, general psychopathology was influenced mainly by general psychopathology at earlier time points. For AN patients, both categories of psychopathology (eating specific and general) were relevant for the 6‐year outcome. The potential impact of 14 factors on the level of pathology was estimated (a) at baseline (at the beginning of treatment), (b) during the course of illness (baseline controlled), and (c) on the 6‐year outcome of eating disorders (baseline and course controlled). Although there were many correlations between potential factors and baseline pathology, there was only a limited number of significant correlations with the 6‐year outcome. This effect was mediated largely by the level of general psychopathology.

Discussion

The models for outcome prediction based on structural equation modeling techniques were very similar for BN and BED. For both BN and BED, there were almost entirely separate predictions for the specific eating disorder on the one hand and non–eating‐related (general) psychopathology on the other hand. This was true to a lesser degree for AN.

Conclusions

The use of refined path analytic methods in follow‐up studies on larger general populations will be helpful to increase our understanding of the course of illness of psychiatric disorders. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 292–313, 2003.
Season of birth and disordered eating in female college students
Authors: Munn Melissa A. , Klump Kelly L.
Published: August 2003

Objective

Earlier studies have suggested relationships between season of birth and eating disorders. These studies have found that women with anorexia nervosa (AN) and bulimia nervosa (BN) are more likely to be born in the first 6 months rather than in the last 6 months of the year. The current study examines relationships between season of birth and general disordered eating in female college students.

Method

Subjects included 155 female twin and triplet participants from the Michigan Twin Study. Disordered eating was assessed with subscales from the Minnesota Eating Disorders Inventory (M‐EDI) and the Eating Disorders Examination Questionnaire (EDEQ). Both a two‐group comparison and a three‐group comparison of M‐EDI and EDEQ scores were conducted. The two‐group comparison comprised subjects born between January and June and subjects born between July and December. The three‐group comparison comprised subjects born between January and April, between May and August, and between September and December.

Results

No significant differences in M‐EDI or EDEQ scores were observed in any of the group comparisons.

Discussion

The lack of significant differences across birth periods suggests that season of birth effects may not generalize to general disordered eating characteristics in nonclinical samples. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 343–348, 2003.
The natural course of bulimia nervosa and eating disorder not otherwise specified is not influenced by personality disorders
Authors: Grilo Carlos M. , Sanislow Charles A. , Shea M. Tracie , Skodol Andrew E. , Stout Robert L. , Pagano Maria E. , Yen Shirley , McGlashan Thomas H.
Published: August 2003

Objective

To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) and to test the effects of personality disorder (PD) comorbidity on the outcomes.

Method

Ninety‐two female patients with current BN (N= 23) or EDNOS (N= 69) were evaluated at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study (CLPS). Eating disorders (EDs) were assessed with the Structured Clinical Interview for DSM‐IV Axis I Disorders. Personality disorders (PDs) were assessed with the Diagnostic Interview for DSM‐IV PD (DIPD‐IV). The course of BN and EDNOS was assessed with the Longitudinal Interval Follow‐up Evaluation and the course of PDs was evaluated with the Follow‐Along version of the DIPD‐IV at 6, 12, and 24 months.

Results

Probability of remission at 24 months was 40% for BN and 59% for EDNOS. To test the effects of PD comorbidity on course, ED patients were divided into groups with no, one, and two or more PDs. Cox proportional regression analyses revealed that BN had a longer time to remission than EDNOS (p< .05). The number of PDs was not a significant predictor of time to remission, nor was the presence of Axis I psychiatric comorbidity or Global Assessment of Functioning scores. Analyses using proportional hazards regression with time‐varying covariates revealed that PD instability was unrelated to changes in ED.

Conclusions

BN has a worse 24‐month course (longer time to remission) than EDNOS. The natural course of BN and EDNOS is not influenced significantly by the presence, severity, or time‐varying changes of co‐occurring PDs, co‐occurring Axis I disorders, or by global functioning. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 319–330, 2003.
Self‐competence and self‐liking in the prediction of change in bulimic symptoms
Authors: Bardone Anna M. , Perez Marisol , Abramson Lyn Y. , Joiner Thomas E.
Published: August 2003

Objective

To examine the relationship of self‐competence and self‐liking (two distinct dimensions of self‐esteem) to bulimic symptoms.

Method

Two separate longitudinal studies were conducted on undergraduate women from two universities (Study 1, N = 129; Study 2, N = 406). Measures of self‐competence, self‐liking, and bulimic symptoms were administered on two occasions, separated by several weeks.

Results

Self‐competence demonstrated a stronger relationship than self‐liking to change in bulimic symptoms over time.

Discussion

These findings have significant theoretic implications for the construct of self‐esteem and implications for risk for and treatment of bulimia. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 361–369, 2003.
Occupational exposure to methyl tertiary butyl ether in relation to key health symptom prevalence: the effect of measurement error correction
Authors: Keshaviah Aparna P. , Weller Edie , Spiegelman Donna
Published: August 2003

In 1995, White et al. reported that methyl tertiary butyl ether (MTBE), an oxygenate added to gasoline, was significantly associated with key health symptoms, including headaches, eye irritation, and burning of the nose and throat, among 44 people occupationally exposed to the compound and for whom serum MTBE measurements were available (odds ratio (OR) = 8.9, 95% CI = [1.2, 75.6]). However, these serum MTBE measurements were available for only 29 per cent of the 150 subjects enrolled. Around the same time, Mannino et al. conducted a similar study among individuals occupationally exposed to low levels of MTBE and did not find a significant association between exposure to MTBE and the presence of one or more key health symptoms among the 264 study participants (OR = 0.60, 95% CI = [0.3, 1.21]). In this article, we evaluate the effect of MTBE on the prevalence of key health symptoms by applying a regression calibration method to White et al.'s and Mannino et al.'s data. Unlike White et al., who classified exposure using actual MTBE levels among a subset of the participants, and Mannino et al., who classified exposure based on job category among all participants, we use all of the available data to obtain an estimate of the effect of MTBE in units of serum concentration, adjusted for measurement error due to using job category instead of measured exposure. After adjusting for age, gender and smoking status, MTBE exposure was found to be significantly associated with a 50 per cent increase in the prevalence of one or more key health symptoms per order of magnitude increase in blood concentration on the log10 scale, using data from the 409 study participants with complete information on the covariates (95% CI = [1.00, 2.25]). Simulation results indicated that under conditions similar to those observed in these data, the estimator is unbiased and has a coverage probability close to the nominal value. The methodology illustrated in this article is advantageous because all of the available data were used in the analysis, obtaining a more precise estimate of exposure effect on health outcome, and the estimate is adjusted for measurement error due to using job category instead of measured exposure. Copyright © 2003 John Wiley & Sons, Ltd.
Influence of external heat flux and coating thickness on the thermal insulation properties of two different intumescent coatings using cone calorimeter and numerical analysis
Authors: Bartholmai M. , Schriever R. , Schartel B.
Published: August 2003

Polymeric intumescent coatings are fire protective materials that increase their thermal resistance when exposed to high temperatures to prevent building structures from damage. The idea of the investigation was to develop a simple test method to determine the time dependent thermal conductivity of intumescent coatings. Therefore steel plates were coated with two different intumescent systems. During cone calorimeter tests the temperature at the back side of the coated plates was measured. These results were used to calculate the time dependent thermal resistance of the protective layer with the simulation program IOPT2D for different external heat fluxes and different layer thickness. Copyright © 2003 John Wiley & Sons, Ltd.
Dietary supplement use in old age: associations with childhood IQ, current cognition and health
Authors: Whalley L. J. , Fox H. C. , Lemmon H. A. , Duthie S. J. , Collins A. R. , Peace H. , Starr J. M. , Deary I. J.
Published: August 2003

Aims

Dietary supplement (DS) use is actively promoted among old people but there is little evidence in favour of DS use or information about the demographic, health and cognitive characteristics of DS users.

Method

We examined 176 healthy, old people without dementia all born in 1921 and living independently in the community. IQ scores aged about 11 years were available for all subjects. DS users were more often female, had a lower BMI and were taking fewer prescribed medications than non‐users.

Results

Usual dietary intake, as measured by food frequency questionnaire, did not differ between DS users and DS non‐users. DS users were seen to have higher Vitamin C (p<0.05), α‐carotene (p<0.05) and lower γ‐tocopherol (p<0.001) and homocysteine (p<0.01). DS users did not differ from DS non‐users in years of education, indices of occupational code, current socio‐economic category or parameters of cardiovascular or respiratory functions. DS users had higher (p<0.05) childhood IQ scores but did not differ in current Mini‐Mental State Examination (MMSE) score or performance on Raven's Progressive Matrices (RPM) either before or after adjustment for childhood IQ.

Conclusions

DS users may enjoy somewhat better general health than non‐users but the source of this difference is unknown. Possible health benefits of DS use merit further study. Copyright © 2003 John Wiley & Sons, Ltd.
Acceptance of dementia screening in continuous care retirement communities: a mailed survey
Authors: Boustani Malaz , Watson Lea , Fultz Bridget , Perkins Anthony J. , Druckenbrod Richard
Published: August 2003

Background

In a recent systematic review of the evidence for dementia screening to support recommendations from the US Preventive Services Task Force, we found no evidence regarding the interest or willingness of older adults to be screened, and insufficient evidence to provide an estimate of the potential harms of dementia screening.

Objective

In an attempt to address the acceptability of dementia screening, we asked older adults living in two Continuous Care Retirement Communities (CCRC) if they would agree to routine screening for memory problems.

Design

Cross‐sectional study using self‐administered mailed survey questionnaires.

Setting

Two CCRCs in Orange County, North Carolina.

Participants

500 residents of the independent living section of CCRCs.

Results

There was a 64% survey response rate. Of these, 49% of participants stated they would agree to routine screening for memory problems. In comparison to people who would not agree to routine memory screening, those who accepted memory screening were more likely to accept depression screening, be male, use drug‐administration assisted devices, and take more medications.

Conclusion

Approximately half of the residents in this affluent residential community setting were not willing to be screened routinely for memory problems. This high refusal rate indicates that dementia screening may be associated with perceived harms. We must improve our understanding of the decision‐making process driving individual's beliefs and behaviors about dementia screening before implementing any broad‐based screening initiatives for dementia or cognitive impairment. Copyright © 2003 John Wiley & Sons, Ltd.
Factors influencing intentions to seek a cognitive status examination: a study based on the Health Belief Model
Authors: Werner Perla
Published: August 2003

Aims

The aim of the present study was to examine the factors influencing intention to seek a cognitive status evaluation in the presence of memory problems.

Methods

A convenience sample of 186 community‐dwelling adults (mean age=64) were interviewed face‐to‐face using measures derived from the Health Belief Model.

Results

Participants' intentions to be examined were higher when presented with scenarios describing family history of Alzheimer's disease (AD). Perceived barriers and cues to action were significant predictors of intention, accounting for 24% of the variance.

Conclusions

These findings suggest the need to develop effective educational strategies to improve knowledge about AD and decision‐making concerning cognitive status examinations. Copyright © 2003 John Wiley & Sons, Ltd.
Fixed fees and physician‐induced demand: A panel data study on French physicians
Authors: Delattre Eric , Dormont Brigitte
Published: August 2003

This paper investigates on the existence of physician‐induced demand (PID) for French physicians. The test is carried out for GPs and specialists, using a representative sample of 4500 French self‐employed physicians over the 1979–1993 period. These physicians receive a fee‐for‐services (FFS) payment and fees are controlled. The panel structure of our data allows us to take into account unobserved heterogeneity related to the characteristics of physicians and their patients. We use generalized method of moments (GMM) estimators in order to obtain consistent and efficient estimates. We show that physicians experience a decline of the number of consultations when they face an increase in the physician:population ratio. However this decrease is very slight. In addition, physicians counterbalance the fall in the number of consultations by an increase in the volume of care delivered in each encounter. Econometric results give a strong support for the existence of PID in the French system for ambulatory care. Copyright © 2003 John Wiley & Sons, Ltd.