bluuebunny/crossref_metadata_2025 huggingface dataset:
An unexpected supraclavicular swelling
Authors: Patel Nishith NB , Shah Parin R , Wilson Eliie , Haray Puthcode N
Published: August 2007

Background

Colorectal cancer is the third commonest cause of cancer death in UK. It commonly metastasises to the liver but rarely to small bones.

Case presentation

We describe a case of a patient with adenocarcinoma of the descending colon who presented preoperatively with a right supraclavicular swelling. Subsequent imaging and cytology of the lesion revealed this to be a metastasis to the right clavicle resulting in a pathological fracture.

Conclusion

This report describes the rare occurrence of a colorectal metastasis to the clavicle. It emphasises that although bone metastases from primary colorectal tumours are rare events, they tend to metastasise to small, non-weight bearing bones. It also discusses the utility of isotope bone scanning and that on certain occasions this imaging method may prove to be equivocal. In such circumstances, biopsy or magnetic resonance imaging is more sensitive for the detection of bone metastases.
Facile: a command-line network compiler for systems biology
Authors: Siso-Nadal Fernando , Ollivier Julien F , Swain Peter S
Published: August 2007

Background

A goal of systems biology is the quantitative modelling of biochemical networks. Yet for many biochemical systems, parameter values and even the existence of interactions between some chemical species are unknown. It is therefore important to be able to easily investigate the effects of adding or removing reactions and to easily perform a bifurcation analysis, which shows the qualitative dynamics of a model for a range of parameter values.

Results

We present Facile, a Perl command-line tool for analysing the dynamics of a systems biology model. Facile implements the law of mass action to automatically compile a biochemical network (written as, for example, ) into scripts for analytical analysis (Mathematica and Maple), for simulation (XPP and Matlab), and for bifurcation analysis (AUTO). Facile automatically identifies mass conservations and generates the reduced form of a model with the minimum number of independent variables. This form is essential for bifurcation analysis, and Facile produces a C version of the reduced model for AUTO.

Conclusion

Facile is a simple, yet powerful, tool that greatly accelerates analysis of the dynamics of a biochemical network. By acting at the command-line and because of its intuitive, text-based input, Facile is quick to learn and can be incorporated into larger programs or into automated tasks.
Stabilin-2 is involved in lymphocyte adhesion to the hepatic sinusoidal endothelium via the interaction with αMβ2 integrin
Authors: Jung Mi-Yeon , Park Seung-Yoon , Kim In-San
Published: August 2007

Although lymphocyte recirculation to the endothelium plays a critical role in the movement of immune cells from the blood into tissues and sites of inflammation, the mechanisms involved in lymphocyte trafficking via the hepatic circulation have yet to be elucidated fully. In this study, we investigated the role of stabilin-2, which is expressed specifically in the sinusoidal endothelium, in the adhesion of lymphocytes to the hepatic endothelium. Stabilin-2-expressing cells mediate the adhesion of PBLs. This interaction was attributed specifically to the interaction of stabilin-2 with αMβ2 integrin. Using mutant stabilin-2 molecules with deletions in the extracellular domain, we mapped the binding site for αMβ2 integrin to the fasciclin 1 (FAS1) domains of stabilin-2. The specificity of the interaction between αMβ2 integrin and the FAS1 domain was confirmed further by binding assays using neutralizing antibodies. More physiologically, we showed that the down-regulation of stabilin-2 results in the defective binding of lymphocytes to hepatic sinusoidal endothelial cells under conditions of static and physiological flow. Together, these data show that stabilin-2 can reconstitute the lymphocyte–endothelial adhesion cascade under physiological shear stress. We propose a critical role for stabilin-2 in lymphocyte adhesion to specialized endothelia, such as that of the hepatic sinusoid.
A phenotypic and functional characterization of NK cells in adenoids
Authors: Mizrahi Sa’ar , Yefenof Eitan , Gross Menahem , Attal Pierre , Ben Yaakov Avraham , Goldman-Wohl Debra , Maly Bella , Stern Noam , Katz Gil , Gazit Roi , Sionov Ronit Vogt , Mandelboim Ofer , Chaushu Stella
Published: August 2007

Adenoids are part of the MALT. In the present study, we analyzed cell surface markers and cytolytic activity of adenoidal NK (A-NK) cells and compared them with NK cells derived from blood of the same donors (B-NK). NK cells comprised 0.67% (0.4–1.2%) of the total lymphoid population isolated from adenoids. The majority (median=92%) of the A-NK cells was CD56brightCD16–. A-NK cells were characterized by the increased expression of activation-induced receptors. NKp44 was detected on >60%, CD25 on >40%, and HLA-DR on >50% of freshly isolated A-NK cells. Functional assays indicated that the cytotoxic machinery of A-NK is intact, and sensitive target cells are killed via natural cytotoxicity receptors, such as NKG2D. Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1; CD66) expression was up-regulated in 23% (median) of the A-NK cells by IL-2 activation but unchanged in B-NK cells. CEACAM1 inhibited the A-NK killing of target cells. CXCR4 was expressed on more than 40% A-NK cells prior to activation. Its ligand, CXCL12, was found in endothelial cells of the capillaries within the adenoid and in cells of the epithelial lining. In addition, A-NK cells migrated in vitro toward a gradient of CXCL12 in a dose-responsive manner, suggesting a role for this chemokine in A-NK cell recruitment and trafficking. We conclude that the A-NK cells are unique in that they display an activated-like phenotype and are different from their CD16– B-NK cell counterparts. This phenotype presumably reflects the chronic interaction of A-NK cells with antigens penetrating the body through the nasal route.
Neuroprotective activities of CD4+CD25+ regulatory T cells in an animal model of Parkinson’s disease
Authors: Reynolds Ashley D , Banerjee Rebecca , Liu Jianou , Gendelman Howard E , Lee Mosley R
Published: August 2007

Progressive loss of dopaminergic neurons in the substantia nigra pars compacta and their terminal connections in the striatum are central features in Parkinson’s disease (PD). Emerging evidence supports the notion that microglia neuroinflammatory responses speed neurodegenerative events. We demonstrated previously that this can be slowed by adoptive transfer of T cells from Copolymer-1-immunized mice administered to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) recipients. The cellular basis for this neuroprotective response was the CD4+ T cell population, suggesting involvement of CD4+CD25+ regulatory T cells (Tregs), cells known to suppress immune activation and maintain immune homeostasis and tolerance. We show for the first time that adoptive transfer of CD3-activated Tregs to MPTP-intoxicated mice provides greater than 90% protection of the nigrostriatal system. The response was dose-dependent and paralleled modulation of microglial responses and up-regulation of glial cell-derived neurotrophic factor (CDNF) and TGF-β. Interestingly, that adoptive transfer of effector T cells showed no significant neuroprotective activities. Tregs were found to mediate neuroprotection through suppression of microglial responses to stimuli, including aggregated, nitrated α-synuclein. Moreover, Treg-mediated suppression was also operative following removal of Tregs from culture prior to stimulation. This neuroprotection was achieved through modulation of microglial oxidative stress and inflammation. As Tregs can be modulated in vivo, these data strongly support the use of such immunomodulatory strategies to treat PD.
Conformational activation of CD11b without shedding of L-selectin on circulating human neutrophils
Authors: Orr Y , Taylor J M , Cartland S , Bannon P G , Geczy C , Kritharides L
Published: August 2007

Membrane-activated complex 1 (Mac-1; CD11b/CD18) is a β2 integrin implicated in the pathophysiology of neutrophil-mediated tissue injury whose functional capacity is determined by stimulus-induced conformational activation rather than up-regulation. Mac-1 up-regulation and conformational activation, together with shedding of L-selectin, are reported after in vitro neutrophil activation. However, their regulation on circulating human neutrophils during acute inflammation is unclear. Using flow cytometry, we investigated neutrophil expression of Mac-1, its activation-reporter neo-epitope CBRM1/5, and L-selectin during the inflammatory stimulus of cardiac surgery. A subpopulation of circulating neutrophils expressed CBRM1/5 (CBRM1/5+) under basal conditions (6.28±2.59%) and was persistently expanded (9.95±4.0%–15.2±4.2%; P<0.0001) peri-operatively, whereas total CD11b expression increased only transiently, intra-operatively. L-selectin expression was unchanged on CBRM1/5+ neutrophils, and soluble L-selectin levels decreased intra-operatively (P<0.01), indicating that L-selectin was not shed. Increased CBRM1/5 expression without L-selectin loss or CD11b up-regulation was replicated in vitro by neutrophil stimulation with IL-8, C3a, and platelet-activating factor. Heparin, a known CD11b ligand, which is administered during cardiac surgery, markedly reduced neutrophil expression of conformationally active CD11b in vivo and in vitro, identifying a potential mechanism for its anti-inflammatory properties. We conclude that conformational activation of CD11b occurs on circulating neutrophils in vivo and can occur in the absence of CD11b up-regulation and L-selectin shedding.
A 5.8-kDa component of manuka honey stimulates immune cells via TLR4
Authors: Tonks A J , Dudley E , Porter N G , Parton J , Brazier J , Smith E L , Tonks A
Published: August 2007

Honey is used as a therapy to aid wound healing. Previous data indicate that honey can stimulate cytokine production from human monocytes. The present study further examines this phenomenon in manuka honey. As inflammatory cytokine production in innate immune cells is classically mediated by pattern recognition receptors in response to microorganisms, bacterial contamination of honey and the effect of blocking TLR2 and -4 on stimulatory activity were assessed. No vegetative bacteria were isolated from honey; however, bacterial spores were cultured from one-third of samples, and low levels of LPS were detected. Blocking TLR4 but not TLR2 inhibited honey-stimulated cytokine production significantly. Cytokine production did not correlate with LPS levels in honey and was not inhibited by polymyxin B. Further, the activity was reduced significantly following heat treatment, indicating that component(s) other than LPS are responsible for the stimulatory activity of manuka honey. To identify the component responsible for inducing cytokine production, honey was separated by molecular weight using microcon centrifugal filtration and fractions assessed for stimulatory activity. The active fraction was analyzed by MALDI-TOF mass spectroscopy, which demonstrated the presence of a number of components of varying molecular weights. Additional fractionation using miniaturized, reverse-phase solid-phase extraction resulted in the isolation of a 5.8-kDa component, which stimulated production of TNF-α via TLR4. These findings reveal mechanisms and components involved in honey stimulation of cytokine induction and could potentially lead to the development of novel therapeutics to improve wound healing for patients with acute and chronic wounds.
Improving prescription quality in an in-patient mental health unit: three cycles of clinical audit
Authors: Ved Priti , Coupe Tim
Published: August 2007

Aims and Method

We undertook three cycles of clinical audit of prescription charts to improve the quality of the prescriptions written in an in-patient unit. Pharmacy and medical staff reviewed a total of 1466 prescriptions on 242 prescription charts against local guidelines and provided feedback to medical staff. The pharmacist also regularly reviewed prescription charts on the wards between audits.

Results

After three cycles of audit, 99.5% of prescriptions written were legible. The recording of drug allergies, section 58 status and patient age remained poor.

Clinical Implications

A combination of clinical audit and continual pharmacist review of prescription charts can improve the quality of prescriptions written by medical staff in an in-patient unit.
A Simple Route to Preparation and Characterization of Er2O3 Microspheres
Authors: Han Kaidong , Zhang Youjin , Fang Zhiyong , Cheng Tao , Gao Minrui
Published: August 2007

Large scale, uniform Er2O3 microspheres have been prepared with CO(NH2)2 as the precipitant through a hydrothermal method. The obtained products were characterized by X-ray powder diffraction, X-ray photoelectron spectroscopy, transmission electron microscopy, and field-emission scanning electron microscopy. The Er2O3 microspheres are composed of nanoparticles, and the diameter is in the range of 200–300 nm. In addition, a possible formation mechanism of Er2O3 microspheres was discussed.
Oxidative Degradation of Nylon-6 and Nylon-6,6 with Nitrogen Dioxide in Supercritical Carbon Dioxide
Authors: Yanagihara Naohisa , Abe Naoto , Takama Hironori , Shimamura Yuichiro , Yoshida Masaaki
Published: August 2007

Nylon-6 and nylon-6,6 were subjected to oxidative degradation with NO2 in supercritical CO2. It was found that valuable short-chain α,ω-diacid mixture could be obtained in good yield under relatively mild conditions.
Preparation of Gold Nanoparticles by the Laser Ablation in Room-temperature Ionic Liquids
Authors: Kimura Yoshifumi , Takata Hiroshi , Terazima Masahide , Ogawa Tetsuo , Isoda Seiji
Published: August 2007

Gold nanoparticles have been prepared by the laser ablation of a gold plate in imidazolium-based ionic liquids. The size and stability of gold nanoparticles were dependent on the wavelength of the laser light and the alkyl-chain length of the imidazolium-based cation.
Synthesis of Tetragonal ZrO2 Nanocrystals with a High Proton Conductivity
Authors: Wang Hui , Qiu Xiaoqing , Li Liping , Li Guangshe
Published: August 2007

Pure tetragonal ZrO2 nanocrystals were prepared at low temperature (85 °C). Their proton conductivity measured at 80 °C in N2 is 5.63×10−5 S/cm which is one order of magnitude higher than that of 1.72×10−6 S/cm for the sulfated counterpart or of 4.17×10−6 S/cm reported in the literature for 3-nm crystals of ZrO2·nH2O.
Diversification of Nonionic Amphiphilic Poly(N-vinylacetamide) Hydrogels by a Double Network Approach
Authors: Ajiro Hiroharu , Watanabe Junji , Akashi Mitsuru
Published: August 2007

The amphiphilic aprotic vinyl monomer, N-vinylacetamide (NVA), was firstly employed to fabricate double network (DN) hydrogels in water at 37 °C. Although N,N-methylenebisacrylamide as a crosslinker did not form hydrogels, novel crosslinker which is based on the structure of NVA was effective in creating first and second network hydrogels. DN structures of nonionic NVA hydrogels will expand the pool of various functional hydrogels, as well as give rise to stronger NVA hydrogel preparations.
Sound Insulation in Timber Buildings: The Finnish Experience
Authors: Sipari Pekka
Published: August 2007

In Finland timber multi-storey houses have been in development for ten years. During this period, the sound insulation of timber structures has been actively studied both in the laboratory and on site. One of the main tasks was to ascertain if the impact sound insulation requirements were being achieved. An early consideration was the use of additional mass to achieve acceptability. However, there has been relatively little practical experience of this type of floor. A pilot building project, to develop new concepts of timber multi-storey houses is described. The buildings were erected using double frame wooden walls between flats and wooden truss floors with an in situ cast concrete top layer. The preliminary sound insulation measurement results between flats surpassed the expectations and the official requirements. The success was mainly due to the proper detailing of both wall and floor connections and proper workmanship.
Comparison of Measured and Computer-Modeled Objective Parameters for an Existing Coupled Volume Concert Hall
Authors: Bradley David T. , Wang Lily M.
Published: August 2007

This paper details the comparison of a built coupled volume concert hall and a computer-generated model of the hall. Coupled volume spaces typically have an auxiliary volume connected to the main volume through an acoustically transparent aperture. In this type of space, architectural parameters such as volume size and surface absorption can be designed to produce a non-linear reverberant decay, known as double-slope decay. Objective reverberation and clarity parameters were calculated for the sound fields measured in the built hall and predicted in the computer modeled hall. These objective parameters were compared between the two modalities for several configurations of the hall to determine the accuracy of the computer modeling prediction scheme for coupled volume spaces. The results showed a high level of computer model accuracy in the high frequency range, with differences in reverberation parameters being less than 1 just noticeable difference (jnd). Lower frequencies proved computer modeling to be less accurate, particularly for the clarity parameter, which had differences up to 8 jnd.
Double Sloped Decay: Subjective Listening Test to Determine Perceptibility and Preference
Authors: Ermann Michael
Published: August 2007

Can music listeners, both experienced and inexperienced, distinguish a double-sloped decay from a Sabine decay? Do they prefer the double slope? A simulated space, based on an actual built coupled-volume hall, was conceived in room acoustics software to create double sloped and classic Sabine auralizations. The simulated decays were compared with in situ measurements taken in a built coupled volume concert hall for validation. The impulse responses generated were convolved with an anechoic musical recording, grouped in pairs, and played for subjects. Participants listened to the recorded pairs over headphones and were asked to determine (1) if the two recordings sounded different, (2) which recording was more likely to have a double slope or had a more dramatic double slope, and (3) which of the two recordings they prefer. The more a recording diverged from a standard Sabine decay, the more likely the respondents were to identify that recording as having a double slope. When asked to identify a preference, subjects were no more likely to select a recording with a double-sloped decay, than a Sabine decay.
A simple array platform for microRNA analysis and its application in mouse tissues
Authors: Tang Xiaoqing , Gal Jozsef , Zhuang Xun , Wang Wangxia , Zhu Haining , Tang Guiliang
Published: August 2007

MicroRNAs (miRNAs) are a novel class of small noncoding RNAs that regulate gene expression at the post-transcriptional level and play a critical role in many important biological processes. Most miRNAs are conserved between humans and mice, which makes it possible to analyze their expressions with a set of selected array probes. Here, we report a simple array platform that can detect 553 nonredundant miRNAs encompassing the entire set of miRNAs for humans and mice. The platform features carefully selected and designed probes with optimized hybridization parameters. Potential cross-reaction between mature miRNAs and their precursors was investigated. The array platform was used to analyze miRNAs in the mouse central nervous system (CNS, spinal cord and brain), and two other non-CNS organs (liver and heart). Two types of miRNAs, differentially expressed organ/tissue-associated miRNAs and ubiquitously expressed miRNAs, were detected in the array analysis. In addition to the previously reported neuron-related miR-124a, liver-related miR-122a, and muscle-related miR-133a, we also detected new tissue-associated miRNAs (e.g., liver-associated miR-194). Interestingly, while the majority of pre-miRNAs were undetectable, miR690, miR709, and miR720 were clearly detected at both mature and precursor levels by the array analysis, indicating a limited cross-reaction between pre-miRNAs and their mature miRNAs. The reliability of this array technology was validated by comparing the results with independent Northern blot analyses and published data. A new approach of data normalization based on Northern blot analysis of one ubiquitously expressed miRNA is introduced and compared with traditional approaches. We expect this miRNA array platform to be useful for a wide variety of biological studies.
Does Geography Matter for Science-Based Firms? Epistemic Communities and the Geography of Research and Patenting in Biotechnology
Authors: Gittelman Michelle
Published: August 2007

The spatial clustering of innovation has been associated with localized knowledge flows among small, knowledge-intensive firms, but knowledge flows may extend beyond regional boundaries through the participation of firm employees in broader knowledge-based communities. This paper analyzes biotechnology firms jointly engaged in technological innovation and open scientific research and proposes that the geography of their collaborations should reflect the distinctive social logics of these activities. I hypothesize that projects involving local ties are more likely to be patented by a firm than are projects involving distant contacts, both because proximity is conducive to innovation and because a small firm’s social capital is likely to be greatest in its home region. However, classic studies in the sociology of science show that scientific communities are socially stratified and geographically dispersed. As a result, I hypothesize that ties to distant partners and prestige in scientific communities are positively associated with scientific impact but negatively associated with firm patenting. The analysis focuses on 5,143 collaborative research papers published by a large sample of small biotechnology firms. The average distance among coauthors on a paper is some 1,500 miles, indicating that the firms are engaged in geographically far-flung research networks; however, the distribution of teams in space is strongly bimodal, revealing an important core of regional ties alongside a set of much more distant ties. Regression analysis show that the spatially clustered teams are more likely to publish papers that are subsequently cited in the authoring firms’ patents, whereas teams that are globally dispersed produce papers that are more highly cited in the scientific literature, but less cited in the authoring firms’ patents. Status in the scientific community has the expected positive effects on paper citations, but a negative effect on patent citations. The results give evidence of different—and in some respects conflicting—logics governing the creation of new technologies on the one hand and valuable ideas in science on the other, highlighting challenges faced by firms that aim to profit from knowledge created in open scientific communities.
The effect of reconfiguration
Authors: Sutcliffe RP , Hale PC
Published: August 2007

High-quality care of acute surgical patients depends on excellent clinical judgement, technical ability and experience. Clinical judgement and technical ability are developed throughout a surgeon's career by effective supervision combined with adequate operative exposure. A number of changes to working practice, such as the European Working Time Directive (EWTD) and to surgical training (eg Calman) have resulted in a significant reduction in emergency operative exposure for surgical trainees over the last ten years. The additional impact on operative exposure of recent changes in NHS structure and postgraduate training, such as the reconfiguration of emergency ser vices, independent treatment centres and Modernising Medical Careers, is unknown. The principal aims of this study were to report the volume of emergency surgery in a single centre and to evaluate the impact of reconfiguration on exposure of surgical trainees to emergency surgery.
The learning agreement
Authors: Beard Jonathan , Bussey Maria
Published: August 2007

The fundamental principle at the heart of the inter collegiate surgical curriculum project (ISCP) is that surgeons should continue to learn and develop throughout each stage of their careers and that learning should be formalised and demonstrable according to predefined standards. In order to ensure these standards have been met, learning is underpinned by a formal appraisal process designed to provide supervision of surgical trainees as they progress through each stage of the curriculum.
Surgical training in Russia
Authors: Tarasevich Tatyana
Published: August 2007

The beginning of surgical training in Russia, as a separate discipline, dates back to the 17th century and is closely connected with Peter the Great. It arose from the state's need for qualified doctors with knowledge and sufficient expertise to perform surgery, above all in the army.
Trauma Specialist Centres
Authors: Brohi Karim
Published: August 2007

In 2011 it will be 50 years since the Osmond-Clarke report first proposed a network of specialist units to care for injured patients across England and Wales. Since that time there have been multiple aborted attempts to implement regionalisation of trauma care. For the first time in half a century the clinical imperative now appears to be supported by a political recognition of the importance of a national trauma system to UK citizens. With this in mind, this paper aims to describe the role of a trauma specialist centre within its regional trauma system; the capabilities, resources and infrastructure required; and the functions of a specialist trauma service.
Children's Surgical Forum report
Authors: Jones David
Published: August 2007

The Children's Surgical Forum (CSF) will launch its new report in mid-July. In the seven years since the CSF published its first report, Children's Surgery: A First Class Service, the surgical landscape has changed almost beyond recognition and there are major threats to the standards of surgical care for children. While it may no longer be possible to treat children in the ways to which the population is accustomed, there must be networks of care in place that maintain the best quality of treatment for them. It is against this background that the CSF has brought thinking on the organisation and delivery of surgical care to the young up to date.
ASiT backs trainees through upheaval
Authors: Towell Elaine
Published: August 2007

There is no doubt that surgical training is going through a period of major upheaval. The implementation of Modernising Medical Careers (MMC) has been steeped in controversy with recent months bringing uncertainty and anger as junior doctors compete for a limited number of training places. The introduction of a new selection and recruitment system, the Medical Training Applications System (MTAS), only served to exacerbate the anger. The system, as well as being involved in a major security breach, also failed to take into account doctors' qualifications and experience and was subsequently dropped, leaving a trail of destruction and high-profile resignations in its wake.
The Eagle flies east
Authors: Jones R Pritchard , Choke E
Published: August 2007

China is now firmly established as a world economy and with the arrival of the Olympic Games in Beijing next year, keen to show the world the progress made over recent years. The former British colony of Hong Kong was returned to the Chinese in 1997 and in some ways little appears to have changed. However, the engineering projects are remarkable: only a few years ago the islands such as Lantau were accessible only by boat, but now huge suspension bridges connect the islands off Hong Kong and bring the traffic in by road. It was against the exciting backdrop of such rapid expansion and progress that the College arrived on the first leg of the trip.
Reflection, brooding, and suicidality: A preliminary study of different types of rumination in individuals with a history of major depression
Authors: Crane Catherine , Barnhofer Thorsten , Williams J. Mark G.
Published: August 2007

Objective To examine the relationship between reflection, brooding, and suicidality in participants with a history of major depression.

Method Participants were divided into three groups – those who had never been suicidal (N=11), suicide ideators (N=11), and suicide attempters (N=10). Participants completed the Ruminative Responses Scale to explore scores on the brooding and reflection subscales in each group.

Results There was a significant interaction between groups and type of self‐focused thinking: suicide attempters more strongly endorsed brooding than reflection, whilst non‐suicidal, but previously depressed individuals showed the reverse trend. Suicidal and non‐suicidal groups differed significantly in levels of reflection, but did not differ significantly in levels of brooding.

Conclusions Deficits in reflection appear to be linked to suicidality in major depression consistent with evidence of problem‐solving deficits in these groups.
Structural Determinants of Vertebral Fracture Risk
Authors: Melton L Joseph , Riggs B Lawrence , Keaveny Tony M , Achenbach Sara J , Hoffmann Paul F , Camp Jon J , Rouleau Peggy A , Bouxsein Mary L , Amin Shreyasee , Atkinson Elizabeth J , Robb Richard A , Khosla Sundeep
Published: August 2007

Vertebral fractures are more strongly associated with specific bone density, structure, and strength parameters than with areal BMD, but all of these variables are correlated.

Introduction: It is unclear whether the association of areal BMD (aBMD) with vertebral fracture risk depends on bone density per se, bone macro- or microstructure, overall bone strength, or spine load/bone strength ratios.

Materials and Methods: From an age-stratified sample of Rochester, MN, women, we identified 40 with a clinically diagnosed vertebral fracture (confirmed semiquantitatively) caused by moderate trauma (cases; mean age, 78.6 ± 9.0 yr) and compared them with 40 controls with no osteoporotic fracture (mean age, 70.9 ± 6.8 yr). Lumbar spine volumetric BMD (vBMD) and geometry were assessed by central QCT, whereas microstructure was evaluated by high-resolution pQCT at the ultradistal radius. Vertebral failure load (∼strength) was estimated from voxel-based finite element models, and the factor-of-risk (ϕ) was determined as the ratio of applied spine loads to failure load.

Results: Spine loading (axial compressive force on L3) was similar in vertebral fracture cases and controls (e.g., for 90° forward flexion, 2639 versus 2706 N; age-adjusted p = 0.173). However, fracture cases had inferior values for most bone density and structure variables. Bone strength measures were also reduced, and the factor-of-risk was 35–37% greater (worse) among women with a vertebral fracture. By age-adjusted logistic regression, relative risks for the strongest fracture predictor in each of the five main variable categories were bone density (total lumbar spine vBMD: OR per SD change, 2.2; 95% CI, 1.1–4.3), bone geometry (vertebral apparent cortical thickness: OR, 2.1; 95% CI, 1.1–4.1), bone microstructure (none significant); bone strength (“cortical” [outer 2 mm] compressive strength: OR, 2.5; 95% CI, 1.3–4.8), and factor-of-risk (ϕ for 90° forward flexion/overall vertebral compressive strength: OR, 3.2; 95% CI, 1.4–7.5). These variables were correlated with spine aBMD (partial r, −0.32 to 0.75), but each was a stronger predictor of fracture in the logistic regression analyses.

Conclusions: The association of aBMD with vertebral fracture risk is explained by its correlation with more specific bone density, structure, and strength parameters. These may allow deeper insights into fracture pathogenesis.
Stability of Soluble Adhesion Molecules, Selectins, and C-Reactive Protein at Various Temperatures: Implications for Epidemiological and Large-Scale Clinical Studies
Authors: Hartweg Janine , Gunter Michael , Perera Rafael , Farmer Andrew , Cull Carole , Schalkwijk Casper , Kok Astrid , Twaalfhoven Harry , Holman Rury , Neil Andrew
Published: August 2007

Background: We assessed the impact of sample storage conditions on soluble vascular cell adhesion molecules (sVCAM), soluble intracellular adhesion molecules (sICAM-1), soluble (s)E-selectin, C-reactive protein (CRP), and sP-selectin.

Methods: Markers were measured by ELISA in venous blood from 10 healthy volunteers on aliquots stored as plasma or whole blood at 4, 21, or 30 °C for 1–5 days and after 1–5 freeze-thaw cycles. We compared results on these samples to results for samples processed immediately and stored at −80 °C. Statistical models assessed time-related effects and effects of postprocessing conditions.

Results: Using an upper limit of 10% variation from baseline with P >0.05, we found that stability duration in plasma was 5 days for sVCAM-1 and sICAM-1 and at least 2 days for sE-selectin at 4, 21, and 30 °C and 5 days for CRP at 4 and 21 °C and 1 day at 30 °C. Stability duration in whole blood was 5 days for sVCAM-1 and sICAM-1 and at least 2 days for sE-selectin at 4, 21, and 30 °C and 5 days for CRP at 4 and 21 °C and 2 days at 30 °C. sP-selectin was not stable in plasma or whole blood. sICAM-1, sVCAM-1, CRP, and sE-selectin were stable after 5 freeze-thaw cycles.

Conclusions: sVCAM-1, sICAM-1, and CRP are stable in plasma or whole blood at 4 and 21 °C for at least 3 days and sE-selectin for 2 days. sP-selectin is not stable and therefore requires immediate assay.
An Analysis of Sites of Disease in Revision Endoscopic Sinus Surgery
Authors: Chu C. Timothy , Lebowitz Richard A. , Jacobs Joseph B.
Published: August 2007

Revision endoscopic sinus surgery is performed when symptoms associated with sinusitis persist after sinus surgery and despite continued medical therapy. The causes of treatment failure are varied and may include systemic, mucosal, and anatomic factors associated with persistent inflammatory disease. The purpose of this retrospective review was to define the sites of recurrent or persistent sinonasal disease in patients undergoing revision endoscopic sinus surgery. This data was based on our preoperative CT scan and nasal endoscopy, as well as intraoperative findings. This study includes an evaluation of the most recent sinus surgery in a group of 153 patients and 265 operated sides. The frequency and distribution of regional anatomic sites of disease is presented and discussed.
Capsaicin's Effect on Rat Nasal Mucosa Substance P Release: Experimental Basis for Vasomotor Rhinitis Treatment
Authors: Kuhn Frederick A. , Gonzalez Sergio , Rodriguez Magdalena , Siller Carlos Cuilty , Zachariou Venetia , Goldstein Barry D.
Published: August 2007

Substance P (SP) is one of several neuropeptides found in nasal mucosa. It exists primarily in sensory afferent neurons, which are best demonstrated by immunohistochemical staining. These substance P-like immunoreactive (SPLI) nerve fibers are unmyelinated C fibers, which connect to the trigeminal ganglion and the spinal trigeminal nucleus. They are found around vessels and seromucinous glands in the submucosa. When the nasal mucosa receives a noxious stimulus, SP is released and acts orthodromically as a comediator of nasal pain, while antidromically it induces vasodilatation, plasma extravasation, mucosal edema, and rhinorrhea. Its antidromic effects have been implicated in vasomotor rhinitis and can be blocked by topical intranasal capsaicin application. Wolf and others have demonstrated in human subjects that vasomotor rhinitis can be blocked up to 1 year by a series of intranasal capsaicin applications. It has not yet been demonstrated that nasal mucous SP levels following noxious nasal stimulus change after intranasal capsaicin pretreatment. Consequently, a project was designed to determine whether intranasal capsaicin pretreatment would affect nasal substance P release measured in nasal secretion. Nasal secretion SP levels were measured before and after noxious nasal stimulus in controls and in capsaicin pretreated rats. The difference in measured nasal secretion SP levels were significant (p < 0.05).
The Role of Nitric Oxide in the Neural Control of Nasal Fluid Production
Authors: Lane Andrew P. , Prazma Jiri , Gibbons Patrick J. , Rose Austin S. , Pillsbury Harold C.
Published: August 2007

The production of nasal fluids serves an important role in the protection of the upper respiratory system, but can also be a troublesome symptom of rhinitis. The chief sources of nasal fluids are serous and mucous glandular secretion, epithelial goblet cell exocytosis, and exudation from submucosal blood vessels. This study was designed to investigate the role of nitric oxide in neurogenically mediated nasal vascular exudation and mucus secretion. A rat model of the naso-nasal reflex was developed in which one nasal cavity was challenged with histamine while albumin and mucin production were measured in the continuously perfused contralateral side. Histamine challenge was associated with a significant rise in contralateral albumin and mucin content. Perfusion with a nitric oxide synthase inhibitor (L-NAME) in the nasal cavity contralateral to nasal challenge was found to block albumin leakage, but not mucin secretion, on that side. The inhibition of vascular exudation was overcome by the addition of L-arginine, the natural substrate of nitric oxide synthase, to the perfusate. Treatment of the ipsilateral nasal cavity with L-NAME did not significantly alter the contralateral response. A high correlation was observed between albumin and mucin concentration in the perfusate. These findings indicate that NO is a mediator of the effector arm of the naso-nasal reflex that increases vascular permeability, but is not involved in the sensory nerve afferent pathway or in reflex mucin release. Further elucidation of the role of NO in nasal physiology may lead to novel pharmacotherapeutic approaches to the treatment of allergic and nonallergic rhinitis.
Paranasal Sinus Development in Chronic Sinusitis, Cystic Fibrosis, and Normal Comparison Population: A Computerized Tomography Correlation Study
Authors: Kim Hung Jeff , Friedman Ellen M. , Sulek Marcelle , Duncan Newton O. , McCluggage Charles
Published: August 2007

Chronic sinus disease in patients with and without cystic fibrosis may have an impact on the pattern of paranasal sinus pneumatization. Arrest of pneumatization has been reported in both of these conditions. To assess the development of the paranasal sinuses in relationship to chronic sinusitis and cystic fibrosis (CF), a retrospective review of coronal CT scans of the age-matched patients with no previous sinus disease, patients with chronic sinusitis, and cystic fibrosis patients was conducted. The patients’ ages ranged from 4 to 17 years. The maxillary sinus volume, anteroposterior diameter, and greatest transverse diameter and height were determined using image analysis software after the coronal CT scans were scanned into Macintosh computer. The size of the maxillary sinus increased with advancing age in the control and chronic sinusitis group, but not in the patients with cystic fibrosis. The patients with cystic fibrosis had a statistically significant smaller maxillary sinus size. Approximately 50% of the patients with chronic sinusitis had anatomic anomalies, the most common being paradoxical middle turbinates. The CT scans of CF patients were characterized by uncinate process demineralization and medial displacement of the lateral nasal wall in the middle meatus, and decreased maxillary sinus pneumatization.
Surgical Treatment of Aspirin Triad Sinusitis
Authors: McFadden Edith A. , Woodson B. Tucker , Fink Jordan N. , Toohill Robert J.
Published: August 2007

Aspirin sensitivity, asthma, and chronic sinusitis with polyposis comprises the syndrome of Aspirin Triad (AT). The sinusitis associated with this disease is often fulminate and difficult to treat. In order to evaluate the surgical treatment of chronic sinusitis of AT a 17-year retrospective study of 80 patients was performed. Friedman Class III or IV sinus CT scans were present in 73 patients (90%) preoperatively. Twenty-five patients (30.1%) had steroid-dependent asthma and an additional 40 (50%) required intermittent oral steroids for asthma control. All patients underwent bilateral sinus surgery by either a conservative or a radical approach. Patients were followed from 3 weeks to 16 years postoperatively, with an average followup of 3 years. Sixty-eight patients (85%) had significant improvement in their sinus symptoms and 67 (83%) had relief of their asthma. The eight patients (10%) who remained steroid dependent required smaller doses of steroids. Seven patients (8.8%) had nonoperative orbital complications. There was a significant incidence of revision surgery after both conservative and radical sinus procedures. We conclude that surgical treatment by either a conservative or a radical approach controlled the sinusitis in the majority of AT patients, but neither was effective in eliminating the need for subsequent sinus surgery in a significant number of patients with severe sinus disease (Classes III and IV). Control of the sinus disease has a definite beneficial effect on steroid dependency and the need for intermittent oral steroids in managing the asthma in AT. We recommend conservative surgery in the surgical treatment of these patients. AT patients also require close long-term followup with intense medical management of their chronic respiratory inflammation that appears to put them at increased risk for nonoperative complications of their severe sinusitis.
Distribution of Mast Cells and Eosinophils in Nasal Polyps from Atopic and Nonatopic Subjects: A Morphometric Study
Authors: Pawliczak Rafal , Kowalski Marek L , Danilewicz Marek , Wagrowska-Danilewicz Malgorzata , Lewandowski Andrzej
Published: August 2007

The pathogenetic mechanism of nasal polyps remains unknown, although polyps seem to be an expression of chronic nasal inflammation of both allergic and nonallergic origin. The goal of our study was to compare the distribution mast cells and eosinophils (cells traditionally associated with allergic inflammation) in nasal polyps from well defined atopic and nonatopic patients, using advanced morphometric analysis system. Nasal polyps were removed during routine nasal polypectomy performed in 17 atopic and 19 nonatopic patients. Parrafin sections of nasal polyps were stained with haematoxilin/eosin, chromotrope R2 or toluidine blue, and light microscopy, assisted with computerized picture analysis system, was used to count the number of cells in the superficial and stromal layer of the mucosa. Regardless of the presence or absence of atopy, eosinophils were predominant cells in the polyps, and both eosinophils and mast cells were more abundant in the superficial layer than in the stromal layer of the mucosa. The density of eosinophils in both layers and mast cells in the stromal layer was similar in atopic and nonatopic patients. Only the density of mast cells in the superficial layer of the mucosa was slightly higher (p < 0.005 in atopic compared to nonatopic patients). In both groups of patients a significant correlation between the number of mast cells and eosinophils in the superficial layer of the polyp mucosa was found (r = 0.84; p < 0.001). Our study demonstrates that eosinophils and mast cells are abundant in nasal polyps from both atopic and nonatopic patients and that mast cells seem to be more superficially distributed in atopic compared to nonatopic patients.
Frontal Sinus Outflow Anatomy
Authors: Lee Dennis , Brody Robin , Har-El Gady
Published: August 2007

Most of the studies of frontal sinus anatomy were completed 50 to 70 years ago. The information they provide is not necessarily relevant or helpful to the modem rhinologic surgeon who approaches the frontal sinus transnasally and endoscopically. We performed anatomical dissections of the outflow tract of 82 frontal sinuses in 41 cadaver heads to illustrate the various drainage patterns from the frontal sinus to the nose and to correlate these drainage sites with the distance and angle from the pyriform aperture. We found that the frontal sinus drained anterior to the uncinate process in 24 specimens (29.3%) with an average distance of 3.65 cm from the pyriform aperture and 58° from the nasal floor. The frontal sinus drained posterior to the uncinate process in 56 specimens (68.3%) with an average distance of 4.10 cm and 65 degrees from the nasal floor. In this latter group, most of the sinuses (51 specimens) drained into the ethmoid infundibulum. Two of the specimens had a hypoplastic frontal sinus with no outflow tract at all. These findings are different from those described in the early 20th century.
The Role of Endoscopy in the Management of Nasal Neoplasia
Authors: Homer Jarrod J. , Jones Nick S. , Bradley Patrick J.
Published: August 2007

Fiberoptic endoscopy has made a notable impact in rhinology over the last decade, mainly in the diagnosis and treatment of paranasal sinus inflammatory disease. The aim of this article is to review, discuss, and illustrate the role of endoscopy in the management of nasal neoplasia. We have reviewed our own experience and illustrate this with four cases. We discuss the role of endoscopy in the diagnosis, biopsy, resection, post-therapeutic surveillance, and palliation of these tumors.
Gram Negative Sinusitis: A Bacteriologic and Histologic Study in Rabbits
Authors: Bolger William E. , Leonard Dave , Dick Edward J. , Stierna Pontus
Published: August 2007

Recent investigations of chronic sinusitis that is “recalcitrant” to traditional medical and surgical therapy indicate that gram negative bacteria are frequently involved, most commonly Pseudomonas aeruginosa. Analysis of infection-induced histopathologic changes in the underlying sinus mucosa may provide important insight into the recalcitrant nature of these infections. Therefore, the aim of this investigation is to experimentally induce sinus infection in the rabbit with Pseudomonas aeruginosa, a bacterium commonly associated with “recalcitrant sinusitis, “ and evaluate the histopathologic findings. A unilateral maxillary sinusitis was induced in 33 New Zealand white rabbits. Histologic analysis at 4, 14, 21, and 28 days revealed a moderate inflammation that persisted throughout the study period. Initial changes included edema, loss of submucosal glands, and ulceration. Fibroplasia and bone remodeling were evident throughout the study. Epithelial plaque formation occurred early in the infection, whereas goblet cell formation was a later change. Experimental sinusitis induced by Pseudomonas aeruginosa causes an intense transmucosal injury. The histopathologic injury and response to Pseudomonas aeruginosa appears to be more intense than that noted on previous investigations of experimental sinusitis using other bacteria. The significant histopathologic changes noted could explain the recalcitrant nature of gram negative sinusitis observed clinically in patients.
A Comparison of Nasal Resistance in White Caucasians and Blacks
Authors: Canbay Ercan I. , Bhatia Suren N.
Published: August 2007

Total nasal resistance was measured in 42 white Caucasian and 32 black healthy adults by both anterior and posterior rhinomanometry after using a nasal decongestant. The nasal airway resistance was found to be lower in the blacks compared to the Caucasians by both anterior and posterior methods. The mean total nasal airway resistance was 0.136 Pa/cm3/s in the blacks and 0.179 Pa/cm3/s in the Caucasians by the anterior method, and 0.134 Pa/cm3/s and 0.161 Pa/cm3/s, respectively, by the posterior method. These differences were highly statistically significant.