bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Benefit‐Risk Assessments: No Escape from Expert Judgments in Risk Management
Authors: Claycamp H. Gregg
Published: February 2006

The “human health impacts assessment” described by Cox and Popken (this issue) is intended to be a benefit‐risk tool that avoids pitfalls of using expert judgments for policy analysis or during strict application of the precautionary principle in risk management. The proposed benefit‐risk calculation uses numerous assumptions and suppositions to calculate a ratio of quality‐adjusted life years (QALYs) lost for the number of human illness days prevented by the use of a food‐animal antimicrobial drug, to the number of human illness days caused by the use of the antimicrobial drug. Assumptions about data—e.g., expert judgments on the representativeness of parameter estimates—are commonly used in risk assessment and risk management, including Cox and Popken's method. Cox and Popken apply the technique to specific examples of enrofloxacin and macrolides antimicrobial drugs, sometimes used in broiler chickens for human food. Although enthusiastically portrayed as a straightforward calculation of QALYs lost for two decision alternatives, Cox and Popken were silent on the pivotal expert judgment subsumed in their method: quality weights for illnesses caused by antimicrobial‐resistant and antimicrobial‐sensitive microbes are tacitly assumed to be equal. Yet, the costs in terms of prolonged illness, additional medications, repeat medical visits, and dread of more serious sequelae are expected to differ substantially for antimicrobial‐resistant versus antimicrobial‐sensitive illnesses. Despite their enthusiasm to the contrary, the “human health impacts assessment” by Cox and Popken is not immune from expert judgments in risk management.
Health resource utilization associated with switching to risperidone long‐acting injection
Authors: Young C. L. , Taylor D. M.
Published: February 2006

Objective  Studies have shown oral risperidone and conventional depot antipsychotics decrease direct healthcare costs largely by reducing hospitalization. Our aim was to assess the effect on bed stay of risperidone injection prescribed in normal clinical practice.

Method  Patients prescribed risperidone long‐acting injection (RLAI) were identified and followed‐up for 1 year. Resource use data were collected for 3 years before and for 1 year after the initiation of RLAI. The main outcome measure was bed stay before and after the prescription of RLAI.

Results  Outcome data were available for 250 subjects. Eighty‐one subjects (32.4%) completed 1 year's treatment. Days spent in hospital increased from (mean number/patient) 31 in year −3 to 44 in year −2 to 90 in year −1 to 141 in year +1. Direct healthcare costs increased accordingly. Outcome for RLAI continuers was similar to that of discontinuers.

Conclusion  Switching to RLAI was associated with a continuation of the trend for increased bed stay and use of healthcare resources.
The cardiovascular and respiratory health of people with schizophrenia
Authors: Filik R. , Sipos A. , Kehoe P. G. , Burns T. , Cooper S. J. , Stevens H. , Laugharne R. , Young G. , Perrington S. , McKendrick J. , Stephenson D. , Harrison G.
Published: February 2006

Objective:  To examine the cardiovascular and respiratory health of people with severe mental illness (SMI) and compare findings with the Health Surveys for England.

Method:  A prospective, multi‐centre observational prevalence study of 602 patients with schizophrenia‐related psychoses carried out in six locations across the UK over 24 months.

Results:  Compared with general population subjects, people with SMI reported higher rates of angina and respiratory symptoms and had poor lung function. Much of this increased risk could be explained by lifestyle risk factors; there were increased levels of obesity among younger people with SMI.

Conclusion:  Key indicators of the cardiovascular and respiratory health of people with SMI are poor compared with those of the general population. Care plans should prioritize interventions to attenuate lifestyle risk factors. Evidence of increasing obesity in younger patients is of particular concern, predicting even greater health needs in the future.
Effect of Rotation and Surface Roughness on Heat Transfer Rate to Flow through Vertical Cylinders in Steam Condensation Process
Authors: Mohamed Hany A.
Published: February 2006

The enhancement in the rate of the heat transfer resulting from rotating smooth and rough vertical cylinders, of 1.28 and 21.75μm average roughness, respectively, are experimentally studied. Experiments were carried out for cooling fluid Reynolds numbers from 3300 to 7800 with varying the rotational speed up to 280rpm. Experimental runs at the stationary case showed an acceptable agreement with the theoretical values. The experimental Nusselt number values at various rotational speeds are correlated as functions of Reynolds, Weber, and Prandtl numbers for smooth and rough surfaces. The correlated equations were compared with the correlation obtained by another author. The results show that the enhancement of the heat transfer rate becomes more appreciable for low Reynolds numbers at high rotational speeds and for high Reynolds numbers at low rotational speeds. The rotation causes an enhancement in the overall heat transfer coefficient of ∼89% at Re=7800, We=1084, and Pr=1.48 for smooth surface and of ∼13.7% at Re=4700, We=4891, and Pr=1.696 for rough surface. Also, the enhancement in the heat transfer rates utilizing rotary surface becomes more pronounced for the smooth surface compared with the rough one, therefore the choice of the heat transfer surface is very important. The present work shows a reduction in the heat transfer rate below its peak value depending on the type of the heat transfer surface. It is shown that the enhancement in the heat transfer, i.e., enhancement in the Nusselt number, depends on the Weber number value and the surface type while the Nusselt number value mainly depends on the Reynolds and Prandtl numbers. Correlated equation have been developed to represent the Nusselt number values as functions of the Weber and Reynolds numbers within the stated ranges of the parameters.
Heat Transfer Enhancement of a Circular Cylinder
Authors: Tsutsui Takayuki , Igarashi Tamotsu
Published: February 2006

A rod was positioned upstream of a circular cylinder to enhance its heat transfer in an air stream. The diameter of the cylinder was 40mm and the diameter of the rod ranged from 1to12mm. The distance between the axes of the cylinder and the rod was varied between 40 and 120mm and the Reynolds number ranged from 1.5×104 to 6.2×104. In the optimum configuration, the heat transfer on the front face of the cylinder increases remarkably relative to a single circular cylinder, and results in a 40% overall increase in heat transfer.
Thermal Contact Resistance and Thermal Conductivity of a Carbon Nanofiber
Authors: Yu Choongho , Saha Sanjoy , Zhou Jianhua , Shi Li , Cassell Alan M. , Cruden Brett A. , Ngo Quoc , Li Jun
Published: February 2006

We have measured the thermal resistance of a 152‐nm-diameter carbon nanofiber before and after a platinum layer was deposited on the contacts between the nanofiber and the measurement device. The contact resistance was reduced by the platinum coating for about 9–13% of the total thermal resistance of the nanofiber sample before the platinum coating. At a temperature of 300K, the axial thermal conductivity of the carbon nanofiber is about three times smaller than that of graphite fibers grown by pyrolysis of natural gas prior to high-temperature heat treatment, and increases with temperature in the temperature range between 150K and 310K. The phonon mean free path was found to be about 1.5nm and approximately temperature-independent. This feature and the absence of a peak in the thermal conductivity curve indicate that phonon-boundary and phonon-defect scattering dominate over phonon-phonon Umklapp scattering for the temperature range.
Convective Transport in Nanofluids
Authors: Buongiorno J.
Published: February 2006

Nanofluids are engineered colloids made of a base fluid and nanoparticles (1-100nm). Nanofluids have higher thermal conductivity and single-phase heat transfer coefficients than their base fluids. In particular, the heat transfer coefficient increases appear to go beyond the mere thermal-conductivity effect, and cannot be predicted by traditional pure-fluid correlations such as Dittus-Boelter’s. In the nanofluid literature this behavior is generally attributed to thermal dispersion and intensified turbulence, brought about by nanoparticle motion. To test the validity of this assumption, we have considered seven slip mechanisms that can produce a relative velocity between the nanoparticles and the base fluid. These are inertia, Brownian diffusion, thermophoresis, diffusiophoresis, Magnus effect, fluid drainage, and gravity. We concluded that, of these seven, only Brownian diffusion and thermophoresis are important slip mechanisms in nanofluids. Based on this finding, we developed a two-component four-equation nonhomogeneous equilibrium model for mass, momentum, and heat transport in nanofluids. A nondimensional analysis of the equations suggests that energy transfer by nanoparticle dispersion is negligible, and thus cannot explain the abnormal heat transfer coefficient increases. Furthermore, a comparison of the nanoparticle and turbulent eddy time and length scales clearly indicates that the nanoparticles move homogeneously with the fluid in the presence of turbulent eddies, so an effect on turbulence intensity is also doubtful. Thus, we propose an alternative explanation for the abnormal heat transfer coefficient increases: the nanofluid properties may vary significantly within the boundary layer because of the effect of the temperature gradient and thermophoresis. For a heated fluid, these effects can result in a significant decrease of viscosity within the boundary layer, thus leading to heat transfer enhancement. A correlation structure that captures these effects is proposed.
Heat Transfer Augmentation by Ion Injection in an Annular Duct
Authors: Grassi Walter , Testi Daniele
Published: February 2006

The thermofluid-dynamic effects of ion injection from sharp metallic points added perpendicularly to the inner wire of a short horizontal annulus were experimentally investigated. A dielectric liquid (FC-72 by 3M) was weakly forced to flow in the duct, which was uniformly heated on the outer wall. A dc voltage as high as 22kV was applied to the inner electrode, while the heated wall was grounded. Both the laminar and the turbulent mixed-convection regimes were obtained, varying the imposed flow rate. Once an electric field is applied, the flow is dramatically modified by the jets of charged particles, which transfer their momentum to the neutral adjacent ones. Different injection strengths were obtained on the emitters, because the shape of the point tips was not controlled at the microscale. Nusselt number distributions were obtained azimuthally and longitudinally, monitoring the wall temperatures. In all cases, heat transfer turned out greatly enhanced in the proximity of the emitters, without a significant increase in pressure drop through the test section and with a negligible Joule heating, making this technique very attractive for application in compact heat exchangers.
Thermal Analysis on Flat-Plate-Type Divertor Based on Subcooled Flow Boiling Critical Heat Flux Data Against Inlet Subcooling in Short Vertical Tube
Authors: Hata Koichi , Noda Nobuaki
Published: February 2006

The critical heat fluxes (CHFs) and the heat transfer coefficients (HTCs) in subcooled flow boiling were applied to a thermal analysis of the flat-plate-type divertor of a helical-type fusion experimental device, which is a Large Helical Device (LHD) located in the National Institute for Fusion Science (NIFS), Japan. The incident CHF, qcr,inc, for the divertor plate with the cooling tube diameter, d, of 10mm and the plate width, w, ranging from 16 to 30mm were numerically analyzed based on the measured CHFs, qcr,sub, and HTCs for the test tube inner diameter, d, of 9mm and the heated length, L, of 48 to 149mm. The peripheral distributions of the surface heat flux and the surface temperature in the cooling tube were obtained. Numerical solutions of qcr,inc become larger with a decrease in w∕d at a fixed L. It is confirmed that the ratio of the one-side heat loading data, qcr,inc, to the uniform heat loading data, qcr,sub, can be represented as the simple equation based on the numerical solutions. The values of the qcr,inc for the tube length of 50, 100, and 150mm were estimated with various w∕d at a higher pressure.
Radiative Characteristic of Spherical Cavities With Specular Reflectivity Component
Authors: Kowsary F. , Mahan J. R.
Published: February 2006

An exact analytical method is presented for determination of emissive as well as absorptive performance of spherical cavities having diffuse-specular reflective walls. The method presented utilizes a novel coordinate transformation technique, which provides convenient means for setting up the governing radiant exchange integral equations. These equations are then solved by the usual iterative method devized for the Fredholm integral equation of the second kind. The suggested coordinate transformation is also utilized for determination of directional absorptivity of a fully specular spherical cavity when collimated radiation enters through its mouth from a specified direction. Results show that for a spherical cavity the dependence of the apparent emissivity on the degree of specularity is high when the emissivity of the cavity wall is low, but this dependence decreases as the emissivity of the cavity wall increases. Also there are situations, unlike cases of cylindrical and conical cavities, for which the purely diffuse spherical cavity is a more efficient emitter than the purely specular cavity having an identical geometry and wall emissivity. Moreover, it is shown that the apparent directional absorptivity of specular spherical cavities having small openings becomes highly fluctuating as the direction of the incident radiation changes
KNOT GROUP EPIMORPHISMS
Authors: SILVER DANIEL S. , WHITTEN WILBUR
Published: February 2006

Let G be a finitely generated group, and let λ ∈ G. If there exists a knot k such that πk = π1(S3\k) can be mapped onto G sending the longitude to λ, then there exists infinitely many distinct prime knots with the property. Consequently, if πk is the group of any knot (possibly composite), then there exists an infinite number of prime knots k1, k2, … and epimorphisms ⋯ → πk2→ πk1→ πk each perserving peripheral structures. Properties of a related partial order on knots are discussed.
BIRMAN'S CONJECTURE IS TRUE FOR I2(p)
Authors: EAST JAMES
Published: February 2006

In 1993, Birman conjectured that the desingularization map from the singular braid monoid to the integral group ring of the braid group determined by [Formula: see text] and [Formula: see text] is injective. The conjecture, which has recently been proven true by Paris (2004), may be generalized to all Artin groups. In this article we prove that the generalized conjecture holds for one of the infinite families of Artin groups of spherical type, namely I2(p).
AN INVARIANT FOR OPEN VIRTUAL STRINGS
Authors: SILVER DANIEL S. , WILLIAMS SUSAN G.
Published: February 2006

Extended Alexander groups are used to define an invariant for open virtual strings. Examples of non-commuting open strings and a ribbon-concordance obstruction are given. An example is given of a slice open virtual string that is not ribbon. Definitions are extended to open n-strings.
RECURRENCE FORMULAS FOR THE ALEXANDER POLYNOMIALS OF 2-BRIDGE LINKS AND THEIR COVERING LINKS
Authors: LEE SANG YOUL , SEO MYOUNGSOO
Published: February 2006

We give a recurrence formula for calculating the Alexander polynomials of 2-bridge links by using a special type of Conway diagram. As an application we give sufficient and necessary conditions for the periodic covering link over a 2-bridge link to be a fibered link. We also give a recurrence formula to calculate the reduced Alexander polynomials of periodic covering links over 2-bridge links.
THE EFFECT OF MUTATION ON LINK CONCORDANCE, 3-MANIFOLDS, AND THE MILNOR INVARIANTS
Authors: CHA JAE CHOON
Published: February 2006

We study the effect of mutation on link concordance and 3-manifolds. We show that the set of links concordant to sublinks of homology boundary links is not closed under positive mutation. We also show that mutation does not preserve homology cobordism classes of 3-manifolds. A significant consequence is that there exist 3-manifolds which have the same quantum SU(2) -invariants but are not homology cobordant. These results are obtained by investigating the effect of mutation on the Milnor [Formula: see text]-invariants, or equivalently the Massey products.
DETECTING TORSION IN SKEIN MODULES USING HOCHSCHILD HOMOLOGY
Authors: McLENDON MICHAEL
Published: February 2006

Given a Heegaard splitting of a closed 3-manifold, the skein modules of the two handlebodies are modules over the skein algebra of their common boundary surface. The zeroth Hochschild homology of the skein algebra of a surface with coefficients in the tensor product of the skein modules of two handlebodies is interpreted as the skein module of the 3-manifold obtained by gluing the two handlebodies together along this surface. A spectral sequence associated to the Hochschild complex is constructed and conditions are given for the existence of algebraic torsion in the completion of the skein module of this 3-manifold.
COMPARATIVE BIOMECHANICS: CERVICAL SPINE FACET JOINT VERSUS LATERAL MASS SCREW INSERTION TECHNIQUE
Authors: Kam Boon Horng , Chou Siaw Meng , Tan Seang Beng
Published: February 2006

This study involves a comparative biomechanics of facet joints (FJ) versus lateral mass (LM) screw insertion technique in the human cadaveric lower cervical spine (C3, C4, C5 and C6). The objective of this study is to understand the promising usage of the facet joint insertion technique and to determine the pullout strength of FJ insertion technique for posterior cervical fixation system. A total of 52 disarticulated human vertebrae (C3–C6) were used in this study. DEXA scan was carried out on all specimens before testing. Cortical screws of 3.5 mm and 4.0 mm were used for both FJ and LM techniques, which were subjected to uniaxial load. From the study made so far, the facet joint technique performed well based on the pullout strength values obtained. Having addressed the main concern on screw perforation of lateral mass technique, this facet joint technique not only demonstrated a significantly higher pullout resistance but it is also a relatively low risk surgical procedure.
UTILIZATION OF TWO-DIMENSIONAL FAST FOURIER TRANSFORM AND POWER SPECTRAL ANALYSIS FOR ASSESSMENT OF EARLY DEGENERATION OF ARTICULAR CARTILAGE
Authors: Wu J. P. , Kirk T. B. , Peng Z. , Miller K. , Zheng M. H.
Published: February 2006

Degeneration of articular cartilage begins from deterioration of the collagen fibres in the superficial zone. Standard histology using 2D imaging technique is often used to determine the microstructure of collagen fibres and the physiological functions of articular cartilage. However, information of the 3D collageneous structure in the cartilage could be lost and misinterpreted in 2D observations. In contrast, confocal microscopy permits studying the 3D internal structure of bulk articular cartilage with minimal physical disturbing. Using fibre optic laser scanning confocal microscopy, a 3D histology has been previously developed to visualize the collagen matrix in the superficial zone by means of identifying the early arthritic changes in articular cartilage. In this study, we characterized the collagen orientation in the superficial zone of normal cartilage, the cartilage with surface disruption and fibrillated cartilage using Fast Fourier transforms and power spectral analysis techniques. Thus, we have established an objective method for assessing the early pathology changes in the articular cartilage.
What do dendrites and their synapses tell the neuron?
Authors: Segev Idan
Published: February 2006

This essay looks at the historical significance of four APS classic papers that are freely available online:

Rall W.

Distinguishing theoretical synaptic potentials computed for different soma-dendritic distributions of synaptic input. J Neurophysiol 30: 1138–1168, 1967 ( http://jn.physiology.org/cgi/reprint/30/5/1138 ).

Rall W, Burke RE, Smith TG, Nelson PG, and Frank K.

Dendritic location of synapses and possible mechanisms for the monosynaptic EPSP in motoneurons. J Neurophysiol 30: 1169–1193, 1967 ( http://jn.physiology.org/cgi/reprint/30/5/1169 ).

Rall W and Shepherd GM.

Theoretical reconstruction of field potentials and dendrodendritic synaptic interactions in olfactory bulb. J Neurophysiol 31: 884–915, 1968 ( http://jn.physiology.org/cgi/reprint/31/6/884 ).

Segev I and Rall W.

Computational study of an excitable dendritic spine. J Neurophysiol 60: 499–523, 1988 ( http://jn.physiology.org/cgi/reprint/60/2/499 ).
Pattern-Specific Synaptic Mechanisms in a Multifunctional Network. I. Effects of Alterations in Synapse Strength
Authors: Lieske Steven P. , Ramirez Jan-Marino
Published: February 2006

Many neuronal networks are multifunctional, producing different patterns of activity in different circumstances, but the mechanisms responsible for this reconfiguration are in many cases unresolved. The mammalian respiratory network is an example of such a system. Normal respiratory activity (eupnea) is periodically interrupted by distinct large-amplitude inspirations known as sighs. Both rhythms originate from a single multifunctional neural network, and both are preserved in the in vitro transverse medullary slice of mice. Here we show that the generation of fictive sighs were more sensitive than eupnea to reductions of excitatory synapse strength caused by either the P/Q-type (α1A-containing) calcium channel antagonist ω-agatoxin TK or the non- N-methyl-d-aspartate (NMDA) glutamate receptor antagonist 6-cyano-7-nitroquinoxalene-2,3-dione (CNQX). In contrast, the NMDA receptor antagonist MK-801, while also inhibiting eupnea, increased the occurrence of sighs. This suggests that among the glutamatergic synapses subserving eupneic rhythmogenesis, there is a specific subset—highly sensitive to agatoxin and insensitive to NMDA receptor blockade—that is essential for sighs. Blockade of N-type calcium channels with ω-conotoxin GVIA also had pattern-specific effects: eupneic activity was not affected, but sigh frequency was increased and postsigh apnea decreased. We hypothesize that N-type (α1B) calcium channels selectively coupled to calcium-activated potassium channels contribute to the generation of the postsigh apnea.
Pattern-Specific Synaptic Mechanisms in a Multifunctional Network. II. Intrinsic Modulation by Metabotropic Glutamate Receptors
Authors: Lieske Steven P. , Ramirez Jan-Marino
Published: February 2006

The in vitro respiratory network contained in the transverse brain stem slice of mice simultaneously generates fast (∼15 min-1) and slow (∼0.5 min-1) rhythmic activities corresponding to fictive eupnea (“normal” breathing) and fictive sighs. We show that these two activity patterns are differentially controlled through the modulatory actions of metabotropic glutamate receptors (mGluRs). Sighs were selectively inhibited by agonists of the group III mGluRs according to a pharmacological profile most consistent with activation of mGluR8. Sighs were also blocked by the supposedly inactive L-isomer of the widely used N-methyl-d-aspartate (NMDA) receptor antagonist 2-amino-5-phosphonopentanoic acid (L-AP5, 5 μM), an effect that was abolished in the presence of group III mGluR antagonists. Excitatory postsynaptic potentials (EPSPs) were recorded in pre-Bötzinger Complex neurons after stimulation of the contralateral ventral respiratory group (VRG); evoked EPSP amplitude was variably reduced after bath application of the group III agonist l-serine- O-phospate (L-SOP), with an average reduction of 15%. Therefore although group III mGluRs do play a role in regulating synapse strength, this seems to be only a minor factor in the regulation of synapses made by midline-crossing axons. Intrinsic modulation of the respiratory central pattern generator by mGluRs appears to be an essential component of the multifunctionality that characterizes this network.
Response Properties of Dural Nociceptors in Relation to Headache
Authors: Strassman Andrew M. , Levy Dan
Published: February 2006

Single-unit electrophysiological recording studies have examined the activity of sensory neurons in the trigeminal ganglion that innervate the intracranial meninges to better understand their possible role in headache. A key question is whether the meningeal sensory neurons are similar to nociceptive neurons in other tissues or, alternatively, whether they have unique properties that might be of significance for headache pathogenesis and drug therapy. Such studies have indeed found that the intracranial dura is innervated by neurons that exhibit properties characteristic of nociceptors in other tissues, including chemosensitivity and sensitization. This sensitization, consisting of an enhanced responsiveness to mechanical stimuli, might be relevant to symptoms that are characteristic of certain headaches that indicate the presence of an exaggerated intracranial mechanosensitivity. Studies that examined whether the anti-migraine agent sumatriptan might inhibit this sensitization (in addition to its well-known inhibition of neurotransmitter release) found that it had no inhibitory effect but rather produced a calcium-dependent discharge, which might account for the initial worsening of headache that can follow sumatriptan administration. In studies that examined the effects of vasodilator agents, nitroprusside produced mixed effects on mechanosensitivity, whereas calciton gene-related peptide (CGRP) had no effect on either spontaneous or mechanically evoked discharge. These results call into question the role of vasodilation in headache and suggest that the role of CGRP in headache may be through its action as a central neurotransmitter rather than through vasodilation and activation of meningeal nociceptors. In general, studies of meningeal sensory neurons have not found evidence of unique properties that distinguish them from nociceptive neurons in other tissues. Ultimately the distinctive clinical characteristics of headache may prove to be related not so much to any differences in the intrinsic molecular or cellular properties of the meningeal sensory neurons but rather to the distinctive properties of the tissue that they innervate.
Gene expression profiling during cellular differentiation in the embryonic pituitary gland using cDNA microarrays
Authors: Ellestad Laura E. , Carre Wilfrid , Muchow Michael , Jenkins Sultan A. , Wang Xiaofei , Cogburn Larry A. , Porter Tom E.
Published: February 2006

The anterior pituitary is comprised of five major hormone-secreting cell types that differentiate during embryonic development in a temporally distinct manner. Microarrays containing 5,128 unique cDNAs expressed in the chicken neuroendocrine system were produced and used to identify genes with potential involvement in the onset of thyroid-stimulating hormone β-subunit (TSHβ), growth hormone (GH), and prolactin (PRL) mRNA during embryonic development. We identified 352 cDNAs that were differentially expressed (P ≤ 0.05) on embryonic day 10 (e10), e12, e14, or e17, the period of thyrotroph, somatotroph, and lactotroph differentiation. Self-organizing maps were used to identify genes that may function to initiate hormone gene transcription. Consistent with cellular ontogeny, TSHβ mRNA increased steadily between e10 and e17, GH mRNA increased between e12 and e17, and PRL mRNA did not increase until e17. Expression of 141 genes increased in a manner similar to TSHβ mRNA, and 64 genes decreased between e10 and e17. Although genes with these expression profiles are likely involved in development of the pituitary gland as a whole, some of these could be specifically associated with thyrotroph differentiation. Similarly, the expression profiles of 69 and 61 genes indicate a potential involvement in the induction of GH and PRL mRNA, respectively. Quantitative real-time RT-PCR was used to confirm microarray results for 31 genes. This is the first study to evaluate changes in anterior pituitary gene expression during embryonic development of any species using microarrays, and numerous transcription factors and signaling molecules not previously implicated in pituitary development were identified.
The Importance of Bacterial Superantigens Produced by Staphylococcus aureus in the Treatment of Atopic Dermatitis Using Povidone-Iodine
Authors: Sugimoto Kazuo , Ishikawa Nobuyasu , Terano Takashi , Kitukawa Yoshio , Kubosawa Hitoshi , Ito Shoichi , Hattori Takamichi
Published: February 2006

Atopic dermatitis (AD) is frequently associated with intestinal and cervical lesions. Staphylococcus aureus produces many kinds of toxins, the bacterial superantigens. The detection rate of toxins was 80.1% from 196 S. aureus strains. Neurological examinations revealed abnormalities in 59 out of 81 AD patients. Cervical magnetic resonance imaging (MRI) was performed in 46 patients randomly and showed abnormal findings in 38 of these patients. In 23 patients who underwent MRI and duodenal biopsy, 3 were found to be normal neurologically and 2 patients showed normal duodenal tissue. However, 18 patients had abnormal findings both on neurological examination and in duodenal tissue. Serial duodenal biopsy tests were performed in 10 AD patients. In 5 patients, the findings of chronic duodenitis disappeared after the therapy with povidone-iodine. These data indicate that the therapy was effective not only for the skin lesions, but improved gastrointestinal tract lesions and cervical myelopathy, by eradicating bacterial superantigens.
Systemic Iodine Absorption after Preoperative Antisepsis Using Povidone-Iodine in Cataract Surgery – An Open Controlled Study
Authors: Below H. , Behrens-Baumann W. , Bernhardt C. , Völzke H. , Kramer A. , Rudolph P.
Published: February 2006

After preoperative conjunctival and periorbital antisepsis with povidone-iodine (PVP-I), the systemic absorption of iodine after cataract surgery was measured to evaluate the risk of thyroid side effects. Five different combinations of PVP-I alone or in combination with PVP-I-free antiseptics were applied to the conjunctiva and periorbital skin. An iodine-free product served as control. Iodide and creatinine in urine were analyzed before intervention and 24 and 48 h postoperatively. Depending on the concentration and application site, 0.3–4.5% of the total applied iodine or 3.6–45.4% of the free iodine were absorbed. The range of urine iodine excretion was between 11.7 and 71.0 µg iodine/g creatinine, depending on the PVP-I concentration and the site of application. The increase in iodine excretion was significant at 24 h postoperatively in trials receiving PVP-I both periorbitally and conjunctivally, depending of the concentration used. Because the iodine absorption is only slight and of doubtful clinical relevance, presurgical conjunctival antisepsis can be achieved with 1.25% PVP-I; so far clinically manifest anamnestic thyroid disorders are excluded. Presently, periorbital skin antisepsis with PVP-I cannot be recommended until data on thyroid metabolism in the population have been collected and evaluated, especially in a region currently or previously deficient in iodine.
Effects of Applying Povidone-Iodine Just before Skin Closure
Authors: Harihara Yasushi , Konishi Toshiro , Kobayashi Hiroyoshi , Furushima Kaoru , Ito Kei , Noie Tamaki , Nara Satoshi , Tanimura Kumi
Published: February 2006

Many surgeons apply povidone-iodine (PVP-I) to the skin around an incision before closing a wound to reduce wound infection rates. However, the effectiveness of this procedure has not been proven. Forty-seven cases of gastric surgery and 60 cases of colorectal surgery performed at Kanto Medical Center between July 2004 and December 2004 were randomly assigned to the group with PVP-I or the group without PVP-I. Wound infection and surgical site infection (SSI) rates were compared between these two groups. Applying PVP-I was effective in eliminating skin contamination, as cultures became negative in all cases after applying PVP-I. However, this study could not demonstrate the reduction of wound infection or SSI in the group with PVP-I, possibly because the number of cases in this study was too small to make a difference. Subcutaneous tissue contamination was considered a more important factor than skin contamination in causing wound infection.
Repithel®: Removing the Barriers to Wound Healing
Authors: Mueller S. , Vogt P.M. , Steinau H.-U. , Bosse B. , Hopp M. , Fleischer W. , Reimer K.
Published: February 2006

Background: Various standardized and/or validated models exist to test wound healing products. This article discusses their usefulness in clinical practice. Objectives: Major barriers to wound healing have been identified after intense interaction of research and practitioners. Although extensively tested, wound healing products are still associated with trial and error due to the high variability and complexity associated with the treatment of wounds. Therefore, the results of preclinical testing are compared and contrasted with clinical observations of a liposomal hydrogel containing 3% povidone-iodine (Repithel®, PVP-ILH) to assess their expressiveness and to give the practitioner more guidance in application. Methods: Testing of PVP-ILH included physicochemical testing according to ISO norms, testing in in vitro and in vivo models. The obtained results are compared to the clinical profile of the obtained product in randomized controlled trials and ultimately expressive case studies. Results: PVP-ILH displays good local tolerance, the basis for use in sensitive and predamaged tissue. As observed in laboratory testing, it readily provides moisture and takes up limited amounts of moisture. This was also seen in the clinical testing, as the ability to keep wounds moist and incorporate a certain – but not large – amount of exudates. Clinical results also show clean, well-debrided wounds, an effect that (in the absence of an established model for wound cleansing) was traced to the hydrogel component carbomer. Discussion: Recent consensus advocates the concept of wound bed preparation as a systematic approach to removing barriers to healing (TIME). Based on the results, tissue (removing non-viable tissue and debris) and moisture (balance) can now be better understood, and infection/inflammation (control) and edge (progressing, non-advancing or undermining wound edges) are reviewed together with previously published data to assess all aspects potentially impeding wound healing. Conclusion: PVP-ILH successfully removes barriers to wound healing, thus laying the foundation to high-quality wound closure. Results from many scientific disciplines can help the user to better understand a product, standardization of testing is the only way of making results comparable.
Topical Application of Povidone-Iodine Solution (Betadine®) in the Management of Giant Omphaloceles
Authors: Tran Dong A. , Truong Quang Dinh , Nguyen Minh Tam
Published: February 2006

Giant omphaloceles, especially if they contain liver tissue, remain the greatest challenge to pediatric surgeons for the coverage of the huge defect. Various reconstructive techniques have been described in the literature, each with advantages and disadvantages. Standard treatment has been placement of a Silastic silo to allow gradual return of abdominal organs to the abdomen with its limited space. The worst complication of silo placement is infection of the fascia with disruption of the suture line. When fascial infection occurs, closure of the abdominal wall is very difficult or impossible. In this report, the authors describe their experience in treating 5 patients with giant omphaloceles, between 1999 and 2003, utilizing an abs orbable synthetic mesh (polyglactin 910-Vicryl) for abdominal closure and topical application of povidone-iodine 10/100 solution (Betadine®) to prevent infection. All patients had perfect results with the simple postoperative care, early oral feeding and were discharged after 2 months of hospitalization with complete skin coverage.
Significant Reduction of Nosocomial Pneumonia after Introduction of Disinfection of Upper Airways Using Povidone-Iodine in Geriatric Wards
Authors: Masaki Hironori , Nagatake Tsuyoshi , Asoh Norichika , Yoshimine Hiroyuki , Watanabe Kiwao , Watanabe Hiroshi , Oishi Kazunori , Rikitomi Naoto , Matsumoto Keizo
Published: February 2006

We investigated the efficacy of disinfection of the upper airway using povidone-iodine against nosocomial pneumonia in geriatric wards. Cases of nosocomial pneumonia were retrospectively analyzed between January 1991 and March 1995 in geriatric wards (190 beds). Moreover, the relationship concerning methicillin-resistant Staphylococcus aureus (MRSA) isolates between patient and environment was investigated using pulsed-field gel electrophoresis (PFGE) with the SmaI restriction enzyme. The incidence of nosocomial pneumonia decreased significantly (p < 0.05). Major causative organisms of nosocomial pneumonia were MRSA and Pseudomonas aeruginosa, which significantly decreased. PFGE studies showed that the patterns of MRSA isolates show a strong association between patient and environment. Our study indicates that disinfection of the upper airways by povidone-iodine is very important in the prevention of nosocomial pneumonia in geriatric wards.
Outbreak of Highly Pathogenic Avian Influenza in Japan and Anti-Influenza Virus Activity of Povidone-Iodine Products
Authors: Ito Hiroshi , Ito Toshihiro , Hikida Muneo , Yashiro Junko , Otsuka Akira , Kida Hiroshi , Otsuki Koichi
Published: February 2006

Objectives: On January 12, 2004, an outbreak of highly pathogenic avian influenza, caused by the H5N1 strain, occurred in a one-layer flock in Yamaguchi Prefecture, Japan. It had been 79 years since the last outbreak of avian influenza was confirmed in Japan. By February, 3 additional outbreaks had occurred (1 in Oita Prefecture and 2 in Kyoto Prefecture). Influenza viruses are enveloped viruses and are relatively sensitive to inactivation by lipid solvents, such as detergents. Infectivity is also rapidly destroyed by ether, sodium hypochlorite, povidone-iodine (PVP-I), peracetic acid and alcohol. However, these antiviral effects were only tested against human influenza A viruses. In the present study, the antiviral activity of PVP-I products against H5, H7 and H9 avian influenza A viruses, which had recently been transmitted to humans, were investigated. Methods: The in vitro antiviral activity of PVP-I products (2% PVP-I solution, 0.5% PVP-I scrub, 0.25% PVP-I palm, 0.23% PVP-I gargle, 0.23% PVP-I throat spray and 2% PVP-I solution for animals) against avian influenza A viruses [a highly pathogenic avian influenza virus, A/crow/Kyoto/T2/04 (H5N1; 106.5 EID50/0.1 ml), and 3 low pathogenic avian influenza A viruses, A/whistling swan/Shimane/499/838 (H5N3; 104.8 EID50/0.1 ml), A/whistling swan/Shimane/42/80 (H7N7; 105.5 EID50/0.1 ml) and A/duck/Hokkaido/26/99 (H9N2; 104.8 EID50/0.1 ml)] were investigated using embryonated hen’s eggs. Results/Discussion: Viral infectious titers were reduced to levels below the detection limits by incubation for only 10 s with the PVP-I products used in this study. These results indicate that PVP-I products have virucidal activity against avian influenza A viruses. Therefore, the PVP-I products are useful in the prevention and control of human infection by avian influenza A viruses.
Inactivation of SARS Coronavirus by Means of Povidone-Iodine, Physical Conditions and Chemical Reagents
Authors: Kariwa Hiroaki , Fujii Nobuhiro , Takashima Ikuo
Published: February 2006

The efficacy of several povidone-iodine (PVP-I) products, a number of other chemical agents and various physical conditions were evaluated for their ability to inactivate the severe acute respiratory syndrome coronavirus (SARS-CoV). Treatment of SARS-CoV with PVP-I products for 2 min reduced the virus infectivity from 1.17 × 106 TCID50/ml to below the detectable level. The efficacy of 70% ethanol was equivalent to that of PVP-I products. Fixation of SARS-CoV-infected Vero E6 cells with a fixative including formalin, glutaraldehyde, methanol and acetone for 5 min or longer eliminated all infectivity. Heating the virus at 56°C for 60 min or longer reduced the infectivity of the virus from 2.6 × 107 to undetectable levels. Irradiation with ultraviolet light at 134 µW/cm2 for 15 min reduced the infectivity from 3.8 × 107 to 180 TCID50/ml; however, prolonged irradiation (60 min) failed to eliminate the remaining virus, leaving 18.8 TCID50/ml.
Early Fatal Pontocerebellar Hypoplasia with Simplified Cerebral Gyration and Pseudolissencephaly
Authors: Hoffmann Adrienne , Weber Peter , Fallet-Bianco Catherine , Radü Ernst-Wilhelm , Probst Alphonse
Published: February 2006

We report the observation of a child born at 38 5/7 weeks’ gestation, who presented with marked microcephaly and suffered from persistent intractable epilepsy up to his death at the age of 5 days. Magnetic resonance imaging suggested lissencephaly. But interestingly no submicroscopical deletion in LIS-1 gene could be detected and true lissencephaly could not be confirmed histologically. Instead, primary degenerative process was considered the most probable cause of congenital pontocerebellar hypoplasia II in this case, which may be associated with a maturation delay of the cerebral hemispheres. The present case points to possible pitfalls in neuroradiological interpretation of simplified cerebral gyration and to the necessity to take into account cerebral pathologies leading to slowing or arrest of intrauterine cerebral development and delay of cerebral gyration.
Usefulness of Magnetic Resonance Imaging for Accurate Diagnosis of Pfeiffer Syndrome Type II in utero
Authors: Itoh Shigeru , Nojima Michio , Yoshida Koyo
Published: February 2006

Objective: To present the usefulness of fetal magnetic resonance (MR) imaging for accurate diagnosis of Pfeiffer syndrome type II. Case and Methods: A 19-year-old woman was referred to us at 29 weeks of gestation for prenatal management of hydrocephalus. Ultrasonography of the fetus showed cloverleaf skull with dilated lateral ventricles, exophthalmos, macroglossia, and a single ventricle of the heart in addition to polyhydramnios. MR imaging was performed at 30 weeks of gestation and revealed cloverleaf skull, dilated lateral ventricles, and broad thumb. Fetal karyotyping indicated 46,XY, but DNA sequence analysis showed a single sequence variation (Nt 1198A>G) in the fibroblast growth factor receptor (FGFR) 2 gene (exon 10). On the basis of these findings, the baby was diagnosed in utero with Pfeiffer syndrome type II. Following counseling, the pregnancy was terminated because polyhydramnios made the patient’s symptoms more severe. The patient delivered her baby vaginally at 34 weeks of gestation. The baby’s birth weight was 2,298 g; the baby was declared dead at 25 min after birth. Conclusion: The detailed findings obtained by a combination of ultrasound that included three-dimensional and MR imaging and confirmation sought via molecular testing led to an accurate diagnosis of Pfeiffer syndrome type II in utero.
Successful Management of Intrauterine Twin and Concomitant Cervical Pregnancy: A Case Report
Authors: Ujvari E. , Krizsa F. , Sebestyen A. , Varbiro S. , Paulin F.
Published: February 2006

Use of in vitro fertilization techniques increases the frequency of pathological implantation. However, simultaneous pregnancies are a rarity. Ectopic implantation of the embryo may occur in the cervical canal. This is the first case report, which describes successful management of an intrauterine twin pregnancy which occurred simultaneously with a cervical pregnancy. Diagnostic and therapeutic options are discussed along with the outcome of pregnancies. The cervical pregnancy was removed by aspiration, without dilation of cervical canal, which saved the lives of intrauterine fetuses and preserved fertility for following pregnancies. Finally we review the advanced methods in the literature.
Percutaneous Fetoscopic Patch Coverage of Spina Bifida Aperta in the Human – Early Clinical Experience and Potential
Authors: Kohl Thomas , Hering Rudolph , Heep Axel , Schaller Carlo , Meyer Bernhard , Greive Claudia , Bizjak Gabriele , Buller Tim , van de Vondel Patricia , Gogarten Wiebke , Bartmann Peter , Knöpfle Gisela , Gembruch Ulrich
Published: February 2006

Objective: The current operative approach for fetal repair of spina bifida aperta requires maternal laparotomy and hysterotomy. Following technical feasibility studies in sheep, we performed percutaneous fetoscopic patch coverage of this lesion in 3 human fetuses between 23 + 4 and 25 + 3 weeks of gestation. Methods and Results: Whereas the patch detached in the first case 3 weeks after the procedure, it covered the exposed neural tissue in the 2 other fetuses beyond their delivery. Two of the three children survived, but 1 unexpectedly died from a ventilation problem in its 3rd week of life. In 1 of the 2 survivors, ventriculoperitoneal shunt insertion was delayed. Conclusions: Percutaneous fetoscopic patch coverage of spina bifida aperta is feasible in human fetuses and offers a substantial reduction of maternal trauma compared to open fetal repair. Further clinical experience is now required before the efficacy of the new approach to protect the exposed neural tissue from mechanical and chemical damage and to improve hindbrain herniation can be evaluated.
Congenital Heart Diseases in Twin Pregnancies
Authors: Hajdu J. , Beke A. , Marton T. , Hruby E. , Pete B. , Papp Z.
Published: February 2006

Objective: To find connection between the type of congenital heart malformations and twin pregnancies. Method: Retrospective analysis of data of fetal cardiology database between 1 January 1996 and 30 November 2003. Results: In single pregnancies 455 and in twin pregnancies 31 severe congenital heart malformations were diagnosed prenatally. In monozygotic twin pregnancies 36% of heart malformations were pulmonary stenosis and 45% endocardial fibroelastosis, which is significantly higher than in single pregnancies. In dizygotic twin pregnancies Ebstein malformation was significantly more frequent than in single pregnancies. With the exception of Ebstein malformation in dichorionic and dizygotic twin pregnancies the cardiac malformations were similar to the ones in single pregnancies. Conclusions: The twin pregnancy alone can be considered as indication for fetal echocardiography. The type of congenital heart malformations detected in monochorial twin pregnancies was different from those found in single, dizygotic or dichorionic twin pregnancies. Chorionicity seems to be more important than zygosity.