bluuebunny/crossref_metadata_2025 huggingface dataset:
The Echinocandins
Authors: Cappelletty Diane , Eiselstein‐McKitrick Kasi
Published: February 2007

The changing pattern in fungal infections has driven the need to expand the targets of antifungal activity. The echinocandins are the newest addition to the arsenal against fungal infections. Three echinocandins have been approved by the United States Food and Drug Administration: caspofungin, micafungin, and anidulafungin. These agents have a broad spectrum of activity and are similar to each other with respect to in vitro activity against Candida sp, with micafungin and anidulafungin having similar minimum inhibitory concentrations (MICs) that are generally lower than the MIC of capsofungin. The MICs of the echinocandins are highest against Candida parapsilosis; however, whether this will affect clinical outcomes is unknown. Several case reports have identified clinical failure due to elevated MICs with caspofungin or micafungin against Candida albicans, Candida krusei, and C. parapsilosis. Resistance to the echinocandin class was present in some but not all of the isolates. Empiric therapy with one of the echinocandins for candidemia or invasive candidiasis in patients with neutropenia and those without neutropenia appears to be appropriate when one factors in mortality rate, the increasing frequency of non‐albicans Candida infections, and the broad spectrum, safety, and fungicidal effect of the echinocandins. After speciation of the organism, continued therapy with an echinocandin can and should be reevaluated. The echinocandins demonstrate similar in vitro and in vivo activity against Aspergillus sp, but only caspofungin is approved for treatment in patients who are intolerant of or refractory to other therapies. Voriconazole and amphotericin B have demonstrated synergy with the echinocandins. The clinical response to combination therapy has been variable; however, the mortality rate appears to be lower with combination therapy than monotherapy. Large controlled trials are needed to determine the role of combination therapy for invasive aspergillosis. Micafungin and anidulafungin generally have a lower frequency of adverse reactions compared with caspofungin. Phlebitis (3.5–25% of patients) and elevated liver enzyme levels (1–15%) occur more often with caspofungin compared with micafungin and anidulafungin (< 8%). Overall, the three echinocandins are relatively safe and effective agents for the treatment of Candida infections.
Clinical Pharmacokinetic Monitoring of Midazolam in Critically Ill Patients
Authors: Spina Sean P. , Ensom Mary H. H.
Published: February 2007

Midazolam is a commonly used sedative in critically ill, mechanically ventilated patients in intensive care unit (ICU) settings worldwide. We used a nine‐step decision‐making algorithm to determine whether therapeutic monitoring of midazolam in the ICU is warranted. Midazolam has a higher clearance and shorter half‐life than other benzodiazepines, and prolonged sedation is achieved with continuous infusion. There appears to be very good correlation between plasma concentrations of both midazolam and its active metabolite, α1‐hydroxymidazolam, and the degree of sedation. However, due to high interpatient variability, it is not possible to predict the level of sedation in any given individual based on plasma concentration of midazolam or its metabolites. Moreover, no simple and practical assay is available to quantitate midazolam plasma concentrations in the acute ICU setting. Many scales are available to assess the sedative effects of midazolam. Because the plasma concentration of midazolam required to achieve a constant level of sedation is highly variable, it is usually more prudent for the clinician to monitor for sedation with a validated clinical scale than by plasma concentrations alone. Various physiologic parameters, including age‐related effects, compromised renal function, and liver dysfunction affect the pharmacokinetics of midazolam and α1‐hydroxymidazolam. Although routine drug monitoring for all critically ill patients receiving midazolam is not recommended, this practice is likely beneficial in patients with neurologic damage in whom sedation cannot be assessed and in patients who have renal failure with a prolonged time to awakening.
Pharmacotherapy for Microscopic Colitis
Authors: Wall Geoffrey C. , Schirmer Lori L. , Page Michael J.
Published: February 2007

Microscopic colitis is a common cause of chronic watery diarrhea. Its etiology is unknown, but use of nonsteroidal antiinflammatory drugs, aspirin, and lansoprazole may be risk factors for developing the disorder. Therapy is directed primarily at resolving the symptoms of microscopic colitis; bismuth subsalicylate, aminosalicylates, traditional corticosteroids, and budesonide have been evaluated. Compared with other therapies, budesonide has the strongest evidence for effectiveness in decreasing the volume and frequency of stools and improving the quality of life; it is, however, a costly drug. We reviewed all available primary English‐language literature accounts of treatment of microscopic colitis. We performed searches of MEDLINE and International Pharmaceutical Abstracts, as well as reviewing the bibliographies from key articles, to procure pertinent reports. Microscopic colitis can be successfully treated with pharmacotherapy. Based on cost and adverse‐effect profiles, antidiarrheals and bismuth subsalicylate are reasonable first options, but many patients may require budesonide to achieve remission.
Generation of Cardiac and Endothelial Cells from Neonatal Mouse Testis-Derived Multipotent Germline Stem Cells
Authors: Baba Shiro , Heike Toshio , Umeda Katsutsugu , Iwasa Toru , Kaichi Shinji , Hiraumi Yoshimi , Doi Hiraku , Yoshimoto Momoko , Kanatsu-Shinohara Mito , Shinohara Takashi , Nakahata Tatsutoshi
Published: February 2007

Multipotent germline stem (mGS) cells have been established from neonatal mouse testes. Here, we compared mGS, embryonic stem (ES), and embryonic germ (EG) cells with regard to their ability to differentiate into mesodermal cells, namely, cardiomyocytes and endothelial cells. The in situ morphological appearances of undifferentiated mGS, ES, and EG cells were similar, and 4 days after being induced to differentiate, approximately 30%–40% of each cell type differentiated into Flk1+ cells. The sorted Flk1+ cells differentiated efficiently into cardiomyocytes and endothelial cells. By day 10 after differentiation induction, the three cell types generated equal number of endothelial colonies. However, by day 13 after differentiation induction, the Flk1+ mGS cells generated more contractile colonies than did the Flk1+ ES cells, whereas the Flk1+ EG cells generated equivalent numbers as the Flk1+ mGS cells. Reverse transcriptase polymerase chain reaction (RT-PCR) analysis of differentiation markers such as Rex1, FGF-5, GATA-4, Brachyury, and Flk1 revealed that mGS cells expressed these markers more slowly during days 0–4 after differentiation induction than did ES cells, but that this mGS cell pattern was similar to that of the EG cells. RT-PCR analysis also revealed that the three differentiation cell types expressed various cardiac markers. Moreover, immunohistochemical analysis revealed that the contractile colonies derived from Flk1+ mGS cells express mature cardiac cell-specific markers. In conclusion, mGS cells are phenotypically similar to ES and EG cells and have a similar potential to differentiate into cardiomyocytes and endothelial cells.

Disclosure of potential conflicts of interest is found at the end of this article.
Conditional Gene Expression in Human Embryonic Stem Cells
Authors: Vallier Ludovic , Alexander Morgan , Pedersen Roger
Published: February 2007

Human embryonic stem cells (hESCs) possess unique properties for studying mechanisms controlling cell fate commitment during early mammalian development. Gain of function is a common strategy to study the function of specific genes involved in these mechanisms. However, transgene toxicity can be a major limitation, especially with factors influencing proliferation or differentiation. Here, we describe an efficient method based on the inducible recombinase Cre-ERT2 for conditional gene expression in hESCs and their differentiated derivatives. Using this approach, we have established several hESC sublines inducible for the expression of the enhanced green fluorescent protein and the transforming growth factor β family member Nodal. Together, these results demonstrate that Cre-ERT2 can be used to control gene expression in undifferentiated and differentiated cells, thereby providing the first conditional transgene expression system that works effectively in hESCs.

Disclosure of potential conflicts of interest is found at the end of this article.
Effect of Testosterone on Intracavernous Pressure Elicited With Electrical Stimulation of the Medial Preoptic Area and Cavernous Nerve in Male Rats
Authors: Suzuki Noriyoshi , Sato Yoshikazu , Hisasue Shin‐Ichi , Kato Ryuichi , Suzuki Kazuhiro , Tsukamoto Taiji
Published: February 2007

ABSTRACT: We studied the effects of castration and testosterone (T) replacement on intracavernous pressure (ICP) elicited with electrical stimulation of the medial preoptic area (MPOA) and cavernous nerve (CN) in male rats. We measured the ICP during electrical stimulation of the MPOA and CN in castrated male rats with and without testosterone replacement. The experimental group consisted of 20‐week‐old male rats at 2 weeks (n = 8), 4 weeks (n = 8) and 8 weeks (n = 8) after castration, and at 8 weeks after castration with T replacement (n = 4). Intact 20‐week‐old rats (n = 8) served as controls. The erectile response was expressed as the ICP/blood pressure (BP) ratio. The ICP/BP ratios during CN stimulation of the animals at 2, 4, and 8 weeks after castration were significantly lower than those of the intact animals. However, the erectile responses were not eliminated. In contrast to these peripherally evoked responses, erectile responses elicited by electrical stimulation of the MPOA were eliminated following castration. After testosterone replacement, both erectile responses were restored. Testosterone plays important roles in both the central and peripheral neural pathways for the maintenance and restoration of erectile capacity. The central control of erection shows more extensive changes following testosterone replacement than the peripheral control.
Characterizing the Glycocalyx of Poultry Spermatozoa: I. Identification and Distribution of Carbohydrate Residues Using Flow Cytometry and Epifluorescence Microscopy
Authors: Peláez Jesús , Long Julie A.
Published: February 2007

ABSTRACT: The aim of the present work was to use a battery of lectins to 1) delineate the carbohydrate content of sperm glycocalyx in the turkey and chicken using flow cytometry analysis, and 2) evaluate the distribution of existing sugars over the sperm plasma membrane surface with epifluorescent microscopy. Carbohydrate groups (corresponding lectins) that were investigated included galactose (GS‐I, Jacalin, RCA‐I, PNA), glucose and/or mannose (Con A, PSA, GNA), N‐acetyl‐glucosamine (GS‐II, s‐WGA, STA), N‐acetyl‐galactosamine (SBA, WFA), fucose (Lotus, UEA‐I), sialic acid (LFA, LPA), and N‐acetyl‐lactosamine (ECA). Spermatozoa were assessed before and after treatment with neuraminidase to remove sialic acid. Mean fluorescence intensity (MnFI) was used as indicator of lectin binding for flow cytometry analysis. Nontreated spermatozoa from both species showed high MnFI when incubated with RCA‐I, Con A, LFA, and LPA, as did chicken spermatozoa incubated with s‐WGA. Neuraminidase treatment increased the MnFI for most lectins except LFA and LPA, as expected. Differences in MnFI between species included higher values for s‐WGA and ECA in chicken spermatozoa and for WFA in turkey spermatozoa. Microscopy revealed segregation of some sugar residues into membrane‐specific domains; however, the 2 staining techniques (cell suspension vs fixed preparation) differed in identifying lectin binding patterns, with fixed preparations yielding a high degree of nonspecific binding. We conclude that 1) the glycocalyx of turkey and chicken spermatozoa contains a diversity of carbohydrate groups, 2) these residues are extensively masked by sialic acid, 3) the glycocalyx composition is species‐specific, and 4) some glycoconjugates appear to be segregated into membrane‐specific domains. Characterization of the poultry sperm glycocalyx is the first step in identifying the physiological impact of semen storage on sperm fucntion.
The Digital Divide and First-Year Students
Authors: Goodfellow Marianne , Wade Barbara
Published: February 2007

Current cross-campus computing initiatives demand both access and skill in employing technology as a tool for academic success. Consequently, lack of computer skills can affect first-year students' potential for success because many courses assume students are computer literate. In this study, 888 first-year students completed a survey—administered for three years—that examined technology variables. A chi-square statistic and associated p-value indicated that students' access to computers increased over a three-year period, albeit it was income-related. Results showed an improvement in word processing, Internet and library-searching skills, and developing computer-enhanced presentations. However, results from the last year of the study showed that more than 50% of students rated themselves unskilled at library-searching and developing computer-enhanced presentations, with approximately one-third of students rating themselves unskilled at e-mail. Implications for first-year student computer-training support are discussed.
A Motivational/Empowerment Model Applied to Students on Academic Probation
Authors: Kamphoff Cindra S. , Hutson Bryant L. , Amundsen Scott A. , Atwood Julie A.
Published: February 2007

This article outlines a motivational/empowerment model for students on academic probation implemented at The University of North Carolina Greensboro (UNCG). The model draws from several theoretical orientations, and includes individual and group interaction as well as discussion in four key topic areas: personal responsibility, positive affirmations, goal setting/life planning, and self-management. Since implementation, the percentage of UNCG students eligible to return to the institution after being placed on academic probation has increased from 40% to 58% over a four-year period. When comparing the net gain in grade point average of students completing the program to a control group, students enrolled in the program had a significantly higher academic achievement ( p = .036). Generalizability of the model and future research recommendations are explored in the article.
Non-Traditional Student Persistence and First Year Experience Courses
Authors: Cavote Steve , Kopera-Frye Karen
Published: February 2007

Using the National Postsecondary Student Aid Study Risk Factor Index, students were placed into four traditional/non-traditional (NT) status categories. For each category, persistence was compared between students who completed a First-Year Experience (FYE) course and a control group of students that did not. It was hypothesized that having a FYE experience would be significantly associated with greater persistence among the most highly NT students. Attrition, analyzed over three semesters, determined that persistence was not related FYE completion.
Subacute Effects of Ozone Exposure on Cultivated Human Respiratory Mucosa
Authors: Gosepath Jan , Schaefer Dirk , Brommer Christian , Klimek Ludger , Amedee Ronald G. , Mann Wolf J.
Published: February 2007

This study was designed to investigate subacute effects of long-term exposure of both healthy and chronically inflamed human respiratory mucosa to ozone. Functional and metabolic effects on ciliary beat frequency (CBF), release of interleukin 8 (IL-8), interleukin 4 (IL-4), and γ interferon (g-INF), as well as cellular viability and cytotoxicity, were monitored. Cell cultures of 60 specimens (healthy mucosa: n = 30, inflamed mucosa: n = 30) were exposed to synthetic air and to ozone-enriched synthetic air in different concentrations of WO, 500, and WOO μg/m3. Continuous expositions were performed using an air/liquid interface cell culture technique for a period of 4 weeks. CBF was monitored using video-interference contrast microscopy and cytokine release was quantified by enzyme immunoassays. Cellular viability and cytotoxicity were controlled by measuring lactate dehydrogenase activity, cytosolic activity of esterases, and by staining of nuclear DNA. Synthetic air had no influence on CBF during the 4 weeks of exposure. IL-8 release was continuously diminished in unaffected and in chronically inflamed mucosa. Within the first week of continuous exposure with any ozone concentration neither CBF nor release of IL-8 were affected in healthy or in inflamed mucosa. During the second and the following weeks of exposure CBF and the release of IL-8 were reduced in both tissues. Release of IL-4 or g-INF were not detectable at any time during the 4 weeks of ozone exposure. At higher ozone concentrations of 500 and 1000 μg/m3 there was an increase of cytotoxicity which was greater in chronically inflamed than in healthy mucosa. In conclusion, ozone had no measurable effect on those parameters measured in human upper respiratory epithelium after one week of in vitro exposure to different concentrations, but did after longer periods of exposure. Chronically inflamed mucosa had a tendency toward a higher susceptibility to intermediate and high concentrations of ozone that did not reach a level of statistical significance under the conditions used in this study.
Malignant Fibrous Histiocytoma of the Nasal Cavity and Paranasal Sinuses
Authors: Rodrigo Juan P. , Fernáandez José A. , Suárez Carlos , Gómez Justo , Llorente Jose L , Herrero Agustín
Published: February 2007

Malignant fibrous histiocytomas are uncommon in the head and neck, the sinonasal tract being the most common location. This report describes 5 cases in this area: two in the nasal cavity, two in the maxillary sinus, and one in the frontal sinus. Four were primary cases and one was secondary to previous irradiation. All patients received surgical treatment, one of them with postoperative irradiation. All five patients experienced local recurrences and three also experienced distant metastases. Only one of these recurrences was successfully salvaged and the patient is alive and free of disease 3 years after resection. A summary of knowledge about the entity is reviewed.
Interleukin-1β, Interleukin-5, Interleukin-6, Interleukin-8, and Tumor Necrosis Factor-α in Chronic Sinusitis: Response to Systemic Corticosteroids
Authors: Lennard Colleen M. , Mann Eric A. , Sun Leon L , Chang Audrey S. , Bolger William E.
Published: February 2007

Recently, the role of various cytokines in the pathogenesis of chronic rhinosinusitis has come under investigation. Various studies have reported increased levels of interleukin-3, interleukin-4, interleukin-5, interleukin-13, and granulocyte macrophage-colony stimulating factor in the sinonasal mucosa of patients with chronic rhinosinusitis. The present study investigated the levels of pro-inflammatory cytokines, including interleukin-1β (IL-1β), interleukin-5 (IL-5), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α), in the sinonasal mucosa of patients with chronic rhinosinusitis, and evaluated the response of these cytokines to oral corticosteroids. Chronic rhinosinusitis subjects (n = 15) and control subjects (n = 9) underwent nasal endoscopy and biopsy of the sinonasal mucosa. Chronic rhinosinusitis subjects were subsequently treated with a 10-day tapering dose of prednisone followed by a second sinonasal endoscopic exam and biopsy. Mucosal biopsy specimens were immunostained for IL-1β, IL-5, IL-6, IL-8, and TNF-α. In chronic rhinosinusitis subjects, mucosal levels of IL-1β, IL-6, IL-8, and TNF-α were significantly elevated when compared with control subjects, and levels of IL-5 demonstrated a strong trend toward elevation. In posttreatment chronic rhinosinusitis subjects, levels of IL-6 were significantly decreased when compared with pretreatment levels, and TNF-α levels demonstrated a significant trend toward reduction. These findings support the hypothesis that the inflammatory response in chronic rhinosinusitis is associated with elevated levels of pro-inflammatory cytokines, and suggest that oral corticosteroids may exert a beneficial effect by significantly reducing the levels of IL-6 and TNF-α.
Nasal Mucociliary Transport in Pregnancy
Authors: Ellegård Eva K. , Karlsson N. Göran
Published: February 2007

Using the saccharin method, we performed tests of mucociliary function four times during pregnancy and once one month after delivery in 27 women. As the transport distance for saccharin varied from 37 to 65 mm, we used the transport speed for evaluation. Pregnancy rhinitis affects at least 20% of pregnancies. The mucociliary transport speed was higher in the group of women with pregnancy rhinitis, and was reduced during pregnancy in the group of women without that condition. We found no significant correlation between mucociliary transport speed and objectively registered nasal peak expiratory flow index. The pathophysiology of pregnancy rhinitis is not known, but is possibly multifactorial. The changes occurring in the nasal mucociliary transport system during normal pregnancy and in pregnancy rhinitis need further studies.
Effect of Topical Nasal Pharmaceuticals on Sodium and Chloride Transport by Human Airway Epithelia
Authors: Jepsen Matthew , Graham Scott , Karp Philip H. , Zabner Joseph
Published: February 2007

The human airway epithelium lines the respiratory tract from the nasal mucosa to the bronchioles. Electrolyte transport by these epithelia is crucial in maintaining the appropriate volume and salt composition of the airway surface fluid. When this epithelium becomes functionally impaired, the airways are more prone to respiratory infections. We studied the effect of six common topical agents that are commonly used to treat rhinorrhea and nasal inflammation on the transepithelial resistance, sodium, and chloride transport of primary cultures of human airway epithelia grown at the air-liquid interface. The pharmaceuticals fluticasone propionate, cromolyn sodium, ipratropium bromide, azelastine, oxymetazoline, and normal saline were used and the electrical function of the epithelia was studied in Ussing chambers. Azelastin and ipratropium bromide-treated epithelia were found to have a significant decrease in transepithelial resistance. Both normal saline and fluticasone propionate resulted in significant increases in amiloride-sensitive short circuit currents that reflect sodium transport Finally, normal saline resulted in a significant increase in bumetanide-sensitive short circuit current that reflects chloride transport across the epithelia. The data presented may explain a mechanism by which some topical pharmaceuticals help reduce rhinorrhea, and may point to some unwanted side effects of some pharmaceuticals on the electrolyte transport of the airway epithelia. In summary, several of the common topical nasal agents alter the electrolyte transport of the nasal airway epithelia. The in vivo significance of these findings is to be determined.
Pediatric Transseptal Transsphenoidal Pituitary Surgery
Authors: Orvidas Laura J. , Kasperbauer Jan L. , Meyer Fredric B. , Zimmerman Donald
Published: February 2007

The use of the transseptal transsphenoidal approach to the pituitary gland has gained acceptance as a safe, relatively atraumatic means of removing pituitary tumors. The outcome in adult patients has been successful; however, the outcome in pediatric patients whose noses may still be developing is not well described. We reviewed the outcomes in 41 patients younger than age 18 years who underwent transseptal transsphenoidal pituitary surgery at our institution between 1986 and 1997 (20 boys and 21 girls; age, 3 to 17 years; mean age, 13.4 years). The most common diagnosis was prolactin-secreting adenoma (14 patients), followed by craniopharyngioma (7 patients). Presenting symptoms included headache (20 patients), galactorrhea (13 patients), and menstrual irregularities (11 patients). The most common early complication was transient diabetes insipidus (20 patients). No patient experienced serious bleeding at pack removal and no patient developed a cerebrospinal fluid leak postoperatively. Follow-up ranged from 3 months to 12.7 years, with 7 patients experiencing recurrent or residual disease between 6 days and 2 years after their original transseptal procedure. The most common long-term surgical complication was nasal obstruction in 5 patients, 3 of whom also complained of seasonal allergies. Four patients complained of recurrent sinus infections, and 4 patients noted an external nasal deformity as a result of the surgery.
Chronic Sinusitis Complicating Sinus Lift Surgery
Authors: Galli Suzanne K. Doud , Lebowitz Richard A. , Giacchi Renato J. , Glickman Robert , Jacobs Joseph B.
Published: February 2007

Sinusitis has been reported as a complication of sinus lift surgery with antral bone augmentation. The procedure involves the creation of a submucoperiosteal pocket in the floor of the maxillary sinus for placement of a graft consisting of autogenous, allogenic, or alloplastic material. This can result in inadvertent tearing of the mucoperiosteal flap with extrusion of graft material into the antrum. Obstruction of the sinus outflow tract by mucosal edema and particulate graft material may result in sinusitis. We will discuss the clinical presentation and management of 14 cases of chronic sinusitis following sinus lift surgery with alloplastic hydroxyapatite (HA) augmentation of the maxillary antrum.
The Effects of Endoscopic Sinus Surgery on the Nasal Cycle as Assessed by Acoustic Rhinometry
Authors: Anselmo-Lima Wilma Terezinha , Lund Valerie Joan
Published: February 2007

Previous studies have demonstrated that acoustic rhinometry (AR) has a considerable utility in measuring nasal patency and in detecting the nasal cycle. This study was performed in 10 patients with chronic rhinosinusitis who were submitted to endoscopic sinus surgery. AR was used to determine minimum nasal cross-sectional area and volume as the indices of the nasal patency in all patients on the day before the surgery and 3 months postoperatively. We did not find any significant alteration when comparing the pattern of fluctuation, the periodicity. and the amplitude of the nasal cycle demonstrated by patients in the pre and postoperative periods, confirming that this surgery does not have any adverse effect On this physiologic cycle.
Histopathologic Evaluation of the Ethmoid Bone in Chronic Sinusitis
Authors: Giacchi Renato J. , Lebowitz Richard A. , Yee Herman T. , Light Joshua P. , Jacobs Joseph B.
Published: February 2007

Chronic rhinosinusitis (CRS) is defined as a condition lasting for a period greater than 12 weeks, and manifested by an inflammatory response involving the mucous membranes of the nasal cavity and paranasal sinuses, fluids within these cavities, and/or the underlying bone. The mucosal changes that occur in CRS have been well described, and include edema, decreased number of ciliated cells, and goblet cell hyperplasia. However, the changes that may occur in the underlying ethmoid bone have only recently been investigated. We evaluated decalcified ethmoid bone specimens from 20 patients undergoing endoscopic sinus surgery for CRS. Our analysis revealed histopathologic changes consistent with varying grades of bone remodeling. Polarized light microscopy demonstrated changes in the extracellular matrix, such as bone resorption and neo-osteogenesis. Preoperative clinical data and CT staging were recorded on all patients and correlated with the histopathologic findings. These findings suggest that CRS may be associated with osteitis of the underlying ethmoid bone.
Sinonasal Disease in Patients with Sarcoidosis
Authors: Long Christopher M. , Smith Timothy L , Loehrl Todd A. , Komorowski Richard A. , Toohill Robert J.
Published: February 2007

Sarcoidosis is a chronic granulomatous disease of unclear etiology with a propensity to involve the lower respiratory tract, but may also involve the upper respiratory tract. Histologically. it is characterized by non-caseating granulomas of various organ systems. Although nasal and sinus involvement is uncommon, patients with sarcoidosis presenting with nasal and sinus complaints may have sinonasal sarcoidosis or simply rhinosinusitis. We reviewed the cases of six patients with pulmonary sarcoidosis who developed chronic sinonasal disease. All six patients had intranasal findings consistent with sinonasal sarcoidosis. but only four had histologic evidence of sinonasal sarcoidosis. These four patients continue to require extensive therapy including topical steroids. systemic steroids, intralesional steroid injections. and nasal irrigations. We conclude that patients with histologically proven sinonasal sarcoidosis present a significant therapeutic challenge because their symptoms and physical findings are often persistent despite aggressive medical and surgical therapy. Their recalcitrant sinonasal disease is thought to result from the destruction of cilia and mucus-producing glands by the granulomatous process.
Extent of Pathological Changes in the Paranasal Sinuses of Patients with Cystic Fibrosis: CT Analysis
Authors: Krzeski Antoni , Kapiszewska-Dzedzej Dorota , Jakubczyk Iwona , Jȩdrusik Agnieszka , Held-Ziółkowska Marta
Published: February 2007

The aim of the study was to define the characteristic changes revealed by computed tomography (CT) examination of the paranasal sinuses in patients with cystic fibrosis (CF). The group of 30 CF patients was evaluated in the outpatient clinic of the Department of Otorhinolaryngology, Medical University of Warsaw, from 1996 to 1998. The control group consisted of 30 patients with chronic rhinosinusitis (CRS). CT scans were obtained from both groups of patients, and findings revealed more advanced pathological changes in the CF than CRS group. The extensive inflammatory process observed in CT scans of CF patients resulted in the impairment of frontal and maxillary sinus development, destruction of bony structures, and medial projection of the lateral nasal wall.
Ipratropium Bromide Nasal Spray for Treatment of Rhinorrhea in the Laryngectomized Patient: A Pilot Study
Authors: Magardino Thomas M. , Suskind-Liu Dana , Kroger Hans , Mirza Natasha
Published: February 2007

Many who have had a total laryngectomy complain of unrelenting rhinorrhea that is often very difficult to control. This study was undertaken to evaluate the effect of ipratropium bromide (IB), an anticholinergic nasal spray, on rhinorrhea in these patients. This was designed as a prospective, randomized, double-blind, placebo-controlled, crossover pilot study. Participants were selected if they had a total laryngectomy and complained of rhinorrhea. They were asked to rate the severity and duration of their rhinorrhea each day throughout the study on a scale from zero to six. Each participant was initially given a saline nasal spray for one week. They were then randomized to use either IB or saline for the double-blinded portion of the study. Two sprays of IB at a dose of 42 micrograms/spray (0.06%), or saline, were administered intranasally twice daily for two weeks, after which time the participants were given another nasal spray (either IB or saline) for the crossover portion of the study. Six patients entered and completed the study. Those patients using the IB recorded a mean 55% decline in severity and a mean 51% decline in duration of the rhinorrhea as compared to placebo. The relief in both severity and duration of rhinorrhea obtained by patients was analyzed using the Wilcoxon signed-rank test and found to be highly significant (p < 0.001). Despite the limitations of a small sample size in this study, ipratropium bromide nasal spray significantly reduced both the severity and duration of rhinorrhea in laryngectomized patients. We suggest ipratropium nasal spray as a safe, effective way to treat chronic rhinorrhea in laryngectomized patients, improving their quality of life.
Sense of Smell in Long-Standing Nasal Polyposis
Authors: Vento Seija I. , Simola Markku , Ertama Liisa O. , Malmberg C. Henrik O.
Published: February 2007

An impaired sense of smell is a common complaint in patients with nasal polyposis, and hyposmia is usually attributed to obstruction of the nasal airways. The duration of nasal polyposis and nasal surgery may also affect olfaction. It has been shown that aging and chronic rhinitis both impair olfaction. The aim of our study was to evaluate the sense of smell in patients who had had nasal polyposis for at least 20 years. The olfactory threshold was assessed with a commercially available odor detection threshold test. The threshold of 19 (46%) of 41 patients was greater than the age-related upper 95% reference limit. In a forward stepwise multiple regression analysis of all the polyposis patients, the degree of opacity of ethmoidal sinuses seen in computed tomography (CT), polyposis visible in anterior rhinoscopy, total nasal resistance, and gender had a significant association with olfactory threshold.
Production of β-Defensin Antimicrobial Peptides by Maxillary Sinus Mucosa
Authors: Carothers Daniel G. , Graham Scott M. , Jia Hong Peng , Ackermann Mark R. , Tack Brian F. , McCray Paul B.
Published: February 2007

β-Defensins are endogenous cationic peptides with broad-spectrum antimicrobial activity that are thought to play a role in the innate immune response. Two human β-defensins, β-defensin-1 (HBD-1) and β-defensin-2 (HBD-2), have been identified. These peptides have recently been characterized in several human tissues. The presence of these peptides in the paranasal sinuses has not been investigated. We examined maxillary sinus secretions from six patients with sinusitis and 10 patients without signs, symptoms, or radiologic evidence of sinus disease for the presence of β-defensins. Cationic peptides were extracted from antral lavage specimens and examined for the presence of HBD-1 and HBD-2 by Western blot. Normal maxillary sinus epithelium was obtained from two patients and analyzed by RT-PCR for the presence of HBD-I and HBD-2 mRNA. Tissue immunostaining for the two peptides was also used. Western blot analysis identified HBD-1 in two of 10 patients in the control group and in three of six patients in the sinusitis group. HBD-2 was identified in one of 10 patients in the control group and in four of six patients in the sinusitis group. RT-PCR revealed HBD-1 mRNA in one of two normal controls tested. Immunostaining localized HBD-1 and HBD-2 to the epithelial cell cytoplasm. This is the first demonstration of HBD-1 and HBD-2 production in the paranasal sinuses. In the present study, HBD-1 and HBD-2 were detected more frequently in the maxillary sinus fluid of patients with inflamed sinuses than in normal controls.
Changes in retention behavior of fluorescently labeled proteins during ion‐exchange chromatography caused by different protein surface labeling positions
Authors: Teske Christopher A. , Simon Robert , Niebisch Axel , Hubbuch Jürgen
Published: February 2007

Confocal laser scanning microscopy (CLSM) is a method allowing in situ visualization of protein transport in porous chromatography resins. CLSM requires labeling a protein with a fluorescent probe. Recent work has shown that conjugation of the protein with fluorescent probes can lead to significant changes in the retention time of the protein–dye conjugate with respect to the unlabeled protein. In this study, we show that common labeling procedures result in a heterogeneous mixture of different variants and that attachment location of the fluorescent probe on the protein surface can have a strong effect on the retention of protein‐dye conjugate. Lysozyme was labeled with Cy5 and BODIPY‐FL succinimidyl esters, followed by chromatographic separation of the different lysozyme–dye conjugates and subsequent determination of the label position using MALDI‐TOF‐MS. Finally, homogenously labeled lysozyme–dye conjugates were used in CLSM experimentation and compared to published results arising from heterogeneously labeled feedstocks. The results confirm that the attachment location of the fluorescent probe has a strong effect on chromatographic retention behavior. When addressing the binding affinities of the different labeled protein fractions, it was found that native lysozyme was able to displace lysozyme–dye conjugates when the fluorescent label was attached to lysine‐33, but not when attached to lysine‐97. Finally, it could be shown that when superimposing the single profiles of the three major fractions obtained during a labeling procedure a qualitative picture of the net profile is obtained. Biotechnol. Bioeng. 2007; 98: 193–200. © 2007 Wiley Periodicals, Inc.
The concept of free will: philosophy, neuroscience and the law
Authors: Pockett Susan
Published: February 2007

Various philosophical definitions of free will are first considered. The compatibilist definition, which says simply that acts are freely willed if they are not subject to constraints, is identified as much used in the legal system and essentially impervious to scientific investigation. A middle‐ground “incompatibilist” definition, which requires that freely willed acts be consciously initiated, is shown to be relevant to the idea of mens rea and in the author's view not actually incompatible in principle with a fully scientific worldview. Only the strong libertarian definition, which requires that freely willed acts have no physical antecedents whatsoever, makes the existence of free will very hard to swallow scientifically. However, with regard to the middle‐ground “incompatibilist” definition, three different lines of scientific experimental evidence are then described, which suggest that, in fact, consciousness is not the real cause of much of what is generally considered as voluntary behavior. Many voluntary actions are initiated preconsciously, with consciousness kept informed only after the neural events leading to the act have begun. It is suggested that a reasonable way of integrating these experimental findings with the idea that persons do have a somewhat more than compatibilist version of free will is to acknowledge explicitly that a person is a mixture of conscious and unconscious components. In this scenario, the mind in mens rea would have to be judged guilty if it contained either conscious or unconscious intentions to perform the guilty act. Copyright © 2007 John Wiley & Sons, Ltd.
Magnetic properties of PLD‐fabricated ND‐Fe‐B film magnets and their applications to millimeter‐size motors
Authors: Nakano Masaki , Kato Ryutaro , Fukunaga Hirotoshi , Yamashita Fumitoshi
Published: February 2007

We succeeded in depositing 200‐ to 300‐µm‐thick Nd‐Fe‐B film magnets with (BH)max of approximately 55 kJ/m3 on Fe substrates by the PLD method. In addition, we confirmed that a millimeter‐size motor, which was prepared from the obtained film, rotates at 15,160 rpm under a no‐load test. © 2007 Wiley Periodicals, Inc. Electr Eng Jpn, 159(2): 1–6, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20215
A simple instant‐estimation method for time‐average quantities of single‐phase power and application to single‐phase power grid connection by inverter
Authors: Shinnaka Shinji
Published: February 2007

This paper presents and analyzes a new simple instant‐estimation method for time‐average quantities such as rms values of voltage and current, active and reactive powers, and power factor for single‐phase power with the fundamental component of constant or nearly constant frequency by measuring instantaneous values of voltage and current. According to the analyses, the method can instantly estimate time‐average values with accuracy of the fundamental frequency, and estimation accuracy of the power factor is about two times better than that of voltage, current, and powers. The instant‐estimation method is simple and can be easily applied to single‐phase power control systems that are expected to control instantly and continuously power factor on a single‐phase grid by inverter. Based on the proposed instant‐estimation method, two methods for such power control systems are also proposed and their usefulness is verified through simulations. © 2007 Wiley Periodicals, Inc. Electr Eng Jpn, 159(2): 34–43, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20236
Luminescent and Electronic Properties of Stilbenoid NCN‐Pincer PtII Compounds
Authors: Batema Guido D. , van de Westelaken Koen T. L. , Guerra Javier , Lutz Martin , Spek Anthony L. , van Walree Cornelis A. , de Mello Donegá Celso , Meijerink Andries , van Klink Gerard P. M. , van Koten Gerard
Published: February 2007

A series of novel 4,4′‐disubstituted organic–organometallic stilbenes were synthesized, that is, the 4′‐substituted stilbenoid–NCN‐pincer platinum(II) complexes [PtCl(NCN–R‐4)] (NCN–R‐4 = [C6H2(CH2NMe2)2‐2,6‐R‐4]– in which R = C2H2C6H4‐R′‐4′ with R′ = NMe2, OMe, SiMe3, H, I, CN, NO2) (1–7). In these compounds the PtCl grouping can be considered to be present as a donor substituent. Their synthesis involved a Horner–Wadsworth–Emmons reaction of [PtCl(NCN–CHO‐4)] (9) with the appropriate phosphonate ester derivatives (8a–g). Under these reaction conditions, the C–Pt bond in aldehyde 9 was not affected, and the platinated stilbene products were obtained in 53–90 % yield. The solid‐state structures of complexes 1, 2 and 5–7 were determined by single‐crystal X‐ray diffraction, which revealed interesting bent conformations for 2, 5 and 7. Linear correlations were found between both the 13C{1H} (C ipso to Pt) and the 195Pt{1H} NMR chemical shift and the Hammett σp value of the R′ substituent; therefore, these NMR shifts can be used as a qualitative probe for the electronic properties of the delocalized π‐system to which it is connected. The platinum–stilbene complexes were investigated for charge‐transfer properties in solvents of different polarity. The luminescent properties, shown by donor–acceptor complexes 1, 6 and 7, were investigated by fluorescence spectroscopy, and the complexes showed positive solvatochromism, which indicates dipolar character of the excited state. The excited state lifetimes, which were in the picosecond range, and the quantum yields (ranging from 0.002 to 0.2) were also determined for these complexes. It was established that the presence of the transition metal favours nonradiative decay from the excited state to the ground state.(© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007)
A New and Efficient Heterogeneous System for the Phthalimide N‐Oxyl (PINO) Radical Generation
Authors: Coseri Sergiu
Published: February 2007

Sodium periodate/wet silica gel in the presence of dichloromethane is an efficient reagent at room temperature for the phthalimide N‐oxyl (PINO) radical generation from its precursor N‐hydroxyphthalimide (NHPI). PINO reactions with cycloalkenes occur exclusively by a “pure” radical mechanism, contrasting with PINO's behavior when it is generated using lead tetraacetate.(© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007)
Age comparison of treatment adherence with antipsychotic medications among individuals with bipolar disorder
Authors: Sajatovic Martha , Blow Frederic C. , Kales Helen C. , Valenstein Marcia , Ganoczy Dara , Ignacio Rosalinda V.
Published: February 2007

Background

Few studies have evaluated medication adherence among older vs younger individuals with bipolar disorder (BPD). We compared adherence with antipsychotic medication among older (age 60 and older) and younger individuals using a large case registry (n = 73,964).

Methods

Adherence was evaluated using the medication possession ratio (MPR) for patients receiving antipsychotic medication.

Results

Twenty six thousand five hundred and thirty younger individuals (mean age 46.9) and 6,461 older individuals (mean age 69.2) were prescribed antipsychotic medication. Among older individuals, 61.0% (n = 3,350) were fully adherent, while 19.0% (n = 1,043) were partially adherent and 20.0% (n = 1,098) were non‐adherent. Among younger individuals, 49.5% (n = 10,644) were fully adherent, while 21.8% (n = 4,680) were partially adherent, and 28.7% (n = 6,170) were non‐adherent. As with younger patients, comorbid substance abuse and homelessness predicted non‐adherence among older patients with BPD.

Conclusion

Older individuals with BPD were more adherent with antipsychotic medications compared to younger individuals. However, a substantial proportion (approximately 39%) of older patients with BPD still have difficulties with adherence. Copyright © 2007 John Wiley & Sons, Ltd.
Fabrication and characterization of hydrophilic electrospun membranes made from the block copolymer of poly(ethylene glycol‐co‐lactide)
Authors: Yang De‐Juan , Zhang Li‐Fang , Xu Liang , Xiong Cheng‐Dong , Ding Jing , Wang Yu‐Zhong
Published: February 2007

To improve the hydrophilicity, pliability, and egradability of some biodegradable polymers such as polylactide (PLA), a triblock copolymer, and poly(ethylene glycol‐co‐lactide) (PELA) has been electrospun into fibrous membranes in the fiber sizes of 7.5 μm to 250 nm. The relationship between electrospinning parameters (such as voltage, concentration, and feeding rate) and the fiber diameters has been investigated. The characterizations for the structure and morphology of electrospun membranes were carried out using differential scanning calorimetry (DSC), 1H NMR, and scanning electron microscopy (SEM). The hydrophilicity of the membrane was determined by contact angle measurements in bidistilled water, and it was shown that the hydrophilicity of the copolymer could be adjusted by the content of the poly (ethylene glycol) (PEG) segment in the copolymer. The results of in vitro degradation study showed that the submicrostructure of the fibrous membrane and the incorporation of hydrophilic PEG into PLA block could accelerate the degradation of the membrane in regards to the changes of inherent viscosity, tensile strength, and weight loss. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res 2007
Biaxial flexural modulus of antibiotic‐impregnated orthopedic bone cement
Authors: Leone James , Johnson Amy , Ziada Samir , Hashemi Ata , Adili Anthony , de Beer Justin
Published: February 2007

Previously reported antibiotic‐impregnated cement strengths have been based on uniaxial and fatigue testing methodologies. These methods may not provide an accurate characterization of bone cement's true load‐bearing capacity in total joint replacement (TJR). The present study utilized biaxial testing to report on the properties of antibiotic‐impregnated cement. Test groups included: PMMA mixed with Vancomycin, Gentamicin, Tobramycin, or no antibiotic (control). In comparison to the control group, PMMA samples mixed with powdered gentamicin resulted in an increase in the mean elastic modulus by 6.50% versus a drop noted with powdered vancomycin and tobramycin by 2.65 and 1.37% respectively. The mean elastic modulus in samples containing liquid gentamicin dropped by 11.6%. This study supports the continued use of powdered antibiotics when clinically indicated, but suggest caution in the use of liquid gentamicin in TJR. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2007
Erratum: Women entrepreneurs in the Gambia: challenges and opportunities
Authors: Della‐Giusta Marina , Phillips Christine
Published: February 2007

Women Entrepreneurs in the Gambia: Challenges and Opportunities. M. Della‐Giusta, C. Phillips. Journal of International Development (18)8: 1051–1064.

The authors should appear in the following order: ‘C. Phillips and M. Della‐Giusta’ and not ‘M. Della‐Giusta and C. Phillips’ as published.