bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence Summaries and Synthesis: Necessary but Insufficient Approach for Determining Clinical Practice of Integrated Medicine?
Authors: Coulter Ian D.
Published: November 2006

The heart of evidence-based practice is in fact to be found in the use of evidence gained from systematic reviews or more correctly in the synthesis of evidence from systematic reviews. But just as studies vary in the quality of the design so do systematic reviews, and it is therefore necessary for those wishing to make clinical decisions based on this evidence to evaluate the evidence summaries and synthesis themselves. This article examines the criteria available for evaluating the quality of the evidence summary and synthesis. It provides a set of questions for doing this: who did the review; w hat was the objective of the review; how was the review done? Together these questions allow us to determine the trustworthiness of the review. However, that by itself is insufficient for making clinical decisions. The article suggests that this occurs because the very studies that improve the quality of reviews, that is, the randomized controlled trials, deal with efficacy and not effectiveness. Because they tend to be conducted under ideal conditions, they seldom provide the type of information needed to make a decision vis-à-vis an individual patient. The article suggests that observation studies provide much better information in this regard. The challenge here, however, is to develop standards for judging quality observation studies. In conclusion, systematic reviews and syntheses of evidence are a necessary but an insufficient method for making clinical decisions.
Immune Reconstitution Syndrome Presenting With Cerebral Varicella Zoster Vasculitis in HIV-1-Infected Patient: A Case Report
Authors: Patel Atul K. , Patel Ketan K. , Shah Shalin D. , Desai Joy
Published: November 2006

Neurologic dysfunction complicating HIV infection may occur in up to 70% of AIDS patients. The advent of highly active antiretroviral therapy has reduced central nervous system opportunistic infections. Immune reconstitutions after highly active antiretroviral therapy also lead to atypical presentations of neurologic opportunistic infections. We report a man who developed an encephalitic illness 10 months after institution of highly active antiretroviral therapy and improvement in his CD4 count. Varicella zoster vasculitis involving the brain was suspected. Acyclovir therapy resulted in complete clinical and radiologic recovery. Symptomatic reactivation of varicella zoster infection within the encephalon during therapeutic immunologic reconstitution is rare and should be suspected, especially in patients with neurologic syndrome consistent with encephalitis with recent history of herpes zoster and multiple, discrete areas of infarct or demyelination on brain magnetic resonance imaging. The clinical and neuroradiologic features of this condition and its relevance to the immune reconstitution syndrome are discussed.
Calcium-zinc and calcium-cadmium exchange in suspensions of various types of clays
Authors: van Bladel R. , Halen H. , Cloos P.
Published: November 2006

Calcium-cadmium and calcium-zinc exchange equilibria were studied at 20°C and constant ionic strength (0·015) on four clay minerals, viz. montmorillonite, bentonite, illite and vermiculite. Vermiculite and, to a lesser extent, illite and bentonite showed the strongest affinity for Cd2+ or Zn2+ over Ca2+ ions, whereas on the Camp Berteau montmorillonite nearly nonpreferential exchange isotherms were observed. With this one exception, selectivity for the heavy metals was greatly enhanced in the trace Cd or Zn regions, suggesting the presence of specific adsorption sites in these clays. Generally, the adsorption increased with the polarizing power of the exchangeable cation. Thermodynamic equilibrium constants and standard free energy changes for the complete exchange of Ca-clay to Cd- or Zn-clay were calculated.
Adsorption of alkylamines by a crystalline silicic acid
Authors: Döring J. , Lagaly G.
Published: November 2006

Amines are strongly adsorbed by the crystalline silica H4Si20O42·4H2O and are intercalated into the interlayer spaces. The adsorption of butyl-, hexyl-, octyl-, and decylamine from alcoholic solutions (ethanol, butanol…decanol) is competitive as both types of molecules, amines and alcohols, are adsorbed in the interlamellar space. The adsorption isotherms are presented as composite isotherms showing the specific reduced surface excess of amine, n°(n)/m, as a function of the molar fraction of amine in the equilibrium solution. These isotherms increase to a plateau-like section (n°(n)/m≈1·4 mmol/g) when the interlamellar adsorption is restricted to formation of monolayers of flat-lying molecules (in water, ethanol and butanol). In the presence of longer chain alcohols, the isotherms increase stepwise to a second "plateau" (at n1°(n)/m = 2·2-2·7 mmol/g) which corresponds to paraffin-type bilayers of amine and alcohol molecules. The composition of the adsorption phase is estimated from the specific reduced surface excess of amine on the basis of the interlamellar structure derived from basal spacing measurements.
Thermogravimetric, infrared and mass-spectroscopic analysis of the desorption of methanol, propan-1-ol, propan-2-ol and 2-methylpropan-2-ol from montmorillonite
Authors: Breen C. , Flynn J. J. , Parkes G. M. B.
Published: November 2006

The desorption of methanol (MeOH), propan-1-ol (n-PrOH), propan-2-ol (i-PrOH) and 2-methylpropan-2-ol (t-BuOH) from Na+-, Ca2+-, Al3+-, Cr3+- and Fe3+-exchanged montmorillonite has been studied using variable temperature infrared (IR) spectroscopy and thermogravimetric analysis (TGA). Alcohol-saturated trivalent cation (M3+) exchanged samples exhibit maxima in the derivative thermograms at 20 and 110°C (MeOH), 30 and 160°C (n-PrOH), 20 and 110°C (i-PrOH) and 20, 55 and 80°C (t-BuOH). Alcohol-saturated Na+ and Ca2+-exchanged montmorillonite samples exhibit maxima at higher temperatures in the i-PrOH (20 and 140°C) and t-BuOH (30, 90 and 110°C) desorption profiles but at the same temperatures for MeOH and n-PrOH. Mass spectroscopic analysis of the vapours desorbed from the alcohol-treated samples show that the low-temperature maxima in the alcohol desorption from the M3+-exchanged clays are due to unchanged alcohol, whilst those occurring at 80°C (t-BuOH), 110°C (i-PrOH) and 160°C (n-PrOH) are due, in the main, to alkene produced from the intramolecular dehydration of the respective alcohol. Changes in the IR spectra of the adsorbed alcohols occur at temperatures which are in accord with the mass spectral data. No mass spectral evidence was found for the formation of dialkylethers via the competing intermolecular process but dimerisation and oligomerisation of t-BuOH were observed.
Structural Model for Ferrihydrite
Authors: Drits V. A. , Sakharov B. A. , Salyn A. L. , Manceau A.
Published: November 2006

The structure of 6-line and 2-line ferrihydrite (Fh) has been reconsidered. X-ray diffraction (XRD) curves were first simulated for the different structural models so far proposed, and it is shown that neither of these corresponds to the actual structure of ferrihydrite. On the basis of agreement between experimental and simulated XRD curves it is shown that Fh is a mixture of three components: (i) Defect-free Fh consisting of anionic ABACA . . . close packing in which Fe atoms occupy only octahedral sites with 50% probability; the hexagonal unit-cell parameters are a = 2-96 Å and c = 9-40 Å, and the space group is P1c. (ii) Defective Fh in which Ac1Bc2A and Ab1Cb2A structural fragments occur with equal probability and alternate completely at random; Fe atoms within each of these fragments have identical ordered distribution with in the hexagonal super-cell with a = 5.26 Å. (iii) Ultradispersed hematite with mean dimension of coherent scattering domains (CSD) of 10-20 Å. The main structural difference between 6-line and 2-line Fh is the size of their CSD which is extremely small for the latter structure. Nearest Fe-Fe distances calculated for this new structural model are very close to those determined by EXAFS spectroscopy on the same samples.
On the Possibility of Removal of Non-Structural Iron from Kaolinite-Group Minerals
Authors: Bahranowski K. , Serwlcka E. M. , Stoch L. , Strycharski P.
Published: November 2006

The efficiency of removal of the free iron from kaolinite-group minerals by means of acid leaching was followed by chemical, AES, XRD and ESR analyses. Structural Fe responsible for the g = 4 ESR signal represented only a small fraction of Fe impurity in the natural samples. The remaining non-structural Fe was found to exist both as forms easily extractable with acid, as well as deposits that were moderately resistant to the acid treatment. At least part of the latter could be associated with the broad g ~- 2 ESR signal typical of clustered Fe 3+ ions, which in most samples persisted even after prolonged acid leaching. The data demonstrate that procedures commonly used to clean kaolinite of free iron are by no means 100% efficient. In particular, frequently encountered quantitative association of the Fe remaining in the deferrated solids with purely structural Fe, homogeneously distributed in the kaolinite matrix, is probably significantly overestimated and should be treated with great caution.
Determination of Shape of Kaolin Pigment Particles
Authors: Slepetys R. A. , Cleland A. J.
Published: November 2006

Characterization of platiness of kaolin pigments was derived from the divergence of measurements of their particle size distribution by two different techniques: sedimentation and light scattering. A numerical shape factor, which is related to the ratio of kaolin particle face diameter to its thickness, can be calculated to provide a quantitative measure of such platiness. Two sets of kaolin pigments were prepared from a Middle Georgia kaolin: delaminated and non-delaminated. Shape factors of delaminated samples were higher than those of non-delaminated ones. Maximum platiness was found between equivalent volume diameters of 1·0 and 2·0 μm. Examples are presented where properties of coated paper are correlated with the size and shape of kaolin pigments.
The Use of Clay Particle Morphology Studies to Characterize Industrial Clay Deposits: Examples from Brazil
Authors: De Souza Santos P.
Published: November 2006

The use of transmission electron microscopy in association with other methods is described for the characterization of Brazilian industrial clays, especially kaolinitic-halloysitic clays. Examples are presented from: (a) tubular 7 Å-halloysites and the characterization of mixtures with ordered and disordered kaolinites in residual china clays; (b) tubular kaolinitic clay from Piedade, São Paulo; (c) platey 10 Å-halloysite from Poģos de Caldas, Minas Gerais; (d) rolled forms similar to 10 Å-tubular halloysite formed by repeated K Ac intercalation in well ordered kaolinite; (e) use of particle shape and size of kaolinite crystals in the São Simão, São Paulo ball clays as orientation for good sanitaryware ball clays; (f) characterization of gibbsite crystals in high alumina gibbsite/kaolinite clays; (g) antigorite as a clay mineral; (h) electron optical studies of thermal phase transformations involving tubular kaolinite, halloysites, antigorite, chrysotile, talc and pyrophyllite mono crystals.
Sulphate Expansion of Lime-Stabilized Kaolinite: II. Reaction Products and Expansion
Authors: Wild S. , Abdi M. R. , Leng-Ward G.
Published: November 2006

The results of detailed analyses of the samples discussed in part I are reported. The chemical, morphological and microstructural changes which occurred during moist curing and soaking have been determined using thermal analysis, X-ray powder diffraction analysis, and scanning and transmission electron microscopy combined with EDAX. The analytical results together with the physical observations have shown that the period of volume instability and swelling coincides with the period of gypsum consumption and ettringite formation. However, swelling is not caused by growth of crystalline ettringite but is the result of water absorption. An osmotic mechanism is proposed in which concentration gradients are generated within a surface colloidal layer on the clay particles. Ettringite rods nucleate and grow within this layer and C-A-S-H gel is produced in the areas between the rods. This results in concentration gradients at the clay particle surfaces which provide the driving force for osmosis. The implications of these findings are discussed in relation to lime- stabilization of soils.
Relationships between Structural Parameters and Chemical Composition of Micas
Authors: Smoliar-Zviagin B. B.
Published: November 2006

Regression analysis of high-precision structural and chemical data on trioctahedral and dioctahedral micas yielded interrelationships between unit-cell parameters, chemical composition and structural details. Regression equations relating b and csinβ parameters of micas to composition were used for estimating composition from cell data in order to analyse P-T conditions of rock formation. Algorithms for computing atomic coordinates for 2M1 37' and 1M dioctahedral micas having either centrosymmetric or non-centrosymmetric layers and 1M trioctahedral micas are presented. Deviations of computed atomic coordinates from experimental values are, on average, 0·002 Å for octahedral cations and 0·005-0·010 Å for other atoms. Discrepancies between calculated and experimental individual interatomic distances seldom exceed 0·01 Å. Computed atomic coordinates were used to calculate X-ray diffraction patterns for glauconite and illite. Results indicate a close fit between the calculated and experimental patterns. The local structure around an octahedral cation of interest can be determined.
Management of APL in Developing Countries: Epidemiology, Challenges and Opportunities for International Collaboration
Authors: Ribeiro Raul C. , Rego Eduardo
Published: November 2006

Acute promyelocytic leukemia (APL), a relatively rare hematologic malignancy, is highly curable with current treatment strategies. However, these strategies may be unavailable in countries with limited resources. A review of records in several Latin American countries revealed that approximately 30% of deaths among children and adults with APL were caused by early complications associated with the disease or its treatment. Further, APL accounts for 20% to 25% of cases of AML in these countries, consistent with the previous observation of increased incidence of APL in Latin Americans. The lack of population-based registries in developing countries has made it difficult to determine the real incidence of APL. Moreover, APL appears to have other unique epidemiologic characteristics, including association of primary APL with an increased body mass index at diagnosis and association of secondary APL with breast cancer. To facilitate the development of local capacity and implement effective treatment of APL in developing countries, the International Committee of the American Society of Hematology has assembled a working group to formulate treatment guidelines based on evidence from clinical trials results in the developed world but adapted to local resources. It is hoped that uniform treatment, careful documentation of specific outcome data, and ongoing monitoring of treatment efficacy and toxicity will improve the cure rate and provide biologic and epidemiologic information about APL in developing countries. This initial demonstration project may be joined by other countries, providing a framework for additional clinical investigation in this highly curable form of leukemia.
Cold Hemolytic Syndrome
Authors: Gertz Morie A.
Published: November 2006

In most cases, immune-mediated hemolysis occurs extravascularly and is associated with IgG antibodies on the surface of red cells. Rare syndromes include IgG antibodies that cause direct intravascular hemolysis, such as paroxysmal cold hemoglobinuria. Also rare are extravascular hemolytic syndromes caused by IgM polyclonal or monoclonal antibodies that demonstrate red cell agglutination at 3°C, so-called cold antibodies. Because cold agglutinin disease has a high association with several lymphoproliferative disorders and IgM monoclonal gammopathies, its management differs significantly from that associated with warm autoimmune hemolytic anemia. This case-based presentation is designed to guide the reader to the diagnosis and to the initiation of prompt, effective therapy.
Reduced-Intensity Regimens in Allogeneic Stem-Cell Transplantation for Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia
Authors: Khouri Issa F.
Published: November 2006

Autologous stem-cell transplantation is widely accepted as effective therapy for patients with relapsed aggressive B-cell non-Hodgkin lymphomas. Although 40–60% of younger patients with diffuse large cell lymphoma can expect to be cured, substantial numbers will experience a relapse. In addition, certain histologic subtypes are associated with particularly poor prognoses with combination chemotherapy alone (e.g., mantle cell lymphoma). Relatively few of these patients will experience long-term responses. Although other NHL subtypes are associated with more favorable prognoses in terms of overall survival, they are rarely cured (e.g., follicular lymphoma, chronic lymphocytic leukemia). Allogeneic transplantation has been increasingly utilized in patients with lymphoid malignancies but is associated with high toxicity. Recently, reduced-intensity conditioning regimens have shown encouraging results, attributed to graft-versus-lymphoma effects. This article discusses changes in the way autologous and allogeneic transplants may be carried out in the future to treat patients with lymphoid malignancies.
Gene expression profiles identify a role for cyclooxygenase 2–dependent prostanoid generation in BMP6-induced angiogenic responses
Authors: Ren Rongqin , Charles Peter C. , Zhang Chunlian , Wu Yaxu , Wang Hong , Patterson Cam
Published: November 2006

The bone morphogenetic protein (BMP) family of proteins participates in regulation of angiogenesis in physiologic and pathologic conditions. To investigate the molecular mechanisms that contribute to BMP-dependent angiogenic signaling, we performed gene expression profiling of BMP6-treated mouse endothelial cells. We detected 77 mRNAs that were differentially regulated after BMP6 stimulation. Of these, cyclooxygenase 2 (Cox2) was among the most highly up-regulated by BMP stimulation, suggesting a role for Cox2 as a downstream regulator of BMP-induced angiogenesis. Up-regulation of Cox2 by BMP6 was detected at both mRNA and protein levels in endothelial cells, and BMP6 increased production of prostaglandins in a Cox2-dependent fashion. BMP6 up-regulated Cox2 at the transcriptional level through upstream SMAD-binding sites in the Cox2 promoter. Pharmacologic inhibition of Cox2, but not Cox1, blocked BMP6-induced endothelial cell proliferation, migration, and network assembly. BMP6-dependent microvessel outgrowth was markedly attenuated in aortic rings from Cox2−/− mice or after pharmacologic inhibition of Cox2 in aortas from wild-type mice. These results support a necessary role for Cox2 in mediating proangiogenic activities of BMP6. These data indicate that Cox2 may serve as a unifying component downstream from disparate pathways to modulate angiogenic responses in diseases in which neovascularization plays an underlying pathophysiologic role.
Double‐Layer Thermocapillary Convection in a Differentially Heated Cavity
Authors: GUPTA NIVEDITA R. , HAJ‐HARIRI HOSSEIN , BORHAN ALI
Published: November 2006

Abstract:  Many materials‐processing applications such as crystal growth from the melt involve thermocapillary flows that can affect the quality of the final product, particularly under microgravity conditions where the influence of buoyancy‐driven convection is minimized. When the melt contains volatile components, as in the production of III–V semiconductor crystals, it is often encapsulated in a low‐melting point amorphous molten glass phase such as boron oxide or pyrolytic boron nitride in order to prevent evaporation of the volatile components. The addition of the encapsulant layer and the melt–encapsulant interface in such cases can alter the thermocapillary flow in the melt. In this study, thermocapillary convection within a differentially heated rectangular cavity containing two immiscible liquid layers is considered in the absence of gravity. Domain mapping is used in conjunction with a finite difference scheme on a staggered grid to solve for the temperature and flow fields. The melt–encapsulant and the air–encapsulant interfaces are allowed to deform, with the contact lines pinned on the solid boundaries. The computed flow fields are compared to the corresponding results for a cavity with a rigid top surface. The presence of a free surface at the top leads to increased convection in the encapsulant phase while suppressing the thermocapillary flow in the melt phase. The flow pattern in the encapsulated layer is strongly dependent on the viscosity of the encapsulant layer. The intensity of the thermocapillary flow within the melt is significantly reduced as the viscosity of the encapsulant layer is increased. However, for a higher encapsulant viscosity, the retarding effect of the free top surface on thermocapillary convection in the melt is weakened.
Hydrostatic Compressibility Phenomena
Authors: POLEZHAEV V.I. , GORBUNOV A.A. , NIKITIN S.A. , SOBOLEVA E.B.
Published: November 2006

Abstract:  Peculiarities of the isothermal and isentropic equilibrium in highly compressible media with nonperfect state equations are discussed. Formulation of the adiabatic temperature gradient using Schwarzschild criterion and equilibrium equations for nonperfect gas are considered. Criterion for the onset of convection in the van der Waals (VDW) gas is examined using direct numerical modeling on the basis of equation for convection in compressible viscous nonperfect gas. Results of three‐dimensional modeling near‐critical convection in the vicinity of the convection onset in space flight with quasi‐steady microaccelerations are given. A proposal for the microgravity research of the near‐critical convection is discussed.
Effect of Input Diffusivity in an Axisymmetric Mass Diffusivity Model for Liquid Metals with an Applied Magnetic Field
Authors: KHINE Y.Y. , BANISH R.M.
Published: November 2006

Abstract:  Depending on the magnitude of the diffusivity, convective contamination may result in erroneous measurement of mass diffusivity even in microgravity. The effect of natural or buoyant convection is numerically investigated for liquid germanium with an axisymmetric model using two different magnetic field strengths and four heat transfer conditions. Since the reported input diffusivity value may vary due to inaccuracies in measurements, an order of magnitude lower and higher input diffusivity from the base value of D0= 2 × 10−4 cm2/sec was used to evaluate the behavior of liquid germanium in the presence of a magnetic field. From the numerical results, the temperature nonuniformity and the flow velocities in the liquid vary according to the input diffusivity (i.e., an order of magnitude lower and higher than the base cases). The heat transfer pattern is important in achieving a larger temperature nonuniformity in the liquid during the experiments. A stronger magnetic field can tolerate a higher temperature nonuniformity as expected.
The Anatomy of the Exposures That Occurred around the World Trade Center Site
Authors: LIOY PAUL J. , GEORGOPOULOS PANOS
Published: November 2006

Abstract:  The attack on the World Trade Center (WTC) resulted in a new era of awareness on terrorism in the United States and the issues surrounding the potential for acute and/or long‐term health outcomes caused by personal exposures to toxicants released during a terrorist event or an accident. The aftermath of the collapse yielded a situation usually not encountered in environmental health science: a large population's exposure to a previously uncharacterized complex mixture of airborne gases and particles, and re‐suspendable particles (>2.5 μm in diameter). This led to a series of rapidly changing potential and actual exposure categories, both in space and time that were associated with the complex mixture of heterogeneous composition and character; e.g., very large particles mixed with much smaller amounts of fine particles, and gases released by uncontrolled combustion. The four categories of outdoor exposure that were encountered will be discussed over the period from September 11 until the fires ended on December 20, 2001
. Further, the complex issue of indoor exposure to deposited dust will be highlighted from the beginning through the residual exposure issues being examined today (Category 5 period). The strength of the information on the initial WTC dust and smoke, and the smoke plumes from the fires and the continuing (permanent) gaps in our knowledge within the exposure sciences will be discussed, as well as our attempt to reconstruct exposure for various segments of the population in southern Manhattan and the surrounding areas. This all will be tied to lessons that must be considered in response to future events, natural or otherwise.
Glycol Ethers: A Ubiquitous Family of Toxic Chemicals
Authors: CICOLELLA ANDRÉ
Published: November 2006

Abstract:  Glycol ethers (GE) are chemicals used since the 1930s as solvents in paints, inks, varnishes, and cleaning agents, mainly in water‐based products, cosmetics, and drugs. World production approximates 1 million tons. Nineteen GE are produced or imported each year; over 1000 tons in European Union (EU) have been classified as high production volume chemicals (HPVCs). First animal data were published in 1971 and 1979 showing severe reprotoxicity for some GE. Two alerts were launched in the United States in 1982 and 1983, but the first partial GE regulation only occurred in 1993 in the EU. Although these chemicals may expose a very large population, basic toxicity data, more especially carcinogenicity, are still lacking (3/32 GE). However, experimental data were sufficient to lead developmental toxicity risk assessment since the early 1980s. Risk indices over 1000 have been calculated for consumers and workers exposed to reprotoxic GE in domestic and industrial activities. The first ban was decided in 1999 in France, but was only for drugs and cosmetics. Not surprisingly, since the late 1980s, human studies have found results similar to those in animal data: spontaneous abortions, malformations, testicular toxicity, and hematotoxicity. Despite this highly coherent set of data, and although substitution products are available, reprotoxic GE have been and still remain widely used in the world. The case of GE shows the failure of the present system based on a posteriori risk assessment. This pleads for the change of paradigm through the European REACH regulation based on the “No data, no market” principle. Ethics in REACH management should also be considered.
Dangerous and Cancer‐Causing Properties of Products and Chemicals in the Oil Refining and Petrochemical Industries. Part XXX
Authors: MEHLMAN MYRON A.
Published: November 2006

Abstract:  Benzene and benzene‐containing products and solvents have long been associated with bone marrow toxicity. Both animal studies and human epidemiological studies have shown statistically significant increases of leukemia and other lymphohematopoietic cancers in workers exposed to benzene. The most common leukemia that has been associated with benzene exposure, also called benzene poisoning, is acute myelocytic leukemia (AML). A review of the epidemiological literature on workers exposed to benzene or benzene‐containing solvents and products shows, without question, that this exposure is significantly related to other types of leukemia and lymphoma. In this article, we review the literature on the relationship between benzene exposure and chronic myelogenous leukemia (CML) and find that benzene and benzene‐containing products are significantly related to morbidity and mortality from CML.
An analysis of the strategies for public hospitals
Authors: Madorran-García Cristina , de Val-Pardo Isabel
Published: November 2006

Today, more than ever, the variables that define the health-care environment (demand, costs, system deregulation) are undergoing rapid change, thus obliging hospital administrators to develop and implement competitive strategies in order to survive in the increasingly competitive environment of hospital management. The primary objective of this paper is to identify strategies in a sample of Spanish public hospitals. Following this, we try to detect groups of organizations using similar strategies and ultimately analyse their influence on hospital performance.
Heterodimerization regulates RNase MRP/RNase P association, localization, and expression of Rpp20 and Rpp25
Authors: Welting Tim J.M. , Peters Florence M.A. , Hensen Sanne M.M. , van Doorn Nienke L. , Kikkert Bastiaan J. , Raats Jos M.H. , van Venrooij Walther J. , Pruijn Ger J.M.
Published: November 2006

Rpp20 and Rpp25 are subunits of the human RNase MRP and RNase P endoribonucleases belonging to the Alba superfamily of nucleic acid binding proteins. These proteins, which bind very strongly to each other, transiently associate with RNase MRP. Here, we show that the Rpp20-Rpp25 heterodimer is resistant to both high concentrations of salt and a nonionic detergent. The interaction of Rpp20 and Rpp25 with the P3 domain of the RNase MRP RNA appeared to be strongly enhanced by their heterodimerization. Coimmunoprecipitation experiments demonstrated that only a single copy of each of these proteins is associated with the RNase MRP and RNase P particles in HEp-2 cells. Both proteins accumulate in the nucleoli, which in case of Rpp20 is strongly dependent on its interaction with Rpp25. Finally, the results of overexpression and knock-down experiments indicate that their expression levels are codependent. Taken together, these data indicate that the Rpp20-Rpp25 heterodimerization regulates their RNA-binding activity, subcellular localization, and expression, which suggests that their interaction is also crucial for their role in RNase MRP/P function.
Advantages and disadvantages of three‐dimensional computed tomography intraoperative localization for functional endoscopic sinus surgery
Authors: Roth Maurice , Lanza Donald C. , Kennedy David W. , Yousem David , Scanlan Kim A. , Zinreich James
Published: November 2006

Intraoperative three‐dimensional computed tomography (3‐D CT) localization has been available for use during functional endoscopic sinus surgery (FESS) for several years, although relatively few otolaryngologists operate in conjunction with this technology. Proponents of intraoperative localization believe that operating with stereotaxis enhances surgical precision and reduces complications. A 1‐year review was conducted at the University of Pennsylvania from January 1994 through January 1995. During this period 5% of sinus operations were performed in conjunction with intraoperative localization. The advantages and disadvantages of using intraoperative localization were evaluated for each case. Also examined were type and indication for surgery, anesthesia used, added time, and cost. Overall, intraoperative localization was found to be helpful when anatomy was distorted or obscured. However, selecting patients who may have benefited from localization was often not possible using preoperative data. Ideally, localization should be available for all FESS. Criteria are outlined which will need to be met prior to localization becoming a significant aspect of FESS.
Secondary tobacco smoke and preventive and protective measures
Authors: Hick Julius N.
Published: November 2006

The American Academy of Otolaryngology—Head and Neck Surgery has been concerned about the effect of environment degradation on health.There is particular interest in the deleterious health effects of secondary smoke.This report reviews the recent literature regarding passive smoke and clinical disorders and discusses management strategies.
Sensory recovery in noninnervated free flaps for head and neck reconstruction
Authors: Shindo Maisie L. , Sinha Uttam K. , Rice Dale H.
Published: November 2006

Recent studies have reported sensory recovery in innervated (“sensate”) microvascular free flaps used for oromandibular reconstruction. To evaluate the efficacy of sensate free flaps used for head and neck reconstruction, the natural outcome of noninnervated flaps must be known. Data on the natural recovery of sensation in noninnervated head and neck free flaps are lacking in the literature. This study evaluates the degree of spontaneous sensory reinnervation in noninnervated microvascular free flaps used for reconstruction of a variety of head and neck defects. Eighteen flaps were evaluated–9 fibula osseocutaneous and 9 radial forearm. The fibula flapswere used to reconstruct composite defects of the mandible and oral cavity mucosa. The radial forearm flaps were used to reconstruct defects resulting from floor of mouth resection (3), total glossectomy (2), pharyngectomy (1), full‐thickness cheek (1), and facial skin (2). Sensation to pinprick, light touch, and temperature discrimination were tested over the skin paddle at time intervals ranging from 6 to 24 months. The pattern of sensory reinnervation in these noninnervated flaps over time and by location is discussed.
Repair of chronic tympanic membrane perforations with long‐term epidermal growth factor
Authors: Dvorak Douglas W. , Abbas Greg , Ali Tatar , Stevenson Sherman , Welling D. Bradley
Published: November 2006

Chronic tympanic membrane (TM) perforation is a common problem worldwide. Recent reports have shown epidermal growth factor (EGF) to stimulate healing in approximately 80% of chronic TM perforations in chinchillas when applied in three doses over 1 week. The objective of this controlled study is to evaluate the efficacy of long‐term EGF in the closure of TM perforations. Chronic chinchilla TM perforations were treated with EGF for up to 6 weeks. One hundred percent (17 of 17) of treatment group perforations completely healed. However, two new findings with this long dosing scheme were reperforation on long‐term follow‐up and three TMs with cholesteatomas. It is likely that reperforation was due to a progressive thinning seen with prolonged EGF application.

Long‐term EGF use is not recommended for the treatment of TM perforations because of possible wound healing impairment and possible cholesteatoma induction.
Fine‐needle biopsy techniques of aspiration versus capillary in head and neck masses
Authors: Hamaker Ronda A. , Moriarty Ann T. , Hamaker Ronald C.
Published: November 2006

Fine‐needle aspiration and fine‐needle capillary biopsy techniques were compared, and the number of samples necessary to assure a diagnostic specimen was determined. In this study, each mass served as its own control, since both aspiration and capillary fine‐needle biopsy were performed randomly on each mass. The study found the number of “superior” slides to be evenly distributed between the two biopsy techniques, but a distinct preference, based on tumor type, was noted for one or the other technique. The “best” slides were obtained from one of the first four samples 92% of the time. The authors concluded that both fine‐needle aspiration and capillary biopsy should be used and that three to four samples should be obtained to increase the likelihood of a diagnostic biopsy.
Morphologic study of the laryngeal taste buds in the cat
Authors: Shin Takemoto , Nahm Insung , Maeyama Tadatsugu , Miyazaki Junji , Matsuo Hiromichi , Yu Youngchae
Published: November 2006

The distribution of laryngeal taste buds (TBs) and their neural components in the cat were investigated by immunohistochemistry and electron microscopy. The antisera used in this study were against cytokeratin, protein gene product 9.5 (PGP9.5), neuron‐specific enolase (NSE), S‐100 protein, calbindin‐D, calcitonin gene‐related peptide (CGRP), and substance P(SP).

Taste bud cells were specifically immunoreactive to the antibodies of human cytokeratin subtypes 8 and 18 (CAM5.2). On observation with CAM5.2, TBs were seen distributed on the laryngeal surface of the epiglottis and spread caudally along the aryepiglottic folds, reaching peak density at the laryngeal side of the arytenoid tubercle.

The PGP9.5 and NSE immunoreactivities were recognized in TB cells and nerve fibers, both within the TBs and in the subepithelial connective tissue. S‐100 protein immunoreactivities were not found in any of the cells in the TBs but were found exclusively in the subepithelial neural elements. The calbindin‐D, CGRP, and SP immunoreactivities were confined to a part of the neural elements that was very thin.

Taste pores, taste villi, neuronal varicosity, and synapselike structures were observed by scanning and transmission electron microscopic study.

From these results it is considered that the TBs act as a chemical receptor.
Reducing ischemia‐reperfusion injury in rat island groin flaps by dexamethasone and BW755C
Authors: Dolan Robert W. , Kerr Donald , Arena Sebastian
Published: November 2006

Despite the known effectiveness of anti‐inflammatory therapy in reducing reperfusion injury, no studies to date involve the use of anti‐inflammatory therapy in reducing ischemia‐reperfusion injury in fasciocutaneous flaps. Dexamethasone (a phospholi‐pase A2 inhibitor) and specific cyclooxygenase and lipoxygenase inhibitors (indomethacin and BW755C) were administered to rats with ischemic island groin (fasciocutaneous) flaps. Significant improvement in ischemic flap survival was found with dexamethasone and BW755C. The mode of action of dexamethasone was not specifically investigated in our study; however, it may suppress neutrophil function and reduce ischemia‐reperfusion injury in its shared ability with BW755C to reduce the formation of leukotrienes. Dexamethasone could be applied in the clinical setting to reduce ischemic flap loss by attenuating the systemic inflammatory response to reperfused ischemic‐damaged tissueb.
Suction drain management of salivary fistulas
Authors: Bastian Robert W. , Park Albert H.
Published: November 2006

Salivary fistulas remain an unpleasant complication of upper aerodigestive tract surgery. To avoid a disastrous outcome such as carotid rupture, clinicians “medialize” (i.e., incise the skin flap in the anterior aspect of the neck and insert a Penrose drain) to divert fistula fluid from the carotid sheath and then perform laborious wound care. Meanwhile, patients endure the unpleasant odor, discomfort due to the wound dressing, occasional secondary surgical procedures, a lengthened hospital stay, and increased financial costs.

In an effort to mitigate these problems, suction drains that had been placed at the time of the original surgical procedure were used as an alternative fistula management technique. Out of a population of 118 reviewable patients who underwent standard or extended variations of supraglottic laryngectomy, partial laryngopharyngectomy, near‐total laryngectomy, or total laryngectomy between 1988 and 1992, 16 patients appropriate for inclusion in this study developed postsurgical fistulas. Eight of these patients were treated with traditional medialization procedures, and the other 8 patients were treated with suction drainage. Comparison of the two groups revealed no significant difference with respect to complications or time to fistula closure. The advantages of simplified postsurgical care, less patient discomfort, reduced time demands on the clinician, and cost containment were noted for the group treated with suction drainage.
Off‐axis rotation as a test of otolith function
Authors: Blakely Brian W.
Published: November 2006

This experiment was performed to determine whether linear acceleration causes a change in the vestibulo‐ocular reflex (VOR) that could be exploited as a research and/or clinical test of otolith function. The effect of otolith stimulation on the VOR was studied in the horizontal and vertical planes in 10 cats. The VOR was induced by pulses of angular acceleration (velocity ramps). During some of the test runs, a centripetal linear acceleration stimulus was also applied to stimulate the otolith organs.

Using the stimuli combination as tested in this project, the authors found that otolith stimulation affected the vertical VOR but not the horizontal VOR. The vertical VOR was asymmetric. While the methods used in this study are useful in research applications, the data variability and the equipment requirements make these techniques generally impractical for clinical testing.
Mastoidectomy elimination
Authors: Black Bruce
Published: November 2006

Surgery that eliminates the open radical cavitytakes three forms: obliteration (cavity fill‐in, reconstruction (canal wall defect repair), or ablation (external canal closure). The evolution of each variety is reviewed in detail and a personal series of 240 cases is discussed. These included obliterations and reconstructions using organic materials, then reconstructions employing porous hydroxylapatite ceramic implants. Larger defects required Grote implants, but high facial ridge cases were managed with attic defect plates and limited canalplasty. Canal repair success rates improved with the use of the middle temporal flap to improve canal wall vascularity. Residual cholesteatoma has been prevented by staged surgery, and recurrent disease has been virtually abolished by aggressive prevention techniques which employ drum reinforcement with finely shaven cartilage‐perichondrium composite grafts.

Ossiculoplasty procedures included 85 Plastipore® columellas, 107 Oval‐Top hydroxylapatite/Teflon® columellas and, more recently, 17 Spanner malleus‐stapes/footplate assemblies. Earlier poor results have been succeeded by more satisfactory levels.Since 1990, the air‐bone gap has been closed to within 10 dB in 33% of cases and to within 20 dB in 66% of cases. Studies using SPITE (surgical, prosthetic, in fection, tissues, and eustachian) adverse indicators have demonstrated high levels of pathology in elimination cases, when compared with nonelimination series. The SPITE studies have also demonstrated the reduction of pathology levels by staged surgery.

Elimination surgery now provides permanent relief from the problem cavity in all but a few cases.
Retrospective Study on the Diagnostic Value of Full-Thickness Biopsies from the Stomach and Intestines of Dogs with Chronic Gastrointestinal Disease Symptoms
Authors: Kleinschmidt S. , Meneses F. , Nolte I. , Hewicker-Trautwein M.
Published: November 2006

An evaluation of histologic findings in full-thickness biopsies from the gastrointestinal tract (GIT) from 64 dogs with chronic GIT disease symptoms was performed. In the majority of cases (38/64; 59%), intestinal lymphangiectasia and mucosal edema of unknown etiology were present. In 10 dogs (16%) an eosinophilic colitis, either alone or together with gastritis and/or enteritis, was found. In 5 dogs (8%) lymphocytic-plasmacytic enteritis or enterocolitis was diagnosed. Five dogs (8%) had an intestinal T-cell lymphoma. Samples from the remaining cases were histologically normal or did not allow for a final diagnosis. In contrast to reports about findings in endoscopic biopsies (which often are of varying quality or inadequate for diagnosis), in the majority of cases of this study, examination of full-thickness biopsies from the GIT allowed us to make a definitive histopathologic diagnosis. Furthermore, the study revealed that transmural biopsies are very helpful for diagnosing lymphoma.
Histiocytic Sarcoma in the Tarsus of a Cat
Authors: Pinard J. , Wagg C. R. , Girard C. , Kiupel M. , Bédard C.
Published: November 2006

A 12-year-old Persian cat was examined for a firm swelling of the right tarsal region and enlargement of the corresponding right popliteal lymph node. Cytologic evaluation demonstrated a population of malignant cells consistent with large cell lymphoma. Necropsy revealed a multi-lobulated subcutaneous mass involving the tarsus with some extension into adjacent deep muscular tissue. Histologically, the mass was composed of round cells with eosinophilic cytoplasm and pleomorphic anisokaryotic nuclei. Evidence of articular and nodal infiltration by these cells was observed. Differential diagnoses included synovial sarcoma and histiocytic sarcoma. Neoplastic cells were negative for cytokeratin, CD79a, and CD3 and positive for CD18, vimentin, lysozyme, and alpha-1-antitrypsin, most consistent with a diagnosis of histiocytic sarcoma. This is the first report of a histiocytic sarcoma involving a joint of a cat. The final diagnosis was based on the light microscopic appearance in combination with the immunohistochemical stains.
Congenital Multiple Ocular Defects with Falciform Retinal Folds among Japanese Black Cattle
Authors: Uchida K. , Kunieda T. , Abbasi A. R. , Ogawa H. , Murakami T. , Tateyama S.
Published: November 2006

To clarify the morphologic features of the ocular disease recently occurring among Japanese Black cattle in southern Kyushu, 6 globes from 3 Japanese Black cattle, between 11 and 20 months old (cow Nos. 1 to 3), were pathologically examined. cow Nos. 1 and 2 were sired by the same Japanese Black bull, and cow No. 3 was sired by the ancestor (sire) of the former bull. The ocular lesions were pathologically similar to each other, except for the left eye of cow No. 1. The ocular lesions of 5 globes were characterized by microphthalmia, hypoplasia, and/or dysplasia of the lenses; persistence of the primary vitreous; and retinal dysplasia with total nonattachment. The left globe from cow No. 1 had no lens and severe hypoplasia and nonattachment of the retina. Because dysplastic retinal lesions that formed crescentic folds and a central column were the most characteristic features of the eyes, the falciform retinal fold with congenital nonattachment was the most likely disease entity. Although the cause of the ocular disease could not be clarified with the present study, an inherited ocular defect of the bull and its ancestor was suspected.
Eosinophilic Granulomatous Gastroenterocolitis and Hepatitis in a 1-year-old Male Siberian Husky
Authors: Brellou G. D. , Kleinschmidt S. , Meneses F. , Nolte I. , Hewicker-Trautwein M.
Published: November 2006

A case of eosinophilic granulomatous gastroenterocolitis and hepatitis in a 1-year-old male Siberian Husky is described. The dog presented with a history of diarrhea, weakness, lethargy, and anorexia of several months' duration. Hematologic and biochemical examinations, abdominal ultrasonography, computer tomography, and exploratory laparotomy were performed. Histopathologic examination of full-thickness biopsies from the gastrointestinal tract and liver revealed the presence of eosinophilic granulomatous lesions in the submucosa and tunica muscularis of stomach, jejunum, ileum, colon, and liver. infectious agents were not detected by light microscopic and electron microscopic examination or by immunohistochemistry. On the basis of the findings, it is concluded that the disease in this dog represents an unusual manifestation of chronic idiopathic inflammatory bowel disease.