bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of preoperative ultrasound examination in the selection of women with adnexal masses for laparoscopic surgery
Authors: Yazbek J. , Helmy S. , Ben‐Nagi J. , Holland T. , Sawyer E. , Jurkovic D.
Published: October 2007

Objectives

To assess the value of preoperative ultrasound examination in predicting the feasibility of intermediate‐level laparoscopic surgery for benign adnexal masses.

Methods

Symptomatic women with a clinical or ultrasound diagnosis of adnexal mass were offered a detailed transvaginal ultrasound scan in order to assess the feasibility of laparoscopic cystectomy/oophorectomy. In all cases an attempt was made to establish a likely histological diagnosis using the pattern recognition method. The selection criteria for laparoscopic surgery were: no ultrasound features suggestive of ovarian cancer, predominantly cystic lesion with no solid foci > 5 cm in mean diameter, no evidence of severe pelvic endometriosis or severe pelvic adhesions and dermoid cyst < 10 cm in mean diameter. Laparoscopic surgery was classified as successful if the mass was removed completely without resorting to a laparotomy.

Results

One hundred and forty‐three women were diagnosed with a total of 162 adnexal cysts. The final dataset consisted of 137 women (with 153 lesions), 113 (82.5%) of whom were selected for laparoscopy and 24 (17.5%) for laparotomy. On histological examination 152 (99.3%) cysts were benign and the remaining one (0.7%) was borderline. The operation was successfully completed laparoscopically in 107/113 (94.7%) cases. The preoperative ultrasound assessment predicted the successful outcome of laparoscopic surgery with a sensitivity of 98% (95% CI, 94–99%), specificity of 79% (95% CI, 60–90%), positive predictive value of 95% (95% CI, 89–98%), positive likelihood ratio of 4.58 (95% CI, 2.25–9.32) and negative likelihood ratio of 0.02 (95% CI, 0.01–0.09).

Conclusions

A detailed preoperative transvaginal ultrasound examination is a helpful tool for assessing the feasibility of intermediate‐level laparoscopic surgery in women with benign adnexal lesions. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Determination of the elemental distribution in human joint bones by SR micro XRF
Authors: Zoeger N. , Streli C. , Wobrauschek P. , Jokubonis C. , Pepponi G. , Roschger P. , Hofstaetter J. , Berzlanovich A. , Wegrzynek D. , Chinea‐Cano E. , Markowicz A. , Simon R. , Falkenberg G.
Published: October 2007

In humans the toxic trace element lead (Pb) mainly accumulates in the skeletal tissue where it resides for a long period. Although Pb is known to play a role in bone and cartilage diseases, the distribution of Pb in these tissues is mostly unknown. Therefore synchrotron‐radiation‐induced micro x‐ray fluorescence analysis (SR µ‐XRF) in various geometries was used to determine the distributions of Pb, Ca, Zn and Sr at the cartilage‐bone interface in human femoral heads and patellae. SR µ‐XRF results were matched with backscattered electron (BE) images providing information on structural features of the tissue. Conventional SR µ‐XRF at HASYLAB beamline L showed that Pb mostly accumulates in a zone of some micrometers around the transition between non‐calcified and calcified cartilage. However, the relatively large sample thickness did not allow more precise conclusions. Exploiting the 3D capabilities of confocal SR µ‐XRF and SR microfluorescence tomography at ANKA Fluo‐Topo beamline and HASYLAB beamline L, the spatial resolution could be improved and a highly specific accumulation of Pb at the tidemark, the calcification front between non‐calcified and calcified cartilage, was detected. It was found that Pb and Zn accumulation coincide at the tidemark. Since the tidemark plays an important role in osteoarthritis, the results may strengthen other authors' conclusions that Pb is associated with this joint disease. Although offering less spatial resolution when compared to micro‐tomography, confocal SR µ‐XRF is best suited for such studies. It facilitates the comparison of element maps with other imaging techniques like BE imaging. Copyright © 2007 John Wiley & Sons, Ltd.
Coming Full Circle: A Reciprocal‐Engagement Model of Genetic Counseling Practice
Authors: Veach Patricia McCarthy , Bartels Dianne M. , LeRoy Bonnie S.
Published: October 2007

As genetic health care and genetic testing expand from primarily addressing conditions that are exclusively genetic in nature to common diseases with both genetic and environmental components, the scope of genetic counseling has grown. Identification and utilization of a normative model of practice defined by members of the profession is critical as genetic services become more commonplace in medical care. The purpose of this paper is to describe the results of a consensus conference convened to define a model of genetic counseling practice based on the guidance of educators and leaders in the profession. Twenty‐three program directors or their representatives from 20 genetic counseling graduate programs in North America listened to presentations and participated in group discussions aimed at determining the elements of a model of practice, including tenets, goals, strategies, and behaviors for addressing patients’ genetic concerns. Their discussion is summarized, training implications and research recommendations are presented, and a model of practice that extends their ideas is proposed.
Spatial variation of species diversity across scales in an old‐growth temperate forest of China
Authors: Wang Xugao , Hao Zhanqing , Ye Ji , Zhang Jian , Li Buhang , Yao Xiaolin
Published: October 2007

Species richness and abundance are the two most important diversity variables. Species abundance is additive when aggregated across spatial scale, whereas species richness is non‐additive. This study analyzes the effect of spatial scale and site on species abundance and richness in a 25‐ha temperate forest plot in the Changbai Mountains, northeastern China. The result shows that species abundance and richness are not only dependent on spatial scales, but also dependent on site. Species abundance responds linearly to changes of spatial scale with no intersection in different sites of the study area. However, although species richness also increases with the increase of spatial scale, there are some intersections for the different sites, suggesting that a species‐rich site does not always have a high value if the spatial scale is changed. In all, with respect to additive variables, it is relatively easy to extrapolate them from one spatial scale to another spatial scale, as they and the spatial scale usually form a linear relationship. In contrast, non‐additive variables are difficult to extrapolate across spatial scales, because they often respond nonlinearly to spatial scale changes. In order to extrapolate these non‐additive variables across spatial scales, it is necessary to estimate the relationships between them and spatial scales. As a result, extrapolation of information among spatial scales may be possible, but very difficult, especially for non‐additive variables. Because the 25‐ha Changbai plot is very small compared to the extent of the world temperate forests, and the vegetation is a relatively uniform type, more such studies in other ecosystems are needed before theories and generalization about scaling effects can be formulated.
How do dams affect freshwater fish distributions in Japan? Statistical analysis of native and nonnative species with various life histories
Authors: Han Mideok , Fukushima Michio , Kameyama Satoshi , Fukushima Takehiko , Matsushita Bunkei
Published: October 2007

We examined the effects of dams on freshwater fish species based on data collected during 1990–2004 from 200 drainage systems in Japan. Of the 76 fish species examined, the occurrence of 20 species within Petromyzontidae, Cyprinidae, Cobitididae, Salmonidae, Cottidae, and Gobiidae was negatively affected by the presence of dams located in the downstream reaches of fish survey sites, whereas the occurrence of 12 species within Cyprinidae, Adrianichthyidae, Centrarchidae, and Gobiidae was positively associated with the presence of dams. A significantly higher proportion of the fishes with a negative damming effect were diadromous species as compared to the fishes with a positive damming effect. Conversely, the latter group had a significantly higher proportion of nonnative species than the former. A significant interaction existed between the effects of damming and the effects of elevation on family‐specific species richness. Families dominated by native migratory species showed a greater reduction in the number of species above dams at lower elevations, whereas families represented primarily by nonnative species had higher species richness above dams at higher elevations, except for Centrarchidae, which was always higher in species richness above dams regardless of elevation. Based on our findings, dams in Japan have adversely affected native freshwater fishes by blocking their migration routes, favoring nonnative fishes, or altering existing habitats.
Characterization and Compositional Studies of Oil from Seeds of Desi Chickpea (Cicer arietinum L.) Cultivars Grown in Pakistan
Authors: Zia‐Ul‐Haq Muhammad , Ahmad Mansoor , Iqbal Shahid , Ahmad Shakeel , Ali Hakoomat
Published: October 2007

The physiochemical properties and fatty acid (FA) composition of oil from seeds of four desi chickpea cultivars, grown in Pakistan, were investigated. The oil content was relatively low (5.88–6.87%). The physiochemical parameters determined included refractive indices (RI) at 40 °C (1.48–1.49), relative density (0.95–0.96), iodine value (IV) (111.87–113.69), acid value (AV) (2.55–2.73 mg KOH/g), saponification value (SV) (183.98–185.64 mg KOH/g), unsaponifiable matter (UM) (2.99–3.71%), peroxide value (PV) (3.97–6.37 mequiv/Kg), p‐anisidine value (p‐AV) (5.39–8.74), and oxidation value (OV) (13.67–22.34). Linoleic acid and oleic acid were the dominant FAs. Results from most of the parameters revealed significant (P < 0.05) differences among the cultivars. The findings reveal Desi chickpea (Cicer arietinum L.), indigenous to Pakistan, to be a potentially valuable legume crop with comparable nutritional quality oil.
Full‐Press Oil Extraction of Cuphea (PSR23) Seeds
Authors: Evangelista Roque L. , Cermak Steven C.
Published: October 2007

Cuphea PSR23, a semi‐domesticated, high‐capric‐acid hybrid from Cuphea viscosissima × Cuphea lanceolata, is being developed as a potential commercial alternative source of medium‐chain fatty acids. The present study evaluated the effects of initial seed moisture and final moisture contents of cooked flaked seed on Cuphea’s pressing characteristics and the quality of the extracted oil. Seeds with 9 and 12% initial moisture contents (MC) were flaked and cooked at different residence times to produce cooked seeds with MC of 3.0–5.5%. Cooked seeds were pressed using a laboratory screw press. Eighty and 84% oil were extracted from cooked seeds with 5.5 and 3.0% MC, respectively. The seeds with 9% initial MC exhibited lower pressing load increase (9.1 per 1% decrease in MC) than the seeds with 12% initial MC (16.4 per 1% decrease in MC). The pressing rate decreased by 3% as the cooked flaked seed MC decreased. The amount of foots in the oil increased from 3 to 6.6% and chlorophyll content increased from 200 to 260 ppm as cooked flaked seed MC decreased from 5.5 to 3.0%. FFA contents were 2.5% for all treatments MC studied. The phosphatide content increased as the cooked flaked seed MC decreased but the amounts were still within the levels of water‐degummed oil.
Heat Treatment Improves Olive Oil Extraction
Authors: Cruz Sergio , Yousfi Khaled , Oliva Jesús , García José M.
Published: October 2007

To determine the effect of hot water pre‐treatment on olive oil extraction, six cultivars of olive fruit (Olea europaea L. cvs. “Arbequina”, “Hojiblanca”, “Lechín”, “Manzanilla”, “Picual”, and “Verdial”) were heated at 50, 55, and 60 °C prior to laboratory scale oil extraction. Heat treatment resulted in higher oil extraction than unheated control samples. Quality parameters of the oils were not significantly (P < 0.05) affected by these treatments; however, oil stability and bitterness intensity were reduced and pigment content was increased through pre‐heat treatment. This process may be incorporated economically into olive oil processing.
Pseudoparalysis in the Pavlik Harness: Beware of septic arthritis
Authors: Stevenson Andrew J. , Shewalle Sandeep B. , Clarke Nicholas M. P.
Published: October 2007

Purpose

Pseudoparalysis of the leg occurring during use of the Pavlik Harness (PH) is a seldom-reported condition. Three cases of pseudoparalysis are reported here to illustrate the need for careful assessment of this condition.

Methods

A series of patients using the PH and presenting with pseudoparalysis was compiled following a retrospective review of case notes.

Results

In 3 cases, infants treated for developmental dysplasia of the hip using the PH were found to have developed a pseudoparalysis of the affected limb. All presented with similar signs, with the infant being systemically irritable and reluctant to move the limb. In 2 of the cases, this was related to the harness—its removal resulted in recovery of the affected limb. The third case was proven to be septic arthritis, unrelated to the harness, and treatment by means of arthrotomy, intravenous antibiotics and use of the PH for hip stabilisation was used successfully. In the first two cases, the pseudoparalysis was noticed at routine review clinic, and clinical assessment, ultrasound scan and blood tests were performed. The case of septic arthritis was similarly assessed, following referral by paediatric physicians.

Conclusion

Pseudoparalysis in the PH is a rare event and requires careful investigation.
Cobalamin and homocysteine in older adults: Do we need to test for serum levels in the work0up of dementia?
Authors: Garcia Angeles
Published: October 2007

This article reviews available information on the relationship between cobalamin (Cbl), homocysteine (tHcy) and cognitive decline and dementia in older adults with the aim to propose recommendations as to the need to perform such determinations in the work‐up for dementia. The article includes brief reviews of the magnitude of the problem, effects of the Canadian folic acid fortification program on the Cbl and tHcy status in older adults, relation between Cbl and tHcy and cognition and cognitive changes, and available data on treatment trials up to March 2007. Recommendations and levels of evidence were assigned and approved by consensus following the directives of the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. The review concludes that determination of Cbl (vit B12) levels are recommended in the work‐up for dementia and cognitive decline because of the high prevalence of Cbl deficits in this population, independently of the possible effects of normalization of Cbl levels on cognitive function. Even though elevated tHcy is a risk factor for dementia, there is no prooof that normalization of tHcy levels changes the course of the disease. Clinical trials on that regard are on going.
Disclosure of the diagnosis of dementia
Authors: Fisk John D. , Beattie B. Lynn , Donnelly Martha , Byszewski Anna , Molnar Frank J.
Published: October 2007

Most ethical guidelines strongly promote disclosure of a diagnosis of dementia to the affected individual, based on the principle of autonomy. Nevertheless, codes of medical ethics allow for various interpretations of this issue and surveys of clinical practice illustrate that such disclosure is by no means the rule. We argue that diagnostic disclosure for persons with dementia must be considered a process that begins when cognitive impairment is first suspected and that evolves over time as information is obtained. Whenever possible and appropriate, this process should involve not only the affected individual but also their family and/or other current or potential future care providers. Once a diagnosis is established it should be disclosed in a manner consistent with the expressed wishes of the patient, using an individualized patient‐centered approach that maintains the individual's personal integrity. Diagnostic disclosure of dementia is a process that may require additional time as well as follow‐up or referral to other specialists. We recommend that a progressive disclosure process be employed to address issues including: remaining diagnostic uncertainty, treatment options, future plans, financial planning, assigning power of attorney, wills and “living wills”, driving privileges and the need for eventual driving cessation, available support services, and potential research participation. The potential for adverse psychological consequences to diagnostic disclosure must be assessed and these should be addressed through education and support of the patient and their family/caregivers throughout the diagnostic disclosure process. At present, few data are available regarding patients' perspectives on the diagnostic disclosure process and its consequences. This limitation and the apparent discrepancies in physician and caregiver opinions about the disclosure process, make it incumbent upon health care professionals to evaluate the diagnostic disclosure process within their practice.
Ethical considerations for decision making for treatment and research participation
Authors: Fisk John D. , Beattie B. Lynn , Donnelly Martha
Published: October 2007

Here we review issues of patient decision‐making and consent to treatment and research by persons with cognitive impairment and dementia. Clinicians and researchers must recognize their primary duty to care for the individual and must clearly distinguish their role as a clinician and/or researcher. Distinctions between standard care and research must be clearly understood by everyone, as must the clinician's role in each. Both actual and perceived conflicts of interest must be avoided. At present there is insufficient evidence to recommend specific methods for determining competency for decision‐making, but a diagnosis of cognitive impairment or dementia does not preclude such competence. Competency is not a unitary or static construct and must be considered as the ability to make an informed decision about participation in the particular context of the specific treatment or study. Clinicians and researchers should consider consent as a process involving both the patient with cognitive impairment and his or her family/caregiver, particularly given the potential that competency for decision‐making will change over time. As the availability of advance directives remains limited, clinicians and researchers must make efforts to ensure that decisions made by proxies are based on the prior attitudes and values of the patient.
Clinical diagnosis of dementia
Authors: Robillard Alain
Published: October 2007

This paper presents recommendations deriving from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, concerning the clinical diagnosis of dementia. There are currently no universally accepted biological or radiological markers of dementia. In the absence of these, the diagnosis of dementia remains a clinical exercise aiming to integrate all available clinical and laboratory information. It is proposed that the currently used National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRA) criteria for diagnosis of Alzheimer's disease (AD) be retained. The currently available vascular dementia (VaD) diagnostic criteria have variable accuracy. An integrative approach to VaD diagnosis based on all the available evidence (history, vascular risk factors, physical exam, clinical course, neuroimaging, cognitive impairment pattern) is recommended. The separation of Lewy body dementia (DLB) from Parkinson's disease dementia (PDD) is based on the dominant clinical presenting feature of each syndrome, and relies on the duration of this feature: long duration of parkinsonian “motor” syndrome preceding dementia for PDD versus early/initial dementia accompanied by extrapyramidal symptoms for DLB. It is recognized that it is impossible clinically to characterize DLB with (pathologically) coexisting AD changes. The Frontotemporal group of dementia syndromes are discussed in regards to their typical clinical pictures, recognizing that their neuropathological substrate are not predictable from their mode of presentation. Finally, the particular rapid time sequence of evolution of the dementias due to prior disease is recognized as the clinically most useful distinguishing feature of these syndromes.
Prevalence and distribution of mastitis pathogens in subclinically infected dairy cows in Flanders, Belgium
Authors: Piepers Sofie , De Meulemeester Luc , de Kruif Aart , Opsomer Geert , Barkema Herman W , De Vliegher Sarne
Published: October 2007

The main objective was to determine the prevalence of intramammary infections (IMI) in dairy cows in Flanders, Belgium. Data were obtained from quarter milk samples of dairy herds subjected to a mandatory yearly screening of all lactating cows. A total of 178 668 quarter milk samples were collected at 1087 cross-sectional dairy herd screenings performed in three consecutive years. Of the dairy cows, 40% had at least one culture-positive quarter. More than 50% of all IMI were caused by non-aureusstaphylococci.Streptococcus agalactiaeis almost eradicated in Flanders, whereasStaphylococcus aureuswas isolated from 18% of the culture-positive quarters. In addition, the distribution of mastitis pathogens in quarter milk samples from selected dairy cows with an elevated somatic cell count (SCC) is described. From 6390 cows with a geometric mean composite SCC ⩾250 000 cells/ml, nearly 65% had at least one culture-positive quarter. The majority of the IMI were caused by non-aureusstaphylococci (41·1%), whereasStaph. aureusand aesculin-positive cocci were found in respectively 25% and 18% of the culture-positive milk samples. We conclude that more efforts are needed in the prevention and control of subclinical mastitis in Flanders. Non-aureusstaphylococci are the predominant cause of IMI, warranting more research regarding the epidemiology and pathogenicity of those species.
Hypopharyngeal cancer treatment based on definitive radiotherapy: who is suitable for laryngeal preservation?
Authors: Chen S-W , Tsai M-H , Yang S-N , Liang J-A , Shiau A-C , Lin F-J
Published: October 2007

Aims:

To investigate prognostic factors for survival and locoregional control in patients with stage I–IVA hypopharyngeal cancer treated with laryngeal preservation radiotherapy.

Methods:

This study was a retrospective analysis of 108 patients with stage I–IVA squamous cell carcinoma of the hypopharynx, treated with laryngeal preservation radiotherapy. Actuarial survival, disease-specific survival and local relapse-free survival were calculated, and multivariate analyses were performed using Cox's proportional hazards model.

Results:

After a median follow-up duration of 39 months, the five-year local relapse-free survival rate was 35 per cent for all patients, 66 per cent for those with stage I–II disease, 46 per cent for those with stage III disease and 20 per cent for those with stage IVA disease (p = 0.004). Multivariate analyses showed that tumour and node stages were independent prognostic factors.

Conclusions:

Patients with stage I–II disease were suitable for laryngeal preservation radiotherapy. For most patients with stage III–IVA disease, other than those who were T1 N1 or T2 N1, the treatment results were poor.
Advances in management of paranasal sinus aspergillosis
Authors: Daudia A , Jones N S
Published: October 2007

Surgery remains the treatment of choice for mycetoma of the paranasal sinuses. Itraconazole has a useful role in reducing both the amount of surgery required and the amount of peri-operative bleeding in allergic aspergillosis, and continuing its use post-operatively for six weeks appears to reduce the recurrence rate (although a case–control study is required to validate this observation). In chronic invasive aspergillosis, itraconazole alone appears to be curative, although liver function tests should be monitored and other interactions considered. Imaging is required to monitor resolution; remineralisation occurs after approximately six months. In fulminant aspergillosis, radical surgery and amphotericin B continue to be the treatments of choice. This review discusses the management of aspergillosis of the paranasal sinuses, and in particular the role of itraconazole antifungal therapy.
Auricular syncope
Authors: Thakar A , Deepak K K , Shyam Kumar S
Published: October 2007

Objective:

To describe a previously unreported syndrome of recurrent syncopal attacks provoked by light stimulation of the external auditory canal.

Case report:

A 13-year-old girl had been receiving treatment for presumed absence seizures, with inadequate treatment response. Imaging was normal. Careful history taking indicated that the recurrent syncopal attacks were precipitated by external auditory canal stimulation. Targeted autonomic function tests confirmed a hyperactive vagal response, with documented significant bradycardia and lightheadedness, provoked by mild stimulation of the posterior wall of the left external auditory canal. Abstinence from ear scratching led to complete alleviation of symptoms without any pharmacological treatment.

Conclusions:

Reflex syncope consequent to stimulation of the auricular branch of the vagus nerve is proposed as the pathophysiological mechanism for this previously undocumented syndrome.
Investigation of age, sex and menstrual stage variation in human cerumen lipid composition by high performance thin layer chromatography
Authors: Koçer M , Güldür T , Akarçay M , Miman M C , Beker G
Published: October 2007

Objective:

The objective of the study was to correlate quantitative changes in the lipid composition of human cerumen with changes in age, sex and menstrual cycle stage.

Design:

Cerumen samples were collected from the external ear canal and analysed using sequential, one dimensional, high performance thin layer chromatography.

Subjects:

The following age groups of both sexes were investigated: one to 10 years; 11–18 years; 19–40 years; and 40 years and over. Additionally, cerumen samples from subjects in three stages of the menstrual cycle were compared.

Results:

In the cerumen samples, the peak values for wax ester and cholesterol occured between the ages of one and 10 years for both sexes. However, squalene and triglyceride content reached maximum levels at puberty. Men aged 19–40 years had a significantly greater percentage of cerumen lipid squalene content than women from the same age group; however, their cholesterol content was found to be lower. Regarding the various menstrual cycle stages, cerumen samples taken at the follicular stage from women aged 19–40 years had a significantly lower free fatty acids content, and higher cholesterol and squalene levels, compared with samples taken in the luteal or menstrual stages.

Conclusion:

The proportions of the lipid constituents of cerumen varied with age, sex and menstrual stage. In cerumen, the main lipid constituent stimulated at puberty appears to be squalene, not wax esters as reported for sebum. The relevance of lipid constituents to cerumen's protective role is discussed.
Revisiting the risks involved in using homograft ossicles in otological surgery
Authors: Lubbe D , Fagan J J
Published: October 2007

Despite the fact that cartilage, cortical bone and corneal homograft tissue is still widely used in South Africa and that there has never been a reported case of human immunodeficiency virus or Creutzfeldt–Jakob disease infection transmission via this route, otolaryngologists are still reluctant to use homograft ossicles. In third world countries, such as South Africa, where ossicular prostheses are not always readily available due to financial constraints, the question arises as to whether we should be reconsidering the use of homograft ossicles. This review examines the risk of developing Creutzfeldt–Jakob disease or acquiring human immunodeficiency virus following the use of homograft ossicles during ossicular reconstruction, and discusses sterilization techniques that have proven effective in eradicating the human immunodeficiency virus and prions.

For decades, homograft ossicles have been used worldwide in otological surgery, especially in patients lacking suitable autograft ossicles. There has never been a reported case of transmission of the human immunodeficiency virus, and no cases of transmissible spongiform encephalopathy have been reported in the literature after otological surgery involving only the use of homograft ossicles. There have only been two documented otological cases of Creutzfeldt–Jakob disease; these involved the use of cadaveric dura mater and pericardium for tympanic membrane grafting. The human immunodeficiency virus is easily inactivated by simple sterilisation techniques, and there is a statistically insignificant risk of transmitting this virus if proper sterilisation protocols are followed.
Foreign body reaction mimicking a second primary tumour of the oesophagus
Authors: Pollock J , Beasley N
Published: October 2007

Objective:

To present a significant complication of pharyngolaryngeal reconstruction, which resulted in diagnostic confusion as it mimicked a second primary tumour of the head and neck.

Methods:

Case report and review of the world literature.

Case report:

A 61-year-old man developed a granulomatous foreign body reaction, mimicking a second primary tumour, at the distal end of a salivary bypass tube, following pharyngolaryngectomy and reconstruction using a tubed anterolateral thigh flap. Clinically and radiologically, this was felt to represent a second primary tumour of the oesophagus, but biopsies revealed full thickness inflammation of the mucosa and granulation tissue. Repeat oesophagoscopy two weeks after removal of the tube showed complete resolution.

Conclusion:

No record of an oesophageal foreign body reaction to a Montgomery salivary bypass tube has previously been reported in the world literature. This report highlights the potential for such a lesion to cause diagnostic confusion with a second primary tumour.
Ear packing after ear surgery: is it really necessary?
Authors: Borgstein J , de Zwart G , Bruce I A
Published: October 2007

Objective:

We question the need for packing of the ear canal after ear surgery. For several years, it had not been the first author's standard practice to use post-operative ear packing. During this period, few problems or complications had been encountered.

Setting:

Tertiary referral, academic, paediatric hospital.

Materials and methods:

A retrospective review of all children who had undergone major ear surgery in our unit over the last year was carried out. These cases represented a full range of otological procedures. Post-operative complications and infections in the first six post-operative weeks were recorded.

Results:

A total of 135 ears were operated upon in 107 patients ranging in age from 11 months to 19 years (mean 9.5 years). During this time period, eight children (7.5 per cent) developed a post-operative ear infection. No cases of tympanic or meatal granulations, problems with the tympanomeatal flap, or meatal stenosis were encountered. All infections were successfully managed with topical antibiotics.

Discussion:

We conclude that packing after ear surgery may be safely abandoned. This would not only save valuable operating time, but would also obviate the need for pack removal, always a source of discomfort and anxiety. This is especially important in children, who may subsequently require a further general anaesthesia in order to remove the pack.
Widespread infection of the Eastern red-spotted newt (Notophthalmus viridescens) by a new species of Amphibiocystidium, a genus of fungus-like mesomycetozoan parasites not previously reported in North America
Authors: RAFFEL T. R. , BOMMARITO T. , BARRY D. S. , WITIAK S. M. , SHACKELTON L. A.
Published: October 2007

Given the worldwide decline of amphibian populations due to emerging infectious diseases, it is imperative that we identify and address the causative agents. Many of the pathogens recently implicated in amphibian mortality and morbidity have been fungal or members of a poorly understood group of fungus-like protists, the mesomycetozoans. One mesomycetozoan, Amphibiocystidium ranae, is known to infect several European amphibian species and was associated with a recent decline of frogs in Italy. Here we present the first report of an Amphibiocystidium sp. in a North American amphibian, the Eastern red-spotted newt (Notophthalmus viridescens), and characterize it as the new species A. viridescens in the order Dermocystida based on morphological, geographical and phylogenetic evidence. We also describe the widespread and seasonal distribution of this parasite in red-spotted newt populations and provide evidence of mortality due to infection.
Gene expression profiling ofLeishmania (Leishmania) donovani: overcoming technical variation and exploiting biological variation
Authors: DECUYPERE S. , VANAERSCHOT M. , RIJAL S. , YARDLEY V. , MAES L. , DE DONCKER S. , CHAPPUIS F. , DUJARDIN J.-C.
Published: October 2007

Gene expression profiling is increasingly used in the field of infectious diseases for characterization of host, pathogen and the nature of their interaction. The purpose of this study was to develop a robust, standardized method for comparative expression profiling and molecular characterization ofLeishmania donovaniclinical isolates. The limitations and possibilities associated with expression profiling in intracellular amastigotes and promastigotes were assessed through a series of comparative experiments in which technical and biological parameters were scrutinized. On a technical level, our results show that it is essential to use parasite harvesting procedures that involve minimal disturbance of the parasite's environment in order to ‘freeze’ gene expression levels instantly; this is particularly a delicate task for intracellular amastigotes and for specific ‘sensory’ genes. On the biological level, we demonstrate that gene expression levels fluctuate duringin vitrodevelopment of both intracellular amastigotes and promastigotes. We chose to use expression-curves rather than single, specific, time-point measurements to capture this biological variation. Intracellular amastigote protocols need further refinement, but we describe a first generation tool for high-throughput comparative molecular characterization of patients' isolates, based on the changing expression profiles of promastigotes duringin vitrodifferentiation.
Expression ofPlasmodium falciparum3D7 STEVOR proteins for evaluation of antibody responses following malaria infections in naïve infants
Authors: SCHREIBER N. , KHATTAB A. , PETTER M. , MARKS F. , ADJEI S. , KOBBE R. , MAY J. , KLINKERT M.-Q.
Published: October 2007

Clinical immunity toPlasmodium falciparummalaria develops after repeated exposure to the parasite. At least 2P. falciparumvariant antigens encoded by multicopy gene families (varandrif) are targets of this adaptive antibody-mediated immunity. A third multigene family of variant antigens comprises thestevorgenes. Here, 4 differentstevorsequences were selected for cloning and expression inEscherichia coliand His6–tagged fusion proteins were used for assessing the development of immunity. In a cross-sectional analysis of clinically immune adults living in a malaria endemic area in Ghana, high levels of anti-STEVOR IgG antibody titres were determined in ELISA. A cross-sectional study of 90 nine-month-old Ghanaian infants using 1 recombinant STEVOR showed that the antibody responses correlated positively with the number of parasitaemia episodes. In a longitudinal investigation of 17 immunologically naïve 9-month-old infants, 3 different patterns of anti-STEVOR antibody responses could be distinguished (high, transient and low). Children with high anti-STEVOR-antibody levels exhibited an elevated risk for developing parasitaemia episodes. Overall, a protective effect could not be attributed to antibodies against the STEVOR proteins chosen for the study presented here.
Folding of a universal ribozyme: the ribonuclease P RNA
Authors: Baird Nathan J. , Fang Xing-Wang , Srividya Narayanan , Pan Tao , Sosnick Tobin R.
Published: October 2007

Ribonuclease P is among the first ribozymes discovered, and is the only ubiquitously occurring ribozyme besides the ribosome. The bacterial RNase P RNA is catalytically active without its protein subunit and has been studied for over two decades as a model system for RNA catalysis, structure and folding. This review focuses on the thermodynamic, kinetic and structural frameworks derived from the folding studies of bacterial RNase P RNA.
Linear stability analysis of the figure-eight orbit in the three-body problem
Authors: ROBERTS GARETH E.
Published: October 2007

We show that the well-known figure-eight orbit of the three-body problem is linearly stable. Building on the strong amount of symmetry present, the monodromy matrix for the figure-eight is factored so that its stability can be determined from the first twelfth of the orbit. Using a clever change of coordinates, the problem is then reduced to a 2×2 matrix whose entries depend on solutions of the associated linear differential system. These entries are estimated rigorously using only a few steps of a Runge–Kutta–Fehlberg algorithm. From this, we conclude that the characteristic multipliers are distinct and lie on the unit circle. The methods and results presented are applicable to a wide range of Hamiltonian systems containing symmetric periodic solutions.
Non-standard smooth realizations of Liouville rotations
Authors: FAYAD B. R. , SAPRYKINA M. , WINDSOR A.
Published: October 2007

We augment the $C^\infty $ conjugation approximation method with explicit estimates on the conjugacy map. This allows us to construct ergodic volume-preserving diffeomorphisms measure-theoretically isomorphic to any a priori given Liouville rotation on a variety of manifolds. In the special case of tori the maps can be made uniquely ergodic.
On the rigidity of quasiconformal Anosov flows
Authors: FANG YONG
Published: October 2007

We develop further our study of quasiconformal Anosov flows in our previous (Y. Fang. Smooth rigidity of uniformly quasiconformal Anosov flows. Ergod. Th. & Dynam. Sys.24 (2004), 1–23). For example, we prove the following result: Let φ be a transversely symplectic Anosov flow with dim  Ess≥2 and dim  Esu≥2. If φ is quasiconformal, then it is, up to finite covers, $C^\infty $ orbit equivalent either to the suspension of a symplectic hyperbolic automorphism of a torus or to the geodesic flow of a closed hyperbolic manifold.
The zero angular momentum, three-body problem: All but one solution has syzygies
Authors: MONTGOMERY RICHARD
Published: October 2007

A syzygy in the three-body problem is a collinear instant. We prove that, with the exception of Lagrange’s solution, every solution to the zero angular momentum, Newtonian three-body problem suffers syzygies. The proof works for all mass ratios.
On the total disconnectedness of the quotient Aubry set
Authors: SORRENTINO ALFONSO
Published: October 2007

In this paper we show that the quotient Aubry set, associated to a sufficiently smooth mechanical or symmetrical Lagrangian, is totally disconnected (i.e. every connected component consists of a single point). This result is optimal, in the sense of the regularity of the Lagrangian, as Mather’s counterexamples (J. N. Mather. Examples of Aubry sets. Ergod. Th. & Dynam. Sys.24(5) (2004), 1667–1723) show. Moreover, we discuss the relation between this problem and a Morse–Sard-type property for (the difference of) critical subsolutions of Hamilton–Jacobi equations.
Optimal arrest and guidance of a moving prismatic object using multiagents
Authors: Sharma Pankaj , Saxena Anupam , Dutta Ashish
Published: October 2007

Genetic algorithm is used to determine the optimal capture points for the multi agents required to grasp a moving generic prismatic object by arresting it in form closure. Thereafter, the agents approach their respective moving goals using a decentralized projective path planning algorithm. Post arrest, the object is guided along a desired linear path to a desired goal point. Form closure of the object is obtained using the concept of accessibility angle. A convex envelop is formed around the object, and the goal points on the object boundary are mapped onto the envelope. The robots approach the mapped goal points first, and then, converge on the actual object. This ensures that the agents reach the actual goal points almost simultaneously, and do not undergo looping at a local concave region. The object is assumed alive while being captured but is assumed compromised thereafter. Post arrest, robots alter their positions optimally around the object to transport it along a desired direction. Frictionless point contact between the object and a robot is assumed. The shape of the mobile robot is considered cylindrical such that it can only apply force along the outward radial direction. Simulation results are presented that illustrate the effectiveness of the proposed method.
Adaptation of microbial communities in soil contaminated with polychlorinated biphenyls, leading to the transformation of more highly chlorinated congeners in biofilm communities
Authors: Macedo A. J. , Neu T. R. , Kuhlicke U. , Abraham W.-R.
Published: October 2007

A site polluted for many years with polychlorinated biphenyls (PCB) was used to elucidate the metabolic adaptation of microbial communities to these xenobiotics. Soil samples taken along a gradient of PCB-pollution at this site were used to grow biofilm communities on PCB oil. The biofilm communities originating from the non-polluted soil formed rather uniform and thin bacterial layers on PCB oil, while the biofilms originating from contaminated soil samples formed agglomerated structures on the PCB droplets. Biofilm communities were very diverse but those from highly polluted soil were dominated byBurkholderiaspecies, a genus known for degrading several PCBs. All biofilm communities could transform low to medium chlorinated PCB congeners but a strong increase in the rate and degree of PCB transformation in communities from heavily polluted soil was observed. Notably, pentachlorinated congeners were transformed only by biofilms derived from the highly polluted soil but at the same time the content of trichlorinated congeners did not decrease. It is assumed that biofilms from the highly contaminated soil reductively dechlorinated PCB, converting pentachlorinated congeners to trichlorinated congeners in the spherical biofilm aggregates by diffusing to the surface of the aggregates, where aerobic transformation took place.
Aussteigen oder Durchhalten
Authors: Schiefele Ulrich , Streblow Lilian , Brinkmann Julia
Published: October 2007

Zusammenfassung. In der vorliegenden längsschnittlichen Studie wurden Studienabbrecher mit Weiterstudierenden hinsichtlich einer Reihe relevanter Merkmale verglichen. Im Vordergrund standen motivationale Variablen, Aspekte des Selbstkonzepts, Lernstrategien, soziale Kompetenz, Wahrnehmung der Lehrqualität, epistemologische Überzeugungen und die Finanzierung des Studiums. Die Stichprobe setzte sich aus 47 Studienabbrechern (26 Frühabbrecher, 21 Spätabbrecher) und einer Gruppe von 94 parallelisierten Weiterstudierenden zusammen. Die Ergebnisse zeigen Folgendes: (1) Studienabbrecher unterscheiden sich von Weiterstudierenden vor allem hinsichtlich motivationaler Merkmale, der wahrgenommenen Lehrqualität, des selbsteingeschätzten Kenntnisstands, des Strategieeinsatzes und der sozialen Kompetenz im Studium. (2) Die Unterschiede zwischen Studienabbrechern und Weiterstudierenden sind zu Studienbeginn geringer ausgeprägt als zum Abbruchzeitpunkt. (3) Die Spätabbrecher unterscheiden sich stärker von den Weiterstudierenden als die Frühabbrecher.
Full‐scale observations of wave‐induced vortex generation over a rippled bed
Authors: Nichols C. S. , Foster D. L.
Published: October 2007

Our understanding of vortex generation over rippled beds is largely based on small‐scale laboratory studies. The insight provided by such studies has been considerable, although questions remain regarding the applicability to the field. This paper presents observations from a full‐scale investigation of wave‐induced vortex generation events over a movable sediment bed. Observations of the two‐dimensional time varying velocity field were obtained with a submersible Particle Image Velocimetry (PIV) system in a field‐scale, experimental environment at the O. H. Hinsdale Wave Research Laboratory. The observations were obtained over an irregularly rippled bed with ripple height and wavelength of roughly 0.01 m and 0.1 m, respectively. The vortices generated during offshore directed flow over the steeper bed form slope were regularly ejected into the water column and were consistent with conceptual models of the oscillatory flow over a backward facing step. The observations allowed for an examination of the generation and subsequent ejection of individual vortical structures. Vortical structures are identified with a measure of the flow field that estimates the time for a complete revolution of a vortex called swirling strength. An analysis of these structures reveals that the swirling strength nondimensionalized by the wave period is correlated to the Keulegan‐Carpenter. These results offer new insight into fluid sediment interaction over rippled beds.
On the inversion of polarity of the electric field at very close range from a tower struck by lightning
Authors: Mosaddeghi A. , Pavanello D. , Rachidi F. , Rubinstein M.
Published: October 2007

In this paper, we show that the electric field generated by a lightning return stroke to a tall structure can change polarity at very close distance range, typically at distances of about one tenth the height or so of the struck object. This change in the polarity seems to be a specific signature of the very close vertical electric field. Two different theoretical explanations of such an inversion of polarity are given, the first based on general field equations for a perfectly conducting ground and the second based on the equation derived by Baba and Rakov (2005a) for the case when the return stroke wavefront speed is assumed to be equal to the speed of light and the reflection coefficient at the top of the tall structure is zero. A simple equation is derived which provides an estimate of the critical distance below which such an inversion of polarity might occur. It is also shown that the inversion of polarity depends on the value of the reflection coefficient at the base of the tower and disappears for reflection coefficients close to 1. On the other hand, other parameters such as the return stroke speed, the reflection coefficient at the top of the strike object, and the adopted return stroke model seem not to have an impact on the inversion of polarity. The need of obtaining experimental data on electromagnetic fields at very close range to a tower struck by lightning is emphasized in order to confirm the theoretical finding.