bluuebunny/crossref_metadata_2025 huggingface dataset:
Mobile phone-induced myocardial oxidative stress: protection by a novel antioxidant agent caffeic acid phenethyl ester
Authors: Ozguner Fehmi , Altinbas Ahmet , Ozaydin Mehmet , Dogan Abdullah , Vural Huseyin , Kisioglu A Nesimi , Cesur Gokhan , Yildirim Nurhan Gumral
Published: November 2005

Electromagnetic radiation (EMR) or radiofrequency fields of cellular mobile phones may affect biological systems by increasing free radicals, which appear mainly to enhance lipid peroxidation, and by changing the antioxidant defense systems of human tissues, thus leading to oxidative stress. Mobile phones are used in close proximity to the heart, therefore 900 MHz EMR emitting mobile phones may be absorbed by the heart. Caffeic acid phenethyl ester (CAPE), one of the major components of honeybee propolis, was recently found to be a potent free radical scavenger and antioxidant, and is used in folk medicine. The aim of this study was to examine 900 MHz mobile phone-induced oxidative stress that promotes production of reactive oxygen species (ROS) and the role of CAPE on myocardial tissue against possible oxidative damage in rats.

Thirty rats were used in the study. Animals were randomly grouped as follows: sham-operated control group (N: 10) and experimental groups: (a) group II: 900 MHz EMR exposed group (N: 10); and (b) group III: 900 MHz EMR exposed+CAPE-treated group (N: 10). A 900 MHz EMR radiation was applied to groups II and III 30 min/day, for 10 days using an experimental exposure device. Malondialdehyde (MDA, an index of lipid peroxidation), and nitric oxide (NO, a marker of oxidative stress) were used as markers of oxidative stress-induced heart impairment. Superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities were studied to evaluate the changes of antioxidant status. In the EMR exposed group, while tissue MDA and NO levels increased, SOD, CAT and GSH-Px activities were reduced. CAPE treatment in group III reversed these effects. In this study, the increased levels of MDA and NO and the decreased levels of myocardial SOD, CAT and GSH-Px activities demonstrate the role of oxidative mechanisms in 900 MHz mobile phone-induced heart tissue damage, and CAPE, via its free radical scavenging and antioxidant properties, ameliorates oxidative heart injury. These results show that CAPE exhibits a protective effect on mobile phone-induced and free radical mediated oxidative heart impairment in rats.
NDELA and nickel modulation of triazine disposition in skin
Authors: Baynes Ronald E , Brooks James D , Barlow Beth M , Riviere Jim E
Published: November 2005

Cutting fluids can become contaminated with metals (e.g., nickel, Ni) and nitrosamines (e.g., N-nitrosodiethanolamine, NDELA) and there is concern that these classes of contaminants can modulate dermal disposition and ultimately the toxicity of cutting fluid additives, such as irritant biocides (e.g., triazine). Biocides are added to these formulations to prevent bacterial degradation of commercial cutting fluids. The purpose of this study was to assess the dermal absorption and skin deposition of 14C-triazine when topically applied to porcine skin in an in vitro flow-through diffusion cell system as aqueous soluble oil (mineral oil, MO) or aqueous synthetic (polyethylene glycol, PEG) mixtures. 14C-Triazine mixtures were formulated with NDELA and/or Ni, or with a combination of three additional cutting fluid additives; namely, 5% linear alkylbenzene sulfonate (LAS), 5% triethanolamine (TEA) and 5% sulfurized ricinoleic acid. Neither Ni nor NDELA was absorbed during these 8-h studies. However, 14C-triazine absorption ranged from 2.72 to 3.29% dose in MO and 2.29-2.88% dose in PEG with significantly greater triazine absorption in MO than PEG when all additives and contaminates were present. The difference between these two diluents was most pronounced when NDELA and/or Ni were present in cutting fluids. These contaminants also enhanced triazine deposition on the skin surface and skin tissues especially with PEG-based mixtures. In essence, the dermal disposition of irritant biocides could be dependent on whether the worker is exposed to a soluble oil or synthetic fluid when these contaminants are present. Workers should therefore not only be concerned about dermatotoxicity of these contaminants, but also the modulated dermal disposition of cutting fluid additives when these contaminants are present in cutting fluid formulations.
Inhaled vanadium pentoxide decrease gamma-tubulin of mouse testes at different exposure times
Authors: Mussali-Galante Patricia , Rodríguez-Lara Vianey , Hernández-Tellez Beatriz , Ávila-Costa Maria Rosa , Colín-Barenque Laura , Bizarro-Nevarez Patricia , Martínez-Levy Gabriela , Rojas-Lemus Marcela , Piñón-Zarate Gabriela , Saldivar-Osorio Liliana , Diaz-Beck Patricia , Herrera-Enríquez Miguel Angel , Tovar-Sánchez Efraín , Fortoul Teresa I
Published: November 2005

Vanadium is an important environmental and industrial pollutant whose concentrations have increased in the last decades. Due to its status as reproductive toxicant and a microtubule damaging agent, the present study investigated by immunohistochemistry the effect of the inhalation of vanadium pentoxide on gamma-tubulin within somatic and testicular germ cells. Male mice inhaled vanadium pentoxide (V2O5) (0.02 M) 1 h/twice a week for 12 weeks. Our results demonstrated that vanadium accumulates in the testes starting with the initial inhalation (24 h), and this pattern remained until the last week of treatment. In general, vanadium was capable of significantly decreasing the percentage of gamma-tubulin in all analyzed testicular cells (Sertoli, Leydig and germ cells) starting with the first week of treatment. For all cell types studied, regression analysis revealed a negative and significant relationship between the percentage of immunopositive cells to gamma-tubulin and exposure time, showing a time dependent response in all cases. Our findings suggest that alterations on this protein might imply changes in microtubule-involved function such as cell division, which in the testes might lead to damage in the spermatogenesis, leading probably to infertility.
Peroxisome Proliferator-Activated Receptor-γ Transcriptionally Up-Regulates Hormone-Sensitive Lipase via the Involvement of Specificity Protein-1
Authors: Deng Tuo , Shan Song , Li Ping-Ping , Shen Zhu-Fang , Lu Xian-Ping , Cheng Jing , Ning Zhi-Qiang
Published: November 2005

Both peroxisome proliferator-activated receptor (PPAR)-γ and hormone-sensitive lipase (HSL) play important roles in lipid metabolism and insulin sensitivity. We demonstrate that expression of the HSL gene is up-regulated by PPARγ and PPARγ agonists (rosiglitazone and pioglitazone) in the cultured hepatic cells and differentiating preadipocytes. Rosiglitazone treatment also results in up-regulation of the HSL gene in liver and skeleton muscle from an experimental obese rat model, accompanied by the decreased triglyceride content in these tissues. The proximal promoter (−87 bp of the human HSL gene) was found to be essential for PPARγ-mediated transactivating activity. This important promoter region contains two GC-boxes and binds the transcription factor specificity protein-1 (Sp1) but not PPARγ. The Sp1-promoter binding activity can be endogenously enhanced by PPARγ and rosiglitazone, as demonstrated by analysis of EMSA and chromatin immunoprecipitation assay. Mutations in the GC-box sequences reduce the promoter binding activity of Sp1 and the transactivating activity of PPARγ. In addition, mithramycin A, the specific inhibitor for Sp1-DNA binding activity, abolishes the PPARγ-mediated up-regulation of HSL. These results indicate that PPARγ positively regulates the HSL gene expression, and up-regulation of HSL by PPARγ requires the involvement of Sp1. Taken together, this study suggests that HSL may be a newly identified PPARγ target gene, and up-regulation of HSL may be an important mechanism involved in action of PPARγ agonists in type 2 diabetes.
Multiple Effects of Melatonin on Rhythmic Clock Gene Expression in the Mammalian Pars Tuberalis
Authors: Johnston Jonathan D. , Tournier Benjamin B. , Andersson Hakan , Masson-Pévet Mireille , Lincoln Gerald A. , Hazlerigg David G.
Published: November 2005

In mammals, changing day length modulates endocrine rhythms via nocturnal melatonin secretion. Studies of the pituitary pars tuberalis (PT) suggest that melatonin-regulated clock gene expression is critical to this process. Here, we considered whether clock gene rhythms continue in the PT in the absence of melatonin and whether the effects of melatonin on the expression of these genes are temporally gated. Soay sheep acclimated to long photoperiod (LP) were transferred to constant light for 24 h, suppressing endogenous melatonin secretion. Animals were infused with melatonin at 4-h intervals across the final 24 h, and killed 3 h after infusion. The expression of five clock genes (Per1, Per2, Cry1, Rev-erbα, and Bmal1) was measured by in situ hybridization. In sham-treated animals, PT expression of Per1, Per2, and Rev-erbα showed pronounced temporal variation despite the absence of melatonin, with peak times occurring earlier than predicted under LP. The time of peak Bmal1 expression remained LP-like, whereas Cry1 expression was continually low. Melatonin infusion induced Cry1 expression at all times and suppressed other genes, but only when they showed high expression in sham-treated animals. Hence, 3 h after melatonin treatment, clock gene profiles were driven to a similar state, irrespective of infusion time. In contrast to the PT, melatonin infusions had no clear effect on clock gene expression in the suprachiasmatic nuclei. Our results provide the first example of acute sensitivity of multiple clock genes to one endocrine stimulus and suggest that rising melatonin levels may reset circadian rhythms in the PT, independently of previous phase.
Muscle biochemistry and the ontogeny of flight capacity during behavioral development in the honey bee,Apis mellifera
Authors: Roberts Stephen P. , Elekonich Michelle M.
Published: November 2005

A fundamental issue in physiology and behavior is understanding the functional and genetic mechanisms that underlie major behavioral shifts in organisms as they adopt new environments or life history tactics. Such transitions are common in nature and include the age-related switch from nest/hive work to foraging in social insects such as honey bees (Apis mellifera). Because of their experimental tractability, recently sequenced genome and well understood biology, honey bees are an ideal model system for integrating molecular, genetic, physiological and sociobiological perspectives to advance understanding of behavioral and life history transitions. When honey bees (Apis mellifera) transition from hive work to foraging, their flight muscles undergo changes that allow these insects to attain the highest rates of flight muscle metabolism and power output ever recorded in the animal kingdom. Here, we review research to date showing that honey bee flight muscles undergo significant changes in biochemistry and gene expression and that these changes accompany a significant increase in the capacity to generate metabolic and aerodynamic power during flight. It is likely that changes in muscle gene expression, biochemistry, metabolism and functional capacity may be driven primarily by behavior as opposed to age, as is the case for changes in honey bee brains.
Expression and functional analysis of mussel taurine transporter, as a key molecule in cellular osmoconforming
Authors: Hosoi Masatomi , Takeuchi Kazuharu , Sawada Hideki , Toyohara Haruhiko
Published: November 2005

Most aquatic invertebrates adapt to environmental osmotic changes primarily by the cellular osmoconforming process, in which osmolytes accumulated in their cells play an essential role. Taurine is one of the most widely utilized osmolytes and the most abundant in many molluscs. Here, we report the structure, function and expression of the taurine transporter in the Mediterranean blue mussel (muTAUT), as a key molecule in the cellular osmoconforming process. Deduced amino acid sequence identity among muTAUT and vertebrate taurine transporters is lower (47-51%) than that among vertebrate taurine transporters (>78%). muTAUT has a lower affinity and specificity for taurine and a requirement for higher NaCl concentration than vertebrate taurine transporters. This seems to reflect the internal environment of the mussel; higher NaCl and taurine concentrations. In addition to the hyperosmotic induction that has been reported for cloned taurine transporters,the increase in muTAUT mRNA was unexpectedly observed under hypoosmolality,which was depressed by the addition of taurine to ambient seawater. In view of the decrease in taurine content in mussel tissue under conditions of hypoosmolality reported previously, our results lead to the conclusion that muTAUT does not respond directly to hypoosmolality, but to the consequent decrease in taurine content. By immunohistochemistry, intensive expression of muTAUT was observed in the gill and epithelium of the mantle, which were directly exposed to intensive osmotic changes of ambient seawater.
Actin cytoskeleton of rabbit intestinal cells is a target for potent marine phycotoxins
Authors: Ares I. R. , Louzao M. C. , Vieytes M. R. , Yasumoto T. , Botana L. M.
Published: November 2005

Biotoxins produced by harmful marine microalgae (phycotoxins) can be accumulated into seafood, representing a great risk for public health. Some of these phycotoxins are responsible for a variety of gastrointestinal disturbances; however, the relationship between their mechanism of action and toxicity in intestinal cells is still unknown. The actin cytoskeleton is an important and highly complicated structure in intestinal cells, and on that basis our aim has been to investigate the effect of representative phycotoxins on the enterocyte cytoskeleton. We have quantified for the first time the loss of enterocyte microfilament network induced by each toxin and recorded fluorescence images using a laser-scanning cytometer and confocal microscopy. Our data show that pectenotoxin-6, maitotoxin, palytoxin and ostreocin-D cause a significant reduction in the actin cytoskeleton. In addition, we found that the potency of maitotoxin, palytoxin and ostreocin-D to damage filamentous actin is related to Ca2+ influx in enterocytes. Those results identify the cytoskeleton as an early target for the toxic effect of those toxins.
Reconfigurable Flight Control System Design Using Input-Output Information
Authors: Hyung S , Kim Y
Published: November 2005

An adaptive control algorithm using input-output information is proposed for designing an aircraft fault tolerant control system. An input-output model is derived on the basis of a discrete state-space system. The formulated input-output model has the same structure as the autoregressive moving average (ARMA) model does, and therefore, the conventional system identification method using recursive least square can be used to identify the system. To design a reconfigurable control system, an LQ tracker with output feedback scheme is adopted. During the recursive adaptive control process, the system model is updated periodically. The proposed algorithm is applicable to time-varying systems in real time. To validate the performance of the proposed adaptive fault tolerant control technique, numerical simulation of the high performance aircraft with control surface damage was performed.
Maximizing Federal Natural Gas Royalties
Authors: Stoddard Steven A.
Published: November 2005

I conducted research to enable the US Minerals Management Service (MMS) to maximize natural gas royalties. MMS is the agency of the US Department of the Interior responsible for managing mineral royalties. As part of managing royalties, MMS decides whether to accept royalties in value (cash payment, RIV) or in kind (physical transfer of gas, RIK). When MMS collects RIK, it also decides how to transport, process, and sell the natural gas. RIK is a fairly new program for MMS, which began continuous collection of RIK under a pilot study in 1998. As its RIK program grew, MMS sought my assistance to improve its decision processes for converting RIV to RIK and for choosing among transportation, processing, and sales options. (This is not an army matter; I worked on this project while I was a doctoral student at the Colorado School of Mines.) I provided data-processing applications to improve predictions of royalty volumes and assessments of existing royalty values. To support decisions concerning conversion of royalties from RIV to RIK, I developed a goal-price metric that accounts for a variety of market conditions. This metric compares favorably to alternatives that MMS was using or considering. I used an optimization model to evaluate conversion and contract alternatives so as to maximize total royalties. MMS began using the results of this research in 2002 and continues its use today. The first project it analyzed using these results provided a net royalty increase of $3.4 million over the first contract year.
Merrill Lynch Improves Liquidity Risk Management for Revolving Credit Lines
Authors: Duffy Tom , Hatzakis Manos , Hsu Wenyue , Labe Russ , Liao Bonnie , Luo Xiangdong (Sheldon) , Oh Je , Setya Adeesh , Yang Lihua
Published: November 2005

Merrill Lynch Bank USA has a multibillion dollar portfolio of revolving credit-line commitments with over 100 institutions. These credit lines give corporations access to a specified amount of cash for short-term funding needs. A key risk associated with credit lines is liquidity risk, or the risk that the bank will need to provide significant assets to the borrowers on short notice. We developed a Monte Carlo simulation to analyze liquidity risk of a revolving credit portfolio. The model incorporates a mix of OR/MS techniques, including a Markov transition process, expert-system rules, and correlated random variables to capture the impact of industry correlations among the borrowers. Results from the model enabled the bank to free up about $4 billion of liquidity. Over the 21 months since the bank implemented the model, the portfolio has expanded by 60 percent to over $13 billion. The model has become part of the bank’s tool kit for managing liquidity risk and continues to be used every month.
GE Asset Management, Genworth Financial, and GE Insurance Use a Sequential-Linear-Programming Algorithm to Optimize Portfolios
Authors: Chalermkraivuth Kete Charles , Bollapragada Srinivas , Clark Michael C. , Deaton John , Kiaer Lynn , Murdzek John P. , Neeves Walter , Scholz Bernhard J. , Toledano David
Published: November 2005

GE Asset Management Incorporated (GEAM), a wholly owned subsidiary of General Electric Company (GE), manages investment portfolios on behalf of various GE units and over 200 unaffiliated clients worldwide, including Genworth Financial (Genworth) and GE Insurance (GEI) portfolios worth billions of dollars. GEAM invests portfolios of assets—derived from cash flows for various insurance, reinsurance, and financial products—primarily in corporate and government bonds in accordance with risk and regulatory constraints. In asset-liability management (ALM) applications, portfolio managers try to maximize return or minimize risk and match the characteristics of asset portfolios with corresponding liabilities. While risk is widely represented by variance or volatility, it is usually a nonlinear measure; ALM portfolio managers traditionally need to use linear risk sensitivities for computational tractability. We developed a novel, sequential-linear-programming algorithm that handles the nonlinearity iteratively but efficiently. Patented and implemented on a limited basis since 2003, GE used it to optimize more than 30 portfolios valued at over $30 billion. It is now in broader use at GEAM, GEI, and Genworth. Hypothetically, based on $100 billion of assets, the present value of potential benefits could approximate $75 million over five years.
Unbound Free Fatty Acids and Heart-Type Fatty Acid–Binding Protein: Diagnostic Assays and Clinical Applications
Authors: Azzazy Hassan ME , Pelsers Maurice MAL , Christenson Robert H
Published: November 2005

Background: A biomarker that reliably detects myocardial ischemia in the absence of necrosis would be useful for initial identification of unstable angina patients and for differentiating patients with chest pain of an etiology other than coronary ischemia, and could provide clinical utility complementary to that of cardiac troponins, the established markers of necrosis. Unbound free fatty acids (FFAu) and their intracellular binding protein, heart-type fatty acid–binding protein (H-FABP), have been suggested to have clinical utility as indicators of cardiac ischemia and necrosis, respectively.

Methods: We examined results of clinical assessments of FFAu and H-FABP as biomarkers of cardiac ischemia and necrosis. Data published on FFAu and H-FABP over the past 30 years were used as the basis for this review.

Results: Although little clinical work has been done on FFAu since the initial reports, recent studies documented an association between increased serum FFAs and ventricular dysrhythmias and death in patients with acute myocardial infarction (AMI). Recent data suggest that serum FFAu concentrations increase well before markers of cardiac necrosis and are sensitive indicators of ischemia in AMI. H-FABP is abundant in cardiac muscle and is presumed to be involved in myocardial lipid homeostasis. Similar to myoglobin, plasma H-FABP increases within 3 h after AMI and returns to reference values within 12–24 h.

Conclusions: FFAu may have a potential role in identifying patients with cardiac ischemia. H-FABP is useful for detecting cardiac injury in acute coronary syndromes and predicting recurrent cardiac events in acute coronary syndromes and in congestive heart failure patients. Assays are available for both markers that could facilitate further clinical investigations to assess their possible roles as markers of cardiac ischemia and/or necrosis.
Assay for the Measurement of Copeptin, a Stable Peptide Derived from the Precursor of Vasopressin
Authors: Morgenthaler Nils G , Struck Joachim , Alonso Christine , Bergmann Andreas
Published: November 2005

Background: Arginine vasopressin (AVP) is a key regulator of water balance, but its instability makes reliable measurement difficult and precludes routine use. We present a method for quantifying AVP release by use of copeptin, a glycopeptide comprising the C-terminal part of the AVP prohormone.

Methods: We measured copeptin in 50-μL serum and plasma samples from healthy individuals and from critically ill patients with sepsis. Our sandwich immunoluminometric assay used 2 polyclonal antibodies to amino acids 132–164 of pre-provasopressin.

Results: The assay yielded results within 3 h. The analytical detection limit was 1.7 pmol/L, and the interlaboratory CV was <20% for values >2.25 pmol/L. The assay was linear on dilution of the analyte. Ex vivo copeptin stability (<20% loss of analyte) for at least 7 days at room temperature and 14 days at 4 °C was shown for serum and EDTA-, heparin-, and citrate plasma. Copeptin (median, 4.2 pmol/L; range, 1–13.8 pmol/L) was detectable in 97.5% of 359 healthy individuals and was not associated with age. Median concentrations were considerably higher in men than women, increased significantly after exercise, and were influenced by fasting and water load. Copeptin was significantly (P <0.001) increased in 60 critically ill patients with sepsis (median, 79.5 pmol/L; range, 10.6–228.0 pmol/L). The correlation between copeptin and AVP for 110 samples was r = 0.78 (P <0.0001).

Conclusions: Copeptin is stable for days after blood withdrawal and can be quickly and easily measured. The copeptin assay may be a useful alternative to direct measurement of AVP concentration.
Kinetics of the oxidation of Pu(IV) by manganese dioxide
Authors: Morgenstern A. , Choppin Gregory R.
Published: November 2005

The kinetics of the oxidation of plutonium(IV) by manganese dioxide were studied in 1.0 M NaCl over the pH range from 2.5 to 8.2 with variable concentrations of manganese dioxide from 0.01 m2/L to 4.97 m2/L at a constant temperature of 19 ± 2 °C. The concentration of plutonium in solution was 6.0(± 1.0) × 10−10M. Fractions of Pu(IV), (V) and (VI) as a function of time were determined by removal of plutonium from the solid phase followed by an ultrafiltration/solvent extraction procedure using TTA and HDEHP as extractants. Appropriate removal conditions were established for Pu(IV), Pu(V) and Pu(VI) using Th(IV), Np(V) and U(VI) as oxidation state analogs.

In the pH range from 2.0 to 3.5, the oxidation of Pu(IV) by manganese dioxide was first order with respect to the concentration of manganese dioxide and −0.21 with respect to the hydrogen ion concentration. Consequently, assuming a first order dependence with respect to the concentration of Pu(IV), the oxidation reaction can be described by the following rate equation:

withk= 3.72(± 0.13) × 10−3(m−2L)(mol−1L)−0.21(min)−1. Using the kinetic data determined in this study, the influence of manganese dioxide on the oxidation state distribution of plutonium under various environmental conditions as well as in waste solutions can be estimated.
Single-column extraction chromatographic separation of U, Pu, Np and Am
Authors: Morgenstern A. , Apostolidis C. , Carlos-Marquez R. , Mayer K. , Molinet R.
Published: November 2005

A rapid, single-column extraction chromatographic method using commercially available UTEVA resin has been developed for the separation of uranium, plutonium, neptunium and americium. The method yields recoveries superior to 90% and allows direct loading of separated fractions on filaments for subsequent analysis by thermal ionization mass spectrometry. The use of reagents compatible with robotized equipment allows automation of the separation process for routine analysis of nuclear materials. The redox reactions between plutonium, neptunium and hydrogen peroxide involved in the separation process were studied by UV/Vis/NIR absorption spectroscopy.
Aberrant Genomic Imprinting in Rhesus Monkey Embryonic Stem Cells
Authors: Fujimoto Akihisa , Mitalipov Shoukhrat M. , Kuo Hung-Chih , Wolf Don P.
Published: November 2005

Genomic imprinting involves modification of a gene or a chromosomal region that results in the differential expression of parental alleles. Disruption or inappropriate expression of imprinted genes is associated with several clinically significant syndromes and tumorigenesis in humans. Additionally, abnormal imprinting occurs in mouse embryonic stem cells (ESCs) and in clonally derived animals. Imprinted gene expression patterns in primate ESCs are largely unknown, despite the clinical potential of the latter in the cell-based treatment of human disease. Because of the possible implications of abnormal gene expression to cell or tissue replacement therapies involving ESCs, we examined allele specific expression of four imprinted genes in the rhesus macaque. Genomic and complementary DNA from embryos and ESC lines containing useful single nucleotide polymorphisms were subjected to polymerase chain reaction–based amplification and sequence analysis. In blastocysts, NDN expression was variable indicating abnormal or incomplete imprinting whereas IGF2 and SNRPN were expressed exclusively from the paternal allele and H19 from the maternal allele as expected. In ESCs, both NDN and SNRPN were expressed from the paternal allele while IGF2 and H19 showed loss of imprinting and biallelic expression. In differentiated ESC progeny, these expression patterns were maintained. The implications of aberrant imprinted gene expression to ESC differentiation in vitro and on ESC-derived cell function in vivo after transplantation are unknown.
High-Risk Localized Prostate Cancer: Integrating Chemotherapy
Authors: Oh William K.
Published: November 2005

Learning Objectives

After completing this course, the reader will be able to:Discuss the importance of prostate cancer to public health.Describe the evolving role of systemic treatment in managing high-risk and metastatic disease and discuss the factors that predict for high-risk local disease.Explain the importance of multimodality input in managing high-risk prostate cancer.

Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com

Docetaxel (Taxotere®; Aventis Pharmaceuticals Inc., Bridgewater, NJ, http://www.aventispharma-us.com) is the first agent to significantly extend survival in hormone-refractory prostate cancer. Because agents active in advanced cancers tend to be beneficial in earlier stage disease, docetaxel is now to be assessed, along with hormonal therapy, in the adjuvant setting among patients whose localized prostate cancer has features that put them at particular risk for recurrence and cancer-specific mortality. Data from a pilot study suggest that neo-adjuvant treatment with docetaxel may be appropriate for selected high-risk patients and that such treatment can be undertaken without increasing surgical morbidity. Gene-expression profiling of tissue before and after docetaxel treatment is providing further insight into its effects. A randomized trial, conducted by the Cancer and Leukemia Group B, will evaluate neoadjuvant docetaxel in high-risk patients, whereby patients will be randomized to either immediate radical prostatectomy or surgery preceded by hormonal therapy plus docetaxel. Another large randomized trial will be evaluating the effect of adjuvant hormonal therapy with or without docetaxel in high-risk men after radical prostatectomy.
Relation between age and head and neck cancer recurrence after surgery: A multivariate analysis
Authors: Von Doersten Peter G. , Cruz Raul M. , Rasgon Barry M. , Quesenberry Charles P. , Mlsinger Raymond L.
Published: November 2005

Recent reports have described an increase in squamous cell carcinoma of the upper aerodigestive tract in young adults. As the preponderance of epidemiologic data exists for the population between 50 and 70 years of age, controversy has developed regarding the clinical course of head and neck cancer in youth. Some authors advocate more aggressive management, calling attention to the lack of “classic” predisposing factors and suggesting genetic disorders or Immunodeficiency. Basic science researchers have reported greater DNA fragility, sensitivity to carcinogens, and altered immune responses in young patients with carcinoma. To further elucidate the clinical aspects of this controversy, we performed a retrospective review using multivariate analysis to determine factors that affect recurrence. After screening 820 charts, 155 patients were found who met strict entrance criteria to the study. The patients were separated into five age groups, and 16 clinical variables were collected on each patient. Cox proportional hazards modeling revealed no significantly higher likelihood of recurrence in the 15‐ to 39‐year‐old age group. The model did find that metastatic adenopathy was predictive of recurrence (p= 0.034). The overall model further suggested a trend toward higher relative risk of recurrence in the middle‐aged groups (p= 0.0541). In our review of the English biomedical literature, this is the first study to directly compare the outcome of young head and neck cancer patients with that of old patients using multivariate analysis. Future research is indicated in developing precise outcome predictions according to TNM staging, aneuploidy status, and DNA fragility In young patients. Efforts at limiting carcinogen exposure Should continue.
Comparison of vestibular autorotation and caloric testing
Authors: Saadat Daryoush , O'Leary Dennis P. , Pulec Jack L. , Kitano Hiroya
Published: November 2005

The two most common stimuli of the vestibular system for diagnostic purposes are caloric and rotational head movements. Caloric stimulation, by delivering thermal energy to the lateral semicircular canal, is a well‐studied method of vestibular testing, and its clinical usefulness has been established. Vestibular autorotation testing uses high‐frequency (2 to 6 Hz), active head movements to stimulate the horizontal and vertical vestibulo‐ocular reflex to produce measurable eye movements that can be used to calculate gain and phase. We compared the alternate bilateral bithermal caloric results with the vestibular autorotation test results obtained from 39 patients with peripheral vestibular disorders and from 10 patients with acoustic neuroma. In the peripheral disorder group, only 2 of 14 patients with equal caloric response (<20% reduced vestibular response) had a normal vestibular autorotation test result. No patients with a reduced vestibular response greater than 21% had a normal vestibular autorotation test result. In the acoustic neuroma group, four patients had a normal reduced vestibular response, but all patients had an abnormal vestibular autorotation test result. We conclude that testing both the horizontal and vertical vestibulo‐ocular reflexes in their physiologic frequency range with the vestibular autorotation test provides additional information that could be missed by conventional caloric testing. Therefore high‐frequency rotational testing is a valuable addition to the vestibular test battery.
Results of Intraoral Cortical Bone Screw Fixation Technique for Mandibular Fractures
Authors: Gordon Kyle F. , Reed J. Mark , Anand Vinod K.
Published: November 2005

The intraoral cortical bone screw fixation technique carries many advantages over traditional methods of intermaxillary fixation. Simplicity of the technique, reduction of operative time, and reduction of risk of transmission of human immunodeficiency virus and hepatitis make this an important technique in the armamentarium of busy facial trauma surgeons. Since 1992, 45 mandibular fractures in 29 patients treated with the intraoral cortical bone screw technique for intermaxillary fixation were retrospectively analyzed. At our institution, this technique has become the workhorse method of repairing most mandiublar fractures and is associated with minimal complications.
Oral Cancer and Mouthwash Use: Evaluation of the Epidemiologic Evidence
Authors: Elmore Joann G. , Horwitz Ralph I.
Published: November 2005

BACKGROUND

An association between mouthwash use and cancer of the oropharynx has been the focus of many epidemiologic studies.

PURPOSE

To critically review the methodology of studies of this association.

METHODS

Studies were identified through a computerized MEDLINE search of English‐language publications from 1976 to 1994. Eligible studies were independently reviewed, and specific criteria were applied to assess issues in the design, analysis, and results of the studies. Methodologic criteria were used that define a case‐control study of acceptable epidemiologic quality: (1) histologic confirmation of cancer; (2) use of incident cases; (3) population‐based cases; (4) equal exclusions of controls; (5) population‐based controls; (6) exposure to mouthwash use before the cancer diagnosis; and (7) adjustments or restrictions for tobacco, alcohol, or both.

RESULTS

Seven case‐control studies were identified. The odds ratios for these studies ranged from a protective effect (0.82 for any use of mouthwash) to an elevation in risk (2.5 at the highest exposure). Two studies had significant unadjusted odds ratios for the risk of oral cancer. Of the three studies with data on women adjusted for tobacco and alcohol use, one was statistically significant, and none of the three similar studies in men was significant (although one was close). The five studies with data on female nonsmokers, nondrinkers, or both had odds ratios ranging from 1.1 to 3.16 (only one study was significant at the p = 0.05 level), and the four studies with similar data on men were not significant. Two studies met only two of the methodologic criteria, three studies met three, one met four, and one met all seven.

CONCLUSIONS

Few of the available studies on mouthwash use and risk of subsequent oropharynx cancer adhere to basic methodologic principles of case‐control design. Neither the data for the overall association nor the analysis in patients without other clinical risk factors support a link between mouthwash use and oral cancer.
Anosmia and Chronic Sinus Disease
Authors: Downey Laura L. , Jacobs Joseph B. , Lebowitz Richard A.
Published: November 2005

Chronic sinus disease associated with progressive mucosal disease is often a cause for anosmia. Despite aggressive allergic, medical, and surgical intervention, long‐term relief of anosmia has been difficult to document. Fifty patients sought treatment for subjective anosmia and symptoms of progressive sinusitis and underwent endoscopic sinus surgery. After surgery 52% maintained significant improvement in smell by subjective measures that correlated with objective olfactory University of Pennsylvania Small Identification test (‘UPSIT’) results. Of the remaining patients, some had intermittent improvement, but most remained hyposmic or anosmic despite clinically well‐healed ethmoid surgical beds. Of the preoperative and postoperative historical, clinical, and radiological data analyzed, severity of the presenting sinus disease (defined as stage II in the Kennedy staging criteria or disease extending beyond the ethmoids on preoperative computed tomography scan) and persistent mucosal disease in the surgical bed are associated with persistent anosmia (p = 0.005).
Nasal Septum After Sublabial Transseptal Transsphenoidal Pituitary Surgery
Authors: Urquhart Andrew C. , Bersalona Fernando B. , Ejercito Victor S. , Holt James J.
Published: November 2005

Transseptal transsphenoidal approach to the pituitary fossa is a well‐described and effective procedure. This article relates our experience with this procedure with specific emphasis on the nasal septum, both before and after surgery. It has been our experience that this surgery has minimal local complications in the nose and it would appear to improve septal alignment with subjective improvement in nasal function as reported by the patient. A total of 55 patients undergoing a sublabial transseptal transsphenoidal approach to the pituitary fossa were included in this study. All other approaches to the pituitary gland were excluded. Visual changes and headaches were the most common presenting symptoms, occurring alone or in combination in 28 (51%) patients. Twelve (22%) patients reported symptoms of nasal obstruction before surgery and only one (2%) after surgery. A moderately or severely deviated septum was noted in 30 (54%) patients before surgery and 4 (7%) patients after surgery. The septum was straight in 21 (38%) patients before the procedure and 49 (89%) patients afer the surgery. Sinusitis developed in two patients, and one patient subsequently required surgery. No synechiae or septal perforations were noted.
Vestibular Deficits in Deaf Children
Authors: Selz Peter A. , Girardi Marian , Konrad Horst R. , Hughes Larry F.
Published: November 2005

Considerable knowledge has been accumulated regarding acquired and congenital deafness in children. However, despite the intimate relationship between the auditory and vestibular systems, data are limited regarding the status of the balance system in these children. Using a test population of 15 children, aged 8 to 17 years, we performed electronystagmography testing. The test battery consisted of the eye‐tracking (gaze nystagmus, spontaneous nystagmus, saccade, horizontal pursuit and optokinetic) tests, positional/positioning (Dix‐Hallpike and supine) tests, and rotational chair tests. With age‐matched controls, five children were tested in each of the following three categories: normal hearing, hereditary deafness, and acquired deafness. The children in the hereditary deafness category were congenitally deaf and had a family history of deafness. Those subjects in the acquired deafness category had hearing loss before the age of 2 years, after meningitis. Analysis of variance demonstrated significant differences between the two deaf groups and the control subjects in the gaze nystagmus test, saccade latencies, horizontal pursuit phase, and Dix‐Hallpike and supine positionally provoked nystagmus. Also, significant differences were found in rotational chair gain and phase between the deaf and normal‐hearing children. The children with acquired deafness exhibited the most profound results. In addition, there were significant differences in rotational chair gain between the acquired and congenitally deaf children. No differences were noted in horizontal pursuit gains, saccade accuracies, or saccade asymmetries. These preliminary data demonstrate that the etiologic factors responsible for congenital and acquired deafness in children may indeed affect the balance system as well. These findings of possible balance disorders in conjunction with the profound hearing loss in this patient population will have prognostic implications in the future evaluation, treatment, and rehabilitation of these patients.
Universal Newborn Screening for Hearing Loss: Ideal vs. Reality and the Role of Otolaryngologists
Authors: Bluestone Charles D.
Published: November 2005

In 1993 the National Institutes of Health Consensus Statement, Early Identification of Hearing Impairment in Infants and Young Children, recommended “universal screening for hearing impairment prior to three months of age.” However, the decision to invoke screening programs that include all newborns remains highly controversial, even though such programs now exist in at least 60 hospitals in 18 states. Unfortunately, otolaryngologists in the United States have not been actively involved in this ongoing debate, despite the role of those in our specialty as “gatekeepers” of hearing loss in patients of all ages. In relation to identification of hearing loss in the neonatal period, we have abrogated our responsibility to other health care professionals. Otolaryngologists, this is your “wake up call.”
Electrocautery Burns and Operator Ignorance
Authors: Zinder Daniel J. , Parker Gregg S.
Published: November 2005

The surgeon, however, need not be expected to know the full details of the electrothermic principles which are involved, though it behooves him to have some familiarity with them if he is to do more than merely run the machine. One may learn to pilot a motor driven vehicle without necessarily knowing the principles of the internal combustion engine, but it will add to his efficiency in emergencies if he does so.

–––Harvey Cushing, 19281

Electrocautery is one of the most widely used surgical devices, but injuries occur often and lead to costly litigation. Ignorance is the leading cause of these injuries in the operating theater. Understanding a few simple principles of operation can minimize unnecessary electrocautery injuries to both patients and surgeons.
Basal Cell Adenocarcinoma of the Parotid Gland
Authors: Kacker Ashutosh , Adsay Volkan , Komisar Arnold
Published: November 2005

The term basal cell adenoma was used by Kleinsasser and Klien1 in 1967 to describe benign salivary gland tumors comprised of a single type of epithelium. Basal cell adenocarcinoma is a relatively new entity, and there are only a few cases reported in the literature. It has a morphology like that of a basal cell adenoma but has growth characteristics of a malignant neoplasm.
Welfare states do not crowd out the family: evidence for mixed responsibility from comparative analyses
Authors: MOTEL-KLINGEBIEL ANDREAS , TESCH-ROEMER CLEMENS , VON KONDRATOWITZ HANS-JOACHIM
Published: November 2005

This paper discusses the informal and formal provision of help and support to older people from a comparative welfare state perspective, with particular reference to the relationships between inter-generational family help and welfare state support. While the ‘substitution’ hypothesis states that the generous provision of welfare state services in support of older people ‘crowds out’ family help, the ‘encouragement’ hypothesis predicts a stimulation of family help, and the ‘mixed responsibility’ hypothesis predicts a combination of family and formal help and support. The paper reports findings from the Old Age and Autonomy: The Role of Service Systems and Inter-generational Family Solidarity (OASIS) research project. This created a unique age-stratified sample of 6,106 people aged 25–102 years from the urban populations of Norway, England, Germany, Spain and Israel. The analyses show that the total quantity of help received by older people is greater in welfare states with a strong infrastructure of formal services. Moreover, when measures of the social structure, support preferences and familial opportunity structures were controlled, no evidence of a substantial ‘crowding out’ of family help was found. The results support the hypothesis of ‘mixed responsibility’, and suggest that in societies with well-developed service infrastructures, help from families and welfare state services act accumulatively, but that in familistic welfare regimes, similar combinations do not occur.
Older women's relations to bodily appearance: the embodiment of social and biological conditions of existence
Authors: DUMAS ALEX , LABERGE SUZANNE , STRAKA SILVIA M.
Published: November 2005

Our purpose in this paper is to explore and deepen the understanding of older women's relations to bodily appearance by looking at two different conditions of existence. Recent research has touched on the experiences of older women in societies with youthful norms of beauty, but the diversity of older women's experiences has been little explored, and there has been little dialogue between theoretical writing and empirical research on the topic. It was therefore decided to conduct an empirical study of older women's relations to bodily appearance, applying Pierre Bourdieu's sociological theory and particularly the concept of habitus to the body. Qualitative, semi-structured interviews were conducted with 51 francophone women aged 65 to 75 years from working-class and affluent neighbourhoods of Montréal (Québec, Canada). The findings showed clearly that, despite the social differentiation associated with variations in economic and cultural capital, older women's relations to bodily appearance converged as they aged. Two previously unidentified and overlapping processes of attitudinal change were recognised: (1) differentiation by social class, and (2) convergence with increasing age. In conclusion, we discuss the embodiment of women's social and biological conditions of existence in the context of personal ageing. The notion of age-habitus is introduced to explain how older women maintain their social value in the context of omnipresent youthful ideals of beauty for western women.
The World Trade Organization at ten years
Authors: SUTHERLAND PETER
Published: November 2005

In reflecting on the record of the World Trade Organization during its first ten years of existence I have chosen to take a ‘political’ view. In doing so, I am aware that other observers might well draw quite different conclusions from my own. However, it is often the political perceptions that count. Indeed, in the past few years, as the WTO has gained recognition in the public consciousness, the work of the institution has sometimes been deflected from what strict economic or legal analysis might suggest as the ‘best courses’ for the overall public good.