bluuebunny/crossref_metadata_2025 huggingface dataset:
Imaging the Trigeminal Nerve and Pons before and after Surgical Intervention for Trigeminal Neuralgia
Authors: Jawahar Ajay , Kondziolka Douglas , Kanal Emanuel , Bissonette David J. , Lunsford L. Dade
Published: September 2004

OBJECTIVE

To study the various imaging changes occurring in the trigeminal nerve and brainstem in patients before or after trigeminal neuralgia surgery.

METHODS

During a 7-year period, 275 patients with trigeminal neuralgia underwent high-resolution, contrast-enhanced magnetic resonance imaging (MRI) of the pons during gamma knife radiosurgery. Ninety-seven patients had no previous surgical intervention for trigeminal neuralgia, and 178 patients had undergone one or more previous procedures. Two independent observers, one of whom was blinded to patients' clinical details, reviewed MRI scans retrospectively. The analysis of the independent observers was then correlated with all previous therapeutic interventions.

RESULTS

One hundred one MRI scans demonstrated no radiological changes related to trigeminal neuralgia, and 174 MRI scans exhibited some radiological abnormality. The average axial plane diameter of the nerve for all patients was 4 mm (range, 2–6 mm). In the group that had not undergone previous surgery, 65 patients (67%) exhibited vascular compression. In the 88 patients who had undergone previous microvascular decompression, 21 (24%) had evidence of a pontine infarction. Twenty-six patients experienced facial sensory loss, 22 (88%) of whom had undergone previous surgery with evidence of a pontine infarction (n = 11) or perineural scarring (n = 6).

CONCLUSION

The majority of patients who had undergone previous trigeminal neuralgia surgery demonstrated readily identifiable abnormalities of the trigeminal nerve or brainstem. The frequency of such changes correlated with the type and number of procedures. Evidence of vascular compression was detected in the majority of patients. Most patients with postoperative facial sensory loss demonstrate changes in the nerve or pons on MR images.
Surgical Experience with Frontolateral Keyhole Craniotomy through a Superciliary Skin Incision
Authors: Czirják Sándor , Szeifert György T.
Published: September 2004

OBJECTIVE

The purpose of this study was to evaluate the results of 173 frontolateral keyhole minicraniotomies performed on 155 patients with aneurysms of the anterior or posterior cerebral circulation and for supratentorial tumors.

METHODS

The frontolateral keyhole craniotomy is a modification of the generally used pterional approach. Of the 155 patients studied, 102 harbored saccular arterial aneurysms in the vessels of the anterior or posterior cerebral circulation, and 53 had various tumors in the frontal base, suprasellar, or parasellar region. The operations were carried out through an approximately 2.5- × 3-cm frontolateral miniaturized craniotomy after a skin incision just above the eyebrow.

RESULTS

Despite the small size of the craniotomy, the exploration allows enough room for intracranial manipulation with maximal protection of the brain and other intracranial structures. The presented series of patients did not have any craniotomy-related complications.

CONCLUSION

In our experience, the frontolateral keyhole craniotomy, together with the advent of the modern neuroanesthesia, cerebrospinal fluid drainage, and microsurgical techniques, is a safe approach for an experienced neurosurgeon to use in the treatment of supratentorial aneurysms or tumors of the anterior fossa and sellar regions.
Tonicity of Resuscitative Fluids Influences Outcome after Spinal Cord Injury
Authors: Sumas MariaElaina , Legos Jeffrey J. , Nathan David , Lamperti Albert A. , Tuma Ronald F. , Young William F.
Published: September 2004

OBJECTIVE

This investigation was designed to test the hypothesis that the tonicity of resuscitative fluids administered after spinal cord injury influences the magnitude of secondary injury and, therefore, outcome.

METHODS

Rat spinal cords were compressed with 50 g of weight for 5 minutes to produce injury. After spinal cord injury, the animals were randomized into three experimental groups. Group 1 (n = 10) received no fluid resuscitation after spinal cord injury. Group 2 (n = 6) received 5 ml/kg of intravenously administered Ringer's lactate 1 minute after the removal of compression. Group 3 (n = 7) was treated with 5 ml/kg of intravenously administered 7.5% hypertonic saline 1 minute after the removal of compression. Neurological outcome was assessed daily for 10 days using the Basso, Beattie, and Bresnahan locomotor rating scale. Histological evaluations of the spinal cord were obtained on Day 10.

RESULTS

The average number of recovery days before the rats were able to spontaneously void their bladders was significantly less (P < 0.05) in the hypertonic saline-treated group. Spontaneous hindlimb movement also occurred sooner in the hypertonic saline-treated animals. The average neurological score was significantly higher (P < 0.05) in the hypertonic saline-treated group during each of the 10 days of recovery. Histological evaluation supported the finding of attenuation of injury in the hypertonic saline-treated animals.

CONCLUSION

The results of this investigation with a chronic model of spinal cord injury support the contention that hypertonic saline treatment may provide protection to the spinal cord after mechanical injury.
Training intensity and first labor market outcomes of apprenticeship graduates
Authors: Euwals Rob , Winkelmann Rainer
Published: September 2004

The apprenticeship system is the most important source of formal post‐secondary training in Germany. Using German register data – the IAB Employment Sample – it is found that apprentices staying with their training firm after graduation have a longer first‐job durations but not higher wages than apprentices leaving the training firm. Retention rates, first job durations, and post‐apprenticeship wages are all increasing functions of training intensity. Some implications for the ongoing debate as to why firms are willing to invest in general training are discussed.
Profit related pay in Italy
Authors: Amisano Gianni , Del Boca Alessandra
Published: September 2004

This paper investigates which company characteristics affect the decision to introduce profit‐sharing. Unlike most studies, this paper relies on a ten‐year panel. The results presented in this paper are based on the estimation of a panel data fixed‐effect logit model. Given that they are immune from heterogeneity bias, it is believed that these results are more reliable than those obtained by estimating cross‐sectional models. These results are in line with the common findings of the literature. Companies that are more likely to introduce profit‐sharing (PS) are larger firms which invest more, due to the lower cost of debt, and tend to pay higher wages as an incentive to boost the initially lower productivity. These companies are more likely to undertake investment projects which support the interpretation of PS as a risk‐sharing device.
A conceptual synergy model of strategy formulation for manufacturing
Authors: Fai Pun Kit
Published: September 2004

With the increasing level of competition in many competitive environments, a body of research regards the ability to formulate and implement a formulated strategy as an equally important source of competitive advantage. The rate of change in both internal and external environments of manufacturing firms is increasing, which necessitates that increased attention be paid to strategic planning and strategy formulation. This paper reviews the concepts of strategy, strategic planning and strategy formulation. It then discusses the common strategy determinants and describes the characteristics of several planning frameworks and methodologies. A conceptual synergy model for strategy formulation is proposed, and its features and characteristics are presented along with a discussion of its applicability in manufacturing enterprises.
The Norwegian approach to integrated quality development
Authors: Øvretveit John
Published: September 2004

The UK NHS quality proposals require all NHS organisations to develop an “integrated approach” to quality. In other countries, health care organisations are also working to ensure that the many different quality methods and systems used in health organisations do not duplicate or conflict with each other. The question this paper addresses is “what would an integrated approach to quality look like and how might managers and clinicians develop such an approach in their organisation?“ The findings from the Norwegian total quality management experiment in six hospitals were that TQM could not be applied in its pure form in public health care services to ensure integration. The paper draws on this research to describe these hospitals’ approach to integrate the different projects and systems which were stimulated by their initial quality programmes. The paper describes the ”integrated quality development" approach which characterised these programmes.
Big Brother versus anonymity on the Internet: implications for Internet service providers, libraries and individuals since 9/11
Authors: Nijboer Jelke
Published: September 2004

To communicate anonymously is a basic constitutional right. It is an integral part of the freedom of speech. However, anonymity on the Internet is increasingly not self‐evident. Anonymity is one of the characteristics of the Internet. Is misconduct overemphasized or is improper Internet usage on the rise in the last couple of years? Many governments and lobby groups are of this opinion and want more control over the Internet to prevent misconduct and misuse. Pleas for digital passports and other forms of (self)regulation and legislation are increasing or in some countries legislation is already being put into place to limit the freedom of expression on the Internet. It looks as if anonymity on the Internet will soon be something of the past. The Patriot Act in the USA is an example of the far reaching powers of authorities to limit freedom of speech. It does not only threaten freedom of movement on the Internet, it also affects the business of Internet service providers (ISPs), Internet cafes and libraries. The implications for Internet users and institutions, like libraries, are discussed. It is clarified with some examples from the USA and elsewhere.
Virtual but visible: developing a promotion strategy for an electronic library
Authors: Turner Alison , Wilkie Fran , Rosen Nick
Published: September 2004

The National electronic Library for Health (NeLH) was highly commended in 2003 by the Chartered Institute of Library and Information Professionals, for an awareness campaign delivered in autumn 2002. This article outlines the promotions activity leading up to the award and the achievements made since. The NeLH is now over three years old and has a regular user base of 120,000 users per month, with around 50 per cent of users making repeat visits within the month. A range of activities and tools has been devised to promote the service to the health community. Increasingly, the NeLH works in partnership with health librarians, mainly through the Digital Libraries Network, established during 2003. This collaborative approach has enabled a greater reach for marketing campaigns and offered economies of scale.
Corporate branding and corporate brand performance
Authors: Harris Fiona , de Chernatony Leslie
Published: September 2004

Corporate branding necessitates a different management approach. It requires greater emphasis on factors internal to the organisation, paying greater attention to the role of employees in the brand building process. This paper explores the implications of corporate branding for the management of internal brand resources. We describe a model for managing brands through narrowing the gap between a brand’s identity and its reputation and, building on this, identify three key factors that affect brand perceptions and brand performance. Finally, we review some of the mechanisms that may be used to facilitate greater congruence of brand perceptions within the brand team and communication of a brand’s identity to employees.
Predicting online purchase intentions for clothing products
Authors: Young Kim Eun , Kim Youn‐Kyung
Published: September 2004

Shopping online for clothing products is gaining in popularity. This study identified the dimensions of online shopping attributes and predictors of the intention to purchase clothes, jewelry, or accessories based on online shopping attributes and demographic variables. A mailing survey was conducted with 303 adults who had a computer at home and had access to the Internet in the USA. The perceived attributes of online shopping consisted of four factors: transaction/cost; incentive programs; site design; and interactivity. The transaction/cost factor and the incentive programs factor, along with demographic variables (gender, income and number of children), were important predictors in determining the intention to purchase clothing, jewelry, or accessories via the Internet. Incentive program also mediated the relationship between education level and online purchase intention. This study provides managerial implications for the future online marketing of clothing products.
Letting go of the mouse: using alternative computer input devices to improve productivity and reduce injury
Authors: Bertuca David J.
Published: September 2004

Many computer related injuries occur from mouse use. The mouse is the primary input device by virtue of its universal availability, yet it is not the best for all‐round work. Alternative devices such as the track ball, touch pad, and graphics tablet can be used more effectively for precise cursor control, while reducing stress and the potential for injury. Though these devices may seem exotic or a luxury, they are in fact affordable and well‐suited to daily use by everyone. This article describes the mouse and its inherent weaknesses, and offers more practical alternatives. These alternatives may help reduce injury‐producing activities, and may also improve productivity and creativity by allowing more precision cursor controls.
The internationalization of MARC. Part II: some MARC formats based on USMARC
Authors: Kokabi Mortaza
Published: September 2004

Surveys the development of various MARC formats out of USMARC. Considers the formats for Canada, France, Spain and Indonesia. Indicates their main points of difference and local requirements.
A simulation approach to restructuring call centers
Authors: Lam Kokin , Lau R.S.M.
Published: September 2004

As the call center services are becoming an integrated part of most organizations, the efficiency of their operations is vital to the competitiveness of the organizations. This paper describes a restructuring effort of a Hong Kong‐based company, which provides technical support services in office equipment, computer and system products. Faced with many process improvement opportunities, a simulation approach is used to explore the different options and to evaluate the results for restructuring the existing call centers. The analysis of the simulated results has confirmed that the greatest improvement opportunity is to merge the existing resources into a single call center. Assured by the simulation findings, management is able to evaluate different tangible and intangible benefits before implementing the restructuring plan.
FTIR spectroscopy of lac resin and its derivatives
Authors: Sarkar P.C. , Shrivastava A.K.
Published: September 2004

Applies Fourier transform infrared spectroscopy (FTIR) to the study of lac resin, a complex natural resin of insect origin, and some of its derivatives. Compares the result obtained by this method with those from earlier studies that used classical methods of chemical analysis (the so‐called wet methods). Finds that FTIR has several advantages over the classical methods but, as spectroscopic assignments are still only tentative because of the complex nature of the lac resin, the FTIR data requires supplementing by other instrumental techniques such as FT‐Raman spectroscopy and solid state nuclear magnetic resonance.
The Management of Intellectual Assets: Delivering Value to the Business
Authors: McConnachie Gordon
Published: September 2004

At The Dow Chemical Company, Intellectual Assets are regarded as knowledge with a value and are a key factor in creating wealth for the company. These Intellectual Assets include patents, trade secrets, trademarks and know‐how. The company has devised a six‐step Intellectual Asset model which involves strategy setting; identification and classification of existing Intellectual Assets; valuing these assets; deciding whether to invest in new knowledge through the development or purchase of technology and skills; and assembling the Intellectual Assets into Knowledge Portfolios for each global Dow business. This process is repeated on a regular basis. This paper discusses how the methodology has been developed and implemented at Dow, including the company’s approach to creating a Global Intellectual Asset Technology Centre and multi‐functional and multi‐geographic Intellectual Asset teams. Tools and techniques developed for measuring the company’s Intellectual Assets are generic and may be appropriately applied to any organization.
A Socio‐Technical View of Knowledge Sharing at Buckman Laboratories
Authors: Pan Shan L. , Scarbrough Harry
Published: September 2004

This empirical study reports a unique implementation process of knowledge sharing from Buckman Laboratories. Through a socio‐technical perspective on Knowledge Management, this paper highlights the interplay between Knowledge Management systems and the organizational context.
Strategy and volatility: risk and global strategic challenge
Authors: Haynes Daniell Mark
Published: September 2004

In this extract from his latest book Mark Haynes Daniell analyses new sources of risk and opportunity as the telecommunications industry revolutionises the business world. He looks at recurring risk patterns and what can be done to combat them. He then looks at how some of the biggest names have coped and provides some lessons which should be learned.
Why outsourcing could be good for you
Authors: Winterton Andy
Published: September 2004

Considers the issue of outsourcing the bank’s corporate treasury function. Looks at the benefits and disadvantages involved. Discusses the way in which outsourcing can be achieved. Explains the value of currency overlay.
Beyond Regional Institutions: Widening Unemployment Differentials in Italy
Authors: Limosani Michele
Published: September 2004

Abstract.  Building on Layard and Jackman's framework, we propose a simple model to analyse the relation between labour productivity and unemployment differentials in Italy and present some panel data evidence to support the theoretical predictions of the model. The empirical analysis strongly suggests that the productivity differential is one of the main factors driving the dynamics of the unemployment differential in Italy.
The Employment–Hours Trade‐off: Theory and an Application to the Portuguese Case
Authors: Martins Ana Paula
Published: September 2004

Abstract.  Using traditional production theory, it is possible to estimate production functions in which hours per worker and number of workers hired are treated as endogenous and chosen by the firm, priced respectively by the variable hourly wage and the so‐called quasi‐fixed unit cost. The available data suggested the use of Cobb–Douglas or CES specifications or the use of two‐stage separable technologies, with a second‐level Cobb–Douglas being possible. Quasi‐fixed costs were associated with legal social security payments, which were also conditioned by the data. The estimates for the Portuguese metal products and engineering industries — using cross‐section evidence for 1987 — showed that disaggregation of the labor input is empirically justifiable, and total man‐hours employed and the numbers of workers hired are complements in production. Hours per worker respond negatively to the variable hourly wage and positively to the quasi‐fixed unit cost. Nevertheless, in our framework, this would be so by construction. Total labor costs increase with both the hourly wage and the quasi‐fixed unit costs.
Discriminatory Barriers and the Gender Wage Gap in France
Authors: Moulin Stéphane
Published: September 2004

Abstract.  In this paper, we propose a method of decomposition that identifies the wage effect of the gender discriminatory barriers in the allocation of grades and full‐time jobs. Standard decomposition techniques tend to interpret the explained portion as a non‐discriminatory component, though discriminatory barriers in the labour market also affect the characteristics of individuals. Using survey data generated by INSEE in France in 2000, we find some evidence that the gender discriminatory barriers within the French labour market explain much of the difference between men and women's attainment and full‐time employment. Our method substantially changes the traditional empirical conclusions since the discriminatory barriers in the allocation of grades and full‐time jobs account for one quarter of the gender monthly wage gap. When adding to the pure wage discrimination portion, we thus show that half of the gender monthly wage gap is not explained.
Occupational Attainment and Earnings: The Case of the Disabled
Authors: Thoursie Peter Skogman
Published: September 2004

Abstract.  This paper offers, for the first time, an investigation of wage differentials between disabled and non‐disabled workers in Sweden. It extends the traditional wage decomposition by incorporating explained and unexplained differences in occupational attainment. Data from the Swedish Level of Living Survey for 1981 and for 1991 have been used. The results show that in both years the disabled worked in low‐level occupations to a greater extent relative to the non‐disabled. This is due to the fact that disabled workers have lower qualifications. The unexplained component due to differences in returns on wage determinants is insignificant in the 1981 case but is highly significant in 1991, constituting around 50–60 per cent of the average log wage differential.
Anti‐inflammatory properties of desloratadine
Authors: Agrawal D. K.
Published: September 2004

Background
Allergic rhinitis (AR) is associated with robust infiltration of immune cells and mediators that may contribute to clinical manifestations of the disease.

Objective
To review the complex immune effector mechanisms involved in the allergic response and discuss their effects on the pathophysiological and clinical manifestations of AR. Desloratadine, a novel antihistamine, was used as a probe with the goal of attaining a better understanding of the inflammatory processes underlying the allergic response.

Methods
Data were obtained from abstracts and peer‐reviewed journals. The pathophysiology of the allergic response has been extensively studied. This paper presents only data from studies that used desloratadine at physiologically relevant concentrations.

Results
Key mediators involved in the allergic response and in pathophysiological and clinical manifestations of the immune response were reviewed. Desloratadine was used as a probe to further elucidate the mechanisms involved during an allergic response.

Conclusions
Some have proposed a link between the pathophysiology of AR and the clinical manifestation of symptoms. Desloratadine, a new‐generation antihistamine, has demonstrated anti‐inflammatory effects in vitro; indeed, desloratadine is capable of intervening at various points in the immune cascade. Although in vitro results do not necessarily correlate with clinical efficacy, the anti‐inflammatory properties of desloratadine may contribute to its efficacy in patients with AR, allergy‐induced asthma, and other related allergic conditions. Antihistamines that modulate in the immune system at various stages may optimize treatment of allergic disease.
Altered β2‐adrenergic regulation of T cell activity after allergen challenge in asthma
Authors: Heijink I. H. , Van Den Berge M. , Vellenga E. , De Monchy J. G. R. , Postma D. S. , Kauffman H. F.
Published: September 2004

Background
Airway inflammation in asthma is orchestrated by recruitment of T helper (Th)2 lymphocytes to the lung and subsequent production of Th2‐like cytokines upon allergen challenge.

Objective
To examine whether allergen‐induced dysfunction of the β2‐adrenergic receptor (β2‐AR) contributes to the enhanced T(h2) cell activity in asthma.

Methods
β2‐adrenergic regulation of cytokine mRNA expression was studied in α‐CD3/α‐CD28‐activated peripheral blood lymphocytes from seven asthma patients before and 6 h after allergen challenge, in conjunction with the effects of β2‐agonist fenoterol on T cell chemotaxis and signalling pathways.

Results
A complete loss of β2‐AR control over expression of the Th2 cytokines IL‐4, IL‐5 and IL‐13, but not of the Th1 cytokine IFN‐γ, was observed after allergen challenge. Furthermore, we found impaired β2‐AR regulation of T cell migration as well as signal transduction pathways, i.e. the phosphorylation of cyclic adenosine monophosphate‐responsive element binding protein and the inhibition of the mitogen‐activated protein kinase pathway. The loss of β2‐AR control was associated with increased β‐adrenergic receptor kinase expression, which might be involved in β2‐AR desensitization. In addition, we demonstrate for the first time that T cells exposed to the chemokine thymus and activation‐regulated chemokine show hyporesponsiveness to fenoterol.

Conclusion
Our results suggest that allergen‐induced loss of β2‐AR control, possibly mediated by chemokine release, plays an important role in enhanced Th2‐like activity in asthma.
Increase of CC chemokine receptor 4‐positive cells in the peripheral CD4+ cells in dogs with atopic dermatitis or experimentally sensitized to Japanese cedar pollen
Authors: Maeda S. , Ohmori K. , Yasuda N. , Kurata K. , Sakaguchi M. , Masuda K. , Ohno K. , Tsujimoto H.
Published: September 2004

Background
Since dogs frequently develop allergic diseases, similar to those in humans, dogs represent a possible animal model for allergy in humans. In human atopic dermatitis (AD), CC chemokine receptor 4 (CCR4) has been shown to play an important role in the development of allergic inflammation of AD; however, the association between allergic reaction and CCR4 is not well understood in dogs.

Objective
To examine CCR4 expression in peripheral blood CD4+ cells in dogs that had AD and were experimentally sensitized with Japanese cedar pollen.

Materials and methods
Peripheral blood mononuclear cells (PBMCs) were isolated from 17 dogs with AD. The proportion of CCR4+ cells in peripheral blood CD4+ cells (CCR4/CD4) was evaluated by flow cytometry and compared with that in 10 healthy dogs. Similarly, in dogs that were experimentally sensitized to Japanese cedar pollen antigen, the proportion of CCR4/CD4 was examined pre‐ and post‐sensitization.

Results
The proportion of CCR4/CD4 in dogs with AD was 40.3±3.3%, which was significantly higher than that in normal dogs (23.6±4.3%) (P<0.01). In the experimentally sensitized dogs, the proportion of CCR4/CD4 was 25.4±2.6% at pre‐sensitization and it was significantly increased (29.8±2.9%) at post‐sensitization (P<0.01).

Conclusion
The proportion of CCR4+ cells in peripheral blood CD4+ cells was measured in dogs with allergic conditions. The present findings indicate that CCR4+ cells may be involved in the pathogenesis of allergy in dogs as in humans.
Nerve growth factor‐induced substance P in capsaicin‐insensitive vagal neurons innervating the lower mouse airway
Authors: Dinh Q. T. , Groneberg D. A. , Peiser C. , Springer J. , Joachim R. A. , Arck P. C. , Klapp B. F. , Fischer A.
Published: September 2004

Background
Nerve growth factor (NGF) is elevated in allergic diseases such as bronchial asthma and can lead to an induction of substance P (SP) and related neuropeptides in guinea‐pigs large‐diameter, neurofilament‐positive airway neurons.

Objective
In the present study, the effect of NGF on tyrosine kinase receptor trkA and the capsaicin receptor TRPV1 expression in airway‐specific vagal sensory neurons located in the jugular–nodose ganglia complex (JNC) of mice was investigated.

Methods
Using retrograde neuronal tracing in combination with double‐labelling immunohistochemistry, SP, trkA‐ and TRPV1‐receptor expression was examined in airway‐specific sensory neurons of BALB/c mice before and after NGF treatment.

Results
NGF injected into the lower airway was able to induce SP (13.0±2.03% vs. 5.9±0.33%) and trkA expression (78±2.66% vs. 60±2.11%) in larger diameter (>25 μm), capsaicin‐insensitive and trkA‐positive vagal sensory neurons that were retrograde‐labelled with Fast Blue dye from the main stem bronchi.

Conclusion
Based on the extent of SP and trkA co‐expression in airway‐specific neurons by NGF treatment, the present study suggests that, following a peripheral activation of trkA receptor on SP afferent by NGF which is elevated in allergic inflammation, there may be trkA‐mediated SP induction to mediate neurogenic airway inflammation.
Medullary thyroid carcinoma
Authors: Leboulleux Sophie , Baudin Eric , Travagli Jean‐Paul , Schlumberger Martin
Published: September 2004

Medullary thyroid carcinoma (MTC) arises from parafollicular or C cells that produce calcitonin (CT), and accounts for 5–10% of all thyroid cancers. MTC is hereditary in about 25% of cases. The discovery of a MTC in a patient has several implications: disease extent should be evaluated, phaeochromocytoma and hyperparathyroidism should be screened for and whether the MTC is sporadic or hereditary should be determined by a direct analysis of the RET proto‐oncogene. In this review, pathological characteristics, tumour markers and genetic abnormalities in MTC are discussed. The diagnostic and therapeutic modalities applied to patients with clinical MTC and those identified with preclinical disease through familial screening are also described. Progresses concerning genetics, initial treatment, follow‐up, screening and treatment of pheochromocytoma have permitted an improvement in the long‐term outcome. However, there is no effective treatment for distant metastases, and new therapeutic modalities are urgently needed.
The relation of insulin, leptin and IGF‐1 to birthweight in offspring of women with type 1 diabetes
Authors: Lindsay R. S. , Hamilton B. A. , Calder A. A. , Johnstone F. D. , Walker J. D.
Published: September 2004

objective  Maternal diabetes is associated with excess foetal growth. We have assessed the influence of maternal diabetes on hormones associated with foetal growth and the relationship of these hormones to birthweight.

design  Case–control study.

patients  Singleton offspring of mothers with type 1 diabetes (ODM, n = 140) and control mothers (Control, n = 49).

measurements  Birthweight, cord blood insulin, proinsulin, 32–33 split proinsulin, leptin, IGF‐1, IGFBP‐3, cortisol.

results  Maternal diabetes was associated with higher birthweight (ODM 3·80 ± 0·69 kg; Control; 3·56 ± 0·52 kg, P = 0·02) and marked increases in insulin (median [interquartile range]: ODM 110 [60–217] pmol/l; Control 22 [15–37] pmol/l; P < 0·0001) and leptin (ODM 32 [15–60] ng/ml; Control 9 [4–17] ng/ml; P < 0·0001) but no absolute difference in IGF‐1 (ODM 7·9 [6·2–9·8] nmol/l, Control 7·5 [6·2–9·8] nmol/l, P = 0·24) or its principle binding protein IGFBP‐3 (ODM 1·63 ± 0·38 µg/ml, Control 1·63 ± 0·28 µg/ml; P = 0·12). Individually, insulin, insulin propeptides, leptin, IGF‐1 and IGFBP‐3 were significantly (P < 0·05) correlated with birthweight (in ODM and Control). IGF‐1 and leptin were positively related to birthweight independently of each other and insulin in both ODM and Control. By contrast, insulin showed independent relationships to birthweight in ODM (P < 0·0001) but not in Control (P = 0·4).

conclusions  Maternal diabetes is associated with marked elevation of insulin and leptin in cord blood of their offspring. Hormonal correlates of birthweight differ between ODM and Control with an independent relationship of insulin to birthweight observed only in ODM.
Microgeographic variation of HLA‐A, ‐B, and ‐DR haplotype frequencies in Tuscany, Italy: implications for recruitment of bone marrow donors
Authors: Marroni F. , Curcio M. , Fornaciari S. , Lapi S. , Mariotti M. L. , Scatena F. , Presciuttini S.
Published: September 2004

Abstract:  HLA‐A/B haplotype frequencies were estimated in a sample of 2355 bone marrow donors born in a subregion of Tuscany (Italy), and the HLA‐A, ‐B, ‐DR haplotype frequencies were estimated in a subset of 809 individuals. This area was divided in 10 subsamples (two‐locus haplotypes), or six subsamples (three‐locus haplotypes), all with sample size >50, based on administrative boundaries. A considerable level of heterogeneity of haplotype frequency was present among subsamples; this heterogeneity was associated to a large variation (up to 4‐fold) of the number of new donors that must be typed in order to reach 50% chance of finding an HLA‐A, ‐B phenotype of intermediate frequency. Knowledge of the genetic structure of the population at a microgeographic level may be useful in directing the search of specific bone marrow donors.
Variation in identifying neonatal percutaneous central venous line position
Authors: Odd DE , Battin MR , Kuschel CA
Published: September 2004

Objective:  The study objective was to obtain data on interpretation, including intra and interobserver variation and action taken for a given line tip location, for a series of radiographs demonstrating neonatal long lines.

Methods:  Nineteen radiographs taken to identify line tip position were digitized and published on an internet site. One film was included twice in order to assess intraobserver variation giving a total of 20 images. Fourteen used radio‐opaque contrast and five no contrast. Australian and New Zealand Neonatal Network members and National Women's Hospital NICU staff were invited to participate in the study. For each radiograph, participants were asked to identify if long line tip could be identified, the likely anatomical position and desired action. Interobserver agreement was assessed by the maximum proportion of agreement per radiograph and by the number of different options selected. Intraobserver agreement was assessed by comparing the two reports from the duplicate radiograph.

Results:  Twenty‐seven responses were received. Overall, 50% of the reports stated that the long line tips could be identified. The most commonly reported position was in the right atrium (31%) and most commonly reported action was to pull the line back (53%). The median agreement of whether the line was seen was 68%, agreement on position 62% and agreement on action 86%. On analysis of intraobserver variability, from the identical radiographs, 27% of respondents differed on whether the line tip could be visualized.

Conclusion:  Interobserver and intraobserver reliability was poor when using radiographs to assess long line tips. The major determinant of line repositioning was the perceived location.
Clinical significance of isolated paraventricular cysts on cranial ultrasonography
Authors: Wong F , Fraser S , Kelly E , Acton C
Published: September 2004

Objectives:  Isolated paraventricular cysts detected on routine cranial ultrasonography in premature and full term neonates are often incidental findings. The aetiology and clinical significance of these lesions is uncertain. A case control study was designed to attempt to clarify the clinical significance of isolated paraventricular cysts in terms of growth and neurodevelopment.

Methods:  Ten infants with isolated paraventricular cysts on neonatal cranial ultrasonography were identified. These were matched with 10 control infants for sex, gestational age and birthweight. All infants were assessed at a corrected age of 18−31 months for growth and neurodevelopment. Two index infants and their controls were excluded from analysis of psychometric data as the neurodevelopmental assessment tools used were different.

Results:  There was no statistically significant difference between the index and control groups in terms of growth, motor and psychometric assessment at follow up.

Conclusions:  The study suggests that isolated paraventricular cysts detected on routine cranial ultrasonography have no prognostic significance. However the study involved a small sample size with limited power of study (power = 0.3). A larger prospective cohort study would help to clarify the clinical significance of this condition.
Aberrant cervical thymus mimicking a cervical mass
Authors: Conwell LS , Batch JA
Published: September 2004

Abstract:  A case of a 9‐year‐old female with suprasternal extension of the thymus mimicking thyroid gland enlargement is described. Ultrasonography successfully established the diagnosis. Aberrant cervical thymic tissue is an infrequently reported cause of paediatric neck masses. It is important to be aware of this entity to prevent anxiety and inappropriate investigation and/or intervention.
Efficacy of rituximab plus chemotherapy in follicular lymphoma depends on Ki‐67 expression
Authors: Saito Bungo , Shiozawa Eisuke , Yamochi‐Onizuka Toshiko , Adachi Daisuke , Nakamaki Tsuyoshi , Tomoyasu Shigeru , Omine Mitsuhiro , Mitsuya Toshiyuki , Takimoto Masafumi , Ota Hidekazu
Published: September 2004

Rituximab is widely used for the treatment of B‐cell non‐Hodgkin's lymphoma (NHL), and encouraging results have been obtained. However, some CD20‐positive NHL show minimal response to rituximab, indicating that the treatment effect depends on the presence or absence of an unidentified factor. We analyzed the relationship between the effect of rituximab plus chemotherapy and expression of Ki‐67, p53 and bcl‐2 and several clinical variables in cases of B‐NHL, particularly follicular lymphoma (FL) and diffuse large B‐cell lymphoma (DLBCL). Forty‐four patients were included in the present study, and the overall treatment response rate was 68%. Twelve of 30 patients (40%) achieved a complete response, five (16%) reached an unconfirmed complete response and 13 (43%) achieved a partial response. A high serum lactate dehydrogenase level and International Prognostic Index of high or high intermediate risk were associated with a decreased response in the case of FL. Immunohistochemical assays were performed in 18 FL patients (55%) and 15 DLBCL patients (45%). Significant correlation was found between an inferior response to treatment and high Ki‐67 expression in the cases of FL (P = 0.006). p53 and bcl‐2 expression did not correlate significantly with the response rate. The cell cycle appears to be an important factor in the efficacy of rituximab treatment. Ki‐67 expression might be a predictor of efficacy of rituximab plus chemotherapy.
Laminin 5 β3 and γ 2 chains are frequently coexpressed in cancer cells
Authors: Akimoto Shingo , Nakanishi Yukihiro , Sakamoto Michiie , Kanai Yae , Hirohashi Setsuo
Published: September 2004

Laminin 5 plays an important role in cell migration during tumor invasion and tissue remodeling. However, previous studies have not clarified whether laminin 5 β3 chain is coexpressed with laminin 5 γ 2 chain in cancer cells. The present immunohistochemical study investigated the distribution of the laminin 5 β3 and γ 2 chains in 20 cases of squamous cell carcinoma of the tongue and 17 cases of colorectal carcinoma. Laminin 5 β3 and γ 2 chains were expressed in the cytoplasm of tumor cells. Tumor cells at the cancer–stromal interface and at the invasive front frequently showed immunopositivity for laminin 5 β3 and γ 2 chains in both squamous cell carcinoma of the tongue and colorectal carcinoma. Furthermore, strong expressions of these two proteins were observed in cancer cells invading in a scattered manner. Laminin 5 β3 expression correlated significantly with laminin 5 γ 2 expression in 20 cases of squamous cell carcinoma of the tongue (P = 0.0002) and 17 cases of colorectal carcinoma (P < 0.0001). These results suggest that in squamous cell carcinoma of the tongue and colorectal carcinoma, laminin 5 γ 2 chain and β3 chain are both important in the invasiveness of cancer cells.
Sertoli cell tumor of the testis (not otherwise specified) with the expression of neuroendocrine markers and without the expression of inhibin‐α
Authors: Kuroda Naoto , Senzaki Tomokazu , Yamasaki Yoshikazu , Miyazaki Eriko , Hayashi Yoshihiro , Toi Makoto , Hiroi Makoto , Enzan Hideaki
Published: September 2004

Sertoli cell tumor of the testis (not otherwise specified) in a 43‐year‐old man is reported. Macroscopically, the testicular mass measured 3.0 × 2.3 × 1.5 cm and was well circumscribed. The cut surface was white to tan‐gray in color. Neoplastic cells with eosinophilic cytoplasm proliferated with solid and tubular structures. Neoplastic cells focally contained vacuoles of various sizes in the cytoplasm. Cystic formation and cord formation in the hyalinized stroma was also observed. Immunohistochemically, neoplastic cells were positive for cytokeratin 8, chromogranin A and synaptophysin, but neoplastic cells were negative for placental alkaline phosphatase, inhibin‐α and pancytokeratin. The stroma in the tumor center and capsule contained a significant number of myofibroblasts that were positive for α‐smooth muscle actin and negative for h‐caldesmon, but no CD34‐positive stromal cells were detected in the stroma of the tumor center. Ultrastructurally, neoplastic cells had cytoplasmic processes and abundant rough endoplasmic reticulum and lipid droplets in the cytoplasm. However, dense core granules were absent. It is important to differentiate between Sertoli cell tumor and carcinoid tumor because of the positive reaction for neuroendocrine markers in both tumors. Myofibroblasts are a major stromal component of Sertoli cell tumor of the testis.
Trial of nurse‐run asthma clinics based in general practice versus usual medical care
Authors: PILOTTO Louis S. , SMITH Brian J. , HEARD Adrian R. , McELROY Heather J. , WEEKLEY Josephine , BENNETT Paul
Published: September 2004

Objective:  The aim of this study was to assess the ability of nurse‐run asthma clinics based in general practice compared with usual medical care to produce at least a moderate improvement in the quality of life of adults with asthma.

Methodology:  A randomized controlled trial involving 80 asthma clinic and 90 usual medical care asthma participants, aged 18 years and older was conducted in 11 general practices in Adelaide. The main outcome measure was the St George's respiratory questionnaire (SGRQ), from which quality‐of‐life scores were used to assess therapeutic benefit. Lung function measurements and health services utilization data were also collected.

Results:  One hundred and fifty‐three participants (90%) were reviewed at follow up after 6–9 months. There was little difference between groups in baseline measures or for the 6‐month follow‐up  outcomes,  including  the  mean  difference  in  total  SGRQ  scores  (−0.5,  95%  confidence  interval  (CI) −4.0, 2.9) and the mean difference in percentage predicted FEV1 (2.3%, 95% CI −0.7, 5.3 pre‐bronchodilator; 0.4%, 95% CI −5.1, 5.9 post‐bronchodilator). Trends in health services utilization were noted.

Conclusions:  Nurse‐run asthma clinics based in general practice and usual medical care were similar in their effects on quality of life and lung function in adults. These findings cannot be generalized to hospital outpatients and other clinics that manage more severe asthmatic patients.
Computed tomography‐guided transthoracic fine‐needle aspiration in diagnosis of lung cancer: A comparison of single‐pass needle and multiple‐pass coaxial needle systems and the value of immediate cytological assessment
Authors: KÜÇÜK ÇAğla Uyanusta , YILMAZ Adnan , YILMAZ Aynur , AKKAYA Esen
Published: September 2004

Objectives:  The aim of the present study was to compare single‐pass needle and multiple‐pass coaxial needle systems and to evaluate the value of immediate cytological assessment during the procedure in the diagnosis of lung cancer with CT‐guided transthoracic fine‐needle aspiration.

Methodology:  One hundred and forty‐three consecutive patients who underwent CT‐guided transthoracic fine‐needle aspiration were divided into three groups. In the first group (group A, 48 patients), a single‐pass needle was used for aspiration, but immediate cytological examination was not performed. In the second group (group B, 48 patients), a single‐pass needle was used for aspiration and a pathologist immediately assessed the adequacy of the sample obtained. In the third group (group C, 47 patients), a multiple‐pass coaxial needle was used for aspiration and a pathologist immediately assessed the adequacy of the sample obtained.

Results:  The mean number of fine‐needle aspirations was 1.25 in group A, 1.39 in group B and 1.34 in group C (group A vs group B, P = 0.08). The diagnostic accuracy was 83.3, 97.9 and 100.0%, respectively (group A vs group B, P = 0.03; group B vs group C, P > 0.05). Although immediate cytological assessment resulted in adequate samples being obtained from all patients in groups B and C, adequate samples were obtained in 41 of 48 patients (85.4%) in group A (P = 0.004). There was no statistically significant difference among the groups with respect to the rate of pneumothorax.

Conclusions:  A single‐pass needle technique in transthoracic fine‐needle aspiration is preferred because there is no significant difference between single‐pass needle and multiple‐pass coaxial needle systems with respect to the diagnostic accuracy and the complication rate and, in addition, the single‐pass needle has a lower cost. The results of the present study suggest that immediate cytological assessment during the procedure reduces an inadequate sampling rate, thus increasing the diagnostic accuracy of the procedure.
Defining, Measuring, and Comparing Organisational Cultures
Authors: Van Den Berg Peter T. , Wilderom Celeste P.M.
Published: September 2004

La littérature portant sur la culture des organisations souffre d’un manque manifeste d’enquêtes extensives débouchant sur des études comparatives. Afin de rendre plus comparables les cultures organisationnelles, nous proposons une définition et une série de dimensions. La culture organisationnelle renverrait aux perceptions communes des pratiques de travail dans le cadre des unités constitutives des organisations. A l’examen d’études empiriques, les cinq dimensions suivantes nous sont apparues: autonomie, orientation externe, coordination interdépartementale, orientation vers les ressources humaines et orientation vers le développement. L’utilisation de cette définition et de ces dimensions générales devrait faciliter la comparaison des cultures organisationnelles et l’accumulation de résultats.

Within the body of organisation culture literature, there is a conspicuous absence of large‐scale studies reporting on comparative studies. In order to increase comparability of organisational cultures we propose a definition and a set of dimensions. Organisational culture is defined as shared perceptions of organisational work practices within organisational units. On the basis of empirical studies we discerned the following five dimensions: autonomy, external orientation, interdepartmental coordination, human resource orientation, and improvement orientation. Use of this definition and a set of such generic dimensions would facilitate the comparison of organisational cultures and the accumulation of research findings.