bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduced epinephrine reserve in response to insulin-induced hypoglycemia in patients with pituitary adenoma
Authors: Morita Shinya , Otsuki Michio , Izumi Maki , Asanuma Nobuyuki , Izumoto Shuichi , Saitoh Youichi , Yoshimine Toshiki , Kasayama Soji
Published: August 2007

Objective: Hypoglycemia induces rapid secretion of counterregulatory hormones such as catecholamine, glucagon, cortisol, and GH. Insulin-induced hypoglycemia is used for evaluating GH–IGF-I and ACTH–adrenal axes in patients with pituitary disorders. The aim of this study was to determine whether the response of catecholamine secretion to hypoglycemia is disrupted in patients with pituitary adenoma.

Methods: The study population comprised 23 patients with pituitary adenoma (non-functioning adenoma or prolactinoma). An insulin tolerance test was performed and serum catecholamines as well as plasma GH and serum cortisol were measured.

Results: The study patients showed diminished response of plasma epinephrine to insulin-induced hypoglycemia. With the cutoff level of peak epinephrine for defining severe impairment set at 400 pg/ml, more patients with secondary adrenal insufficiency showed severe impairment of the epinephrine response than did those without it. Peak epinephrine levels to insulin-induced hypoglycemia were significantly correlated with peak cortisol levels. In patients with secondary hypothyroidism, secondary hypogonadism, GH deficiency, or diabetes insipidus, the prevalence of severe impairment of the epinephrine response was similar to that in patients without these deficiencies.

Conclusions: Impaired epinephrine secretion in response to insulin-induced hypoglycemia was frequently observed in patients with pituitary adenoma. This disorder was especially severe in patients with secondary adrenal insufficiency.
Gamma knife stereotactic radiosurgery for acromegaly
Authors: Vik-Mo Einar Osland , Øksnes Marianne , Pedersen Paal-Henning , Wentzel-Larsen Tore , Rødahl Eyvind , Thorsen Frits , Schreiner Thomas , Aanderud Sylvi , Lund-Johansen Morten
Published: August 2007

Background: Gamma knife radiosurgery (GKR) is an adjuvant treatment for acromegaly if surgery fails to normalize GH hypersecretion.

Objective: To examine the effect of GKR on tumor growth and hypersecretion, and to characterize the adverse effect of this treatment.

Design: Cross-sectional follow-up study. First, retrospective data pre- and post-GKR were collected. Patients then underwent a predefined survey including radiological, endocrinological, ophthalmological, and neurosurgical evaluation.

Setting: Norwegian National Center for gamma knife treatment.

Patients: Sixty-one patients treated with GKR for acromegaly. Out of 55, 53 living patients underwent a detailed survey. The mean follow-up was 5.5 years. No patient was lost to follow-up.

Results: Tumor growth was stopped in all patients. At 3, 5, and 10 years after GKR, 45, 58, and 86% of patients had normal IGF-I levels. Consecutive hormone value analysis showed that patients receiving GH-suppressive medication had a more rapid decline in hypersecretion than those who did not receive such medication. Evaluated by survey baseline values alone, non-elevated IGF-I and GH levels below 5 mIU/l were found in 38%. GH-suppressive medication was terminated in 16 out of 40 patients following GKR. Nine out of 53 surveyed patients (17%) had normal IGF-I and GH nadir below 2.6 mIU/l at glucose tolerance tests, while not on hormone-suppressive medication. Two patients developed minor visual field defects. Eight patients started hormone substitution therapy during the follow-up period.

Conclusion: GKR is an effective adjuvant treatment for residual acromegaly, carrying few side effects.
Idiopathic short stature: will genetics influence the choice between GH and IGF-I therapy?
Authors: Savage Martin O , Camacho-Hübner Cecilia , David Alessia , Metherell Louise A , Hwa Vivian , Rosenfeld Ron G , Clark Adrian J L
Published: September 2007

Background: Idiopathic short stature (ISS) includes a range of conditions. Some are caused by defects in the GH–IGF-I axis. ISS is an approved indication for GH therapy in the USA and a similar approval in Europe may be imminent. Genetic analysis for single-gene defects has made enormous contributions to understanding the physiology of growth regulation. Can this type of investigation help in predicting growth responses to GH or IGF-I therapy?

Methods: The rationale for choice of GH or IGF-I therapy in ISS is reviewed. Many ISS patients have low IGF-I, but most can generate IGF-I levels in response to short-term GH administration. Some GH resistance seems to be present. Mutation analysis in several cohorts of GHIS and ISS patients is reviewed.

Results: Low IGF-I levels suggest either unrecognised GH deficiency or GH resistance. In classical GHIS patients, there was a positive relationship between IGFBP-3 levels and height SDS. No relationship exists between mutations and phenotype. There is a wide variability of phenotype in patients carrying identical mutations. Heterozygous GH receptor (GHR) mutations were present in <5% of ISS patients and their role in causing growth defects is questionable. Exceptions are dominant negative mutations that have been shown to disturb growth.

Conclusions: Analysis for single-gene defects does not give sensitive predictions of phenotype and cannot predict responses to GH or IGF-I therapy. Endocrine abnormalities have closer correlations with phenotype and may thus be a better guide to therapeutic responsiveness.
High normal testosterone levels in infants with non-mosaic Klinefelter’s syndrome
Authors: Aksglaede Lise , Petersen Jørgen H , Main Katharina M , Skakkebæk Niels E , Juul Anders
Published: August 2007

Objective: Klinefelter’s syndrome (KS) is associated with hypergonadotrophic hypogonadism in adulthood. However, limited information exists about the age at which hypogonadism occurs. The hypothalamic–pituitary–gonadal (HPG) axis is transiently activated during the first months of life, offering the opportunity to study testicular function by spontaneous, basal hormone levels. The aim of this study was to evaluate the HPG axis in KS infants.

Design: Cross-sectional study.

Methods: Ten KS infants aged 3.1 months (range 1.8–3.8) and 613 healthy controls aged 3.0 months (range 2.0–4.5). Serum levels of total and free testosterone (T), LH, FSH, inhibin B and sex hormone-binding globulin (SHBG) were determined.

Results: KS infants had significantly higher concentrations of total T (5.0 (2.2–11.2) vs 3.4 (0.7–8.3) nmol/l, P = 0.02), free T (31.6 (18.2–61.8) vs 22.1 (4.3–48.4) pmol/l, P = 0.01), LH (3.3 (1.3–4.6) vs 1.7 (0.6–4.3) IU/l, P = 0.005) and FSH (1.7 (1.1–4.1) vs 1.2 (0.4–3.0) IU/l, P = 0.007) than controls. SHBG and inhibin B did not differ from controls. LH/T and LH/free T ratios were normal, whereas the FSH/inhibin B ratio was elevated (6.5 (2.7–16.9) vs 3.0 (0.78–11.4), P = 0.005) when compared to controls. The majority of KS infants had normal bivariate hormonal combinations.

Conclusion: We found increased FSH/inhibin B ratio as a possible sign of Sertoli cell dysfunction. However, serum levels of T were high normal suggesting an altered pituitary–gonadal set point.
Interference by Carbamazepine and Oxcarbazepine With Serum- and Urine-Screening Assays for Tricyclic Antidepressants
Authors: Saidinejad Mohsen , Law Terence , Ewald Michele Burns
Published: August 2007

OBJECTIVE. The purpose of this work was to evaluate the potential cross-reactivity of 2 antiepileptic medications containing 3-ringed structures, namely, carbamazepine and oxcarbazepine, with screening assays for tricyclic antidepressants.

METHODS. A cross-sectional study of 52 patients between 3 and 19 years of age who had been prescribed either carbamazepine or oxcarbazepine was conducted. A serum fluorescence-polarized immunoassay and a urine enzyme-linked immunoassay were used. The serum carbamazepine or oxcarbazepine level was measured. Gas chromatography/mass spectrometry, a confirmatory test for tricyclic antidepressant detection, was subsequently performed on the serum specimen.

RESULTS. A linear dependency on medication level was observed with the serum fluorescence-polarized immunoassay assay. This relationship was stronger for carbamazepine (4.2 μg/L tricyclic antidepressant detected per microgram/liter of carbamazepine) than for oxcarbazepine (0.7 μg/L tricyclic antidepressant detected per milligram/liter). At higher carbamazepine levels (8.0–11.6 mg/L), 12 of 13 patients had a positive serum fluorescence-polarized immunoassay result; at lower levels (0.1–7.9 mg/L), only 1 of 20 had a positive result. None of the patients who were receiving oxcarbazepine showed significant tricyclic antidepressant activity on either assay.

CONCLUSIONS. Carbamazepine interferes at a statistically significant level with serum fluorescence-polarized immunoassay assay and in a dose-dependent fashion. Neither carbamazepine nor oxcarbazepine exhibit significant tricyclic antidepressant activity on urine enzyme-linked immunoassay assay.
Predictors of Mycobacterium tuberculosis Infection in International Adoptees
Authors: Mandalakas Anna M. , Kirchner H. Lester , Iverson Sandra , Chesney Mary , Spencer Mary Jo , Sidler Angela , Johnson Dana
Published: August 2007

OBJECTIVE. The objective of this study was to measure the factors that are associated with Mycobacterium tuberculosis infection in international adoptees.

METHODS. A retrospective chart review was conducted on 880 international adoptees who presented to the International Adoption Clinic at the University of Minnesota between 1986 and 2001. Five tuberculin units of purified protein derivative were placed intradermally on the left forearm. The largest diameter of induration was measured in millimeters between 48 and 72 hours. Nutritional status was assessed using anthropometric measures at initial screening. Data on age, birth country, and year of adoption were assessed.

RESULTS. Adoptees (mean age: 26 months; range: 1–200 months; 62% female) came from 33 birth countries. Twenty-eight percent and 5% had evidence of chronic and acute malnutrition, respectively. Twelve percent had evidence of M tuberculosis infection. The odds of M tuberculosis infection increased 7% for each subsequent year during the period studied, increased 142% with each additional year of age for children ≤24 months of age at baseline screening, and increased 15% with each additional year of age for children >24 months of age at the time of evaluation. Tuberculin skin test induration response was not associated with nutritional status or birth region.

CONCLUSIONS. Our study demonstrated a high prevalence of M tuberculosis infection and malnutrition in internationally adopted children, placing them at considerable risk for progression to tuberculosis disease. These findings also support current guidelines recommending completion of tuberculin screening immediately after adoption.
Resuscitation in the “Gray Zone” of Viability: Determining Physician Preferences and Predicting Infant Outcomes
Authors: Singh Jaideep , Fanaroff Jon , Andrews Bree , Caldarelli Leslie , Lagatta Joanne , Plesha-Troyke Susan , Lantos John , Meadow William
Published: August 2007

OBJECTIVE. We assessed physician preferences and physician prognostic abilities regarding delivery room management of exceedingly low birth weight/short gestation infants.

METHODS. We surveyed US neonatologists to assess their behavior in the delivery room when confronted with infants with gestational ages of 22 to 26 weeks. We identified 102 infants in our NICU with birth weights/gestational ages of 400 g/23 weeks to 750 g/26 weeks, whose follow-up care was ensured because of their participation in ongoing clinical trials. We determined 4 proxy measures for “how the infant looked” in the delivery room (Apgar scores at 1 and 5 minutes and heart rates at 1 and 5 minutes) and assessed the predictive value of each marker for subsequent death or neurologic morbidity.

RESULTS. For infants with birth weights of <500 g and gestational ages of 23 weeks, only 4% of 666 responding neonatologists would provide full resuscitation. In contrast, for infants with birth weights of >600 g and gestational ages of 25 weeks, >90% of neonatologists considered resuscitation obligatory. For infants with birth weights of 500 to 600 g and gestational ages of 23 to 24 weeks, only one third of neonatologists responded that parental preference would determine whether they resuscitated the infant in the delivery room. The majority wanted “to see what the infant looked like.” For 102 infants with birth weights of ≤750 g, Apgar scores at 1 and 5 minutes and heart rates at 1 and 5 minutes were neither sensitive nor predictive for death before discharge, survival with a neurologic abnormality, or intact neurologic survival.

CONCLUSIONS. The “gray zone” for delivery room resuscitation seems to be between 500 and 600 g and 23 and 24 weeks. For infants born in that zone, neonatologists' reliance on accurate prediction of death or morbidity in the delivery room may be misplaced.
“Masculinizing” Effect on Respiratory Morbidity in Girls From Unlike-Sex Preterm Twins: A Possible Transchorionic Paracrine Effect
Authors: Shinwell Eric S. , Reichman Brian , Lerner-Geva Liat , Boyko Valentina , Blickstein Isaac ,   in collaboration with the Israel Neonatal Network
Published: August 2007

OBJECTIVES. Preterm male infants are at a disadvantage when compared with female infants regarding the incidence of respiratory and neurologic morbidity and mortality. At term, female infants from unlike-sex twin pairs have birth weights that are closer to their male co-twins than to girls from like-sex twin pairs. We hypothesized that if the male disadvantage is mediated via factors that affect fetal lung development, there may be a potential effect on the incidence of respiratory distress syndrome and its complications in female infants from unlike-sex pairs.

PATIENTS AND METHODS. In this population-based study we used data from the Israel Neonatal Network, which included data from 8858 very low birth weight (500–1500 g) infants of 24 to 34 weeks' gestation. The incidence of morbidity and mortality was compared in male and female infants from singletons and like-sex and unlike-sex twin pairs. Multivariable analyses were used, accounting for relevant confounding variables.

RESULTS. Male singletons and like-sex twins were at increased risk for mortality, respiratory distress syndrome, pneumothorax, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, and periventricular leukomalacia. However, in unlike-sex twin pairs, no difference was seen in the incidence of respiratory morbidity between male and female twins. The male disadvantage was maintained for mortality and periventricular-intraventricular hemorrhage.

CONCLUSIONS. These findings suggest that the difference in morbidity and mortality between male and female premature infants represents a male disadvantage as opposed to a female advantage and that this disadvantage may be transferred from boys to girls in unlike-sex twin pairs, perhaps via an intrauterine paracrine effect.
Nutritional Content of Television Food Advertisements Seen by Children and Adolescents in the United States
Authors: Powell Lisa M. , Szczypka Glen , Chaloupka Frank J. , Braunschweig Carol L.
Published: August 2007

OBJECTIVE. In light of the high rates of child and adolescent obesity, we examined the nutritional content of food advertising seen by American children and adolescents.

METHODS. We drew samples of top-rated television shows by using ratings data to examine the nutritional content for fat, saturated fat, sugar, sodium, and fiber of food-product advertisements seen on television by both children and adolescents. Food products were examined in aggregate and by 5 separate categories that included cereal, sweets, snacks, drinks, and other food products. For 2- to 11-year-olds and 12- to 17-year-olds, respectively, a sample of 50351 and 47955 30-second-equivalent food-product advertisements and their related nutritional content were weighted by television ratings data to provide actual exposure measures of the nutritional content of food advertising seen by children and adolescents.

RESULTS. Study results showed that 97.8% and 89.4% of food-product advertisements viewed by children 2 to 11 years old and adolescents 12 to 17 years old, respectively, were high in fat, sugar, or sodium. On average, 46.1% and 49.1% of total calories among the products advertised came from sugar in the advertisements seen by these respective age groups. A total of 97.6% of cereal advertisements seen by children 2 to 11 years old were for high-sugar cereals. No substantial differences were found in the nutritional content of advertisements seen by black and white children 2 to 11 years old. However, a slightly higher proportion of food advertisements in general and across all food-product categories seen by black versus white adolescents were for high-sugar products.

CONCLUSION. The overwhelming majority of food-product advertisements seen on television by American children and adolescents are of poor nutritional content.
Clinical Malaria and Sickle Cell Disease Among Multiple Family Members in Chicago, Illinois
Authors: Glikman Daniel , Nguyen-Dinh Phuc , Roberts Jacquelin M. , Montgomery Christopher P. , Daum Robert S. , Marcinak John F.
Published: August 2007

Malaria is a disease of global importance and accounts for up to 500 million cases per year. Nearly all malaria cases in the United States occur among persons who have traveled to areas with ongoing malaria transmission. Among the cases of malaria reported in the United States in 2000–2005, 695 were in US residents under the age of 18 years. The association of malaria with the sickle cell hemoglobin is well described in Africa but is a rare occurrence in the United States. Here we report 5 cases of Plasmodium falciparum malaria in siblings of a family who had traveled to Africa without taking chemoprophylaxis. Two of the children had sickle cell anemia, and 1 of them developed severe life-threatening malaria and hemolysis. The 3 other siblings had sickle cell trait, 2 of whom had complicated malaria. Patients who have sickle cell disease and are infected with malaria are prone to hyperhemolytic crisis; therefore, this complication should be anticipated. The patients we describe emphasize the significance of prompt recognition of malaria and comorbidities and institution of appropriate treatment. The importance of antimalarial prophylaxis should be communicated to parents of children who are traveling to endemic areas as part of routine child care.
Breastfeeding and Smoking: Short-term Effects on Infant Feeding and Sleep
Authors: Mennella Julie A. , Yourshaw Lauren M. , Morgan Lindsay K.
Published: August 2007

OBJECTIVE. The present experimental study was designed to determine how breastfeeding from a mother who smokes affects infants in the short-term.

METHODS. Fifteen mother-infant dyads were tested on 2 days separated by 1 week. Mothers smoked (not in the presence of their infants) on one test day and refrained from smoking on the other. For the next 3.5 hours, infants breastfed on demand. Sleep and activity patterns were monitored by placing an actigraph on the infants' leg, and milk intake was determined by weighing the infants before and after each feeding. The nicotine content of the milk was measured to determine the dose of nicotine delivered to the infants.

RESULTS. Although there was no significant difference in breast milk intake, despite the taste changes in the milk, infants spent significantly less time sleeping during the hours immediately after their mothers smoked (53.4 minutes), compared with the session when their mothers abstained from smoking (84.5 minutes). This reduction was attributable to shortening of the longest sleep bout and reductions in the amounts of time spent in both active sleep and quiet sleep. With greater doses of nicotine delivered to the infant, less time was spent in active sleep.

CONCLUSIONS. An acute episode of smoking by lactating mothers altered infants' sleep/wake patterning. Perhaps concerns that their milk would taste like cigarettes and their infants' sleep patterning would be disrupted would motivate lactating mothers to abstain from smoking and to breastfeed longer.
Randomized Trial of Early Versus Late Enteral Iron Supplementation in Infants With a Birth Weight of Less Than 1301 Grams: Neurocognitive Development at 5.3 Years' Corrected Age
Authors: Steinmacher Jochen , Pohlandt Frank , Bode Harald , Sander Silvia , Kron Martina , Franz Axel R.
Published: August 2007

BACKGROUND. Iron deficiency in early childhood may impair neurodevelopment. In a masked, randomized, controlled trial of early versus late enteral iron supplementation in preterm infants with birth weights of <1301 g, early iron supplementation reduced the incidence of iron deficiency and the number of blood transfusions.

OBJECTIVE. We sought to examine whether early enteral iron supplementation improves neurocognitive and motor development in these infants.

METHODS. Children who participated in the above mentioned trial were evaluated by applying the Kaufmann Assessment Battery for Children and the Gross Motor Function Classification Scale at the age of school entry.

RESULTS. Of the 204 infants initially randomized, 10 died and 30 were lost to follow-up. A total of 164 (85% of the survivors) were evaluated at a median corrected age of 5.3 years. In this population (n = 164), the mean (±SD) mental processing composite in the early iron group was 92 (±17) versus 89 (±16) in the late iron group. An abnormal neurologic examination was found in 17 of 90 versus 26 of 74, and a Gross Motor Function Classification Scale score of >1 was found in 2 of 90 versus 5 of 74, respectively. Fifty-nine of 90 children in the early iron group were without disability, compared with 40 of 74 in the late iron group. Severe disability was found in 5 of 90 versus 6 of 74 children and 67 of 90 versus 49 of 74 qualified for regular schooling, respectively.

CONCLUSIONS. Early enteral iron supplementation showed a trend toward a beneficial effect on long-term neurocognitive and psychomotor development and showed no evidence for any adverse effect. Because the initial study was not designed to evaluate effects on neurocognitive development, the power was insufficient to detect small but potentially clinically relevant improvements. Additional studies are required to confirm the trend towards a better outcome observed in the early iron group.
Continuous Positive Airway Pressure Therapy for Infants With Respiratory Distress in Non–Tertiary Care Centers: A Randomized, Controlled Trial
Authors: Buckmaster Adam G. , Arnolda Gaston , Wright Ian M. R. , Foster Jann P. , Henderson-Smart David J.
Published: August 2007

OBJECTIVE. Our objective was to determine whether continuous positive airway pressure therapy would safely reduce the need for up-transfer of infants with respiratory distress from nontertiary centers.

METHODS. We randomly assigned 300 infants at >30 weeks of gestation with respiratory distress to receive either Hudson prong bubble continuous positive airway pressure therapy or headbox oxygen treatment (standard care). The primary end point was “up-transfer or treatment failure.” Secondary end points included death, length of nursery stay, time receiving oxygen therapy, cost of care, and other measures of morbidity.

RESULTS. Of 151 infants who received continuous positive airway pressure therapy, 35 either were up-transferred or experienced treatment failure, as did 60 of the 149 infants given headbox oxygen treatment. There was no difference in the length of stay or the duration of oxygen treatment. For every 6 infants treated with continuous positive airway pressure therapy, there was an estimated cost saving of $10000. Pneumothorax was identified for 14 infants in the continuous positive airway pressure group and 5 in the headbox group. There was no difference in any other measure of morbidity or death.

CONCLUSIONS. Hudson prong bubble continuous positive airway pressure therapy reduces the need for up-transfer of infants with respiratory distress in nontertiary centers. There is a clinically relevant but not statistically significant increase in the risk of pneumothorax. There are significant benefits associated with continuous positive airway pressure use in larger nontertiary centers.
Infection Prevention and Control in Pediatric Ambulatory Settings
Authors:   Committee on Infectious Diseases
Published: August 2007

Since the American Academy of Pediatrics published a statement titled “Infection Control in Physicians' Offices” (Pediatrics. 2000;105[6]:1361–1369), there have been significant changes that prompted this updated statement. Infection prevention and control is an integral part of pediatric practice in ambulatory medical settings as well as in hospitals. Infection prevention and control practices should begin at the time the ambulatory visit is scheduled. All health care personnel should be educated regarding the routes of transmission and techniques used to prevent transmission of infectious agents. Policies for infection prevention and control should be written, readily available, updated annually, and enforced. The standard precautions for hospitalized patients from the Centers for Disease Control and Prevention, with a modification from the American Academy of Pediatrics exempting the use of gloves for routine diaper changes and wiping a well child's nose or tears, are appropriate for most patient encounters. As employers, pediatricians are required by the Occupational Safety and Health Administration to take precautions to identify and protect employees who are likely to be exposed to blood or other potentially infectious materials while on the job. Key principles of standard precautions include hand hygiene (ie, use of alcohol-based hand rub or hand-washing with soap [plain or antimicrobial] and water) before and after every patient contact; implementation of respiratory hygiene and cough-etiquette strategies for patients with suspected influenza or infection with another respiratory tract pathogen to the extent feasible; separation of infected, contagious children from uninfected children when feasible; safe handling and disposal of needles and other sharp medical devices and evaluation and implementation of needle-safety devices; appropriate use of personal protective equipment such as gloves, gowns, masks, and eye protection; and appropriate sterilization, disinfection, and antisepsis.
Role of fibroblasts in physiologic reparative and pathologic processes
Authors: Salamon Antal , Toldy Erzsébet
Published: September 2007

A fibroblast a kötőszövet egyik fontos sejtje. Ma már több fenotípusa ismert, melyek számos reparatív és patológiás folyamatban vesznek részt. Ezek során sejtes és molekuláris történések zajlanak le, melyekben a fibroblastok fontos szerepet játszanak. A molekuláris tényezők közül az integrinek, növekedési faktorok, citokinek, mátrixmolekulák említendők elsősorban. A jelen munka célja ismertetést adni a laza és tömött rostos kötőszövetben a fibroblastok morfológiai, biokémiai és funkcionális szerepéről a fiziológiás történéseken túlmenően olyan reparatív és patológiás folyamatokban, mint a sebgyógyulás, Dupuytren-betegség, rheumatoid arthritis, Graves-ophthalmopathia és a carcinogenesis. Az ismertetésből kiderül, hogy a fibroblastok milyen dinamikus kapcsolatban vannak más sejtekkel és a sejt közti állománnyal. Az új kutatások eredményei jobban megvilágítják a szövetekben lezajló fiziológiás és patológiás folyamatokat, ugyanekkor potenciálisan segítséget nyújthatnak egyes betegségek új terápiás lehetőségeihez. A szerzők irodalmi adatok és saját vizsgálataik alapján foglalják össze a témakör fontosabb kérdéseit.
Periodisierung der abendländischen Mehrstimmigkeit
Authors: Federhofer Hellmut
Published: September 2007

Die Periodisierung abendländischer Mehrstimmigkeit erfolgt anhand eines satztechnischen Merkmals. Ihm liegt der Konsonanz-Dissonanz-Gegensatz zugrunde. Unter diesem Gesichtspunkt ergeben sich vier Perioden, die sich von der
Musica enchiriadis
bis zur Neuen Musik des 20. Jahrhunderts erstrecken. Die erste Periode reicht bis ca. 1400, in der eine Differenzierung zwischen Konsonanz und Dissonanz noch nicht einheitlich erfolgt. In der zweiten bis ca. 1600 sich erstreckenden Periode bestimmt der Konsonanz-Dissonanz-Gegensatz die Ausbildung des klassischen Intervallsatzes. Als Lehre des strengen Satzes bildet er in der dritten, von 1600 bis 1900 reichenden Periode die Grundlage für den freien Satz. Die anstelle des Intervalls getretene Dreiklangskonsonanz erweitert die Möglichkeiten der Dissonanzfortschreitung, ohne jedoch den Konsonanz-Dissonanz-Gegensatz preiszugeben. Diesen Schritt vollzieht erst die Neue Musik im 20. Jahrhundert, welche die vierte Periode und den verhängnisvollen Bruch zwischen ihr und der Gesellschaft einleitet.
Liszt and the Mozart connection
Authors: Wright William
Published: September 2007

The life and works of Mozart are central to a due understanding of Liszt’s development as pianist, composer, and conductor. Yet, this fact receives inadequate attention in scholarly studies. Liszt readily acknowledged that he ‘owed the greater part of what he was as a musician to Mozart’ and found identity and goal as he sought, as pianist and composer, to emulate the endeavors of the Viennese master. Like Mozart, he was a ‘pioneer of progress’ who refused ‘to be bound by accepted modes of expression.’ Like Mozart, ‘he pushed virtuosity to utmost limits.’ Like Mozart, he was seen by many as an iconic figure of German nationalism. In later life, Liszt took comfort from the fact that Mozart, his illustrious role-model, was not spared bitter experiences. ‘As with every great genius,’ both endured ‘pain and suffering’ in order to accomplish their task. In so many areas of musical activity and experience, Liszt mirrored his great Viennese master. Throughout Liszt’s life, he remained devoted to the scrupulous study and execution of Mozart’s music and played an important part in promoting a better understanding of both man and music via podium and press before, during, and after the Mozart Centenary Celebrations in Vienna in January 1856.
„Der Ton gewinnt einen magischen Zauber“ — Rezeption und Vermittlung der französischen Orgelromantik in der Tätigkeit der Angster-Orgelfabrik zu Fünfkirchen
Authors: Enyedi Pál
Published: September 2007

Die Orgelbaugeschichte von Ungarn und der ganzen Region ist dem Wesen nach ein Teil der deutschen Orgelbaugeschichte. Trotz gewisser lokaler Traditionen haben alle hiesigen Orgelbauer, unabhängig von ihrer ethnischen Abstammung, Instrumente deutschen Grundcharakters geschaffen. In der zweiten Hälfte des 19. Jahrhunderts konnten einige Orgelbauer unserer Region Erfahrungen in Westeuropa sammeln, wodurch der bodenständige Orgelbaustil mit fremden, vor allem französischen Zügen bereichert wurde. Josef Angster, später Orgelbauer in Fünfkirchen (Pécs), wurde von der französischen Orgelbauästhetik am stärksten beeinflusst und hat diese dann in Ungarn mit Erfolg in seine Praxis integriert. In seinem ersten Werk (1869) hat Angster in klanglicher und technischer Hinsicht das Orgelideal von Cavaillé-Coll mit nur geringen Abweichungen verkörpert. Dieser französische Orgeltyp in seiner ursprünglichen Form und die dazugehörige Musik scheinen aber nicht das Ideal von Angster gewesen zu sein. So zeigen seine Orgeln nach dem ersten Opus eine eigenartige Mischung französischer und deutscher Stilmerkmale, mit in klanglicher Hinsicht ausgesprochener Dominanz der letzteren. Von 1896 an übernahm die zweite Generation die Firmenleitung. Unmittelbar nach der Jahrhundertwende wurde die Produktion grundlegend umgestellt, das alte Windladen- und Traktursystem wurde zugunsten der modernen Pneumatik aufgegeben. Auf diese Weise wurde nach dem klanglichen auch der technische Aufbau der Angster-Orgeln wesentlich den deutschen Gepflogenheiten angepasst. Umso überraschender ist, dass die französisch-sinfonische Idee in der Angsterschen Werkstatt nach dem Ersten Weltkrieg plötzlich auftaucht. Diese Idee entstammt der von Emil Rupp und Albert Schweitzer nach der Jahrhundertwende vehement propagierten Elsässer Reform. Nach Ungarn — und in die Firma Angster — kam sie durch die Vermittlung einiger ungarischen Organologen, allen voran durch József Geyer. So konnte die Firma Angster im südöstlichen Grenzgebiet der deutschen Orgellandschaft wesentliche Stilmerkmale der französischen Orgelromantik auch in der Zwischenkriegszeit nach Ungarn vermitteln.
Deformation micromechanisms of ZnO single crystals as determined from spherical nanoindentation stress–strain curves
Authors: Basu Sandip , Barsoum Michel W.
Published: August 2007

In this work, instrumented nanoindentation experiments with two spherical tips with radii of 13.5 and 1 μm were used to explore the deformation behavior of ZnO single crystals with two orientations, C (basal) and A (prism). By converting the nanoindentation load–displacement data to stress–strain curves, we show that the main reason the hardening rates are higher for the C plane than they are for the A plane is the activation of dislocations—with widely different flow stresses—on different sets of slip planes. For the former, glide occurs on basal planes as well as pyramidal planes; for the latter, glide occurs predominantly on basal planes. The C plane is roughly twice as hard as the A plane, probably due to the orientation of basal planes with respect to the indentation axis. A Weibull statistical analysis of the pop-in stresses indicates that the inherent defect concentration at or near the surface is the main factor for the initiation of plastic deformation. The strain energy released when the pop-ins occur determines their extent. The elastic moduli values, determined by Berkovich nanoindentation, are 135 ± 3 GPa and 144 ± 4 GPa for the C and A planes, respectively. In the C orientation repeated indentations to the same stress result in fully reversible hysteretic loops that are attributed to the formation of incipient kink bands.
Effect of the substrate surface condition on the Ni(thin film)/SiC(0001) interfacial reaction
Authors: Dean Cory R. , Robbie Kevin , Madsen Lynnette D.
Published: August 2007

The effect of the substrate surface, structure, and chemistry on the interfacial interaction in Ni(thin film)/SiC was examined, with a focus on the recently discovered formation of a nickel intercalated graphite phase. Very thin Ni films (∼7 nm) were deposited onto heated 6H–SiC(0001) substrates prepared with: (i) an oxide layer, (ii) a surface reconstruction, and (iii) a pristine surface (no oxide and no reconstruction), followed by further annealing. Characterization using x-ray diffraction and atomic force microscopy revealed remarkable differences between the samples in terms of both surface morphology and crystallography. Nickel silicides were present in all samples; however, the phase composition differed depending on sample preparation. Furthermore, the pristine surface was the only one that clearly promoted the growth of the nickel graphite intercalation compound (Ni-GIC).
Enhance plasticity of bulk metallic glasses by geometric confinement
Authors: Yu P. , Liu Y.H. , Wang G. , Bai H.Y. , Wang W.H.
Published: August 2007

We report that bulk metallic glasses (BMGs) with large plasticity can be obtained in conventional brittle BMGs by a shrink-fit metal sleeve. The mechanical performance especially the plasticity in the Zr41.2Ti13.8Cu12.5Ni10Be22.5 BMG with a shrink-fit copper sleeve is much enhanced. The approach results in the formation of the highly dense and frequent interacting and arresting events of shear bands and is the origin of the observed large global plasticity. The results present another simple step toward toughening the inherently brittle BMGs.
Enhancement of plasticity in Zr-based bulk metallic glasses
Authors: Wang X.D. , Yang L. , Jiang J.Z. , Saksl K. , Franz H. , Fecht H-J. , Liu Y.G. , Xian H.S.
Published: August 2007

We present evidence that a minor adjustment in Zr/Ni concentration ratio can dramatically enhance the plasticity of monolithic Zr-based bulk metallic glasses (BMGs) from about 2.2% for Zr65Al8Ni10Cu17 BMG to 14% for Zr62Al8Ni13Cu17 BMG. No deformation-induced nanocrystallization appears in a 55% strained Zr62Al8Ni13Cu17 BMG without catastrophic failure while pre-existing nanocrystals in Zr65Al8Ni10Cu17 BMG result in its limited plasticity. Also note that the stability of Zr62Al8Ni13Cu17 BMG against crystallization upon deformation is somewhat higher than that of Zr65Al8Ni10Cu17 BMG. As determined by x-ray diffraction using synchrotron radiation, the enhanced plasticity of Zr62Al8Ni13Cu17 BMG seems to be related to the relative homogeneity of the amorphous structure.
Effects of Sr and B addition on microstructure and mechanical properties of AZ91 magnesium alloy
Authors: Zhao H.L. , Guan S.K. , Zheng F.Y.
Published: August 2007

The effects of Sr and B addition on the microstructure and mechanical properties of AZ91 alloy were studied. The results of this work show that a small amount of Sr addition to AZ91 refined the grain size. The highest tensile strength was obtained from the alloy with the optimal composition of 0.5% Sr and 0.09% B added, in which the average grain size was 42 μm. The tensile strength and elongation of the AZ91–0.5%Sr–0.09%B alloy were 151 MPa and 1.62%, respectively. Some needle-shaped Al4Sr particles distributed mainly at grain boundaries have been observed in the alloys with Sr and B additions. The fluidity is improved significantly, and the solidification range decreased by adding Sr and B. The liquidus of AZ91 alloy decreased markedly with the addition of Sr and B, but the solidus hardly changed. Therefore, the solidification range can be decreased, which will improve the die-casting properties.
Evaluation of nano-frictional and mechanical properties of a novel Langmuir–Blodgett monolayer/self-assembly monolayer composite structure
Authors: Yang Guang-hong , Dai Shu-xi , Cheng Gang , Zhang Ping-yu , Du Zu-liang
Published: August 2007

A novel stearic acid (SA)/3-aminopropyltrethoxysilane (APS) composite structure was fabricated using the combined method of the Langmuir–Blodgett technique and self-assembly monolayer (SAM) technique. Its frictional, adhesive properties and interface contact types between the atomic force microscope tip and the samples were evaluated based on Amonton’s laws and the general Carpick’s transition equation, respectively. The results showed that the tip–sample contacts corresponded to the Johnson–Kendall–Robert/Derjaguin–Muller–Toporov (DMT) transition model for SiO2, APS-SAMs, and the unheated SA-APS composite structure, and for the heated SA-APS bilayer to the DMT model. Frictional forces for the four samples were linearly dependent on external loads at higher loads, and at lower loads they were significantly affected by adhesive forces. Frictional and scratching tests showed that the heated SA-APS composite structure exhibited the best lubricating properties and adhesion resistance ability, and its wear resistance capacity was greatly improved due to the binding-mode conversion from hydrogen bonds to covalent bonds. Thus, this kind of composite bilayer might be promising for applications in the lubrication of nano/microelectromechanical systems.
High carrier concentrations of n- and p-doped GaN on Si(111) by nitrogen plasma-assisted molecular-beam epitaxy
Authors: Chuah L.S. , Hassan Z. , Ng S.S. , Hassan H. Abu
Published: August 2007

High-quality doped GaN layers were grown on silicon substrates by radio frequency nitrogen plasma-assisted molecular-beam epitaxy. High-temperature-grown AlN (about 200 nm) was used as a buffer layer. In-growth doping was done using high-purity Si and Mg as n- and p-type dopants, respectively. X-ray diffraction revealed that monocrystalline GaN was obtained. This is in good agreement with the results of morphological study by atomic force microscopy. Micro-photoluminescence (PL) and micro-Raman spectroscopy were used to study the room-temperature optical properties of the doping films. No yellow-band emission was observed in the PL spectroscopy. From the Hall measurements, the resulting n-type doping concentration was measured to be (1–2) × 1019 cm−3. Fairly uniform hole concentration as high as (4–5) × 1020 cm−3 throughout the GaN crystal was achieved. In terms of the carrier concentration, it was found that the results determined from the Fourier transform infrared analysis are in good agreement with the results determined from the Hall measurements.
Cancer-Associated Neutropenic Fever: Clinical Outcome and Economic Costs of Emergency Department Care
Authors: Courtney D. Mark , Aldeen Amer Z. , Gorman Stephen M. , Handler Jonathan A. , Trifilio Steven M. , Parada Jorge P. , Yarnold Paul R. , Bennett Charles L.
Published: August 2007

Purpose.

Febrile neutropenia (FN) is a common, costly, and potentially fatal complication in oncology. While FN in the inpatient setting has been extensively studied, only one study has evaluated emergency department (ED) care for FN cancer patients. That study found that 96% of patients survived the complication. We evaluated clinical and economic outcomes for cancer patients with chemotherapy-associated FN treated in an ED.

Methods.

ED records for consecutive oncology patients with FN were reviewed for information on death, intensive care unit (ICU) use, blood cultures, and costs.

Results.

Forty-eight patients (n = 57 visits) were evaluated. Six patients died from FN (12%) and four received ICU care within 2 weeks and survived (8%). Blood cultures were positive for 37% of the ED visits. The median ED time was 3.3 hours. In 91% of visits, i.v. antibiotics were administered in the ED, ordered at a median of 1.7 hours from triage (interquartile range [IQR], 1.2–2.8 hours). All patients with death or ICU in 2 weeks and all but one patient with positive blood cultures received antibiotics. The median per patient ED costs were $1,455 (IQR, $1,300–$1,579)—42.4% for hospital/nursing, 23.5% for radiology, 20.8% for physician services, 10.9% for diagnostic tests, and 2.4% for antibiotics.

Conclusions.

Cancer patients with FN in this sample presenting to the ED frequently had no identified source of infection. One third of the patients had positive ED blood cultures and one fifth died or required ICU care within 2 weeks. Costs of ED care were similar to the cost of a single day of inpatient care.
Valproic Acid Activates Notch-1 Signaling and Regulates the Neuroendocrine Phenotype in Carcinoid Cancer Cells
Authors: Greenblatt David Yu , Vaccaro Abram M. , Jaskula-Sztul Renata , Ning Li , Haymart Megan , Kunnimalaiyaan Muthusamy , Chen Herbert
Published: August 2007

Carcinoid tumors are neuroendocrine malignancies that frequently metastasize and secrete hormones that cause debilitating symptoms in patients. In this study we report the effects of valproic acid (VPA), a drug long used for the treatment of epilepsy, on the growth and neuroendocrine phenotype of human carcinoid cancer cells. VPA treatment of gastrointestinal and pulmonary carcinoid cells resulted in a dose-dependent inhibition of cancer cell growth. Western blot analysis revealed degradation of cyclin D1 and an increase in cyclin-dependent kinases p21 and p27 with VPA treatment. Flow cytometry confirmed that the mechanism of VPA-induced growth inhibition is G1 phase cell cycle arrest. Furthermore, VPA suppressed expression of the neuroendocrine tumor marker chromogranin A. In addition to these effects, VPA also increased levels of full-length Notch-1 and the active Notch-1 intracellular domain. Luciferase reporter assays incorporating the centromere-binding factor 1 (CBF-1) binding site and the achaete-scute complex-like 1 (ASCL-1) promoter confirmed the functional activity of VPA-induced Notch-1. Transfection of Notch-1 small-interfering RNA into carcinoid tumor cells blocked the effects of VPA on Notch-1 activation, ASCL-1 suppression, p21 induction, and cell growth inhibition. VPA also suppressed growth of carcinoid tumors in vivo in a mouse tumor xenograft experiment. These findings confirm the important role of Notch-1 in regulating the growth and neuroendocrine phenotype of carcinoid tumor cells. On the basis of this study, a clinical trial of VPA for patients with advanced carcinoid cancer will be conducted.
Evolving Strategies for Combined-Modality Therapy for Locally Advanced Head and Neck Cancer
Authors: Posner Marshall
Published: August 2007

Learning Objectives

After completing this course, the reader will be able to: Discuss the newest options for curative therapy of locally advanced head and neck cancer.List the pros and cons of the different approaches to treating locally advanced head and neck cancer.Describe sequential therapy for head and neck cancer.

CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Commentary: Induction Chemotherapy for Head and Neck Cancer: Hypothesis-Based Rather Than Evidence-Based Medicine
Authors: Eisbruch Avraham
Published: August 2007

Learning Objectives

After completing this course, the reader will be able to: Discuss the history of clinical trials using surgery, radiation, and chemotherapy in head and neck cancer.Explain the benefit of chemoradiotherapy in locally advanced head and neck cancer.Describe the role of adjuvant chemotherapy with cisplatin and 5-FU followed by chemoradiation with or without taxanes.Evaluate the toxicity of adding taxanes and the need for further clinical trials adding taxanes.

CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Identification of a novel mammalian post-translational modification, phosphocholine, on placental secretory polypeptides
Authors: Lovell Tristan M , Woods Russell J , Butlin David J , Brayley Kerensa J , Manyonda Isaac T , Jarvis Jackie , Howell Steve , Lowry Philip J
Published: August 2007

Placental neurokinin B appears to be post-translationally modified by phosphocholine (PC) attached to the aspartyl side chain at residue 4 of the mature peptide. Corticotrophin releasing factor (CRF) was found to be expressed by the rat placenta with the main secreted forms being phosphocholinated proCRF+/− one or two polysaccharide moieties. A combination of high-pressure liquid chromatography (HPLC) and two-site immunometric analysis suggested that PC was also attached to the placental precursors of adrenocorticotrophin, hemokinin, activin and follistatin. However, the fully processed forms of rat placental activin and CRF were free of PC. Formerly, the parasitic filarial nematodes have used PC as a post-translational modification, attached via the polysaccharide moiety of certain secretory glycoproteins to attenuate the host immune system allowing parasite survival, but it is the PC group itself which endows the carrier with the biological activity. The fact that treatment of proCRF peptides with phospholipase C but not endoglycosidase destroyed PC immunoreactivity suggested a simpler mode of attachment of PC to placental peptides than that used by nematodes. Thus, it is possible that by analogy the placenta uses its secreted phosphocholinated hormones to modulate the mother’s immune system and help protect the placenta from rejection.