bluuebunny/crossref_metadata_2025 huggingface dataset:
Rhythmic expression of the cycle gene in a hematophagous insect vector
Authors: Meireles-Filho Antonio CA , Amoretty Paulo R , Souza Nataly A , Kyriacou Charalambos P , Peixoto Alexandre A
Published: October 2006

Background

A large number of organisms have internal circadian clocks that enable them to adapt to the cyclic changes of the external environment. In the model organism Drosophila melanogaster, feedback loops of transcription and translation are believed to be crucial for the maintenance of the central pacemaker. In this mechanism the cycle (or bmal1) gene, which is constitutively expressed, plays a critical role activating the expression of genes that will later inhibit their own activity, thereby closing the loop. Unlike Drosophila, the molecular clock of insect vectors is poorly understood, despite the importance of circadian behavior in the dynamic of disease transmission.

Results

Here we describe the sequence, genomic organization and circadian expression of cycle in the crepuscular/nocturnal hematophagous sandfly Lutzomyia longipalpis, the main vector of visceral leishmaniasis in the Americas. Deduced amino acid sequence revealed that sandfly cycle has a C-terminal transactivation domain highly conserved among eukaryotes but absent in D. melanogaster. Moreover, an alternative form of the transcript was also identified. Interestingly, while cycle expression in Drosophila and other Diptera is constitutive, in sandflies it is rhythmic in males and female heads but constitutive in the female body. Blood-feeding, which causes down-regulation of period and timeless in this species, does not affect cycle expression.

Conclusion

Sequence and expression analysis of cycle in L. longipalpis show interesting differences compared to Drosophila suggesting that hematophagous vector species might present interesting new models to study the molecular control of insect circadian clocks.
Parents' knowledge and behaviour concerning sunning their babies; a cross-sectional, descriptive study
Authors: Aladag Nihal , Filiz Tuncay M , Topsever Pinar , Gorpelioglu Suleyman
Published: October 2006

Background

For centuries, sunlight has been used for therapeutic purposes. Parents still sun their infants to treat neonatal jaundice, nappy rash or mostly to supply vitamin D for bone development as a consequence of health beliefs. In this study we aimed to assess knowledge and behaviour of parents about benefits of sunlight and sun protection.

Methods

In this study, parents attending to governmental primary healthcare units for their children's routine vaccinations, upon their informed consent, were consecutively enrolled during one month. Data were collected by a semi-structured questionnaire.

Results

The mean age of 118 enrolled parents and their babies were 27.9 ± 6.5 years and 8.3 ± 5.8 months, respectively. Most of the participants were mothers (93.2%), housewives (81.4%) with an educational level of ≥6 years (71.2%). Sunlight was considered beneficial for bone development (86.4%), diaper rash (5.9%) and neonatal jaundice (12.7%). In case of neonatal jaundice 72.0% of the participants reported that they would consult a physician. Most of the participants (82.2%) were sunning their babies outdoors. Nearly half (49.7%) of them got this information from medical staff. Fifty two percent of the parents were sunning their babies before 10–11 a.m. and/or after 3 p.m. Only 13.6% of parents reported using sunscreen for their babies, and the majority of them were using sun protecting factor ≥ 15. One forth of the sunscreen users was using sunscreen according to their physicians' advice.

Conclusion

Most of the participants were aware of the benefits of sunlight; especially for bone development. However they were displaying inappropriate behaviour while sunning their babies for health reasons. More education should be given to parents about the danger of sunlight at primary health care units while advising to sun their babies, if any.
Deriving utility scores for co-morbid conditions: a test of the multiplicative model for combining individual condition scores
Authors: Flanagan William , McIntosh Cameron N , Le Petit Christel , Berthelot Jean-Marie
Published: October 2006

Background

The co-morbidity of health conditions is becoming a significant health issue, particularly as populations age, and presents important methodological challenges for population health research. For example, the calculation of summary measures of population health (SMPH) can be compromised if co-morbidity is not taken into account. One popular co-morbidity adjustment used in SMPH computations relies on a straightforward multiplicative combination of the severity weights for the individual conditions involved. While the convenience and simplicity of the multiplicative model are attractive, its appropriateness has yet to be formally tested. The primary objective of the current study was therefore to examine the empirical evidence in support of this approach.

Methods

The present study drew on information on the prevalence of chronic conditions and a utility-based measure of health-related quality of life (HRQoL), namely the Health Utilities Index Mark 3 (HUI3), available from Cycle 1.1 of the Canadian Community Health Survey (CCHS; 2000–01). Average HUI3 scores were computed for both single and co-morbid conditions, and were also purified by statistically removing the loss of functional health due to health problems other than the chronic conditions reported. The co-morbidity rule was specified as a multiplicative combination of the purified average observed HUI3 utility scores for the individual conditions involved, with the addition of a synergy coefficient s for capturing any interaction between the conditions not explained by the product of their utilities. The fit of the model to the purified average observed utilities for the co-morbid conditions was optimized using ordinary least squares regression to estimate s. Replicability of the results was assessed by applying the method to triple co-morbidities from the CCHS cycle 1.1 database, as well as to double and triple co-morbidities from cycle 2.1 of the CCHS (2003–04).

Results

Model fit was optimized at s = .99 (i.e., essentially a straightforward multiplicative model). These results were closely replicated with triple co-morbidities reported on CCHS 2000–01, as well as with double and triple co-morbidities reported on CCHS 2003–04.

Conclusion

The findings support the simple multiplicative model for computing utilities for co-morbid conditions from the utilities for the individual conditions involved. Future work using a wider variety of conditions and data sources could serve to further evaluate and refine the approach.
Classification of ductal carcinoma in situ by gene expression profiling
Authors: Hannemann Juliane , Velds Arno , Halfwerk Johannes BG , Kreike Bas , Peterse Johannes L , van de Vijver Marc J
Published: October 2006

Introduction

Ductal carcinoma in situ (DCIS) is characterised by the intraductal proliferation of malignant epithelial cells. Several histological classification systems have been developed, but assessing the histological type/grade of DCIS lesions is still challenging, making treatment decisions based on these features difficult. To obtain insight in the molecular basis of the development of different types of DCIS and its progression to invasive breast cancer, we have studied differences in gene expression between different types of DCIS and between DCIS and invasive breast carcinomas.

Methods

Gene expression profiling using microarray analysis has been performed on 40 in situ and 40 invasive breast cancer cases.

Results

DCIS cases were classified as well- (n = 6), intermediately (n = 18), and poorly (n = 14) differentiated type. Of the 40 invasive breast cancer samples, five samples were grade I, 11 samples were grade II, and 24 samples were grade III. Using two-dimensional hierarchical clustering, the basal-like type, ERB-B2 type, and the luminal-type tumours originally described for invasive breast cancer could also be identified in DCIS.

Conclusion

Using supervised classification, we identified a gene expression classifier of 35 genes, which differed between DCIS and invasive breast cancer; a classifier of 43 genes could be identified separating between well- and poorly differentiated DCIS samples.
Uncertainty in a world of regulation
Authors: Coles Colin
Published: October 2006

Medical practice must be regulated, but the form this currently takes is increasingly based on a ‘technical’ view, which wrongly assumes that practice is straightforward and that error is the result of individual failure. The metaphor of ‘delivery’ is currently used to characterise medical practice but this usage is fundamentally flawed. An alternative is presented, supported by a growing literature, that shows that professional practice generally (and medical practice in particular) is characterised by complexity, uncertainty and unpredictability. Practitioners use their judgement and wisdom, developed in their own practice and in their contacts with fellow practitioners. Often, practitioners choose between options that are not ideal, and may need to decide on what they believe is best for an individual rather than what is ‘right’ in some absolute sense. Doctors must find ways of giving a clearer account of their practice, and in so doing become more truly accountable.
Can there be true partnership between clinicians and the Home Office?
Authors: Eastman Nigel
Published: October 2006

Srinivas et al provide a comprehensive guide to the law, regulations and practice concerning the management of ‘restricted patients', who are the responsibility of both the clinical services treating them and the Home Office. In doing so, they make the assumption, with apparent approval, that there is a ‘partnership’ between clinicians and the Home Office. However, partnership assumes parties working towards a common goal on an equal footing. Neither assumption is correct here. Although forensic mental health services direct themselves explicitly towards enhancing public safety, they do so in conjunction with treatment aimed at the relief of dysphoria in the patient. The interest of the Home Office in the patient's mental health is solely in terms of its impact on the risk of harm to others. There is therefore no ‘partnership’. Rather, there is constructive tension between agencies working towards differently valued and balanced objectives. Certainly the relationship is not one of equal power.
Note on Self-Restraint as an Online Entry-Deterrence Strategy
Authors: Liu Yunchuan , Gupta Sunil , Zhang Z. John
Published: October 2006

We develop a game-theoretical model to show that in the markets where price consistency across channels is critical, an incumbent brick-and-mortar retailer can deter the online entry of a pure-play e-tailer by strategically refraining from entering online. In the markets where price consistency is not a constraint, we find that the incumbent can deter the e-tailer’s entry only if it enters online and credibly operates the online channel as an independent profit center. In other words, the incumbent must be willing to cannibalize its own brick-and-mortar business by charging a low online price. We also discuss some social welfare implications of retail online entry and the managerial insights of our analysis.
Transpalatal approach to deeper cranial structures
Authors: Konrad Horst R. , Canalis Rinaldo Fernando
Published: October 2006

The approach to deep midline cranial structures is technically difficult. The transpalatal approach has a relatively wide exposure as compared to the transnasal, transantral and transethmoidal approches. The added advantage of a medial approach which follows medial landmarks and the flexibility of being able to extend exposure to the maxillary sinuses and pterygomaxillary space makes this an attractive approach for large lesions in the nasal passages, nasopharynx and sphenoid sinuses.

Large mucoperiosteal flaps, care to avoid the palatine vessels, and application of a palatal splint postoperatively, minimize complications and patient discomfort. The authors have used this approach to repair naso‐pharyngeal atresia, remove nasopharyngeal angiofibromas, approach the pituitary, craniopharyngioma and isolated sphenoid sinus opacification as well as sphenoid sinusitis with cavernous sinus thrombosis.
Diagnosis and management of cochlear hydrops
Authors: Glasscock III Michael E. , Miller Gale W.
Published: October 2006

In an early case of cochlear hydrops, the symptoms of a mild pressure sensation or fullness in the involved ear may be mistaken for a blocked eustachian tube. More severe cases demonstrate a true sensori‐neural hearing loss that fluctuates. Tinnitis is usually present during the attack and will often subside when the hearing returns to normal. The neurotologic evaluation is negative and attempts to establish an etiology are seldom fruitful. The treatment is usually medical, and empirically, these individuals are treated with diuretics, low salt diet, and vasodilators.

It is felt by most investigators that cochlear hydrops is an early form of Meniere's disease, and over a long period of time these individuals may develop vertigo as a complaint.

The purpose of this paper is to discuss this interesting form of Meniere's disease in detail concerning etiology, physiology, diagnosis, and treatment.

A small series of patients who have undergone the subarachnoid endolymphatic sac procedure will be reported according to the guidelines set forth by the Committee on Hearing and Equilibrium of the American Academy of Ophthalmology and Otolaryngology. Based on the result in these patients, it would appear that this procedure should be considered in those individuals who are refractory to medical management. There is convincing evidence that the shunt does stabilize the hearing in many instances.
Preliminary results with use of an eustachian tube prosthesis
Authors: Wright J. William , Wright III J. William
Published: October 2006

One of the primary causes of tympanoplasty failure is inadequate eu‐stachian tubal function. Measures taken to improve tubal function have often been inadequate for their task. A prosthesis was constructed for the purpose of installation at the time of tympanoplasty to improve eustachian tubal function.

Our early results with a two to 14‐month follow‐up of 38 patients show a success rate of 79 percent in securing an aerated middle ear space in ears which were judged to have poor eustachian tubal function.
A clinical and anatomical study of the various techniques of irrigation of the maxillary sinus
Authors: Ritter Frank N.
Published: October 2006

Irrigation of the maxillary sinus is a common procedure in clinical practice for removing the contents of the antrum for either diagnosis or therapy. For many years, it has been accomplished by inserting a trocar in either the natural ostium or the medial wall of the sinus under the inferior turbinate.

Recently, the anterior wall of the maxillary sinus has been re‐introduced as a better route. It is more direct and is the only one suited for use in a child whose sinus is underdeveloped. The anterior route has been termed the canine fossa technique and is the preferred route since it has a high degree of patient acceptance and safety and can be done easily and quickly by the clinician through a familiar anatomical pathway.
Retropharyngeal abscesses in children revisited
Authors: Seid Allan B. , Dunbar J. Scott , Cotton Robin T.
Published: October 2006

Retropharyngeal abscess appears in infancy and early childhood. Because of the advances in antibiotic therapy, the frequency of this disease has decreased considerably. If overlooked, however, the sequelae of retropharyngeal abscess can be disastrous.

Of the typical signs and symptoms listed in presentation, the swelling of the posterior pharyngeal wall is referred to as an important diagnostic sign. This presentation will discuss the fallibility of this important sign in the evaluation of a retropharyngeal abscess in children. The size of the pediatric oral cavity and the presence of pooling secretions in the pharynx, due to retropharyngeal tissue swelling, make assessment of swelling of the posterior pharyngeal wall extremely difficult.

Radiological assessment of retropharyngeal abscesses cannot differentiate between cellulitis and abscess formation. The presentation will discuss the radiological appearance of a retropharyngeal swelling and discuss the differentiation of abscess formation from cellulitis.

The rationale for a therapeutic regime will be developed to validate the concept that with suggestive clinical signs, suggestive radiological diagnosis, and in spite of negative evidence of retropharyngeal swelling by oral examination, justification exists for an examination under anesthesia and incision and/or aspiration of the retropharyngeal abscess.
Endoscopic lateralization of the vocal cord in abductor paralysis of the larynx
Authors: Kirchner Fernando R.
Published: October 2006

Endoscopic surgical operations of the larynx have many desirable features, including the conservative nature of these procedures, plus the ability to produce surgical changes predictable from the onset. For several years the direct lateralization of the vocal ligament after the removal of a preassessed amount of thyroarytenoid muscle appeared to be the simplest and most accurate surgical procedure. The resection of this wedge of muscle was easily performed with laryngeal microcautery. Posterior cicatricial webs can be easily removed with this instrument. Simple suturing techniques are also described, including the practicability of using padded buttons plus lead fishing sinkers to adjust the tension and secure these sutures on the surface of the neck. So far 16 patients have been rehabilitated using this technique, including 6 patients with posterior commissure webs. These anatomical techniques should be considered because of their obvious simplicity.
The total rehabilitation of graves' ophthalmopathy
Authors: Desanto Lawrence W.
Published: October 2006

The concept of enlarging the orbital space in some patients with Graves' ophthalmopathy is usually acceptable. Controversial, however, are 1. the indications for enlarging the space, 2. the sequence of therapy that is most successful in restoring the eyes to near normal, and 3. the value of enlarging the orbital space and its relationship to non‐surgical alternatives.

Since 1969 a personal experience with more than 600 eyes in over 300 patients using the transantral route to orbital decompression has accumulated. From the surgical experience plus exposure to other non‐surgically treated patients, a concept of total management of Graves' ophthalmopathy has evolved.

The technical aspects of decompression through the sinuses are straight forward. The key to a satisfactory operation is a complete transantral ethmoidectomy; a less than complete ethmoidectomy will eliminate a predictable result.

Transantral decompression as a single procedure will not successfully palliate all aspects of Graves' ophthalmopathy. Eye muscles and lid procedures in a timely sequence may be needed to complete rehabilitation. Perfect eyes are seldom obtained but the goal of satisfied patients is realistic.

This essay will emphasize technical aspects, theoretical advantages, as well as pitfalls and limitations of the transantral orbital decompression.
Place of embolization in the treatment of severe epistaxis
Authors: Merland J. J. , Melki J. P. , Chiras J. , Riche M. C. , Hadjean E.
Published: October 2006

On the basis of long‐term study on embolization for severe epistaxis, the authors show the different indications and results of this relatively new method; and 54 cases are presented including Rendu‐Osler diseases, primary and traumatic epistaxis, or those due to vascular malformation and benign or malignant tumors. Embolization can prove a very effective method in most cases.
Site of lesion vestibular function testing.
Authors: Rubin Wallace
Published: October 2006

The results of conventional electronystagmography (ENG) sometimes are confusing. The Hallpike alternate binaural bithermal (ABB) caloric test is helpful diagnostically except for the group of “sick patients that have a normal test.” Conventional ENG tests also fall short in the area of objective confirmation of patient progress.

What does each test tell us regarding site of lesion? 1. Alternate binaural bithermal stimulation gives us information about the semicircular canals — particularly the horizontal semicircular canal — pickup head. 2. Simultaneous binaural bithermal stimulation gives information brain stem connections — switching and relay. 3. Rotation testing gives information about the processing by the brain — central control.
Immunohistopathology of human olfactory epithelium, nerve and bulb.
Authors: Nakashima Tadashi , Kimmelman Charles P. , Snow James B.
Published: October 2006

The immunohistochemical characteristics of the human olfactory system were studied using antiserum to the olfactory marker protein (OMP). OMP was detected in the olfactory receptor neurons and processes extending from the olfactory neuroepithelium to the olfactory bulb. The olfactory receptor cells located close to the epithelial surface also contained OMP. In severely degenerate regions, only a few OMP‐containing cells were observed. Differences in OMP‐staining intensity were noted among the olfactory receptor cells in thick neuroepithelium. Proliferating olfactory neuroepithelium contained OMP reactive and nonreactive olfactory receptor cells. The presence of OMP reactive and nonreactive olfactory neurons indicates the coexistence of two functionally different phases of olfactory neurons. These findings suggest that continuous cell turnover is occurring in human olfactory neuroepithelium.
Congenital atresia of the external auditory canal.
Authors: Caruz Antonio De La , Linthcum Fred H. , Luxford William M.
Published: October 2006

Children with congenital atresia of the external auditory canal require an early assessment of hearing and a determination of the degree of atresia and associated pathology by polytomography and/or high‐resolution CT scanning.

We analyzed the otologic findings in 302 ears (239 patients) with severe atresia of the external auditory canal. Eighty‐seven primary or revision surgeries were performed. Fifty‐three percent obtained a residual conductive deficit of 20 dB or less. Lateralization of the tympanic membrane graft was the primary cause of failure in obtaining good hearing results. The use of split‐thickness skin graft instead of a full‐thickness skin graft to cover the reconstructed external canal has decreased the incidence of restenosis and revision surgery.
Otitis media with effusion in preschool children.
Authors: Casselbrant Margaretha L. , Brostoff Leon M. , Flaherty Mildred R. , Bluestone Charles D. , Cantekin Erdem I. , Doyle William J. , Fria Thomas J.
Published: October 2006

The incidence, prevalence, and natural history of otitis media with effusion (OME) and middle ear high negative pressure (HNP) were investigated in a group of 2 to 6 year old preschool children. The children were examined monthly over a two year period from September 1981 to August 1983. The middle ear status was assessed using a decision‐tree algorithm which combined the findings of pneumatic otoscopy, tympanometry, and acoustic reflex measurements. Fifty‐three percent of the children in the first year and 61% in the second year developed OME; also during the two years, HNP was documented in 66% of the children. Eighty percent of OME episodes lasted only two months. The prevalence of OME and HNP showed a seasonal variation and a strong association with the presence of upper respiratory infections (URIs). The incidence of OME was independent of age. These data indicate that OME and HNP are prevalent conditions with a high spontaneous recovery in the preschool population.
Experimental evidence against middle ear oxygen absorption.
Authors: Buckingham Richard A. , Stuart Dennis R. , Girgis Samuel J. , Geick Maurine R. , Mcgee Therese J.
Published: October 2006

The present theory of eustachian tube (ET) function and middle ear (ME) ventilation posits that oxygen absorbed by the ME mucosa causes negative ME pressure which is relieved by periodic opening of the ET during swallowing and yawning. After developing a method to cannulate the ET of mongrel dogs we connected the cannulas hermetically to manometers. This system excluded ET function and tested the oxygen absorption capacity of the ME.

When we controlled respiration and maintained blood gas PO2 and PCO2 at normal levels, we were unable to find any manometric evidence of negative pressure of gas absorption in the dog ME.

Lowering the PCO2 and raising the PO2 of the blood by hyperventilation caused negative ME pressure which could be measured manometrically. We confirmed these findings with the tympanometer. Raising the PCO2 and lowering the PO2 by hypoventilation caused positive pressure in the ME.

There is no evidence in these experiments that O2 absorption occurs or causes negative ME pressure in the dog. To the contrary there is evidence that elevated blood levels of the more diffusible CO2 cause an increase in the ME pressure and lowered CO2 level causes a negative ME pressure.
Nasal surgery in children with cystic fibrosis: Complications and risk management
Authors: Reilly James S. , Kenna Margaret A. , Stool Sylvan E. , Bluestone Charles D.
Published: October 2006

Children with cystic fibrosis (CF) are predisposed to pansinusitis and nasal polyposis and, therefore, require frequent surgery by otolaryngologists. These children are at risk to have complications following surgery, both locally, at the surgical site, as well as systemically from their underlying pulmonary disease. A 20‐year retrospective study of children (average census 219 per year) revealed 39 children developed nasal polyps and these children required 85 nasal polypectomies. No major complications occurred and only three minor complications (fever, minor bleeding) were noted. Over 95% of our CF children were able to return home in less than 48 hours, and extensive hospital stays appeared not to be required.
Intraoperative facial nerve monitoring: A comparison of stimulating electrodes
Authors: Kartush Jack M. , Niparko John K. , Bledsoe Sanford C. , Graham Malcolm D. , Kemink John L.
Published: October 2006

Preservation of the facial nerve during acoustic neuroma resection may be enhanced by the use of intraoperative electrical stimulation. Although stimulation of the extratemporal facial nerve is an effective and established procedure, anatomic differences of the intradural facial nerve and its microenvironment demand more exacting stimulus protocols. The absence of epineurium may make the intradural nerve more susceptible to mechanical or electrical trauma while intermittent pooling of cerebrospinal fluid (CSF) at the cerebellopontine angle may shunt current away from nerve.

Four stimulus configurations were examined under varying conditions simulating CSF pooling. The results indicated that: 1. insulation of stimulating electrodes prevents CSF current shunting and allows utilization of a constant current source, and 2. monopolar and bipolar configurations demonstrate significantly different electrical characteristics which may be employed selectively based upon specific clinical goals.
Evaluation of basic fibroblast growth factor in tympanic membrane repair
Authors: Vrabec Jeffrey T. , Schwaber Mitchell K. , Davidson Jeffrey M. , Clymer Mark A.
Published: October 2006

Basic fibroblast growth factor (bFGF) has been shown to enhance speed of wound repair at a number of anatomic sites. This study presents an evaluation of bFGF in a model of acute tympanic membrane (TM) perforation in order to assess rate of healing as well as structural and functional outcome. Perforations were created in the tympanic membranes of rats, then allowed to heal in the presence of topically applied bFGF with the opposite ear serving as a control. The growth factor was applied in repeated doses beginning 2 days after creation of the TM defect. The treated ears healed faster by an average of 4.0 days. The healed tympanic membranes were assessed using tympanometry and light microscopy. Structurally and functionally, the healed tympanic membranes were similar to the controls. The observed results indicate that bFGF promotes accelerated healing and restoration of normal architecture in acute TM defects.
Diagnosis and treatment of persistent dysphonia after laryngeal surgery: A retrospective analysis of 62 patients
Authors: Woo Peak , Casper Janina , Colton Raymond , Brewer David
Published: October 2006

Sixty‐two patients with persistent or recurrent dysphonia after laryngeal surgery underwent interdisciplinary voice evaluation, laryngostroboscopy, and objective measurements of vocal function. The causes of persistent dysphonia were attributed to vocal fold scarring (n = 22), residual mass lesion (n = 8), residual inflammation (n = 13), recurrent mass (n = 4), and hyperfunctional voice disorder (n = 7). Laryngoscopy often showed excessive ventricular compression and anterior‐to‐posterior laryngeal compression. Ventricular dysphonia was often a compensatory gesture in response to poorly mobile vocal fold membranes. Stroboscopy was able to document a number of abnormalities which included abnormalities of laryngeal configuration, vibratory asymmetry, reduction of amplitude, and mucosal wave. Using a diversified approach consisting of medical therapy, voice therapy, and repeat surgery, better vocal function was able to be restored in the majority of patients. An interdisciplinary approach to the dysphonic patient after laryngeal surgery was most useful in defining the pathology and refining a treatment rehabilitation program.
Temporal bone pathology in a case of cogan's syndrome
Authors: Schuknecht Harold F. , Nadol Joseph B.
Published: October 2006

Cogan's syndrome (CS) presents typical and atypical types. Typically, there are episodes of non‐syphilitic keratitis and audiovestibular dysfunction. Atypically, there are inflammatory changes in other eye structures and other organ systems, particularly the cardiovascular system. The temporal bone pathology in a case of CS shows changes that are similar to those observed in other autoimmune disorders associated with audiovestibular dysfunction. The following pathologic features characterize autoimmune inner ear disease: 1. acute labyrinthitis resulting in atrophy of inner ear tissues including the sense organs and their supporting structures; 2. endolymphatic hydrops; 3. focal and diffuse proliferation of fibrous tissue and bone; and 4. retrograde neuronal degeneration. These pathologic findings are consistent with an inflammatory (and possibly ischemic) attack on the membranous labyrinth.
Murine model of otitis media with effusion: Immunohistochemical demonstration of il‐1α antigen expression
Authors: Johnson Michael D. , Contrino Aurora , Contrino Josephine , Maxwell Kenneth , Leonard Gerald , Kreutzer Donald
Published: October 2006

Recent studies have suggested that cytokines likely play a central role in the formation and maintenance of otitis media with effusion (OME). Currently, there is no immunologically defined animal model for the study of cytokines as they contribute to the formation of OME. In the present study, a murine model of OME, using eustachian tube blockage via an external surgical approach, was developed. The murine model temporal bone histology appears to mimic the histology found in chronic otitis media with effusion in humans. Additionally, using this murine model, interleukin‐1α (IL‐1α) expression was detected in the middle ear using standard immunohistochemical techniques. IL‐1α seemed localized to the epithelial lining of the middle ear as well as 5% to 10% of inflammatory cells. This model should provide the necessary tool to further study the immunologic aspects of OME.
Evidence of oxygen radical injury in experimental otitis media
Authors: Parks Robert R. , Huang Cheng‐Chun , Haddad Joseph
Published: October 2006

Free radicals have been implicated in the pathogenesis of an increasing number of diseases and inflammatory states. They may cause tissue damage by their chemical modification of proteins, carbohydrates, nucleotides, and lipids. Lipid peroxidation occurs as a consequence of free radicals acting on the polyunsaturated fatty acids of cellular membranes. To determine if free radicals play a role in the pathogenesis of otitis media, lipid peroxides and their by‐products were assayed in the mucosa of a guinea pig model of otitis media.

Both lipid hydroperoxide (LPO) and malon‐dialdehyde (MDA) were measured in the tissues of the middle ear mucosa. Comparisons were made between an infected and a control group. Both LPO and MDA were found to be significantly elevated (P<.01 and P<.05, respectively) in the infected mucosa. Correlation of the biochemical data was made with histologic studies. The significance of these findings as well as suggestions for future experimentation are addressed.
Social support and psychological outcome in people with Parkinson's disease: Evidence for a specific pattern of associations
Authors: Simpson Jane , Haines Katrina , Lekwuwa Godwin , Wardle John , Crawford Trevor
Published: October 2006

ObjectiveThe aim of this study was to explore the relationship between social support and psychological functioning in people with Parkinson's disease.

Method34 participants with idiopathic Parkinson's disease completed a comprehensive range of social support assessments and measures of depression, anxiety, stress, general psychological distress and positive affect.

ResultsA clear pattern of relationships emerged, with the less satisfaction with social support, the higher the depression, anxiety and stress scores. Conversely, positive affect was related to more quantitative assessments of social support, such as the number of close relationships.

ConclusionThe relationship between social support and psychological outcome in people with PD is complex. Furthermore, the complexity of this relationship should be addressed in any therapeutic attempts to relieve psychological distress and promote happiness.
Content and affect in persecutory delusions
Authors: Green Catherine , Garety Philippa A. , Freeman Daniel , Fowler David , Bebbington Paul , Dunn Graham , Kuipers Elizabeth
Published: October 2006

ObjectivesThe study aimed to explore the content of persecutory delusions and its potential links with levels of affective disturbance. Detailed examinations of the phenomenology of delusional beliefs have been rare, but are important for furthering theoretical and clinical understanding.

DesignA cross‐sectional investigation of 70 individuals with current persecutory delusions was conducted.

MethodsTaped semi‐structured clinical interviews were transcribed for each participant. Using a coding frame devised for the current study, a detailed description of persecutory content was made. Scores on the Beck Depression and Anxiety Inventories, the Rosenberg Self‐esteem Scale and the Psychotic Symptom Rating Scales were used as indicators of emotional distress.

ResultsData were gathered on the identity and type of persecutor, pervasiveness of threat and the power of the persecutor. Reliability was good. Beliefs involving multiple persecutors, human in nature and identifiable to the individual were common. For the majority threat was severe, ongoing and enduring and coupled with frequent feelings of vulnerability. Specific aspects of delusional content were found to be associated with emotional distress. For example, if participants felt more power in the face of persecution this was coupled with lower depression and higher self‐esteem.

ConclusionsPersecutory delusions are beliefs concerning severe threat, particularly of physical harm including death, which is personally significant, frequently involving multiple persecutors known to the individual. Depression is higher in those who felt less powerful than their persecutors. Associations, such as this, with emotional distress support a direct role for emotion in delusion formation and maintenance. It is consistent with cognitive models of delusions which emphasize the importance of considering emotional distress in the context of belief appraisal, although interpretation of the results is limited by the cross‐sectional study design. Recognizing these links may in turn aid therapists in identifying aspects of beliefs that might be targeted to facilitate emotional change.
Is there a magical time boundary for diagnosing eyewitness identification accuracy in sequential line‐ups?
Authors: Sauer James D. , Brewer Neil , Wells Gary L.
Published: October 2006

We examined whether eyewitness identification latencies for sequential line‐up decisions indicate an optimum time boundary that reliably discriminates accurate from inaccurate decisions. Participants (N = 381) observed a crime simulation and attempted two separate identifications from target‐present or target‐absent sequential line‐ups. As has previously been found with simultaneous line‐ups, the optimum time boundary identified did not reliably discriminate accurate from inaccurate identifications for both line‐up targets. Diagnosticity for choosers was, however, much higher at very high confidence levels than at lower levels. Possible reasons for why one index of signal strength (confidence), but not another (latency), might postdict accuracy within the sequential framework were presented.
Adult Human Upper Esophageal Sphincter Contains Specialized Muscle Fibers Expressing Unusual Myosin Heavy Chain Isoforms
Authors: Mu Liancai , Wang Jun , Su Hungxi , Sanders Ira
Published: October 2006

The functional upper esophageal sphincter (UES) is composed of the cricopharyngeus muscle (CP), the most inferior part of the inferior pharyngeal constrictor (iIPC), and the upper esophagus (UE). This sphincter is collapsed and exhibits sustained muscle activity in the resting state; it only relaxes and opens during swallowing, vomiting, and belching. The tonic contractile properties of the UES suggest that the skeletal muscle fibers in this sphincter differ from those in the limb and trunk muscles. In this study, myosin heavy chain (MHC) composition in the adult human UES muscles obtained from autopsies was investigated using immunocytochemical and immunoblotting techniques. Results showed that the adult human UES muscle fibers expressed unusual MHC isoforms such as slow-tonic (MHC-ton), α-cardiac (MHC-α), neonatal (MHC-neo), and embryonic (MHC-emb), which coexisted with the major MHCs (i.e., MHCI, IIa, and IIx). MHC-ton and MHC-α were coexpressed predominantly with slow-type I MHC isoform, whereas MHC-neo and MHC-emb coexisted mainly with fast-type IIa MHC. A slow inner layer (SIL) and a fast outer layer (FOL) in the iIPC and CP were identified immunocytochemically. MHC-ton- and MHC-α-containing fibers were concentrated mainly in the SIL, whereas MHC-neo- and MHC-emb-containing fibers were distributed primarily to the FOL. Identification of the specialized muscle fibers and their distribution patterns in the adult human UES is valuable for a better understanding of the physiological and pathophysiological behaviors of the sphincter.
Methodology of Lifetime Prediction in Polymer Aging
Authors: Verdu J. , Colin X. , Fayolle B. , Audouin L.
Published: October 2006

Two approaches for lifetime prediction in polymer aging are compared: the “simulation approach” and the “ideal approach.” The widely used “simulation approach,” based on the hypotheses which were never clearly formulated, consists of finding a set of exposure conditions such that accelerated aging leads to the same structural states as natural aging. Using simple kinetic models it is demonstrated, that in the general case it is impossible to obtain a “good simulation.” Anyhow, in this approach, the problem of the relationship between accelerated aging and natural lifetimes remains unresolved. The “ideal approach” uses nonempirical kinetic models, taking into account structural changes at all the pertinent scales, and also uses polymer physics to establish the link between the polymer structure and the property under consideration. An important characteristic of this approach is that the accelerated aging serves only to determine the model parameters.
Sequential Liver and Bone Marrow Transplantation for Treatment of Erythropoietic Protoporphyria
Authors: Rand Elizabeth B. , Bunin Nancy , Cochran William , Ruchelli Eduardo , Olthoff Kim M. , Bloomer Joseph R.
Published: October 2006

Erythropoietic protoporphyria is a disorder of heme synthesis in which deficient ferrochelatase activity leads to excess production and biliary excretion of protoporphyrin. The main clinical features, photosensitivity and hepatobiliary disease that may progress to liver failure, are caused by the toxicity of protoporphyrin. Liver transplantation has been used to treat liver failure in erythropoietic protoporphyria, but excess production of protoporphyrin by the bone marrow continues causing recurrence of liver disease in the majority of patients. This is the first report of successful sequential liver and bone marrow transplantation in a patient with liver failure as a result of erythropoietic protoporphyria. This combination corrected the severe phenotype, resolving the severe photosensitivity and halting erythropoietic protoporphyria associated liver graft injury. Splenectomy seemed to facilitate the successful bone marrow transplant.
Modified Coronally Advanced Flap Associated With a Subepithelial Connective Tissue Graft for the Treatment of Adjacent Multiple Gingival Recessions
Authors: Carvalho Paulo F.M. , da Silva Robert C. , Cury Patrícia R. , Joly Julio C.
Published: October 2006

Background: The clinical choice of the appropriate surgical technique aiming at root coverage relies, among other factors, on the number of adjacent gingival recessions. This study aimed to clinically evaluate the effectiveness and the predictability of root coverage at adjacent multiple gingival recessions using a modified coronally positioned flap associated with the subepithelial connective tissue graft.

Methods: Ten non‐smoking, healthy subjects (five men and five women; mean age, 28.7 years) presenting 29 Class I or II adjacent multiple gingival recessions were enrolled. Each patient was treated using a modified coronally advanced flap associated with the subepithelial connective tissue graft. Probing depth (PD), clinical attachment level (CAL), recession depth (RD), and width of keratinized tissue (KT) were measured at baseline and 6 months later. The Student t test was used to compare treatment outcomes through time.

Results: The results revealed significant CAL gain (mean gain ± SD, 1.97 ± 0.94 mm; P <0.0001), RD decrease (2.03 ± 0.78 mm; P <0.0001), and KT increase (1.31 ± 1.23 mm, P <0.0001). The average root coverage was 96.7%, and complete root coverage was found at 93.1% of the defects. Nine of the 10 patients (90% of the patients) experienced complete root coverage.

Conclusions: The modified coronally advanced flap associated with the subepithelial connective tissue graft was effective and predictable to produce root coverage at multiple adjacent gingival recessions associated with gain in the CAL and in the width of KT.
New Evidence of Premature Oxidative DNA Damage: Mitochondrial DNA Deletion in Gingival Tissue of Patients With Periodontitis
Authors: Çanakçı Cenk Fatih , Tatar Abdulgani , Çanakçı Varol , Cicek Yasin , Oztas Sitki , Orbak Recep
Published: October 2006

Background: Overproduction of reactive oxygen species (ROS) causes increased oxidative stress in gingival tissue. It has been generally accepted that increased oxidative stress might contribute to additional damage of lipids, proteins, and DNA molecules. The mitochondrial DNA (mtDNA) mutation is a superb biomarker of oxidative damage. The aim of the present study was to investigate the mtDNA deletions in the gingival tissue of patients with periodontitis and to explain the correlations between mtDNA deletion in gingival tissue and clinical parameters of periodontitis and age.

Methods: Gingival tissue and blood samples were collected from 30 patients with chronic periodontitis (CP group) and 30 healthy control subjects (H group). To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level, and probing depth were measured. Using the polymerase chain reaction (PCR) method, we examined the 7.4‐ and 5‐kbp mtDNA deletions in tissue and blood samples. Three different pairs of PCR primers were used in this study.

Results: In this study, we did not detect any deletions in blood DNA samples in either the CP or H group. Also, the 7.4‐kbp mtDNA deletion was not detected in gingival tissues of subjects. However, the 5‐kbp mtDNA deletion was detected in 24 of the 30 subjects (80%) in the CP group and was not detected in the H group (0%). Significant correlations were found between the occurrence of the 5‐kbp mtDNA deletion and all clinical parameters (P <0.01). A similar correlation was found between the occurrence of the 5‐kbp mtDNA deletion and age (P <0.05).

Conclusions: The overproduction of ROS by activated polymorphonuclear leukocytes in chronic inflammation may lead to premature oxidative damage of the mtDNA. In this study, the occurrence of the 5‐kbp mtDNA deletion in 24 periodontitis subjects may be evidence of premature oxidative DNA damage.
Field Evaluation of a Model for Predicting Nitrogen Losses from Drained Lands
Authors: Youssef Mohamed A. , Skaggs R. Wayne , Chescheir George M. , Gilliam J. Wendell
Published: October 2006

The N simulation model, DRAINMOD‐N II, was field‐tested using a 6‐yr data set from an artificially drained agricultural site located in eastern North Carolina. The test site is on a nearly flat sandy loam soil which is very poorly drained under natural conditions. Four experimental plots, planted to a corn (Zea mays)–wheat (Triticum aestivum L.)–soybean (Glycine max.) rotation and managed using conventional and controlled drainage, were used in model testing. Water table depth, subsurface drainage, and N concentration in drain flow were measured and meteorological data were recorded continuously. DRAINMOD‐N II was calibrated using the data from one plot; data sets from the other three plots were used for model validation. Simulation results showed an excellent agreement between observed and predicted nitrate‐nitrogen (NO3–N) losses in drainage water over the 6‐yr period and a reasonable agreement on an annual basis. The agreement on a monthly basis was not as good. The Nash‐Sutcliffe modeling efficiency (EF) for monthly predictions was 0.48 for the calibration plot and 0.19, 0.01, and −0.02 for the validation plots. The value of the EF for yearly predictions was 0.92 for the calibration plot and 0.73, 0.62, and −0.10 for the validation plots. Errors in predicting cumulative NO3–N losses over the 6‐yr period were remarkably small; −1.3% for the calibration plot, −8.1%, −2.8%, and 4.0% for the validation plots. Results of this study showed the potential of DRAINMOD‐N II for predicting N losses from drained agricultural lands. Further research is needed to test the model for different management practices and soil and climatological conditions.