bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Temperature Wetting and the Work of Adhesion in Metal/Oxide Systems
Authors: Saiz Eduardo , Cannon Rowland M. , Tomsia Antoni P.
Published: April 2008

This article reviews data on wetting and the work of adhesion in metal/oxide systems at high temperatures in terms of proposed mutual adsorption models. Favorable adsorption energies can induce changes, especially near the high- and low-p(O2) limits of the coexistence range that often mimic bulk oxidation or reduction reactions. However, in some systems, an intermediate range of p(O2) exists wherein all the interfaces are stoichiometric and the contact angle and work of adhesion are independent of p(O2). A revision of existing data for several pure metal/Al2O3 systems affirms predicted trends and reveals that the contact angle is 110°–130° at the plateau and drops to or below 90° at the high- and low-p(O2) limits. This article also compares the data with recent advances in the characterization and modeling of metal-ceramic interfaces at the atomic level.
Nutritional Implications of Genetic Taste Variation: The Role of PROP Sensitivity and Other Taste Phenotypes
Authors: Tepper Beverly J.
Published: April 2008

Genetic sensitivity to the bitter taste of phenylthiocarbamide and 6-n-propylthiouracil (PROP) is a well-studied human trait. It has been hypothesized that this phenotype is a marker for individual differences in taste perception that influence food preferences and dietary behavior with subsequent links to body weight and chronic disease risk. Steady progress has been made over the past several decades in defining the involvement of this phenotype and its underlying gene, TAS2R38, in this complex behavioral pathway. However, more work needs to be done to fully determine its overall nutritional and health significance. The primary goal of this review is to assess our current understanding of the role of the PROP bitter taste phenotype in food selection and body weight in both children and adults. A brief history of the field is included and controversies surrounding the use of different PROP screening methods are addressed. The contribution of other receptors (both bitter and nonbitter) to human taste variation is also discussed.
Differences in intragastric pH in diabetic vs. idiopathic gastroparesis: relation to degree of gastric retention
Authors: Hasler William L. , Coleski Radoslav , Chey William D. , Koch Kenneth L. , McCallum Richard W. , Wo John M. , Kuo Braden , Sitrin Michael D. , Katz Leonard A. , Hwang Judy , Semler John R. , Parkman Henry P.
Published: April 2008

Evidence suggests that distinct mechanisms underlie diabetic and idiopathic gastroparesis. Differences in gastric acid in gastroparesis of different etiologies and varying degrees of gastric stasis are uninvestigated. We tested the hypotheses that 1) gastric pH profiles show differential alteration in diabetic vs. idiopathic gastroparesis and 2) abnormal pH profiles relate to the severity of gastric stasis. Sixty-four healthy control subjects and 44 gastroparesis patients (20 diabetic, 24 idiopathic) swallowed wireless transmitting capsules and then consumed99mTc-sulfur colloid-labeled meals for gastric scintigraphy. Gastric pH from the capsule was recorded every 5 s. Basal pH was higher in diabetic (3.64 ± 0.41) vs. control subjects (1.90 ± 0.18) and idiopathic subjects (2.41 ± 0.42; P < 0.05). Meals evoked initial pH increases that were greater in diabetic (4.98 ± 0.32) than idiopathic patients (3.89 ± 0.39; P = 0.03) but not control subjects (4.48 ± 0.14). pH nadirs prior to gastric capsule evacuation were higher in diabetic patients (1.50 ± 0.23) than control subjects (0.58 ± 0.11; P = 0.003). Four-hour gastric retention was similar in diabetic (18.3 ± 0.5%) and idiopathic (19.4 ± 0.5%) patients but higher than control subjects (2.2 ± 0.5%; P < 0.001). Compared with control subjects, those with moderate-severe stasis (>20% retention at 4 h) had higher basal (3.91 ± 0.55) and nadir pH (2.23 ± 0.42) values ( P < 0.05). In subgroup analyses, both diabetic and idiopathic patients with moderate-severe gastroparesis exhibited increased pH parameters vs. those with mild gastroparesis. In conclusion, diabetic patients with gastroparesis exhibit reduced gastric acid, an effect more pronounced in those with severely delayed gastric emptying. Idiopathic gastroparetic subjects exhibit nearly normal acid profiles, although those with severely delayed emptying show reduced acid vs. those with mild delays. Thus both etiology and degree of gastric stasis determine gastric acidity in gastroparesis.
Critical role of angiopoietins/Tie-2 in hyperglycemic exacerbation of myocardial infarction and impaired angiogenesis
Authors: Tuo Qin-hui , Zeng Heng , Stinnett Amanda , Yu Heidi , Aschner Judy L. , Liao Daun-Fang , Chen Jian-Xiong
Published: April 2008

Angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) are the two ligands of the Tie-2 receptor, a receptor tyrosine kinase that is expressed on the endothelium. A balanced angiopoietin/Tie-2 system is critical for the maintenance of vascular integrity. We investigated the potential role of a disrupted angiopoietin/Tie-2 system on hyperglycemic exacerbation of myocardial infarction and impaired angiogenesis. Using streptozotocin (STZ) mice subjected to myocardial ischemia, we examined the effects of shifting the Ang-2-to-Ang-1 ratio on myocardial infarction size, apoptosis, bone marrow (BM) cell-endothelial progenitor cell (EPC) differentiation, and angiogenesis. In control mice, myocardial ischemia increased expression of both Ang-2 and Tie-2. In STZ mice, Ang-2 expression was elevated, whereas Tie-2 expression was reduced, and neither was significantly altered by ischemia. Myocardial infarct size and apoptosis were increased in STZ compared with control mice. Using in vivo administration of an adenovirus containing Ang-1 or Ang-2, we found that shifting the Ang-2-to-Ang-1 ratio to favor Ang-1 reduced myocardial apoptosis and infarct size in STZ mice, while shifting the Ang-2-to-Ang-1 ratio to favor Ang-2 resulted in a significant increase in myocardial infarct size and apoptosis in control mice. Myocardial ischemia-stimulated BM cell-EPC differentiation was inhibited and myocardial angiogenesis was reduced in STZ mice. Systemic administration of Ad-Ang-1 restored BM cell-EPC differentiation and increased myocardial VEGF expression and angiogenesis in STZ mice. Our data demonstrate that disturbed angiopoietin/Tie-2 signaling contributes to the hyperglycemic exacerbation of myocardial infarction and impaired angiogenesis. Restoration of the Ang-2-to-Ang-1 ratio may be a novel therapeutic strategy for the treatment of diabetic myocardial ischemic diseases.
Brachial artery flow-mediated dilation during handgrip exercise: evidence for endothelial transduction of the mean shear stimulus
Authors: Pyke K. E. , Poitras V. , Tschakovsky M. E.
Published: April 2008

Exercise elevates shear stress in the supplying conduit artery. Although this is the most relevant physiological stimulus for flow-mediated dilation (FMD), the fluctuating pattern of shear that occurs may influence the shear stress-FMD stimulus response relationship. This study tested the hypothesis that the brachial artery FMD response to a step increase in shear is influenced by the fluctuating characteristics of the stimulus, as evoked by forearm exercise. In 16 healthy subjects, we examined FMD responses to step increases in shear rate in three conditions: stable shear upstream of heat-induced forearm vasodilation (FHStable); fluctuating shear upstream of heat-induced forearm vasodilation and rhythmic forearm cuff inflation/deflation (FHFluctuating); and fluctuating shear upstream of exercise-induced forearm vasodilation (FEStep Increase). The mean increase in shear rate (±SD) was the same in all trials (FHFluctuating: 51.69 ± 15.70 s−1; FHStable: 52.16 ± 14.10 s−1; FEStep Increase: 50.14 ± 13.03 s−1 P = 0.131). However, the FHFluctuating and FEStep Increase trials resulted in a fluctuating shear stress stimulus with rhythmic high and low shear periods that were 96.18 ± 24.54 and 11.80 ± 7.30 s−1, respectively. The initial phase of FMD (phase I) was followed by a second, delayed-onset FMD and was not different between conditions (phase I: FHFluctuating: 5.63 ± 2.15%; FHStable: 5.33 ± 1.85%; FEStep Increase: 5.30 ± 2.03%; end-trial: FHFluctuating: 7.76 ± 3.40%; FHStable: 7.00 ± 3.03%; FEStep Increase: 6.68 ± 3.04%; P = 0.196). Phase I speed also did not differ ( P = 0.685). In conclusion, the endothelium transduced the mean shear when exposed to shear fluctuations created by a typical handgrip protocol. Muscle activation did not alter the FMD response. Forearm exercise may provide a viable technique to investigate brachial artery FMD in humans.
Paracrine effects of hypoxic fibroblast-derived factors on the MPT-ROS threshold and viability of adult rat cardiac myocytes
Authors: Shivakumar K. , Sollott S. J. , Sangeetha M. , Sapna S. , Ziman B. , Wang S. , Lakatta E. G.
Published: April 2008

Cardiac fibroblasts contribute to multiple aspects of myocardial function and pathophysiology. The pathogenetic relevance of cytokine production by these cells under hypoxia, however, remains unexplored. With the use of an in vitro cell culture model, this study evaluated cytokine production by hypoxic cardiac fibroblasts and examined two distinct effects of hypoxic fibroblast-conditioned medium (HFCM) on cardiac myocytes and fibroblasts. Hypoxia caused a marked increase in the production of tumor necrosis factor (TNF)-α by cardiac fibroblasts. HFCM significantly enhanced the susceptibility of cardiac myocytes to reactive oxygen species (ROS)-induced mitochondrial permeability transition (MPT), determined by high-precision confocal line-scan imaging following controlled, photoexcitation-induced ROS production within individual mitochondria. Furthermore, exposure of cardiac myocytes to HFCM for 5 h led to loss of viability, as evidenced by change in morphology and annexin staining. HFCM also decreased DNA synthesis in cardiac fibroblasts. Normoxic fibroblast-conditioned medium spiked with TNF-α at 200 pg/ml, a concentration comparable to that in HFCM, promoted loss of myocyte viability and decreased DNA synthesis in cardiac fibroblasts. These effects of HFCM are similar to the reported effects of hypoxia per se on these cell types, showing that hypoxic fibroblast-derived factors may amplify the distinct effects of hypoxia on cardiac cells. Importantly, because both hypoxia and oxidant stress prevail in a setting of ischemia and reperfusion, the effects of soluble factors from hypoxic fibroblasts on the MPT-ROS threshold and viability of myocytes may represent a novel paracrine mechanism that could exacerbate ischemia-reperfusion injury to cardiomyocytes.
Effects of long-term immobilization and recovery on human triceps surae and collagen turnover in the Achilles tendon in patients with healing ankle fracture
Authors: Christensen Britt , Dyrberg Eva , Aagaard Per , Enehjelm Susanne , Krogsgaard Michael , Kjær Michael , Langberg Henning
Published: April 2008

The aim of the present study was to analyze how human tendon connective tissue responds to an ∼7-wk period of immobilization and a remobilization period of a similar length, in patients with unilateral ankle fracture, which is currently unknown. Calf muscle cross-sectional area (CSA) decreased by 15% (5,316 to 4,517 mm2) and strength by 54% (239 to 110 N·m) in the immobilized leg after 7 wk. During the 7-wk remobilization, the CSA increased by 9% (to 4,943 mm2) and strength by 37% (to 176 Nm). Achilles tendon CSA did not change significantly during either immobilization or remobilization. Local collagen turnover was measured as the peritendinous concentrations of NH2-terminal propeptide of type I collagen (PINP) and COOH-terminal telopeptide region of type I collagen (ICTP), markers thought to be indexes of type I collagen synthesis and degradation, respectively. Both markers were increased (PINP: 257 vs. 56 ng/ml; ICTP: 9.8 vs. 2.1 μg/l) in the immobilized leg compared with the control leg after the 7 wk of immobilization, and levels decreased again in the immobilized leg during the recovery period (PINP: 103 vs. 44 ng/ml; ICTP: 4.2 vs. 1.9 μg/l). A significant reduction in calf muscle CSA and strength was found in relation to 7 wk of immobilization. Immobilization increased both collagen synthesis and degradation in tendon near tissue. However, it cannot be excluded that the facture of the ankle in close proximity could have affected these data. Remobilization increased muscle size and strength and tendon synthesis and degradation decreased to baseline levels. These dynamic changes in tendon connective tissue turnover were not associated with macroscopic changes in tendon size.
Upper airway neuromuscular compensation during sleep is defective in obstructive sleep apnea
Authors: McGinley Brian M. , Schwartz Alan R. , Schneider Hartmut , Kirkness Jason P. , Smith Philip L. , Patil Susheel P.
Published: April 2008

Obstructive sleep apnea is the result of repeated episodes of upper airway obstruction during sleep. Recent evidence indicates that alterations in upper airway anatomy and disturbances in neuromuscular control both play a role in the pathogenesis of obstructive sleep apnea. We hypothesized that subjects without sleep apnea are more capable of mounting vigorous neuromuscular responses to upper airway obstruction than subjects with sleep apnea. To address this hypothesis we lowered nasal pressure to induce upper airway obstruction to the verge of periodic obstructive hypopneas (cycling threshold). Ten patients with obstructive sleep apnea and nine weight-, age-, and sex-matched controls were studied during sleep. Responses in genioglossal electromyography (EMGGG) activity (tonic, peak phasic, and phasic EMGGG), maximal inspiratory airflow (VImax), and pharyngeal transmural pressure (PTM) were assessed during similar degrees of sustained conditions of upper airway obstruction and compared with those obtained at a similar nasal pressure under transient conditions. Control compared with sleep apnea subjects demonstrated greater EMGGG, VImax, and PTM responses at comparable levels of mechanical and ventilatory stimuli at the cycling threshold, during sustained compared with transient periods of upper airway obstruction. Furthermore, the increases in EMGGG activity in control compared with sleep apnea subjects were observed in the tonic but not the phasic component of the EMG response. We conclude that sustained periods of upper airway obstruction induce greater increases in tonic EMGGG, VImax, and PTM in control subjects. Our findings suggest that neuromuscular responses protect individuals without sleep apnea from developing upper airway obstruction during sleep.
Effect of exercise on in vitro immune function: a 12-month randomized, controlled trial among postmenopausal women
Authors: Campbell Peter T. , Wener Mark H. , Sorensen Bess , Wood Brent , Chen-Levy Zehava , Potter John D. , McTiernan Anne , Ulrich Cornelia M.
Published: April 2008

Cross-sectional studies suggest that moderate physical activity is associated with enhanced resting immune function; however, few randomized controlled trials have investigated this link. We investigated the effect of 12-mo aerobic exercise, relative to stretching control, on in vitro immune function in a randomized, controlled trial of 115 postmenopausal, overweight, or obese sedentary women, aged 50–75 yr. The exercise goal was ≥45 min/day, 5 days/wk. Control women participated in 1 day/wk stretching classes. Immune markers (natural killer cell cytotoxicity, T-lymphocyte proliferation, immune cell counts and phenotypes, and serum immunoglobulins) were assessed at baseline, 3 mo, and 12 mo under strict blood-draw criteria. General estimation equations evaluated intervention effects at 3 and 12 mo, controlling for baseline. Of the 115 women who began the trial, blood samples were available from 109 at 3 mo (95%) and 108 at 12 mo (94%). From baseline to 12 mo, the exercise group participated in 87% of the prescribed physical activity minutes per week and increased maximal O2uptake by 13.8%; controls experienced no change in fitness. The main outcomes, natural killer cell cytotoxicity and T-lymphocyte proliferation, did not differ between groups at 3 and 12 mo. Secondary outcome and subgroup (e.g., stratification by baseline categories of body mass index, immune status, C-reactive protein, and age) analyses did not show any clear patterns of association. This 12-mo randomized, controlled trial showed no effect of aerobic exercise on in vitro immune function, despite excellent retention, high adherence, and demonstrable efficacy of the exercise intervention.
Unilateral practice of a ballistic movement causes bilateral increases in performance and corticospinal excitability
Authors: Carroll Timothy J. , Lee Michael , Hsu Marlene , Sayde Janel
Published: April 2008

It has long been known that practicing a task with one limb can result in performance improvements with the opposite, untrained limb. Hypotheses to account for cross-limb transfer of performance state that the effect is mediated either by neural adaptations in higher order control centers that are accessible to both limbs, or that there is a “spillover” of neural drive to the opposite hemisphere that results in bilateral adaptation. Here we address these hypotheses by assessing performance and corticospinal excitability in both hands after unilateral practice of a ballistic finger movement. Participants ( n = 9) completed 300 practice trials of a ballistic task with the right hand, the aim of which was to maximize the peak abduction acceleration of the index finger. Practice caused a 140% improvement in right-hand performance and an 82% improvement for the untrained left hand. There were bilateral increases in the amplitude of responses to transcranial magnetic stimulation, but increased corticospinal excitability was not correlated with improved performance. There were no significant changes in corticospinal excitability or task performance for a control group that did not train ( n = 9), indicating that performance testing for the left hand alone did not induce performance or corticospinal effects. Although the data do not provide conclusive evidence whether increased corticospinal excitability in the untrained hand is causally related to the cross-transfer of ballistic performance, the finding that ballistic practice can induce bilateral corticospinal adaptations may have important clinical implications for movement rehabilitation.
Functional Endoscopic Sinus Surgery in China
Authors: Han Demin , Zhang Luo
Published: April 2008

The functional endoscopic sinus surgery (FESS) technique was introduced in China at the beginning of the 1980s and popularized gradually. Now its application has extended to the management of skull base lesions, orbital lesions and sinonasal tumors. This paper will review the application and relevant research of nasal endoscopic surgery and discuss its further perspectives in China.
Endoscopic Anatomic Characterization of the Frontal Recess and Its Implications in Frontal Sinus Surgery
Authors: Zhou Bing , Demin Han , Huachao Liu , Qian Huang , Luo Zhang , Ming Liu , Yongjie Zhang
Published: April 2008

Objective: This study was designed to describe the anatomic features of the frontal recess by transnasal endoscopy (nasoscope), to analyze its implications in endoscopic frontal sinus surgery and to discuss the issues that may be experienced during such operations. Materials and Methods: The patients included in this analysis were adults with chronic sinusitis or nasal polyp (n = 301, 562 sides) hospitalized in our hospital from August 1998 to April 2001. Chronic frontal sinusitis was confirmed in 280 cases (479 sides) by coronal and axial CT scan. Patients with a previous surgical history were excluded from the analysis. The surgical outcomes of these patients and CT imaging data were retrospectively reviewed and analyzed. The drainage pattern of the frontal sinus was identified based on CT scans preoperatively. Endoscopic frontal sinus surgery was performed in 250 cases (421 sides). The anatomic features of the frontal recess under nasoscope were classified into 2 types. Results: The coronal CT results confirmed the position of the frontal sinus ostium between the uncinate process and the middle turbinate in 203 sides (48.2%) of all operated patients and the ostium was found to be located between the uncinate process and the lamina papyracea in 218 sides (51.8%). According to the location of the frontal sinus ostium, we grouped the anatomic features of the frontal recess into 2 types. Type I was documented in 203 sides (48.2%) and type II was seen in 218 sides (51.8%). Conclusions: The anatomic features of the frontal recess under nasoscope and their classification are very important and helpful for endoscopic frontal sinsus surgery. The upper part of the uncinate process is a dependable anatomic landmark for the localization of the frontal sinus ostium in CT scan and endoscopic frontal sinus surgery.
The Role of Superantigens in Chronic Rhinosinusitis with Nasal Polyps
Authors: Wang Mingming , Shi Peng , Chen Bei , Zhang Hongping , Jian Jingfen , Chen Xuemei , Wang Zhe , Zhang Daliang
Published: April 2008

Recent reports suggest that staphylococcal exotoxins, acting as superantigens, activate T cells with subsequent massive proliferation, thereby contributing to the etiology of chronic rhinosinusitis with nasal polyps (CRSwNP). The objectives of this study are (1) to demonstrate directly the presence of staphylococcal exotoxins in nasal mucosa and sinonasal polyp tissue, and (2) provide indirect evidence of the effect of superantigens on the T cells expressing the target of superantigen, i.e., the β variable chain receptor (TCRBV) in polyp tissue and peripheral blood of patients with CRSwNP. Sinonasal polyp tissue and peripheral blood specimens were obtained from 37 patients with chronic rhinosinusitis (22 patients with bilateral nasal polyps, 15 without nasal polyps) and 12 normal subjects for comparative negative controls. Tissue specimens were assayed by enzyme-linked immunosorbent assay (ELISA) for the most common staphylococcal exotoxins (A–D) and toxic shock syndrome toxin type 1. Fresh tissue and blood samples were analyzed by flow cytometry to determine the expression of TCRBV. In the CRSwNP subjects 12 of 22 samples (54.54%) demonstrated reactivity for at least 1 staphylococcal exotoxin, while 2 of the 12 were positive for 2 toxins. There were no positive results in the CRS without nasal polyps or control groups. There was a clear trend of increased TCRBV expression in the ELISA-positive group both for tissue and blood specimens. Staphylococcal superantigens were present in the nasal cavity of patients with CRSwNP with a high percentage of TCRBV, which suggests the possibility of superantigens as etiological agents of CRSwNP.
Clinical Prognostic Factors of Chronic Rhinosinusitis after Endoscopic Sinus Surgery
Authors: Li Yuan , Zhang Ge-hua , Liu Xian , Ye Jin , Zeng Zhuan-ping
Published: April 2008

Objective: We aimed to determine the clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery (ESS) in order to better guide the management of patients. Methods: A total of 254 patients with chronic rhinosinusitis after ESS with a follow-up of 24 months were evaluated retrospectively. Clinical grouping, hyperplasia of the ethmoid bone, anatomic variations, allergy, polyps, previous sinonasal surgery and recurrent polyps were analyzed. Results: The success rates were 64.4 and 91.9% with and without hyperplasia of the ethmoid bone, 87.6 and 86.4% with and without anatomic variations, 67.9 and 92.0% with and without allergy, 81.0 and 94.0% with and without polyps, 72.8 and 93.6% with and without history of surgery and 52.3 and 94.3% with and without recurrent polyps. In logistic multiple regression analysis, allergy (p = 0.0002; estimate, –4.2094), nasal polyps (p = 0.0007; estimate, –3.6393) and history of surgery (p < 0.0001; estimate, –5.0938) were found to reach a statistically significant level. Conclusions: We propose that allergy, polyps and history of surgery might be significant indicators of poor prognosis after ESS.
Stages of Nasal Mucosal Transitional Course after Functional Endoscopic Sinus Surgery and Their Clinical Indications
Authors: Xu Geng , Jiang Hongyan , Li Huabin , Shi Jianbo , Chen Hexin
Published: April 2008

Objective: We aimed to explore the transitional process of sinus cavity mucosa after functional endoscopic sinus surgery (FESS) and divide it into different stages. Method: The morphological characteristics of sinus cavity mucosa after FESS were continuously observed. Results: Over 90% of the nasal and sinus cavities got clean within 1–2 weeks, over 80% of the operative cavities experienced a reaction to mucosa removal or regenerative diseases within 3–10 weeks, such as mucosal edema, vesicles, granulation tissue, mini-polyps, fibrous hyperplasia and adhesion, which competed against the mucosa epithelialization process. After careful treatment, 90% of the nasal and sinus cavities finished epithelialization, and 60% of them completed epithelialization within 11–14 weeks after operation. Conclusion: The recovery process of mucosa after FESS can be divided into 3 stages: the stage of clean operative cavity, the stage of mucosal transition and the stage of complete epithelialization. Proper management at the 3 stages is very essential to the whole curable effect of FESS.
Endoscopic Endonasal Surgery for Clival Chordoma and Chondrosarcoma
Authors: Zhang Qiuhang , Kong Feng , Yan Bo , Ni Zhili , Liu Haisheng
Published: April 2008

Background: Conventional microsurgical approaches are limited to exposing the lateral and bilateral regions because of surgical trauma. Total removal of clival chordoma and chondrosarcoma is very difficult. This study was undertaken to determine the potential role of an endoscopic endonasal approach in improved management of clival chordoma and chondrosarcoma. Methods: Seven patients with chordoma and 2 patients with chondrosarcoma treated by endoscopic endonasal surgery between November 2002 and February 2006 were studied prospectively. The mean age was 35 years. The follow-up periods ranged from 3 to 39 months. Results: Total removal was achieved in 6 cases of chordoma and 1 case of chondrosarcoma, with subtotal removal in 1 case of chordoma and of chondrosarcoma. At the last follow-up, 7 patients had no evidence of disease and 1 was alive with disease. The chordomas had recurred in 1 patient after 5 months with subtotal removal. Conclusion: The use of nasoendoscopy to perform clival chordoma and chondrosarcoma surgery is not limited to merely the minimally invasive aspects. It provides better visualization of the deeper anatomical structures in the skull base and affords a means to ‘look around corners’. This approach promises a simple and rapid access to the clivus. It is both a safe and efficient procedure.
Endoscopic Sinus Surgery for the Management of Orbital Diseases
Authors: Liang Kai-Li , Su Mao-Chang , Shiao Jiun-Yi , Hsin Chung-Han , Jiang Rong-San
Published: April 2008

The indications for endoscopic sinus surgery (ESS) have been widely expanding since its introduction into sinus surgery. ESS has become an ideal method to manage certain orbital diseases and has the advantages of excellent visualization with minimal cosmetic and functional morbidity. In the Department of Otolaryngology of Taichung Veterans General Hospital from 1988 to 2005, 3,136 patients received ESS. Among them, a total of 108 patients received ESS for orbital diseases. These orbital diseases included orbital complications secondary to bacterial rhinosinusitis, fungal rhinosinusitis, skull base osteomyelitis and mucoceles, subperiosteal hematoma, Graves’ disease, traumatic optic neuropathy and orbital blowout fracture. Our results showed that ESS is effective in the management of some of these orbital diseases.
Cancer Risk Assessment and the Genetic Counseling Process: Using Hereditary Breast and Ovarian Cancer as an Example
Authors: Prucka Sandra K. , McIlvried Dawn E. , Korf Bruce R.
Published: April 2008

While only a small proportion of cancers can be attributed to a hereditary susceptibility, identifying high-risk individuals plays an essential role in medical management and has a significant impact on the patient as well as their immediate and extended family members. This paper aims at increasing the medical professionals’ knowledge of the components of a genetic counseling session, with particular attention toward identifying at-risk individuals and understanding the complexities of the testing process. In addition, tools are provided to assist in identifying these individuals in clinical practice and streamlining the referral process to a cancer genetics center.
Experimental Colitis Is Associated with Ultrastructural Changes in Inflamed and Uninflamed Regions of the Gastrointestinal Tract
Authors: Bou-Fersen Azhar M. , Anim Jehoram T. , Khan Islam
Published: April 2008

Objectives: The objective of this study was to examine theultrastructural changes in cell organelles such as mitochondria, endoplasmic reticulum (ER) and Golgi apparatus in inflamed colon and uninflamed ileum in colitic rats. Materials and Methods: Colitis was induced in rats by intracolonic administration of trinitrobenzenesulfonic acid (TNBS). The animals were sacrificed on day 5 after TNBS administration and colonic and ileal samples were used for estimation of myeloperoxidase (MPO) activity, malondialdehyde (MDA) concentration, histologic examination and transmission electron microscopy. Results: TNBS caused a significant reduction in body weight and an increase in MPO activity in colonic, but not in the ileal samples in animals with colitis. MDA levels were increased both in inflamed colon and the uninflamed ileal segments in colitis. Electron microscopy revealed swelling of mitochondria with broken cristae and disruption of the inner membrane. Colitis also caused fragmentation of the ER with loss of ribosomes and swelling of the Golgi apparatus with distended vesicles in both smooth muscle and epithelial cells in the ileal and colonic segments. These changes were absent in the control rats without colitis. Conclusions: These findings demonstrate ultrastructural deformities in both the mucosa and smooth muscle in inflamed and uninflamed regions of the gastrointestinal tract in experimental colitis. The structural changes in mitochondria are responsible for reduced ATP, while abnormalities in the ER and the Golgi apparatus may explain a generalized effect on protein synthesis, trafficking and targeting mechanisms, and may account for physiological changes seen in experimental colitis.
C-Reactive Protein Levels in Patients with Chronic Obstructive Pulmonary Disease: Role of Infection
Authors: Bircan Ahmet , Gokirmak Munire , Kilic Ozkan , Ozturk Onder , Akkaya Ahmet
Published: April 2008

Objective: To investigate the value of C-reactive protein (CRP) as a marker of chronic obstructive pulmonary disease (COPD) exacerbations or specifically bacterial exacerbations and to evaluate a correlation between raised CRP levels and other markers of inflammation in patients with an acute exacerbation (AECOPD). Subjects and Methods: The medical records of patients with AECOPD were retrospectively analyzed. They were categorized according to the nature of sputum as mucoid or purulent and to the findings on chest radiographs as with pneumonia (PCOPD) or without pneumonia. Stable COPD (SCOPD) patients and a group of asymptomatic nonsmokers were also included in the study. Results: All COPD patients (SCOPD: 30; AECOPD: 51; PCOPD: 32) and control subjects (30) were male. The mean CRP levels and WBC counts of the groups were PCOPD: 108.1 ± 61.8 mg/l and 13.7 ± 6.8 × 109/l; AECOPD: 36.8 ± 43.9 mg/l and 11.4 ± 4.8 × 109/l; SCOPD: 3.9 ± 1.4 mg/l and 7.9 ± 1.9 × 109/l; control: 2.1 ± 0.9 mg/l and 7.7 ± 1.1 × 109/l. The mean CRP level of AECOPD was statistically different from those of PCOPD and SCOPD (p = 0.0001, p = 0.002, respectively). The sensitivity and specificity of CRP to determine an acute exacerbation were 72.5 and 100%, respectively. Among the patients with AECOPD, 25 had purulent sputum and a mean CRP level of 46.4 ± 48.6 mg/l, which is significantly higher than the CRP level (28.0 ± 44.5 mg/l) of the 18 patients with mucoid expectoration (p = 0.015). Among the mucoid-expectorating subgroup, the patients with leukocytosis had significantly higher CRP levels than the patients without leukocytosis (p = 0.034). Conclusion: A high serum CRP value may indicate an infectious exacerbation in COPD patients and it correlates with sputum purulence and increased serum WBC counts.
Lateral Cephalometric Norms for Adolescent Kuwaitis: Soft Tissue Measurements
Authors: Al-Azemi Rashed , Al-Jame Badreia , Årtun Jon
Published: April 2008

Objective: The purpose of this study was to establish lateral cephalometric soft tissue norms for adolescent Kuwaitis and to compare these norms to those of the common analysis systems. Subjects and Methods: Digital lateral cephalograms were made of 82 Kuwaiti boys and 80 Kuwaiti girls, of mean age 13.27 ± 0.42 and 13.21 ± 0.43 years, respectively, with almost ideal occlusion. Anatomic landmarks were identified directly on the digital images. Linear and angular measurements were calculated electronically using the Dolphin (version 9) software package. Results: The average subject in the sample had a smaller Z angle, a larger H angle, thicker soft tissue at point A and the pogonion, and an increase in most measurements for lip protrusion when compared to the norms of the common analysis systems. The ranges of the majority of facial and labial parameters were larger than those reported in the above-mentioned norms. Gender differences were limited to upper lip length. Conclusion: Our findings suggest that Kuwaiti norms for lip protrusion should be used when making the extraction decision in adolescent Kuwaiti orthodontic patients. The larger than previously documented variation of the majority of soft tissue parameters suggests a need for establishing different norms for different facial types.
Serum Level of Intercellular Adhesion Molecule-1 in Children with Malignant Lymphoma
Authors: Abdelrazik Nabil , Fouda Manal , Zaghloul Mohammad Hosam El-deen , Abbas Dalia
Published: April 2008

Objective: Toestimate the serum levels of soluble intercellular adhesion molecule-1 (s-ICAM-1) in children newly diagnosed with lymphoma and to correlate levels of s-ICAM-1 in lymphoma patients with clinical stage, pathological types, clinical and laboratory data and patient outcome. Subjects and Methods: Thirty-five children with newly-diagnosed malignant lymphoma (Non-Hodgkin’s lymphoma, NHL: 23), Hodgkin’s disease (HD: 12), and 8 apparently healthy subjects of matched age and sex taken as a control group were studied. For the patients and control group, the following tests were performed: complete blood count, and the following biochemical investigations: liver function tests, lactate dehydrogenase (LDH), and soluble ICAM-1 estimation using ELISA. In addition, for patients, pathological examination of lymph node biopsy for pathological grading, bone marrow aspiration and biopsy were done. Patients were observed for over 12 months or until death. Results: Serum ICAM-1 increased more in HD and NHL than in the control group (p < 0.000); also s-ICAM-1 increased in advanced stages and high-grade NHL (p < 0.008, 0.04, respectively). LDH levels were higher in patients compared to controls (p < 0.000). There was a positive correlation between high levels of s-ICAM-1 and increased levels of LDH in HD (r = 0.72, p < 0.008) and a positive correlation between high levels of s-ICAM-1 and increased ALT in NHL patients. A positive correlation between s-ICAM-1 levels and the presence of B symptoms in HD and NHL, and a positive correlation between elevated s-ICAM-1 levels and worse outcome in HD and NHL were detected. Conclusions: The data indicate that in children with malignant lymphoma, high serum levels of ICAM-1 correlated with tumor aggressiveness, and quantification of s-ICAM-1 levels may identify a subgroup of children with worse prognosis. Therefore, detection of s-ICAM-1 levels in children with malignant lymphoma might represent an additional disease-associated marker for use in the clinical management of the patients.
Cemented and Cementless Total Hip Replacement
Authors: Pospula Wieslaw , Abu Noor Tarek , Roshdy Tarek , Al Mukaimi Ali
Published: April 2008

Objective: In this study we present the results of a series of cemented Exeter and cementless Zweymüller implants. Subject and Methods: Eighty-seven cemented and 95 cementless hip replacements for different hip pathologies were followed for an average period of 36 months for cementless and 60 months for cemented cases. Clinical results were calculated using the Merle d’Aubigne score. The orientation of the prosthetic components and the fixation of the cup and stem were analyzed. The clinical and radiological results were compared using statistical methods. Results: In the average period of 36 months in cementless and 60 months in cemented hip replacements the clinical results improved significantly when compared with the preoperative score (p < 0.05). Sixty-seven cemented acetabular cups (77.1%) were in the desired position (30–50°) and 20 cemented cups (22.9%) were outside this range. Seventy-six cups (80%) were in the desired degree of abduction and 19 (20%) were outside this range. All cups except 1 were anteverted or neutral. Of the femoral stems, 173 were in the neutral position, 5 in the valgus and 4 in the varus position. Cemented cups were more commonly loose and cemented and cementless stems did equally well. No significant differences in rate of complications were found. Conclusion: Cementless acetabular implants had better clinical results and a lower loosening rate at 3 years of follow-up compared to cemented implants at 5 years of follow-up. The cemented femoral implants were equally stable compared to the cementless ones.
Whole Blood Assays to Identify Th1 Cell Antigens and Peptides Encoded by Mycobacterium tuberculosis-Specific RD1 Genes
Authors: Hanif Shumaila N.M. , El-Shammy Abdulsalam M. , Al-Attiyah Rajaa , Mustafa Abu S.
Published: April 2008

Objective: To identify Th1 cell-stimulating antigens/peptides encoded by the genes predicted in the Mycobacterium tuberculosis-specific genomic region of difference (RD)1, deleted in Mycobacterium bovis Bacille Calmette-Guérin(BCG), by using synthetic peptides and whole blood from tuberculosis (TB) patients. Materials and Methods: Heparinized peripheral blood was obtained from culture-proven pulmonary TB patients (n = 16) attending the Chest Disease Hospital, Kuwait. Whole blood was diluted with tissue culture medium RPMI-1640 and tested for Th1 cell stimulation using antigen-induced proliferation and interferon-γ (IFN-γ) secretion assays. The antigens included a peptide pool of 220 peptides covering the sequence of 12 open reading frames (ORFs) of RD1 (RD1mix), peptide pools of RD1 ORF5 (ORF5mix), ORF6 (ORF6mix) and ORF7 (ORF7mix), and individual peptides of ORF6 (P6.1–P6.6) and ORF7 (P7.1–P7.6). M. tuberculosis culture filtrate, cell walls and whole-cell M. bovis BCG were used as complex mycobacterial antigens. The results obtained with different antigens and peptides were statistically analyzed for significant differences using Z test. Results: The complex mycobacterial antigens (culture filtrate, cell walls and M.bovis BCG) and RD1mix induced comparable (p > 0.05) positive antigen-induced proliferation and IFN-γ responses with whole blood from TB patients. However, the positive IFN-γ responses induced by ORF6mix and ORF7mix were higher than ORF5mix. Among the individual peptides, P6.4 and P7.1 of ORF6 and ORF7, respectively, induced the highest IFN-γ responses, suggesting that these peptides represented the immunodominant Th1 cell epitopes of RD1 ORF6 and ORF7 in the patients tested. Conclusion: The whole blood assays with synthetic peptides are useful to identify Th1 cell antigens/peptides encoded by genes located in M. tuberculosis-specific genomic regions.
Prostate Small Cell Carcinoma and Skin Metastases: A Rare Entity
Authors: Yildirim Yesim , Akcay Yesim , Ozyilkan Ozgur , Celasun Bulent
Published: April 2008

Objectives: To report a rare case of small cell carcinoma of the prostate with unusual skin metastasis. Clinical Presentation and Interventions: A 60-year-old was evaluated for difficulty in urinating. Abdominal computed tomography scans revealed a prostatic mass invading the surrounding tissues and multiple perirectal, periprostatic, para-aortic and pericaval lymph nodes. Needle biopsy specimens showed both small cell carcinoma and adenocarcinoma. He was treated with combination chemotherapy: cisplatin and etoposide and bilateral orchiectomy. After six cycles of the chemotherapy, disease progressed and the patient did not respond to salvage therapy; hence, palliative care was instituted. During the follow-up, papillary lesions were observed in the scrotal skin; biopsy showed metastatic small cell carcinoma. Conclusion: Small cell carcinoma of the prostate is an aggressive disease with a highly metastatic potential; but skin metastases are very uncommon. It has poor prognosis despite therapy. Management resembles that of small cell carcinoma of the lung.
The Development of Spinal Cord Anatomy
Authors: Pearce J.M.S.
Published: April 2008

A panel illustrating spinal cord injury in The Dying Lioness in the British Museum dates to 650 BC. This paper outlines the subsequent progression of knowledge of the anatomy of the spinal cord. The animal dissections of Galen are considered because his deductions persisted through the Dark Ages until the late 18th century. Anatomy advanced gradually to yield discoveries of the complex tracts and grey matter elements of the cord and their functions. Amongst many distinguished exponents, the works of Blasius, Huber, Vicq d’Azyr and Stilling are emphasised.
Ineffectiveness of Folic Acid Supplementation against Phenytoin-Induced Decrease in Salivary Immunoglobulin A Concentration of Epileptic Patients
Authors: Zare Mohammad , Ghazvini Mohammad Reza Aghaye , Yazdi Hamid Reza Barkhordari , Nezhad Vahid Shayegan , Chitsaz Ahmad
Published: April 2008

Aims: This study was designed to investigate if folate treatment is able to reverse the phenytoin-induced deficiency of salivary immunoglobulin A (IgA). Methods and Material: Twenty-five epileptic patients who had been under phenytoin therapy for at least the last 6 months were randomly selected and subjected to folic acid supplementation, 1 mg/day. The salivary IgA concentration of these patients was measured before and after 2 months of folic acid administration and compared with those of 10 healthy individuals. Independent and paired Student’s t tests were used to analyze the effects of phenytoin and folic acid, respectively. Results: Salivary IgA levels of patients receiving phenytoin (11.7 ± 4.8 IU/l) were significantly (p = 0.039) lower than those of healthy controls (14.8 ± 3.2 IU/l), but did not statistically (p = 0.541) differ from levels (11.8 ± 4.6 IU/l) measured after 2 months of folic acid supplementation. Conclusions: According to these results, folic acid supplementation does not seem to have the efficacy to ameliorate phenytoin-induced salivary IgA hyposecretion.
Alpha-1 Antichymotrypsin Gene Signal Peptide A/T Polymorphism and Primary Intracerebral Hemorrhage
Authors: Dardiotis E. , Hadjigeorgiou G.M. , Dardioti M. , Scarmeas N. , Paterakis K. , Aggelakis K. , Komnos A. , Tasiou A. , Xiromerisiou G. , Gabranis I. , Zintzaras E. , Papadimitriou A. , Karantanas A.
Published: April 2008

Background/Aims: Alpha-1 antichymotrypsin (ACT), a serine proteinase inhibitor, has been implicated in vascular pathology. The TT genotype of the ACT signal peptide A/T polymorphism has been reported to confer susceptibility to primary intracerebral hemorrhage (PICH). We conducted a prospective study to test possible association of ACT signal peptide A/T polymorphism with PICH in a Greek cohort with enough power (80%) to detect a twofold increase in the odds ratio. Methods: We prospectively recruited 147 patients with PICH. ACT signal peptide A/T genotypes were determined in patients and 206 healthy, age- and sex-matched control subjects from the neurology outpatient clinic using the polymerase chain reaction restriction fragment length polymorphism method. Results: Our study did not show an association between ACT signal peptide A/T polymorphism and PICH. We also failed to find any influence on age at onset, the location and volume of PICH as well as on clinical severity at admission or 6-month outcome. Conclusion: Our data failed to confirm an association between ACT signal peptide A/T polymorphism and PICH. However, we cannot exclude the possibility that the TT genotype confers susceptibility at less than a twofold increase.
Sudden Deafness Related to Posterior Circulation Infarction in the Territory of the Nonanterior Inferior Cerebellar Artery: Frequency, Origin, and Vascular Topographical Pattern
Authors: Lee Hyung
Published: April 2008

Aims: To investigate the frequency and origin of sudden deafness (SD) associated with the nonanterior inferior cerebellar artery (non-AICA) territory posterior circulation infarct(s), and the vascular topographical patterns of ischemic lesion associated with SD. Methods: A total of 685 consecutive cases of vertebrobasilar ischemic stroke diagnosed by brain MRI from acute stroke registry were studied. Results: Seven consecutive patients (1.0%) were identified as having SD as a symptom of non-AICA territory vertebrobasilar ischemic stroke. Audiological testing confirmed sensorineural hearing loss, predominantly cochlear in 4 patients and combined on the affected side cochlear and retrocochlear in 3 patients. Five patients had an isolated cerebellar infarct in the territory of the medial branch of the posterior inferior cerebellar artery and other 2 had infarct in the brainstem. In all, SD was on the side of infarct, as shown on brain MRI. Six patients had accompanied canal paresis to caloric stimulation on the side of SD. Conclusions: SD due to non-AICA territory infarction was mostly associated with infarct in the territory of the posterior inferior cerebellar artery. From the known variation of the anatomy of the internal auditory artery and results of audiovestibular evaluations, SD due to non-AICA territory infarct probably results from the damage to the inner ear.
Clinical Features of Benign Paroxysmal Positional Vertigo in Western Turkey
Authors: Çelebisoy Neşe , Polat Fatma , Akyürekli Önder
Published: April 2008

Background: It was the aim of this study to analyze the clinical manifestations, the incidence of each variant and the comorbid conditions of benign paroxysmal positional vertigo (BPPV) as well as the response to treatment. Methods: One hundred and fifty-seven patients with BPPV were reviewed prospectively. An extensive neurotologic examination was performed. All patients were treated with an appropriate canalith repositioning maneuver (CRM). Results: In 138 patients, the posterior canal (PC) was involved, in 14 patients, the horizontal canal (HC), in 2 patients, the anterior canal (AC), and in 3 patients, both the PC and HC. A history of head trauma was identified in 17 patients. In 1 patient sensorineural hearing loss on the affected side and in another bilateral peripheral vestibular loss was present. A history of migraine was reported in 21 cases. A resolution attributable to the first CRM was achieved in 132 patients. Conclusions: PC involvement was the most frequent type constituting 87.9% of all BPPV cases. HC, AC and mixed canal types were relatively rare constituting 8.9, 1.3 and 1.9% of the cases, respectively. Response to the first CRM was recorded in 84.1%. Association with migraine was recorded in 13.4% of the patients.