bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of choice and relative frequency elicitation on overconfidence: further tests of an exemplar‐retrieval model
Authors: Sieck Winston R.
Published: March 2003

An experiment is reported in which participants rendered judgments regarding the disease states of hypothetical patients. Participants either reported likelihoods that patients had the target disease (no choice), or classified patients into disease categories and then reported likelihoods that their classifications were correct (choice included). Also, participants' likelihood judgments were made in response to either a probability probe question, or a relative frequency probe. Two distinct exemplar‐memory models were compared on their ability to predict overconfidence under these procedures. Both propose that people learn and judge by storing and retrieving examples. The exemplar retrieval model (ERM) proposes that amount of retrieval drives choice inclusion and likelihood probe effects. The alternative model assumes that response error mediates choice inclusion effects. Choice inclusion and the relative frequency probe reduced overconfidence, but the combined effects were subadditive. Only the ERM predicted this pattern, and it further provided good quantitative fits to these results. Copyright © 2003 John Wiley & Sons, Ltd.
Reasonable reasons for waiting
Authors: Tykocinski Orit E. , Ruffle Bradley J.
Published: March 2003

Recent decision‐making research claims to establish that, in violation of Savage's normative sure‐thing principle, individuals often wait to acquire noninstrumental information and subsequently base their decisions upon this information. The current research suggests that characterizing individuals as pursuing noninstrumental or useless information may be overstated. Through a series of experiments we establish, first, that many people choose to wait, even when waiting provides no additional information at all. Second, the longer people are allowed to wait before having to decide, the more people prefer to wait rather than decide immediately. Third, those individuals who choose to wait are the ones less confident about committing themselves to a decision. For them, the benefit from waiting may be especially valuable by allowing them to come to terms with a less‐than‐ideal decision. Copyright © 2003 John Wiley & Sons, Ltd.
Effect of freezing and thawing rates on denaturation of proteins in aqueous solutions
Authors: Cao Enhong , Chen Yahuei , Cui Zhanfeng , Foster Peter R.
Published: March 2003

The freeze denaturation of model proteins, LDH, ADH, and catalase, was investigated in absence of cryoprotectants using a microcryostage under well‐controlled freezing and thawing rates. Most of the experimental data were obtained from a study using a dilute solution with an enzyme concentration of 0.025 g/l. The dependence of activity recovery of proteins on the freezing and thawing rates showed a reciprocal and independent effect, that is, slow freezing (at a freezing rate about 1°C/min) and fast thawing (at a thawing rate >10°C/min) produced higher activity recovery, whereas fast freezing with slow thawing resulted in more severe damage to proteins. With minimizing the freezing concentration and pH change of buffer solution by using a potassium phosphate buffer, this phenomenon could be ascribed to surface‐induced denaturation during freezing and thawing process. Upon the fast freezing (e.g., when the freezing rate >20°C/min), small ice crystals and a relatively large surface area of ice–liquid interface are formed, which increases the exposure of protein molecules to the ice–liquid interface and hence increases the damage to the proteins. During thawing, additional damage to proteins is caused by recrystallization process. Recrystallization exerts additional interfacial tension or shear on the entrapped proteins and hence causes additional damage to the latter. When buffer solutes participated during freezing, the activity recovery of proteins after freezing and thawing decreased due to the change of buffer solution pH during freezing. However, the patterns of the dependence on freezing and thawing rates of activity recovery did not change except for that at extreme low freezing rates (<0.5°C/min). The results exhibited that the freezing damage of protein in aqueous solutions could be reduced by changing the buffer type and composition and by optimizing the freezing–thawing protocol. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 82: 684–690, 2003.
Methodology for real‐time, multianalyte monitoring of fermentations using an in‐situ mid‐infrared sensor
Authors: Kornmann Henri , Rhiel Martin , Cannizzaro Christopher , Marison Ian , von Stockar Urs
Published: March 2003

An in‐situ, mid‐infrared sensor was used to monitor the major analyte concentrations involved in the cultivation of Gluconacetobacter xylinus and the production of gluconacetan, a food‐grade exopolysaccharide. To predict the analyte concentrations, three different sets of standard spectra were used to develop calibration models, applying partial least‐squares regression. It was possible to build a valid calibration model to predict the 700 spectra collected during the complete time course of the cultivation, using only 12 spectra collected every 10 h as standards. This model was used to reprocess the concentration profiles from 0 to 15 g/L of nine different analytes with a mean standard error of validation of 0.23 g/L. However, this calibration model was not suitable for real‐time monitoring as it was probably based on non‐specific spectral features, which were correlated only with the measured analyte concentrations. Valid calibration models capable of real‐time monitoring could be established by supplementing the set of 12 fermentation spectra with 42 standards of measured analytes. A pulse of 5 g/L ethanol showed the robustness of the model to sudden disturbances. The prediction of the models drifted, however, toward the end of the fermentation. The most robust calibration model was finally obtained by the addition of 34 standard spectra of non‐measured analytes. Although the spectra did not contain analyte‐specific information, it was believed that this addition would increase the variability space of the calibration model. Therefore, an expanded calibration model containing 88 spectra was used to monitor, in real time, the concentration profiles of fructose, acetic acid, ethanol and gluconacetan and allowed standard errors of prediction of 1.11, 0.37, 0.22, and 0.79 g/L, respectively. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 82: 702–709, 2003.
Bio‐mimetic hydrogen production from polysaccharide using the visible light sensitization of zinc porphyrin
Authors: Saiki Yoshinobu , Amao Yutaka
Published: March 2003

A biohydrogen production system coupling the polysaccharide such as sucrose and maltose degradation with invertase and glucose dehydrognase (GDH) and hydrogen production with colloidal platinum as hydrogen‐evolved catalyst using the visible light‐induced photosensitization of water‐soluble zinc porphyrin, zinc tetraphenylporphyrin tetrasulfonate (ZnTPPS) has been investigated. Continuous hydrogen gas production was observed when the sample solution containing polysaccharide, invertase, GDH, nicotinamide adenine dinucreotide (NAD+), ZnTPPS, methylviologen (an electron relay reagent), and colloidal platinum was irradiated by visible light. After 240‐min irradiation, the amount of hydrogen production in the system using sucrose and maltose was estimated to be 3.1 and 0.35 μmol, respectively. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 82: 710–714, 2003.
Competition strategies for the decolorization of a textile‐reactive dye with the white‐rot fungi Trametes versicolor under non‐sterile conditions
Authors: Libra Judy A. , Borchert Maren , Banit Salima
Published: March 2003

A variety of white‐rot fungi can oxidize textile dyes under sterile conditions; however, an important consideration for their use in treating wastewater containing textile dyes is whether similar degrees of treatment can be achieved under non‐sterile conditions. Four strategies were investigated for their potential in optimizing the use of the fungus Trametes versicolor in non‐sterile culture for treating wastewater containing the diazo textile dye C.I. Reactive Black 5 (RB5). Three strategies with suspended culture were designed to increase the decolorization activity in suspended culture from a given amount of T. versicolor inoculum based on its tolerance of low pH (pH reduction in medium), production of extracellular enzymes (use of suspended enzymes alone), and its ability to produce enzymes independent of growth (nitrogen limitation in medium). The results showed that reduction of the medium pH to 3 did not suppress bacterial growth, while enzyme production by T. versicolor ceased. The use of the extracellular enzymes alone would allow the decoupling of the process of fungal growth from wastewater treatment; however, the enzyme activity of an enzyme suspension decreased rapidly under non‐sterile conditions. The strategy of limiting nitrogen in the medium to suppress bacterial growth has potential together with the fourth strategy, the cultivation of fungi on organic solids to produce inocula for a decolorization process under non‐sterile conditions. A high degree of decolorization of RB5 under non‐sterile conditions was achieved with T. versicolor grown on grains as sole substrate. The rate of decolorization was dependent on the amount of fungal inoculum used. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 82: 736–744, 2003.
Value of the Van Nuys Prognostic Index in prediction of recurrence of ductal carcinoma in situ after breast-conserving surgery
Authors: Boland G P , Chan K C , Knox W F , Roberts S A , Bundred N J
Published: April 2003

Background

The Van Nuys Prognostic Index (VNPI), an algorithm based on tumour size, tumour grade, presence of necrosis and excision margin width, is claimed to predict local recurrence after breast-conserving surgery for ductal carcinoma in situ (DCIS). The aim of this study was to examine the validity of the VNPI in a UK population.

Methods

Clinicopathological data, including VNPI subgroups, for 237 patients who had breast-conserving operations for DCIS were examined. Multivariate data analysis was performed using a Cox regression model to examine the independence and relative importance of different variables in predicting recurrence, and to compare the data with those used in derivation of the VNPI.

Results

The median follow-up was 47 months. There were 37 ipsilateral local recurrences. Excision margin width (P < 0·001) and tumour grade (by Van Nuys grading (P = 0·014) or simple nuclear grading (P = 0·004)) were the only independent risk factors for local recurrence. Excision margin width had three times more power than grade in predicting local recurrence. Subgrouping data by VNPI score predicted recurrence-free survival (P < 0·001), but stratified 78 per cent of patients into a group with a moderate risk of local recurrence.

Conclusion

Excision margin width is the most important predictor of local recurrence after breast-conserving surgery for DCIS. The VNPI lacked discriminatory power for guiding further patient management.
Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer
Authors: Rullier E , Sa Cunha A , Couderc P , Rullier A , Gontier R , Saric J
Published: April 2003

Background

The feasibility of laparoscopic rectal resection in patients with mid or low rectal cancer was studied prospectively with regard to quality of mesorectal excision, autonomic pelvic nerve preservation and anal sphincter preservation.

Methods

Laparoscopic rectal excision was performed in 32 patients (21 men) with rectal carcinoma located 5 cm from the anal verge. Most patients had T3 disease and received preoperative radiotherapy. The surgical procedure was performed 6 weeks after radiotherapy and included total mesorectal excision, intersphincteric resection, transanal coloanal anastomosis with coloplasty and loop ileostomy.

Results

Three patients needed conversion to a laparotomy. Postoperative morbidity occurred in ten patients, related mainly to coloplasty. Macroscopic evaluation showed an intact mesorectal excision in 29 of 32 excised specimens; microscopically, 30 of the 32 resections were R0. Sphincter preservation was achieved in 31 patients. The hypogastric nerves and pelvic plexuses were identified and preserved in 24 of the 32 patients. Sexual function was preserved in ten of 18 evaluable men.

Conclusion

A laparoscopic approach can be considered in most patients with mid or low rectal cancer.
Segmental nature of the porcine liver and its potential as a model for experimental partial hepatectomy
Authors: Court F G , Wemyss-Holden S A , Morrison C P , Teague B D , Laws P E , Kew J , Dennison A R , Maddern G J
Published: April 2003

Background

In-depth knowledge of pig liver anatomy allows potential research into segmental liver resections and hepatic regeneration, as well as liver transplantation techniques. The segmental anatomy, however, remains largely unknown. This study aimed to delineate the segmental anatomy of the porcine liver in comparison with that of the human.

Methods

The segmental anatomy of the porcine liver was determined using acrylic injection casting of ex vivo pig livers, allowing the arterial, venous and biliary supply to be visualized directly. This was correlated using multi-slice computed tomography (CT) and three-dimensional reconstructions.

Results

Although the external morphology of the porcine liver differs from that of the human, the segmental anatomy is remarkably similar in term of its vascularity and biliary tree.

Conclusion

Acrylic casting of the porcine liver accurately delineates the vascular and biliary anatomy, and is a useful tool for performing experimental liver surgery. The similarities between porcine and human segmental anatomy allow domestic swine to be used as a comparable model. Three-dimensional CT reconstructions can also accurately visualize the anatomy and may be used to perform virtual surgery, or to assess segmental volumes.
Use of hyperbaric oxygen to treat chronic anal fissure
Authors: Cundall J D , Gardiner A , Laden G , Grout P , Duthie G S
Published: April 2003

A novel if expensive treatment for chronic fissure
Registration and validity of surgical complications in colorectal cancer surgery
Authors: Gunnarsson U , Seligsohn E , Jestin P , Påhlman L
Published: April 2003

Background

Population-based quality registers have become an important tool in quality assessment during the past decade. For registers to be reliable, however, data must be checked carefully for validity.

Methods

The present study describes the validity of surgical complications registered in a national register run by the National Board of Health and Welfare (NBH), a register run by Regional Oncological Centres (ROC) and, for comparison, a local quality assurance system at Uppsala University Hospital (UUH). A specialized, independent surgeon checked 10 per cent of patient records against datasheets from the registers.

Results

The local quality assurance system at UUH showed the best validity for surgical complications. Data for complications of colonic cancer surgery were more valid than those for rectal cancer surgery. Registration of serious complications was more valid than that of wound infections. The calculated proportion of missed surgical complications was 0·69, 0·64, 0·40, 0·22 and 0·07 for rectal and colonic cancer in the NBH register, rectal and colonic cancer in the ROC register, and the UUH register respectively. Corresponding figures for reoperation were 0·45, 0·48, 0·04, 0·09 and 0·21.

Conclusion

Local interest and routine use of data for quality assurance are crucial factors for valid registers. Careful monitoring of validity is necessary for use of registry data in structured systems for improvement of surgical results.
Experimental model to estimate intestinal viability using charge-coupled device microscopy
Authors: Yasumura M , Mori Y , Takagi H , Yamada T , Sakamoto K , Iwata H , Hirose H
Published: April 2003

Background

Intraoperative assessment of intestinal viability following release of strangulation remains difficult. The aim of this study was to establish clinical standards for the evaluation of intestinal viability by charge-coupled device (CCD) microscopy.

Methods

A rat ileus model with strangulation for between 15 and 120 min was used. The images obtained by CCD microscopy were used to calculate maximum velocity (Vmax) ratio (ratio of Vmax of blood cell transition in the experimental segment to that in the reference segment) and S ratio (the ratio of S—the effective area of the vascular bed against the total area of the vascular bed—in the experimental segment to that in the reference segment). Rats were divided into group 1, comprising animals that survived for 7 days or more, and group 2, which consisted of animals that died within 4 days.

Results

V max ratio and S ratio in group 1 were both significantly higher than those in group 2 (P < 0·01). No death occurred at a Vmax ratio of 0·76 or higher and an S ratio of 0·61 or more, while there were no survivors with a Vmax ratio of 0·54 or less and an S ratio of 0·51 or less.

Conclusion

V max ratio and S ratio could be used as indices for evaluation of intestinal viability.
Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery
Authors: Gendy R K , Able J A , Rainsbury R M
Published: April 2003

Background

The aim of this study was to compare the outcomes of skin-sparing mastectomy (SSM) with immediate myocutaneous flap reconstruction and partial mastectomy with latissimus dorsi miniflap reconstruction (LDMF) for breast cancer.

Methods

Some 106 disease-free patients (57 SSM, 49 LDMF) who had breast reconstruction between 1991 and 1999 participated in this retrospective review. The mean duration of follow-up was 42 (range 6–102) months. Measured outcomes included surgical complications, functional disability, cosmetic result and psychological morbidity.

Results

SSM outcomes were less favourable than LDMF outcomes with regard to postoperative complications (14 versus 8 per cent), further surgical interventions (79 versus 12 per cent), nipple sensory loss (98 versus 2 per cent), restricted activities (73 versus 54 per cent) and cosmetic outcome by panel assessment. Anxiety about residual cancer and ease of breast self-examination were similar in both groups.

Conclusion

LDMF was associated with fewer adverse surgical and physical sequelae than SSM, without compromising local control or cosmetic outcome. Both operations were associated with low psychological morbidity.
Comparison of POSSUM scoring and the Hardman Index in selection of patients for repair of ruptured abdominal aortic aneurysm
Authors: Neary W D , Crow P , Foy C , Prytherch D , Heather B P , Earnshaw J J
Published: April 2003

Background

The aim was to assess to what extent the POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) and Hardman scoring systems were predictive of outcome after surgery for ruptured abdominal aortic aneurysm (RAAA).

Methods

From January 1990 to December 2001, 232 patients presented with RAAA. Forty-one were treated conservatively and all died; the remainder had emergency surgery. The case notes of all but three of these patients were reviewed retrospectively. POSSUM and Hardman scores were calculated and related to mortality.

Results

The mortality rate after emergency repair was 54 per cent (104 of 191). The physiology-only POSSUM score specific for RAAA and the Hardman Index score were both significantly associated with increased mortality after operation (P < 0·001). Most non-operated patients were in the highest risk bands.

Conclusion

Both POSSUM and Hardman scoring systems predicted outcome after emergency surgery for RAAA. The Hardman Index was simpler to calculate, but POSSUM identified a higher number of patients at risk. Risk scoring may help identify patients with RAAA for whom surgery is futile.
Heat preconditioning prevents oxidative stress-induced damage in the intestine and lung following surgical manipulation
Authors: Thomas S , Pulimood A , Balasubramanian K A
Published: April 2003

Background

The intestine is increasingly recognized as a primary effector of distant organ damage, such as lung, following abdominal surgery. Surgical manipulation of the intestine generates oxygen free radicals resulting in mucosal damage. Heat preconditioning has been proposed to prevent various stress-induced alterations in cells and tissues, including oxidative stress. This study examined the effect of heat preconditioning on oxidative stress-induced damage to the intestine and lung, following surgical manipulation.

Methods

Control rats and rats pretreated with heat were subjected to surgical manipulation by opening the abdominal wall and handling the intestine as done during laparotomy. Intestine and lung were assessed for damage by histology and markers of oxidative stress.

Results

Surgical manipulation resulted in ultrastructural changes in the intestine. Biochemical alterations in the enterocytes were evident, with increased xanthine oxidase activity resulting in production of superoxide anion and with a decrease in antioxidant status. Gut manipulation also resulted in neutrophil infiltration and oxidative stress in the lung as assessed by histology, myeloperoxidase activity, lipid peroxidation and antioxidant status. Heat conditioning before surgical manipulation had a protective effect against this intestinal and lung damage.

Conclusion

This study suggests that mild whole-body hyperthermia before surgery might offer protection from postoperative complications.
Pelvic connective tissue resilience decreases with vaginal delivery, menopause and uterine prolapse
Authors: Reay Jones N H J , Healy J C , King L J , Saini S , Shousha S , Allen-Mersh T G
Published: April 2003

Background

The late onset of pelvic visceral prolapse and incontinence after childbirth injury could be explained by menopause-associated connective tissue weakening. Uterosacral ligament resilience (UsR) was assessed to determine whether it influenced uterine or pelvic floor mobility, or varied with age, vaginal delivery, menopause or histological variations in the ligament.

Methods

UsR was measured by tensiometry in ligaments from 85 hysterectomy specimens, and was correlated with the presence of symptomatic uterocervical prolapse, prehysterectomy uterine and anorectal mobility, patient age, history of vaginal delivery and menopause. Forty-five of these ligaments were examined for ligament thickness, muscle to collagen ratio, and oestrogen and progesterone receptor density. The results were correlated with UsR.

Results

UsR was significantly reduced (P = 0·02) in symptomatic uterovaginal prolapse, but there was no correlation with either uterocervical or anorectal descent in women without symptomatic prolapse. There was a significant decrease in UsR with vaginal delivery (P = 0·003), menopause (P = 0·009) and older age (P = 0·005). The uterosacral ligament was significantly thinner and contained fewer oestrogen and progesterone receptors after menopause, but this did not affect UsR.

Conclusion

Where pelvic floor muscles are weakened, decreases in pelvic connective tissue resilience related to the menopause may facilitate progression to symptomatic pelvic visceral prolapse.
Preoperative fasting
Authors: Ljungqvist O , Søreide E
Published: April 2003

Background and methods

To avoid pulmonary aspiration, fasting after midnight has become standard in elective surgery, but recent studies have found no scientific support for this practice. Several anaesthesia societies now recommend a 2-h preoperative fast for clear fluids and a 6-h fast for solids in most elective patients. The literature supporting such fasting recommendations was reviewed.

Results

The recommendations are safe and improve well-being before operation, mainly by reducing thirst. A carbohydrate-rich beverage given before anaesthesia and surgery alters metabolism from the overnight fasted to the fed state. This reduces the catabolic response (insulin resistance) after operation, which may have implications for postoperative recovery.

Conclusion

Most patients having elective operations can be allowed a free intake of clear fluids up to 2 h before anaesthesia. Preoperative carbohydrates reduce postoperative insulin resistance.
Extracorporeal shockwave lithotripsy in the management of salivary calculi
Authors: Escudier M P , Brown J E , Drage N A , McGurk M
Published: April 2003

Background

The aim was to investigate the results of extracorporeal shockwave lithotripsy in the management of salivary calculi using a dedicated sialolithotriptor.

Methods

Some 122 salivary calculi (84 submandibular and 38 parotid) were treated in an experimental study using a sialolithotriptor.

Results

Complete success was achieved in 40 procedures (33 per cent), 27 of 84 submandibular and 13 of 38 parotid calculi. A further 43 patients (35 per cent) were rendered asymptomatic although some stone debris remained in the duct (26 submandibular and 17 parotid). Failure (retention of stone debris and continued symptoms) occurred in 39 patients (32 per cent), 30 submandibular and eight parotid glands. The chance of failure increased with the size of the calculus and increasing duration of symptoms.

Conclusion

Extracorporeal shockwave lithotripsy provides a useful option for the management of salivary calculi, particularly for stones less than 7 mm in diameter.
Multiple endocrine neoplasia type 1
Authors: Skogseid B
Published: April 2003

Rare and unpredictable
The need for targeted research into breast cancer in the elderly
Authors: Wyld L , Reed M W R
Published: April 2003

Background

Breast cancer is a major source of morbidity and mortality in elderly women. Despite this, many trials on which clinical practice is based have under-represented the elderly. Consequently there is little evidence to guide best practice in this age group.

Methods

A search of the major literature databases was performed using the search terms ‘breast cancer’ and ‘elderly’. Articles relevant to the treatment of breast cancer in the elderly were selected.

Results

The elderly receive less aggressive treatment for breast cancer compared with younger patients. Primary endocrine therapy is sometimes substituted for operation, and axillary surgery, adjuvant chemotherapy and adjuvant radiotherapy are commonly omitted. Evidence for and against such treatment strategies is inadequate, making it difficult to determine what constitutes best practice.

Conclusion

There is a need for research to be targeted at the older age group of patients with breast cancer to enable the development of specific treatment guidelines.
Familial pancreatic cancer
Authors: Bartsch D K
Published: April 2003

Screening advocated
Management of severe acute pancreatitis
Authors: Yousaf M , McCallion K , Diamond T
Published: April 2003

Background

Acute pancreatitis is still associated with significant morbidity and mortality. Current management guidelines are sometimes equivocal, particularly in relation to the surgical treatment of severe disease. This review assesses available investigative and treatment strategies to allow the development of a formalized management approach.

Methods

A literature review of diagnosis, staging and management of acute pancreatitis was performed.

Results and conclusion

Recent evidence has helped to clarify the roles of computed tomography, endoscopic retrograde cholangiopancreatography, prophylactic antibiotics, enteral feeding and fine-needle aspiration for bacteriology in the management of acute pancreatitis. Despite a relative shortage of prospective randomized trials there has been a significant change in the surgical management of acute pancreatitis over the past 20 years. This change has been away from early aggressive surgical intervention towards more conservative management, except when infected necrosis is confirmed. A formalized approach, with appropriate use of the various non-surgical and surgical options, is feasible in the management of severe acute pancreatitis.
Bilateral tentorial sinus drainage of the basal vein (of Rosenthal)
Authors: San Millán Ruíz Diego , Fasel Jean H.D. , Reverdin Alain , Gailloud Philippe
Published: March 2003

We report a case of bilateral collateral tentorial venous sinus drainage of the basal vein (of Rosenthal) (BV). The observation was made on a corrosion cast of the cerebral venous system obtained from a fresh cadaver. Radiographic correlation was obtained by performing standard X‐ray imaging of the corrosion cast. Embryologic and clinical considerations are discussed. Clin. Anat. 16:264–268, 2003. © 2003 Wiley‐Liss, Inc.
Isomerism of the right atrial appendages: Clinical, anatomical, and microscopic study of a long‐surviving case with asplenia and ciliary abnormalities
Authors: Raman R. , Al‐Ali S.Y. , Poole C.A. , Dawson B.V. , Carman J.B. , Calder L.
Published: March 2003

This study describes a case of isomerism of the right atrial appendages (bilateral morphologically right atrial appendages associated with complex congenital cardiac lesions) with ciliary abnormalities. Detailed investigation included gross anatomic dissection, review of the clinical history, and light, confocal, and electron microscopy. Clinically, this 40‐year‐old, long‐surviving male patient had relatively good health until 4 years before death, which was due to cardiac failure. Surgical intervention consisted only of a Blalock‐Taussig shunt (anastomosis of the right subclavian artery to the right pulmonary artery) at 6 years of age. Despite the presence of complex cardiac malformations and asplenia, his longevity may be attributed to the connection of the pulmonary veins to the atrium without pulmonary venous obstruction, pulmonary valvar stenosis rather than atresia, no significant atrioventricular valve regurgitation, and no serious infections during his life. Microscopic examination of bronchial epithelium revealed a narrow, disorganized epithelium with abundant goblet cells and short, angulated cilia with a random orientation and possibly an abnormal central microtubule doublet. These abnormalities were not present in controls, and have been noted in primary ciliary dyskinesia (PCD) or Kartagener's syndrome. Because this syndrome has classically been thought to cause random lateralization resulting in a mirror‐imaged arrangement of the organs, the occurrence of truly isomeric patterns is not widely recognized. Whereas polysplenia and left bronchial isomerism have been reported to occur in immotile cilia syndrome, this is the first report to present detailed postmortem anatomic evidence of isomerism of the right atrial appendages, right bronchial isomerism, and asplenia in association with microscopy suggesting ciliary abnormalities. Clin. Anat. 16:269–276, 2003. © 2003 Wiley‐Liss, Inc.
Lateral arm flap: Analysis of its anatomy and modification using a vascularized fragment of the distal humerus
Authors: Hennerbichler A. , Etzer C. , Gruber S. , Brenner E. , Papp C. , Gaber O.
Published: March 2003

Soft tissue injuries with associated bone defects are difficult to manage and often require prolonged treatment with repeated interventions. Frequently, a free flap is applied as a first step and bone grafting is carried out in a second procedure. Ideally, these two procedures are combined in one operation, utilizing a soft tissue flap with an attached vascularized bone fragment. The lateral arm flap can provide such an osteoseptocutaneous flap and has been utilized clinically with success; however, the vascular anatomy of the flap, especially the humeral fragment, has not been described in detail previously, and there is broad disagreement concerning its innervation. In this study, the arteries and nerves of 24 fresh cadaver arms were dissected after injection of colored latex. The levels of origin of the periosteal arteries of the humerus were also documented. The lateral arm flap has a consistent arterial supply from three septocutaneous perforating branches that are arranged in a predictable pattern. The lateral supracondylar ridge of the humerus is vascularized by direct branches of the posterior branch of the radial collateral artery and by arteries that arise from muscular branches supplying adjacent muscles. The innervation of the lateral arm flap is by the inferior lateral cutaneous nerve of the arm. Knowledge of the consistent vascular anatomy of the lateral humerus and soft tissue of the donor site allows an osteoseptocutaneous flap to be raised safely with an appropriate technique. We recommend use of the lateral arm flap with a humeral fragment for the treatment of combined soft tissue and bone defects when a single step surgical solution is indicated. Clin. Anat. 16:204–214, 2003. © 2003 Wiley‐Liss, Inc.
Comparison of human and porcine aortic valves
Authors: Sim Eugene K.W. , Muskawad Sanjeev , Lim Chu‐Sing , Yeo Joon Hock , Hiang Lim Khee , Grignani Robert T. , Durrani A. , Lau Gilbert , Duran Carlos
Published: March 2003

We compared the anatomy of human and porcine aortic valves. Porcine hearts were collected from the abattoir. Human hearts from patients who had died of non‐cardiac causes were examined in the mortuary; only undamaged and anatomically normal hearts were used. Silicon casts were prepared by injecting engineering silicon at 80 mm Hg into the aortic arch. Various features of the aortic valve were measured: circumference, length between the commissural end point and central point of coaptation, surface diameter, and surface area. In total, 12 porcine and 12 human aortic valves were studied. The average circumferences of the human and porcine aortic valves were 8.00 ± 0.2 (SD) cm and 7.90 ± 1.0 cm, respectively. The central point of coaptation in human valves was skewed toward the left coronary cusp, whereas in porcine valves it was skewed toward the non‐coronary cusp. In human aortic valves, the non‐coronary cusp had the largest surface diameter and surface area with mean measurements of 3.6 ± 0.2 cm and 1.230 ± 0.228 cm2, respectively; the left coronary cusp was smallest for the same variables with measurements of 3.1 ± 0.3 cm and 0.898 ± 0.357 cm2. In porcine valves, the right coronary cusp had the largest surface diameter and surface area with mean measurements of 3.9 ± 0.7 cm and 1.716 ± 0.81 cm2, respectively; the non‐coronary cusp was the smallest for the same variables with measurements of 2.9 ± 0.5 cm and 1.023 ± 0.659 cm2. These differences suggest that when using porcine valves as transplant material (e.g., stentless valves), geometric considerations, such as commissural length, may be important. Clin. Anat. 16:193–196, 2003. © 2003 Wiley‐Liss, Inc.
Interprofessional education: a curriculum response to work with children and young people
Authors: Tucker Stanley
Published: March 2003

This paper charts the development of undergraduate teaching material produced at the Open University in the United Kingdom. The School of Health and Social Welfare at the University has a long history of providing open and distance learning and multiprofessionally focused education and training opportunities. In this instance two courses, entitled ‘Working with Young People’ and ‘Working with Children and Families’, were created to meet the needs of a diverse student audience working across the public, voluntary and private social care, health and education sectors. The materials produced were underpinned by the desire of their academic authors to challenge long‐established assumptions about the nature of children and young people's lives. Crucially though, both course developments reflected a requirement to demonstrate how policies and services for children and young people might be significantly improved. Accordingly, the paper offers some useful indications as to how interprofessional working with children and young people could be fostered. Copyright © 2002 John Wiley & Sons, Ltd.
School breakfast clubs, children and family support†
Authors: Shemilt Ian , O'Brien Margaret , Thoburn June , Harvey Ian , Belderson Pippa , Robinson Jill , Camina Margaret ,   School of Breakfast Clubs Evaluation Group
Published: March 2003

School breakfast clubs are a form of before school provision serving breakfast to children who arrive early. This paper explores their potential to provide support for families at risk of social exclusion. A national evaluation of a Department of Health pilot initiative suggests that their provision can afford valued support to families coping with varying degrees of difficulty in their material, environmental, relational and social circumstances. Many parents regarded clubs as successful in encouraging children to eat breakfast, reducing pressures in the morning and providing an additional source of affordable, trusted child care to those in work, studying or seeking employment. Copyright © 2002 John Wiley & Sons, Ltd.
‘What did you think about that?’ Researching children's perceptions of participation in a longitudinal genetic epidemiological study
Authors: Goodenough Trudy , Williamson Emma , Kent Julie , Ashcroft Richard
Published: March 2003

This paper examines how empirical study of children's involvement in non‐therapeutic health research can contribute to our understanding of the significance of the research to the children themselves. This raises issues that are pertinent to, and which will guide policy relating to ethical protection in research. The paper begins with a brief review of the literature considering how children perceive research in general, and non‐therapeutic health research in particular. The empirical study is then described, outlining the approach to sampling, recruitment and the focus group method used. This is followed by consideration of several key issues relating to research with children, with particular reference to ethical protection. Copyright © 2002 John Wiley & Sons, Ltd.
Family support: the roles of early years' centres
Authors: Kirk Rosalind H.
Published: March 2003

The development of children and the welfare of their parents are closely inter‐linked. The study outlined below uses a longitudinal, ecological approach to explore links between different models of early years' centres and the expansion of parents support networks. Over time, parenting stress reduced and well‐being improved. Sources of informal and formal support developed and extended. It is argued that all types of centres need to develop a comprehensive approach to child development in which child care and education, as well as family support, are explicit functions. This can promote family resilience as well as social inclusion in communities. Copyright © 2002 John Wiley & Sons, Ltd.
‘I'm a good mother really!’ gendered parenting roles and responses to the disclosure of incest
Authors: Bell Patricia
Published: March 2003

The disclosure of incestuous abuse of a child constitutes such a departure from normative expectations of mothering that it necessitates a complete reappraisal and reconstruction of the mother's identity. This article draws on interview material with women in this situation in order to demonstrate how very traditional gendered parenting models were employed in repairing damaged identities. The ways in which such reliance on the protective and selfless aspects of mothering could contribute to the failure to recognise the abuse of their child are also discussed. In conclusion, motherhood as a source of power for women within the family is critically examined. Copyright © 2002 John Wiley & Sons, Ltd.
Structural and compositional analysis of the keratinocyte migration track
Authors: Kirfel Gregor , Rigort Alexander , Borm Bodo , Schulte Carsten , Herzog Volker
Published: April 2003

Slowly migrating cells such as fibroblasts leave behind a “migration track,” which has been assumed not to occur in fast‐moving cells such as keratinocytes. Here we show that keratinocytes left behind “migration tracks” of cellular remnants consisting of membranous patches or macroaggregates that were anchored to a meshwork of extracellular matrix proteins consisting of collagen type IV, fibronectin, laminin, and laminin 5. According to their origin and localisation, two types of macroaggregates could be distinguished : (1) Spherical and elongated tubular structures (diameter about 50–110 nm) both of which were arranged like “pearls on a string” and that apparently derived from fragmentation of retracting fibres. (2) Spherical structures (diameter about 50 nm) left behind in the gaps between the retracting fibres and presumably derived from former focal adhesion sites. Both types of macroaggregates did not contain cytoplasmic proteins but carried on their surface adhesion proteins, particularly high amounts of integrins : type 1 macroaggregates contained α3β1‐integrins, whereas type 2 macroaggregates contained other types of integrins such as α6β4‐integrins. Modulation of keratinocyte adhesion by using poly‐L‐lysine coated cover slips resulted in an increased application of inhibitory β1‐antibodies and slightly reduced migration velocity and track formation. Within 24 h of migration, we observed a migration velocity‐dependent loss of cellular β1‐integrin by macroaggregate formation of about 11% for fast and about 4% for slowly migrating keratinocytes. The physiological role of the migration track is unclear. However, with its multiple adhesion sites it may serve as a provisional basement membrane during reepithelialization of epidermal wounds. Cell Motil. Cytoskeleton 55:1–13, 2003. © 2003 Wiley‐Liss, Inc.
Glutamylated tubulin: Diversity of expression and distribution of isoforms
Authors: Kann Marie‐Louise , Soues Sylvie , Levilliers Nicolette , Fouquet Jean‐Pierre
Published: April 2003

Glutamylation of α and β tubulin isotypes is a major posttranslational modification giving rise to diversified isoforms occurring mainly in neurotubules, centrioles, and axonemes. Monoglutamylated tubulin isoforms can be differentially recognized by two mAbs, B3 and GT335, which both recognize either polyglutamylated isoforms. In the present study, immunoelectron microscopy and immunofluorescence analyses were performed with these two mAbs to determine the expression and distribution of glutamylated tubulin isoforms in selected biological models whose tubulin isotypes are characterized. In mouse spermatozoa, microtubules of the flagellum contain polyglutamylated isoforms except in the tip where only monoglutamylated isoforms are detected. In spermatids, only a subset of manchette microtubules contain monoglutamylated tubulin isoforms. Cytoplasmic microtubules of Sertoli cells are monoglutamylated. Mitotic and meiotic spindles of germ cells are monoglutamylated whereas the HeLa cell mitotic spindle is polyglutamylated. Three models of axonemes are demonstrated as a function of the degree and extent of tubulin glutamylation. In lung ciliated cells, axonemes are uniformly polyglutamylated. In sea urchin sperm and Chlamydomonas, flagellar microtubules are polyglutamylated in their proximal part and monoglutamylated in their distal part. In Paramecium, cilia are bi‐ or monoglutamylated only at their base. In all cells, centrioles or basal bodies are polyglutamylated. These new data emphasize the importance of glutamylation in all types of microtubules and strengthen the hypothesis of its role in the regulation of the intracellular traffic and flagellar motility. Cell Motil. Cytoskeleton 55:14–25, 2003. © 2003 Wiley‐Liss, Inc.
Localization of two IQGAPs in cultured cells and early embryos of Xenopus laevis
Authors: Yamashiro Sawako , Noguchi Tatsuhiko , Mabuchi Issei
Published: April 2003

Mammalian IQGAP1 is considered to modulate organization of the actin cytoskeleton under regulation of signaling proteins Cdc42 or Rac and calmodulin [Bashour et al., 1997: J Cell Biol 137:1555–1566; Hart et al., 1996: EMBO J 15:2997–3005] and also to be involved in cadherin‐based cell adhesion [Kuroda et al., 1998: Science 281:832–835]. However, its function in the cell has not been clear. In order to clarify the function of IQGAP, we investigated IQGAP in Xenopus laevis cells. We isolated two Xenopus cDNAs encoding homologues of mammalian IQGAP, XIQGAP1, and XIQGAP2, which show high homology with human IQGAP1 and IQGAP2, respectively. Immunofluorescent localization of XIQGAPs in Xenopus tissue cultured cells (XTC cells) and in developing embryos was examined. In XTC cells, XIQGAP1 was colocalized with F‐actin at cell‐to‐cell contact sites, membrane ruffles in lamellipodia, and filopodia. During development of embryos, XIQGAP1 was concentrated in the borders of all embryonic cells. An intense staining for XIQGAP1 was found in regions undergoing active morphogenetic movements, such as the blastopore lip of gastrulae, and the neural plate, the notochord, and the somite of neurulae. These results suggest that XIQGAP1 is involved in both cell‐to‐cell adhesion and cell migration during Xenopus embryogenesis and in cultured cells. On the other hand, the localization of XIQGAP2 in XTC cells was distinct from that of XIQGAP1 although it was also seen in lamellipodia, filopodia, and borders between cells. In addition to these regions, strong nuclear staining was observed in both XTC cells and embryonic cells. Cell Motil. Cytoskeleton 55:36–50, 2003. © 2003 Wiley‐Liss, Inc.
Dystrophin upregulation in pressure‐overloaded cardiac hypertrophy in rats
Authors: Maeda Masato , Biro Sadatoshi , Kamogawa Yasuyuki , Hirakawa Tatsumi , Setoguchi Manabu , Tei Chuwa
Published: April 2003

Dystrophin is a cytoskeletal protein localized to the sarcolemma of skeletal and cardiac muscle, and neurons. We have recently demonstrated that a significant cardiac damage including myocytes injury, inflammation, and fibrosis, was found in dystrophin‐deficient myocardium during pressure overload [Kamogawa et al., 2001: Cardiovasc Res 50:509–515]. However, little is known about how the cardiac sarcolemmal cytoskeleton produces qualitative and quantitative changes in response to pressure overload. Accordingly, we investigated dystrophin gene expression and protein accumulation during cardiac hypertrophy. Cardiac hypertrophy was produced by banding of the abdominal aorta of rats. Total RNA from the left ventricle of the heart was used for a quantitative reverse transcription‐polymerase chain reaction (RT‐PCR). Dystrophin mRNA expression significantly increased by 33 ± 18% at 1 day (P < 0.05) and 45 ± 19% at 2 days (P < 0.01) after banding, while G3PDH mRNA showed no significant change. RT‐PCR for dystrophin tissue‐specific exon 1 revealed that only muscle type promoter, but not non‐muscle type promoter (brain and Purkinje‐cell type), was activated immediately after banding. Immunohistochemistry for dystrophin showed intense cellular membrane staining with an increase in the perimeter of the myocytes by 14% at 3 days (46.3 μm, P < 0.01) and 19% at 7 days (51.2 μm, P < 0.01) after banding. Western blotting also showed dystrophin protein increased by 14 ± 6% at 2 days (P < 0.05) and by 32 ± 10% at 3 days (P < 0.01) after aortic banding. In conclusion, upregulation of dystrophin mRNA expression and protein accumulation occurs in response to cardiac hypertrophy. These data and the vulnerability of dystrophin‐deficient myocardium to pressure overload suggest that dystrophin could play an important role in maintaining the integrity of the sarcolemma. Cell Motil. Cytoskeleton 55:26–35, 2003. © 2003 Wiley‐Liss, Inc.