bluuebunny/crossref_metadata_2025 huggingface dataset:
Time Relation between a Syncopal Event and Documentation of Atrioventricular Block in Patients with Bifascicular Block: Clinical Implications
Authors: Tabrizi Fariborz , Rosenqvist Mårten , Bergfeldt Lennart , Englund Anders
Published: October 2006

Background: Transient high-degree atrioventricular (AV) block is a common cause of syncope in patients with bifascicular block (BFB) but the intermittent nature of AV block makes ECG documentation a challenge. A sensitive and safe tool to investigate BFB patients with syncope would be a bradycardia-detecting pacemaker, which provides a possibility of studying the time relation between the index syncopal episode and the development of high-degree AV block. Methods: Twenty-seven patients with BFB and syncope were studied prospectively. All patients received a single-chamber ventricular-based pacemaker with bradycardia-detecting ability. A bradycardia episode was defined as a heart rate of <30 beats/min lasting ≧6 s. Results: During a median follow-up of 60 months, a bradycardia event was detected in 14 patients (52%), of whom 13 also had documented high-degree AV block on ECG. The median time between the syncopal episode and the first pacemaker-detected bradycardia event was 5 months and after an additional median time of 6 months, high-degree AV block was documented on the ECG. In 10 of 13 patients (77%) high-degree AV block was documented within 24 months of the syncopal episode corresponding to an annual incidence of 19% during the first 2 years of follow-up in the study population. Conclusion: In this group of BFB patients a syncopal episode was highly predictive of the development of high-degree AV block within 24 months, justifying pacemaker therapy without prior ECG verification.
Altered Expression of Matrix-Related Molecules in the Development of Chronic Thy1.1 Nephritis
Authors: Kuroda Takayuki , Tanioka Hideki , Masui Masao , Ito Masashi , Notoya Mitsuru , Shinosaki Toshihiro
Published: October 2006

Background/Aim: Matrix production and degradation are critically important in chronic nephritis. Our aim was to investigate the precise expression of matrix-related molecules which is essential for understanding the pathogenesis of renal disease. Methods: Chronic nephritis was induced by a single injection of anti-Thy1.1 antibody to unilaterally nephrectomized rats. RNA was extracted from renal cortex and isolated glomeruli 4, 7, and 10 weeks after the antibody injection. Matrix-related gene expressions were measured by polymerase chain reaction. The expression of α1(IV) and α3(IV) collagens was studied by immunohistochemistry. The gelatinolytic activity in the glomeruli was assayed by gelatin zymography. Results: Polymerase chain reaction revealed an increase of α1(IV) in both glomeruli and renal cortex from nephritic rats. In contrast, the expression of α3(IV), normally a component of the glomerular basement membrane, was decreased in nephritic animals. Immunohistochemistry confirmed the finding that α1(IV) and α3(IV) were up- and downregulated, respectively, in the glomeruli. Gene expression and activity of matrix metalloproteinase 2 were enhanced, while those of matrix metalloproteinase 9 were clearly suppressed in nephritis. Conclusions: Downregulation of α3(IV) and enhancement of the matrix metalloproteinase-2 activity in the glomeruli may contribute to the glomerular damage by altering the glomerular basement membrane components. Impairment of the glomerular basement membrane integrity may possibly be implicated in irreversible renal dysfunction.
The Obstetrical History in Patients with Pfannenstiel Scar Endometriomas – An Analysis of 81 Patients
Authors: Wicherek Lukasz , Klimek Marek , Skret-Magierlo Joanna , Czekierdowski Artur , Banas Tomasz , Popiela Tadeusz J. , Kraczkowski Janusz , Sikora Jerzy , Oplawski Marcin , Nowak Agata , Skret Andrzej , Basta Antoni
Published: October 2006

Introduction: The participation of immune tolerance during pregnancy was suggested to be an important factor predisposing to the implantation of decidual cells after cesarean section in Pfannenstiel scar. Delivery at term is related to the termination of immune tolerance to fetal antigens that is maintained throughout pregnancy. Substantial proportion of cesarean section deliveries is performed before the onset of true term labor. The aim of this study was to analyze the clinical symptoms of spontaneous beginning of labor in pregnant women in whom cesarean sections were performed and in whom Pfannenstiel scar endometriomas were observed during follow-up. Materials and Methods: We have retrospectively analyzed 81 patients following the surgical removal of scar endometrioma after cesarean section. Obstetrical histories of cesarean sections in the number of 5,370 preceding the occurrence of the scar endometrioma were analyzed. These data were collected in six different Gynecological and Obstetrical wards in Malopolska Province in Poland. Analysis of data was started by the retrospective evaluation of regular uterine contractions, uterine cervix ripening before cesarean section and the indications for surgery. Results: In 67 women from the group of 81 patients cesarean sections were performed with unripe uterine cervix and without the presence of regular uterine contractions. Elective indications for cesarean sections were predominant in this group of women. The relative risk of scar endometriomas occurrence following cesarean sections performed before onset of labor in comparison to cesarean sections following spontaneous onset of labor was statistically significantly higher [RR = 2.16, 95% CI = 1.21–3.83; OR = 2.18, 95% CI = 1.22–3.89]. Conclusions: Cesarean section performed before spontaneous onset of labor may increase substantially the risk of occurrence of scar endometriomas.
Induction of Macrophage Chemotaxis by Aortic Extracts of the mgR Marfan Mouse Model and a GxxPG-Containing Fibrillin-1 Fragment
Authors: Guo Gao , Booms Patrick , Halushka Marc , Dietz Harry C. , Ney Andreas , Stricker Sigmar , Hecht Jochen , Mundlos Stefan , Robinson Peter N.
Published: October 2006

Background—

The primary cause of early death in untreated Marfan syndrome (MFS) patients is aortic dilatation and dissection.

Methods and Results—

We investigated whether ascending aortic samples from the fibrillin-1–underexpressing mgR mouse model for MFS or a recombinant fibrillin-1 fragment containing an elastin-binding protein (EBP) recognition sequence can act as chemotactic stimuli for macrophages. Both the aortic extracts from the mgR/mgR mice and the fibrillin-1 fragment significantly increased macrophage chemotaxis compared with extracts from wild-type mice or buffer controls. The chemotactic response was significantly diminished by pretreatment of macrophages with lactose or with the elastin-derived peptide VGVAPG and by pretreatment of samples with a monoclonal antibody directed against an EBP recognition sequence. Mutation of the EBP recognition sequence in the fibrillin-1 fragment also abolished the chemotactic response. These results indicate the involvement of EBP in mediating the effects. Additionally, investigation of macrophages in aortic specimens of MFS patients demonstrated macrophage infiltration in the tunica media.

Conclusions—

Our findings demonstrate that aortic extracts from mgR/mgR mice can stimulate macrophage chemotaxis by interaction with EBP and show that a fibrillin-1 fragment possesses chemotactic stimulatory activity similar to that of elastin degradation peptides. They provide a plausible molecular mechanism for the inflammatory infiltrates observed in the mgR mouse model and suggest that inflammation may represent a component of the complex pathogenesis of MFS.
Indications for Renal Arteriography at the Time of Coronary Arteriography
Authors: White Christopher J. , Jaff Michael R. , Haskal Ziv J. , Jones Daniel J. , Olin Jeffrey W. , Rocha-Singh Krishna J. , Rosenfield Kenneth A. , Rundback John H. , Linas Stuart L.
Published: October 2006

Atherosclerotic renal artery stenosis is commonly present in patients with clinically manifest atherosclerosis in other vascular beds and is independently associated with increased cardiovascular morbidity and mortality. Screening tests such as renal angiography should be selectively applied to patients at high risk for renal artery stenosis who are potential candidates for revascularization. This multispecialty consensus document describes the rationale for patient selection for screening renal angiography at the time of cardiac catheterization.
Pirfenidone Prevents the Development of a Vulnerable Substrate for Atrial Fibrillation in a Canine Model of Heart Failure
Authors: Lee Ken W. , Everett Thomas H. , Rahmutula Dulkon , Guerra Jose M. , Wilson Emily , Ding Chunhua , Olgin Jeffrey E.
Published: October 2006

Background—Atrial fibrosis is an important substrate in atrial fibrillation (AF), particularly in the setting of structural heart disease. In a canine model, congestive heart failure (CHF) produces significant atrial fibrosis and the substrate for sustained AF. This atrial remodeling is a potential therapeutic target. The objective of the present study is to evaluate the effects of the antifibrotic drug pirfenidone (PFD) on arrhythmogenic atrial remodeling in a canine CHF model.

Methods and Results—We studied 15 canines, divided equally into 3 groups: control, CHF canines not treated with PFD, and CHF canines treated with PFD. CHF was induced by ventricular tachypacing (220 bpm for 3 weeks), and oral PFD was administered for the 3-week pacing period. We performed electrophysiology and AF vulnerability studies, atrial fibrosis measurements, and atrial cytokine expression studies. Only canines in the untreated CHF group developed sustained AF (>30 minutes, 4 of 5 canines;P<0.05). Treatment of CHF canines with PFD resulted in an attenuation of arrhythmogenic left atrial remodeling, with a significant reduction in left atrial conduction heterogeneity index (median [25% to 75% interquartile range] 4.96 [3.53 to 5.64] versus 2.52 [2.11 to 2.82],P<0.01; pacing cycle length 300 ms), left atrial fibrosis (16.0% [13.0% to 17.5%] versus 8.7% [5.7% to 10.6%],P<0.01), and AF duration (1800 [1020 to 1800] seconds versus 6 [5 to 22] seconds,P<0.01). Immunoblotting studies demonstrated the drug’s effects on multiple cytokines, including a reduction in transforming growth factor-β1 expression.

Conclusions—Treatment of CHF canines with PFD results in significantly reduced arrhythmogenic atrial remodeling and AF vulnerability. Pharmacological therapy targeted at the fibrotic substrate itself may play an important role in the management of AF.
Absence of Malonyl Coenzyme A Decarboxylase in Mice Increases Cardiac Glucose Oxidation and Protects the Heart From Ischemic Injury
Authors: Dyck Jason R.B. , Hopkins Teresa A. , Bonnet Sebastien , Michelakis Evangelos D. , Young Martin E. , Watanabe Miho , Kawase Yosuke , Jishage Kou-ichi , Lopaschuk Gary D.
Published: October 2006

Background—

Acute pharmacological inhibition of cardiac malonyl coenzyme A decarboxylase (MCD) protects the heart from ischemic damage by inhibiting fatty acid oxidation and stimulating glucose oxidation. However, it is unknown whether chronic inhibition of MCD results in altered cardiac function, energy metabolism, or ischemic cardioprotection.

Methods and Results—

Mcd
-deficient mice were produced and assessed for in vivo cardiac function as well as ex vivo cardiac function, energy metabolism, and ischemic tolerance. In vivo and ex vivo cardiac function was similar in wild-type and
mcd
−/−
mice. Ex vivo working hearts from
mcd
−/−
and wild-type mice displayed no significant differences in rates of fatty acid oxidation, glucose oxidation, or glycolysis. However, cardiac deletion of
mcd
resulted in an increased expression of genes regulating fatty acid utilization that may compensate for the loss of MCD protein and likely contributes to the absence of changes in energy metabolism in the aerobic heart. Despite the lack of changes in fatty acid utilization, hearts from
mcd
−/−
mice displayed a marked preference for glucose utilization after ischemia, which correlated with a significant cardioprotection of ischemic hearts from
mcd
−/−
mice compared with wild-type mice.

Conclusions—

Deletion of MCD markedly increases glucose oxidation and improves functional recovery of the heart after ischemia. As a result, chronic pharmacological inhibition of MCD may be a viable approach to treat myocardial ischemia.
Family Environment, Effortful Control, and Adjustment Among European American and Latino Early Adolescents
Authors: Loukas Alexandra , Roalson Lori A.
Published: October 2006

The present study examined the independent and interactive relations of effortful control and two family environment variables (parent-adolescent conflict and negative family relations) on the subsequent conduct problems and depressive symptoms of 459 European American and Latino adolescents between the ages of 10 and 14. Hierarchical regression analyses showed that even after baseline levels of conduct problems were taken into account, lower levels of effortful control and poorer family relations were uniquely predictive of more conduct problems 1 year later. A three-way interaction among effortful control, negative family relations, and ethnicity indicated that among European Americans only, effortful control moderated the negative family relations effect. High levels of effortful control protected European American adolescents living in homes characterized by negative family relations from elevated levels of subsequent conduct problems. Contrary to findings for the conduct problems outcome, only baseline levels of depressive symptoms predicted subsequent depressive symptoms.
The Changing Nature of Adolescent Friendships
Authors: Marsh Penny , Allen Joseph P. , Ho Martin , Porter Maryfrances , McFarland F. Christy
Published: October 2006

Although success in managing evolving peer relationships is linked to critical adolescent outcomes, little is known about the specific factors that lead to success or failure in peer relationship development across adolescence. This longitudinal study examines the role of adolescents’ level of ego development as a predictor of the future course of several facets of friendship development in early adolescence. Ego development was assessed in a community sample of adolescents at age 13. Several facets of adolescent friendship were also assessed at 13 and then reassessed 1 year later, including adolescent intimate behavior during a supportive interaction with their best friends, adolescent reports of psychological security in their friendships, and peer-rated popularity. As predicted, ego development not only explained concurrent levels of peer functioning but also predicted markers of change over time in each of the assessed domains of peer functioning. Implications for ego development in increasing our understanding of individual differences in adolescent friendship development are discussed.
VEGF-C–induced lymphangiogenesis in sentinel lymph nodes promotes tumor metastasis to distant sites
Authors: Hirakawa Satoshi , Brown Lawrence F. , Kodama Shohta , Paavonen Karri , Alitalo Kari , Detmar Michael
Published: October 2006

The mechanisms by which tumors metastasize to sentinel and distant lymph nodes, and beyond, are poorly understood. We developed transgenic mice that overexpress vascular endothelial growth factor-C (VEGF-C) and green fluorescent protein specifically in the skin and studied the effects of chemically-induced skin carcinogenesis in this model. We found that in contrast to VEGF-A, VEGF-C does not increase the growth of primary tumors, but instead induces expansion of lymphatic networks within sentinel lymph nodes, even before the onset of metastasis. Once the metastatic cells arrived at the sentinel lymph nodes, the extent of lymphangiogenesis at these sites increased. Of importance, in mice with metastasis-containing sentinel lymph nodes, tumors that expressed VEGF-C were more likely to metastasize to additional organs, such as distal lymph nodes and lungs. No metastases were observed in distant organs in the absence of lymph node metastases. These findings indicate an important role of VEGF-C–induced lymph node lymphangiogenesis in the promotion of cancer metastasis beyond the sentinel lymph nodes. VEGF-C is therefore a good target to slow or even prevent the onset of metastasis.
Triglyceride associated polymorphisms of the APOA5gene have very different allele frequencies in Pune, India compared to Europeans
Authors: Chandak Giriraj R , Ward Kirsten J , Yajnik Chittaranjan S , Pandit Anand N , Bavdekar Ashish , Joglekar Charu V , Fall Caroline HD , Mohankrishna P , Wilkin Terence J , Metcalf Bradley S , Weedon Michael N , Frayling Timothy M , Hattersley Andrew T
Published: October 2006

Background

The APOA5 gene variants, -1131T>C and S19W, are associated with altered triglyceride concentrations in studies of subjects of Caucasian and East Asian descent. There are few studies of these variants in South Asians. We investigated whether the two APOA5 variants also show similar association with various lipid parameters in Indian population as in the UK white subjects.

Methods

We genotyped 557 Indian adults from Pune, India, and 237 UK white adults for -1131T>C and S19W variants in the APOA5 gene, compared their allelic and genotype frequency and determined their association with fasting serum triglycerides, total cholesterol, HDL and LDL cholesterol levels using univariate general linear analysis. APOC3 SstI polymorphism was also analyzed in 175 Pune Indian subjects for analysis of linkage disequilibrium with the APOA5 variants.

Results

The APOA5 -1131C allele was more prevalent in Indians from Pune (Pune Indians) compared to UK white subjects (allele frequency 20% vs. 4%, p = 0.00001), whereas the 19W allele was less prevalent (3% vs. 6% p = 0.0015). Patterns of linkage disequilibrium between the two variants were similar between the two populations and confirmed that they occur on two different haplotypes. In Pune Indians, the presence of -1131C allele and the 19W allele was associated with a 19% and 15% increase respectively in triglyceride concentrations although only -1131C was significant (p = 0.0003). This effect size was similar to that seen in the UK white subjects. Analysis of the APOC3 SstI polymorphism in 175 Pune Indian subjects showed that this variant is not in appreciable linkage disequilibrium with the APOA5 -1131T>C variant (r2 = 0.07).

Conclusion

This is the first study to look at the role of APOA5 in Asian Indian subjects that reside in India. The -1131C allele is more prevalent and the 19W allele is less prevalent in Pune Indians compared to UK Caucasians. We confirm that the APOA5 variants are associated with triglyceride levels independent of ethnicity and that this association is similar in magnitude in Asian Indians and Caucasians. The -1131C allele is present in 36% of the Pune Indian population making it a powerful marker for looking at the role of elevated triglycerides in important conditions such as pancreatitis, diabetes and coronary heart disease.
Prognostic significance of fascin expression in advanced colorectal cancer: an immunohistochemical study of colorectal adenomas and adenocarcinomas
Authors: Hashimoto Yosuke , Skacel Marek , Lavery Ian C , Mukherjee Abir L , Casey Graham , Adams Josephine C
Published: October 2006

Background

Fascin is an actin bundling protein with roles in the formation of cell protrusions and motility of mesenchymal and neuronal cells. Fascin is normally low or absent from epithelia, but is upregulated in several epithelial neoplasms where it may contribute to an invasive phenotype. Here, we report on the prevalence and potential clinical significance of fascin expression in relation to the progression of colorectal adenocarcinoma and to tumor cell proliferation as measured by Ki67 index.

Methods

Conventional tissue sections of 107 colorectal adenomas and 35 adenocarcinomas were analyzed by immunohistochemistry for fascin and Ki67 expression.

Fascin expression and Ki67 proliferation index were also investigated by use of a tissue microarray containing cores from a further 158 colorectal adenocarcinomas and 15 adenomas linked to a CCF, IRB-approved database with a mean of 38 months of clinical follow-up. Survival analysis was carried out by the Kaplan-Meier and Cox regression methods.

Results

Fascin was not expressed by the normal colonic epithelium. In conventional sections, 16% of adenomas and 26% of adenocarcinomas showed fascin expression in greater than 10% of the tumor cells. In the clinically-annotated tumors, fascin immunoreactivity was more common in tumors located in the proximal colon (p = 0.009), but was not associated with age, gender, or TNM stage. Patients with stage III/IV adenocarcinomas (n = 62) with strong fascin immunoreactivity had a worse prognosis than patients with low or absent fascin, (3-year overall survival of 11% versus 43% for fascin-negative patients; p = 0.023). In adenomas, fascin and Ki67 tended to be inversely correlated at the cellular level; this trend was less apparent in adenocarcinomas.

Conclusion

Fascin is upregulated in a proportion of adenomas, where its expression is often focal. Strong and diffuse expression was seen in a subset of advanced colorectal adenocarcinomas that correlated with shorter survival in stage III and IV patients. Fascin may have prognostic value as an early biomarker for more aggressive colorectal adenocarcinomas.
Staging Calamity
Authors: Pavis Patrice
Published: October 2006

Translated by Joel Anderson
Infrared Spectroscopic and Density Functional Theory Studies on the Reactions of Zinc and Cadmium Atoms with Ammonia
Authors: Jiang Ling , Xu Qiang
Published: October 2006

Reactions of zinc and cadmium atoms with ammonia molecules in a solid argon matrix have been studied by infrared spectroscopy. MNH3 (M = Zn and Cd) was found from the reaction of ammonia with excited metal atoms, similar to the reaction of ammonia with Hg atom, but quite different from those with other metal atoms (Sc, Ti, V, etc.). The absorptions peaks of HZnNH2 sharply increased upon broad-band irradiation, whereas there was no detectable HCdNH2 produced under the same experimental conditions. Density functional theory calculations were performed on these molecules and the transition states. The agreement between experimental and calculated vibrational frequencies, relative absorption intensities, and isotopic shifts provides strong support for the identification of the products. Furthermore, energetic analysis for possible reaction paths of these reactions is also given.
Synthesis and Spectroscopic Properties of Novel Silacyclic Compounds Containing a Titanium and Some Chalcogen Atoms
Authors: Takeda Nobuhiro , Tanabe Taro , Tokitoh Norihiro
Published: October 2006

Novel silacyclic compounds containing a titanium and some chalcogen atoms, [Tbt(Mes)Si(μ-Ch)2TiCp2] and [Tbt(Mes)Si(μ-Ch)(μ-Ch2)TiCp2] (Ch = S and Se; Tbt = 2,4,6-tris[bis(trimethylsilyl)methyl]phenyl; Mes = mesityl; Cp = cyclopentadienyl), were synthesized by the reactions of the disilene Tbt(Mes)Si=Si(Mes)Tbt with the corresponding [Cp2TiCh5] (Ch = S and Se). The spectroscopic properties of these compounds are presented together with the results of theoretical calculations.
Measuring Cross-Category Price Effects with Aggregate Store Data
Authors: Song Inseong , Chintagunta Pradeep K.
Published: October 2006

Our objective is to understand the cross-category effects of marketing activities using aggregate store-level scanner data. For this, we provide a framework derived from household utility maximizing behavior which assumes that a household chooses the “bundle” of products with the highest utility. We use a second-order Taylor series approximation to an arbitrary utility function to represent bundle utility. Aggregate sales or shares in each category are derived under the assumption that households are heterogeneous in their preferences and in their sensitivities to marketing activities. Our estimation accounts for potential price endogeneity in demand. Using store-level scanner data on four product categories—liquid laundry detergents, powdered laundry detergents, liquid fabric softeners, and sheet fabric softeners—we find evidence for a complementary relationship between liquid softeners and both forms of detergents. We also find that the magnitude of cross-category elasticities are brand specific, i.e., different brands in a category have a different price impact on the demand for a brand in another category. The results have implications for retailers in terms of the potential need for cross-category management, as well as for manufacturers such as Procter & Gamble that participate in all four categories. We compare our model with a log-log regression specification on three criteria—estimated elasticities, hold-out sample predictions, and retailer cross-category pricing. We find that the proposed model produces more reasonable estimates relative to the log-log model; it predicts better and is more useful for pricing purposes. Further, in a simulation study, we show that our proposed model can recover the elasticities from a data-generating process that simulates household-level joint outcomes across categories even after these data have been aggregated to brand-level shares within each category. By contrast, the log-log regression model is unable to do so.
Characterization of the Bullwhip Effect in Linear, Time-Invariant Supply Chains: Some Formulae and Tests
Authors: Ouyang Yanfeng , Daganzo Carlos
Published: October 2006

The authors analyze the bullwhip effect in multistage, decentralized supply chains operated with linear and time-invariant inventory management policies; the focus is on robustness. The supply chain is modeled as a single-input, single-output control system driven by arbitrary customer demands. The authors derive robust analytical conditions to predict the presence of the bullwhip effect and bound its magnitude, based only on the way inventories are managed. These results hold independently of the customer demand. The authors also characterize the stream of orders placed at any stage of the chain when the customer demand process is known and ergodic and give an exact formula for the variance of the orders placed. This formula generalizes existing results by broadening the class of inventory replenishment policies and customer demand processes to which it applies. The authors also show that the bullwhip effect can be mitigated by introducing commitments for future orders into the ordering policies.
Evidence for an etiologic relation of the epstein‐barr virus to human malignancies
Authors: Henle Werner , Henle Gertrude
Published: October 2006

Studies on virus‐induced animal tumors have provided indirect approaches to a search for viruses causing human malignancies. Epstein‐Barr virus (EBV), the cause of infectious mononucleosis, served to illustrate the usefulness of these approaches in linking EBV with Burkitt's lymphoma and nasopharyngeal carcinoma. Despite its demonstrated intimate association with these tumors the role of EBV in their causation remains uncertain.

While a passenger role seems excluded, it cannot be decided whether EBV is the primary or a secondary agent in the etiology of the tumors. If the primary cause, immunologic, genetic, virologic or other environmental factors are undoubtedly needed for EBV to express its obvious onco‐genic potential. The data illustrate the difficulties encountered in proving a viral etiology of human malignancies
Otologic and otoneurologic injuries in divers: Clinical Studies On Nine Commercial and Two Sport Divers
Authors: Caruso V. G. , Winkelmann P. E. , Correia M. J. , Miltenberger G. E. , Love J. T.
Published: October 2006

In the past two decades, we have seen a great increase in the number of injuries from commercial and sport diving. During this time, our knowledge of the physiology and pathophysiology of diving has also increased. As a result, we now can accurately diagnose and successfully treat many of these injuries.

Of the commercial and sport divers examined as patients in the Department of Otolaryngology at the University of Texas Medical Branch in Galveston, Tex., between September, 1974, and May, 1975, 11 showed positive otologic and otoneurologic findings which are reported herein. One patient was surgically explored for an oval window fistula. In localizing and classifying these injuries, we have utilized extensive and broad‐based test batteries, which include complete history, otologic and otoneurologic physical examination, audiometry, a central auditory test battery, and a vestibular test battery. These tests are described.

The findings in each of the divers are illustrated and analyzed. This article further describes the use of these test batteries, which were employed to localize otoneurologic pathology in this sample of injured divers. Based on these cases, we have expanded and modified Edmonds' classification of the etiology of vertigo related to diving. We feel that the test batteries which we describe, or similar tests, should be part of the otologic and otoneurologic workup of injured divers.

Index terms are: 1. central auditory tests; ‐2. oval window rupture; 3. diving injuries; and 4. vestibular test battery
Indications for surgery in meniere's disease
Authors: Pulec Jack L.
Published: October 2006

Ménière's disease has been shown to have multiple causes, each of which requires a specific treatment. Patients who do not respond to medical treatment often are allowed to suffer prolonged disability from their symptoms or develop permanent hearing loss without the benefit of surgery. The physician's uncertainty regarding which patient will ultimately respond to medical treatment or have spontaneous remission of symptoms can cause a delay in what would otherwise have been definitive surgical treatment which would have allowed the patient to return to a happy and productive life.

A careful analysis of 120 patients studied intensively for five years has shown that patients who exhibit specific characteristics and diagnostic findings will ultimately require surgery for control and relief of their symptoms, while others can be expected to recover with medical treatment. Fifty‐six of the 120 patients ultimately required surgery to rid them of their symptoms. These patients were almost exclusively of the group considered to be idiopathic, viral, small internal auditory canal syndrome, or caused by physical or acoustic trauma. Those patients who had other causes for their Meniere's disease rarely required surgical treatment and were well controlled by specific medical therapy.

These observations would seem to provide us with information which would allow patients who might reasonably be expected to ultimately require surgery, to have surgery provided in the earlier stages of their disease where conservative measures can more often be expected to give complete relief with preservation of hearing. The indications for surgery in patients with Meniere's disease based on this information will be reviewed. The use of this knowledge has significantly reduced the morbidity associated with Meniere's disease
Repair of nasal septal perforation with a silicone button
Authors: Beekhuis G. Jan , Eisenstein Byron
Published: October 2006

A symptomatic nasal septal perforation is an annoyance to both the patient and the treating physician. Patients complain of a whistling sound on respiration, persistent nasal crusting, occasional odor, and recurrent bouts of epistaxis. Most of the described surgical methods to attempt to close them, are not very successful; they may require more than one surgical procedure, entailing the associated hospitalization, morbidity, etc., and, at best, dubious outcome.

The technique I have used for the past few years was first proposed to me by Vernon Gray M.D.;1 it offers a simple atraumatic office procedure which, has proven to be successful in eliminating the symptoms resulting from a nasal septal perforation. Naturally, the physician should try to determine the underlying cause of the perforation and when practical, treat it. Most cases, however, are due to previous septal surgery or trauma
Malignant external otitis: Long‐term (months) antimicrobial therapy
Authors: Strauss Melvin , Aber Robert C. , Conner George H. , Baum Sheldon
Published: October 2006

Since Chandler's initial report in 1968 on “malignant external otitis” (MEO), this entity has been recognized in its earlier stages with increasing frequency. As a result of this, the availability of new antimicrobial agents, and the judicious use of surgery, there has been an improvement in the results of therapy. There remains, however, a subgroup of patients who continue to experience a significant mortality from this infection.

A review and selected discussion of our experience with MEO from 1976 to 1979 is presented. Six patients have been diagnosed and successfully treated for MEO. They presented with problems ranging from severe otalgia to multiple cranial neuropathy. For the most part, therapy consisted of the now standard aminoglycoside and carbenicillin combination. Two of the patients were in the high mortality risk group. One of these patients developed an osteomyelitis which extended across the skull base resulting in bilateral cranial neuropathies. His therapy included surgery as well as long‐term (months) outpatient treatment with tobramycin and carbenicillin with an excellent result. The second patient was treated similarly. The efficacy of this approach is discussed as well as the usefulness of radionuclide bone scanning in assessing the course and therapy of patients with MEO.
Histopathology of sudden hearing loss
Authors: Yood Tae H. , Paparella Mirchael M. , Schacern Paricia A. , Alleva Micharl
Published: October 2006

Eleven temporal bones from eight patients who had clinical histories of sudden hearing loss (SHL) were studied to assess the possible etiopathogenesis. The origin of SHL in seven ears from five patients was obscure, but appeared to be due to multiple causes. Common histopathologic changes in the cochlea, although complex, included atrophy of the organ of Corti and loss of cochlear neurons. Loss of cochlear neurons was the main finding in ears of viral infection. Labyrinthine fibrosis and formation of new bone were seen in two ears associated with vascular insult and in two ears of autoimmune disease. Different histopathologic findings causing SHL were observed even in cases with the same etiology. A case of SHL showing endolymphatic hydrops as the main histopathologic finding is described.
Vocal dysfunction following cricothyroidotomy: A prospective study
Authors: Hoist Magnus , Hertegård Stellan , Persson Anders
Published: October 2006

Voice dysfunction is a known consequence of cricothyroidotomy, but few detailed analyses have been published. This study reports an investigation of voice function in 19 patients who underwent cricothyroidotomy during a 12‐month period (54 were patients operated on, 29 survived the primary disease or injury, and 19 agreed to participate in the investigation). The patients were interviewed regarding signs of dysfunction of the cricothyroid muscles, or a diminished external tensor effect on the vocal folds. Laryngos‐copy with a magnifying‐angled endoscope, stroboscopy, phonetography, determination of mean speaking fundamental frequency, perceptual analysis of the voice, and electromyogram of the cricothyroid muscle were all performed. Four patients had signs of diminished external tensor effect on the vocal folds (mild or moderate voice dysfunction), 5 patients had other voice disorders, and 10 were classified as having normal voice. Elective cricothyroidotomy should be avoided in patients with professional or other activities that place heavy demands on the voice.
Gadolinium‐enhanced magnetic resonance imaging in bell's palsy
Authors: Schwaber Mitchell K. , Larson Theodore C. , Zealear David L. , Creasy Jeff
Published: October 2006

Inflammation of the facial nerve in Bell's palsy can be demonstrated on gadolinium‐enhanced magnetic resonance imaging. We have studied a series of 17 Bell's palsy patients with gadolinium‐enhanced magnetic resonance imaging, and the purpose of this paper is to report our findings and discuss their significance. Most acute Bell's palsy cases demonstrate facial nerve enhancement, usually in the distal internal auditory canal and labyrinthine/geniculate segments. Other segments demonstrate enhancement less often. Gadolinium enhancement occurs regardless of the severity of the paralysis and can persist after clinical improvement of the paralysis. The findings of this study corroborate other evidence that the segments of the facial nerve most often involved in Bell's palsy are the only segments that are most often enhanced with gadolinium‐enhanced magnetic resonance imaging. The role of gadolinium‐enhanced magnetic resonance imaging in the management of Bell's palsy patients is discussed.
Computer‐aided three‐dimensional reconstruction and measurement for multiple‐electrode cochlear implant
Authors: Takahashi Haruo , Sando Isamu , Takagi Akira
Published: October 2006

To assist surgeons in performing multiple‐electrode cochlear implant operations, the spatial relations between middle and inner ear structures in six normal temporal bones were studied using the computer‐aided 3‐D reconstruction method. When viewed through the external auditory canal, the approach used for electrode insertion, and the relation of the malleus to the helicotrema or the scala vestibuli in the second turn of the cochlea were found to vary considerably. In contrast, when viewed from the same transmeatal approach, both the direction and the distance from the stapes footplate to the scala vestibuli of the second turn of the cochlea and helicotrema were found to be quite stable. We concluded that the stapes footplate was a better landmark than the malleus when approaching the helicotrema and scala vestibuli of the second turn of the cochlea during multiple‐electrode cochlear implant surgery.
A comparison of class II antigenicity of human tracheal allografts stored in cialit and in merthiolate
Authors: Bujá Jesús , Wilmes Eberhard , Kastenbauer Ernst , Hammer Claus
Published: October 2006

This report deals with some of the immunological aspects of the transplantation and preservation of human tracheal grafts. The immunological behavior of the transplanted graft depends largely on the interaction of the preservatives with the tissue proteins. Using monoclonal antibodies and the immunoperoxidase staining technique we have investigated the effect of Merthiolate, Cialit, formaldehyde/ Merthiolate, and formaldehyde/Cialit preservation techniques on monomorphic determinants of class II transplantation antigens in human tracheal allografts. Unpreserved grafts were found to express class II antigens. These antigens were totally destroyed after 7 days in formaldehyde and 42 days in Cialit and Merthiolate. Preservation in Cialit and Merthiolate showed a gradual disintegration of the histological structures. In contrast, buffered formaldehyde did not appear to alter the histological structure of the tracheal graft. Irrespective of the mode of preservation, the cartilaginous tissue appeared to persist virtually unaffected. No essential differences were observed between the immunological staining of tracheal grafts preserved in Cialit and Merthiolate.
A modified method of prothrombin time/International Normalised Ratio determination in capillary blood and monitoring oral anticoagulant therapy
Authors: Berkovsky Aron , Sergeeva Elena V. , Suvorov Alexander V. , Uljavova Irina S. , Kachalova Natali D. , Klimovich Ljudmila G. , Samsonova Natali N. , Kozlov Albert A.
Published: October 2006

Clin Chem Lab Med 2006;44:1214–7.
Partitioning reference values of several Gaussian subpopulations with unequal prevalence – a procedure with computer program support
Authors: Gellerstedt Martin
Published: October 2006

Clin Chem Lab Med 2006;44:1258–63.
Westgard multirule for calculated laboratory tests
Authors: Coskun Abdurrahman
Published: October 2006

Clin Chem Lab Med 2006;44:1183–7.
Expression profiling of 11β-hydroxysteroid dehydrogenase type-1 and glucocorticoid-target genes in subcutaneous and omental human preadipocytes
Authors: Bujalska I J , Quinkler M , Tomlinson J W , Montague C T , Smith D M , Stewart P M
Published: October 2006

Obesity is associated with increased morbidity and mortality from cardiovascular disease, diabetes and cancer. Although obesity is a multi-factorial heterogeneous condition, fat accumulation in visceral depots is most highly associated with these risks. Pathological glucocorticoid excess (i.e. in Cushing’s syndrome) is a recognised, reversible cause of visceral fat accumulation. The aim of this study was to identify depot-specific glucocorticoid-target genes in adipocyte precursor cells (preadipocytes) using Affymetrix microarray technique. Confluent preadipocytes from subcutaneous (SC) and omental (OM) adipose tissue collected from five female patients were treated for 24 h with 100 nM cortisol (F), RNA was pooled and hybridised to the Affymetrix U133 microarray set. We identified 72 upregulated and 30 downregulated genes by F in SC cells. In OM preadipocytes, 56 genes were increased and 19 were decreased. Among the most interesting were transcription factors, markers of adipocyte differentiation and glucose metabolism, cell adhesion and growth arrest protein factors involved in G-coupled and Wnt signalling. The Affymetrix data have been confirmed by quantitative real-time PCR for ten specific genes, including HSD11B1, GR, C/EBPα, C/EBPβ, IL-6, FABP4, APOD, IRS2, AGTR1 and GHR. One of the most upregulated genes in OM but not in SC cells was HSD11B1. The GR was similarly expressed and not regulated by glucocorticoids in SC and OM human preadipocytes. C/EBPα was expressed in SC preadipocytes and upregulated by F, but was below the detection level in OM cells. C/EBPβ was highly expressed both in SC and in OM preadipocytes, but was not regulated by F. Our results provide insight into the genes involved in the regulation of adipocyte differentiation by cortisol, highlighting the depot specifically in human adipose tissue.
Characterization of the Nurr1 ligand-binding domain co-activator interaction surface
Authors: Volakakis Nikolaos , Malewicz Michal , Kadkhodai Banafsheh , Perlmann Thomas , Benoit Gerard
Published: October 2006

The recently solved crystal structure of the orphan nuclear receptor (NR) Nurr1 ligand-binding domain (LBD) showed that Nurr1 lacks a cavity for ligand binding and a canonical NR co-activator-binding site. Computer modeling of the Nurr1 LBD structure identified a hydrophobic region on the surface of the Nurr1 LBD that was positioned on the opposite side from the classical co-activator-binding site. Site-directed mutagenesis demonstrated that this region is critical for the activity of the Nurr1 LBD. Most mutations introduced in this region reduced or abolished transcriptional activity of the Nurr1 LBD, but mutation at lysine (K577) resulted in a drastically increased activity. Moreover, the activity of the Nurr1 LBD was shown to correlate with a propensity for proteasome-dependent degradation revealing a close association between activity and Nurr1 protein turnover. These data provide novel insights into the mechanisms of transcription via the Nurr1 LBD and identify an alternative co-activator-binding surface that is unique to the NR4A family of NRs.
Gingival Crevicular Fluid Osteopontin Levels in Periodontal Health and Disease
Authors: Sharma C.G. Dileep , Pradeep A.R.
Published: October 2006

Background: Osteopontin (OPN), a glycosylated phosphoprotein, is a bone matrix component produced by osteoblasts, osteoclasts, and macrophages as a multifunctional cytokine. OPN anchors osteoclasts to the bone surface, and its absence leads to impaired bone resorption. The aim of the present study was to assess the relation between clinical parameters and concentrations of OPN within gingival crevicular fluid (GCF) from inflamed gingiva and periodontitis sites and, subsequently, after the treatment of periodontitis sites.

Methods: A total of 45 subjects were divided into the following three groups based on modified gingival index (MGI) and Ramfjord periodontal disease index (PDI) scores: healthy (group I), gingivitis (group II), and chronic periodontitis (group III). A fourth group consisted of 15 subjects from group III, 6 to 8 weeks after treatment (i.e., scaling and root planing [SRP]). GCF samples collected from each patient were quantified for OPN using the enzymatic immunometric assay. Further, the correlation between OPN levels in situ with clinical parameters was analyzed in all groups and before and after treatment in periodontitis patients.

Results: The highest mean OPN concentration in GCF (14.347 μg/ml) was observed in group III, and the lowest mean OPN concentration in GCF (2.522 μg/ml) was observed in group I. Its levels in group III decreased to 8.419 μg/ml after treatment (group IV). Further, GCF OPN levels in all the groups showed a statistically significant positive correlation with clinical attachment loss (P <0.05).

Conclusions: OPN levels increase in GCF from healthy to periodontitis states, and periodontal treatment results in the reduction of OPN levels. The data indicate that OPN may play a key role in, and could be considered a biomarker of, periodontal disease progression.
Changes in Periodontal and Rheumatological Conditions After 2 Years in Patients With Juvenile Idiopathic Arthritis
Authors: Miranda Letícia A. , Braga Flavia , Fischer Ricardo G. , Sztajnbok Flávio R. , Figueredo Carlos Marcelo S. , Gustafsson Anders
Published: October 2006

Background: The aim of this study was to monitor changes in periodontal inflammation in patients with juvenile idiopathic arthritis (JIA) for 2 years. We investigated the influence of rheumatic disease activity and antirheumatic medication on clinical and immunological parameters of periodontal inflammation in these individuals.

Methods: Two years after a baseline examination, the periodontal and rheumatological conditions of 18 adolescents with JIA and 14 control subjects were described. The clinical periodontal inflammation was monitored by registration of visual plaque, marginal bleeding, probing depth, and clinical attachment loss (AL). Periodontal inflammation was also assessed by analysis of the cytokines interleukin (IL)‐1β and IL‐18 and the collagenase matrix metalloproteinase (MMP)‐8 by enzyme‐linked immunosorbent assay.

Results: The erythrocyte sedimentation rate and clinical rheumatological parameters were significantly improved at the 2‐year follow‐up. The number of sites with plaque decreased, and the number of pockets ≥4 mm increased, whereas bleeding levels and the extension of AL remained unchanged. IL‐1β in gingival crevicular fluid decreased significantly in the JIA group after 2 years. No differences were observed for IL‐1β, MMP‐8, or IL‐18 levels between groups after 2 years.

Conclusion: Two years after the baseline examination, no clinical or laboratory differences in periodontal inflammation could be found between JIA patients and control subjects.
In vitro complexes of copper and zinc with chlorophyll
Authors: Petrovic Jelena , Nikolic Goran , Markovic Dejan
Published: October 2006

Complexes of copper and zinc with chlorophyll, the major photosynthesis pigment, were studied by Vis, FTIR and fluorescence spectroscopy. Two types of complexes were recognized. While copper replaces the central magnesium atom of chlorophyll to form a "central" Cu-Chl complex, this was not proposed in the case of zinc. Instead, the zinc-mediated formation of a 6-membered chelate cycle fused at the periphery of the chlorophyll structure is proposed. The latter event could be ascribed to allomerization reactions of chlorophyll.