bluuebunny/crossref_metadata_2025 huggingface dataset:
Accumulation of intracellular ascorbate from dehydroascorbic acid by astrocytes is decreased after oxidative stress and restored by propofol
Authors: Daskalopoulos Rina , Korcok Jasminka , Tao Lei , Wilson John X.
Published: October 2002

Primary rat astrocyte cultures absorbed dehydroascorbic acid from the medium and reduced it to intracellular ascorbate. Uptake of dehydroascorbic acid (5–200 μM) was inhibited only partially by glucose (10 mM). The remaining glucose‐insensitive component of dehydroascorbic acid uptake was inhibited reversibly by sulfinpyrazone (IC50 = 80 μM). Dehydroascorbic acid uptake was not mediated by Na+‐ascorbate cotransporters or volume‐sensitive anion channels because it was neither Na+‐dependent nor blocked by the channel antagonist, 4,4′‐diisothiocyanatostilbene‐2,2′‐disulfonic acid. Oxidative stress, induced in astrocytes by the lipophilic radical generator tert‐butyl hydroperoxide, decreased intracellular glutathione concentration and inhibited accumulation of intracellular ascorbate from dehydroascorbic acid. Subsequent administration of either the native antioxidant alpha‐tocopherol (200 μM) or anesthetic concentrations of the antioxidant sedative propofol (1–8 μM, administered 30 min after tert‐butyl hydroperoxide), did not change glutathione concentration but restored the ability of astrocytes to accumulate intracellular ascorbate from dehydroascorbic acid. These results are consistent with a novel mechanism of astrocytic ascorbate accumulation that is inhibited by lipophilic radicals and protected by lipophilic antioxidants such as propofol. GLIA 39:124–132, 2002. © 2002 Wiley‐Liss, Inc.
A new neuromodulatory pathway with a glial contribution mediated via A2a adenosine receptors
Authors: Nishizaki T. , Nagai K. , Nomura T. , Tada H. , Kanno T. , Tozaki H. , Li X.X. , Kondoh T. , Kodama N. , Takahashi E. , Sakai N. , Tanaka K. , Saito N.
Published: October 2002

A low concentration (10 nM) of adenosine potentiated hippocampal neuronal activity via A2a adenosine receptors without affecting presynaptic glutamate release or postsynaptic glutamatergic conductance. Adenosine inhibited glutamate uptake through the glial glutamate transporter, GLT‐1, via A2a adenosine receptors. In addition, adenosine stimulated GLT‐1‐independent glutamate release from astrocytes, possibly in response to a rise in intracellular Ca2+, via A2a adenosine receptors involving PKA activation. Those adenosine actions could lead to an increase in synaptic glutamate concentrations responsible for the potentiation of hippocampal neuronal activity. The results of the present study thus represent a novel neuromodulatory pathway with a glial contribution, bearing both inhibition of GLT‐1 function and stimulation of glial glutamate release, as mediated via A2a adenosine receptors. GLIA 39:133–147, 2002. © 2002 Wiley‐Liss, Inc.
The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer's disease patients
Authors: Schnaider Beeri Michal , Werner Perla , Davidson Michael , Noy Shlomo
Published: October 2002

Introduction

Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in Alzheimer's disease (AD) patients. They are a source of distress for the caregivers and one of the main reasons for nursing home placement, which is the major component of the cost of Alzheimer's disease. The aim of the present study was to assess the direct and indirect cost related to the care of BPSD within a prospective study examining the overall cost of AD in Israel.

Methods

Seventy‐one community dwelling AD patients were interviewed. Interviews covered information about the number of caregivers' hours invested in caring for the patient and amount of expenditure such as in‐house paid help and payments for day care. Effort devoted to BPSD was defined as the number of hours spent by primary and secondary caregivers in a typical week dealing with BPSD (managing aggression, pacing, attempts to leave the house under inappropriate circumstances, or comforting a hallucinating, depressed or anxious patient).

Results

The annual indirect cost for management of BPSD in an AD patient was approximately $2665—over 25% of the total annual indirect cost of care ($10 520). The annual direct cost of BPSD of an AD patient was approximately $1450—over 35% of the total annual direct cost of care ($3900).

Conclusions

Approximately 30% ($4115) of the total annual cost of AD ($14 420) is invested in the direct management of BPSD. Given the importance of BPSD as one of the main components of the cost of AD, future cost studies should be designed to measure the cost of specific components of BPSD and verify which are the most costly aspects of the disease. Despite the considerable methodological difficulties in disentangling the costs of the specific symptoms of AD, cost effectiveness studies of different interventions should be conducted in order to determine the optimal intervention with relation to cost. Copyright © 2002 John Wiley & Sons, Ltd.
Factors associated with antidepressant treatment in residential care: changes between 1990 and 1997
Authors: Arthur Antony , Matthews Ruth , Jagger Carol , Lindesay James
Published: October 2002

Background

Depression is common among older people living in residential and nursing homes. Detection and treatment of late life depression may be sub‐optimal in these settings.

Aim

To report the changes in, and factors associated with, antidepressant use among residents in care homes in 1990 and 1997.

Method

Censuses of those aged 65 years and over in any type of residential care in the county of Leicestershire, UK, on 27 November 1990 and 30 November 1997. Care staff were asked to complete an assessment form for each resident which included a rating of depression and use of antidepressants.

Results

The use of antidepressants increased from 11% (484/4415) in 1990 to 18.9% (777/4111) in 1997. Severity of depression as assessed by care staff, gender, younger age, better cognitive functioning, and use of other medications were consistently associated with antidepressant treatment. Antidepressant use was associated with better physical functioning (p = 0.001) in 1990 and frequency of falls in 1997 (p = 0.044).

Conclusions

Increased use of antidepressants appears to be due to the wider range of antidepressant drugs available since 1990. However there is a need for better methods for care staff to detect depression in residents, and for appropriate action to be taken by those responsible for their medical management. Copyright © 2002 John Wiley & Sons, Ltd.
Depression in subjects with and without dementia: a comparison using GMS‐AGECAT
Authors: Janzing Joost G. E. , Hooijer Chris , van 't Hof Martin A. , Zitman Frans G.
Published: October 2002

Objective

To compare depression in subjects with and without dementia, adjusting for possible confounders.

Background

The results of comparisons of depression between subjects with and without dementia are inconclusive. Probably confounders play a role.

Methods

Ninety‐one subjects with DSM‐III‐R dementia and 110 controls without dementia were recruited from homes for the elderly using an identical procedure. The prevalences of AGECAT depressive syndromes, subsyndromes and factors of depressive symptoms were compared adjusting for possible confounders.

Results

(1) Both groups had similar prevalences of AGECAT depressive syndromes, subsyndromes and overall rates of depressive symptoms; (2) subjects with dementia had significantly more ‘motivation symptoms’; and (3) there was a trend to a lower prevalence of ‘mood symptoms’ in subjects with dementia. These results refer to a sample of institutionalised elderly subjects. It is not clear to what extent they can be generalised to subjects living in the community.

Conclusion

The results indicate that it is not AGECAT (sub)syndrome measures of depression but the profile of depressive symptomatology which is affected by dementia. Copyright © 2002 John Wiley & Sons, Ltd.
Subjective sleep problems in later life as predictors of cognitive decline. Report from the Maastricht Ageing Study (MAAS)
Authors: Jelicic Marko , Bosma Hans , Ponds Rudolf W. H. M. , Van Boxtel Martin P. J. , Houx Peter J. , Jolles Jelle
Published: October 2002

Background

Although biological sleep criteria seem to be associated with cognitive changes in older people, it is not clear if subjective sleep parameters are related to cognitive decline in later life.

Objectives

The aim of this study was to determine whether subjective sleep complaints in a population‐based sample of 838 middle aged and older adults (≥ 50 years) predicted cognitive decline over a period of 3 years.

Methods

Sleep complaints at baseline, assessed with the subscale Sleep Problems of the Symptoms Checklist−90, were used as a predictor variable. Cognitive performance at follow‐up, measured with the Mini Mental Status Examination, was employed as a dependent variable.

Results

Controlling for the effects of age, gender, length of follow‐up interval, systemic diseases, and cognitive function at baseline, subjective sleep complaints were negatively associated with cognitive performance at follow‐up.

Conclusion

Subjective sleep complaints predict cognitive decline in middle aged and older adults. Mechanisms behind the effect of subjective sleep complaints on cognitive performance are discussed. Copyright © 2002 John Wiley & Sons, Ltd.
Reducing the burden of caring for Alzheimer's disease through the amelioration of ‘delusions of theft’ by drug therapy
Authors: Shigenobu Kazue , Ikeda Manabu , Fukuhara Ryuji , Maki Naruhiko , Hokoishi Kazuhiko , Nebu Akihiko , Komori Kenjiro , Tanabe Hirotaka
Published: October 2002

Background

Delusions of theft (delusions involving the theft of possessions) are one of the most frequent neuropsychiatric manifestations of Alzheimer's disease (AD).

Objective

The current study investigated the presence and extent of such delusions before and after drug treatment in a group of AD patients, and the consequent effects on the burden of care on caregivers.

Method

The study was an open‐label cohort design. The delusions studied consisted only of those involving theft of possessions. Sixteen AD patients served as subjects in order to assess the efficacy of Risperidone administration, in the reduction or elimination of these delusions. The caregiver burden was evaluated using the Zarit Caregiver Burden Interview (ZBI) before the administration of Risperidone and 12 weeks after administration, for cases where delusions of theft were eliminated or reduced.

Results

The burden of care on caregivers was significantly reduced (p < 0.001) through the elimination or reduction of delusions of theft.

Conclusion

Delusions of theft are considered to be a major factor in increasing the burden of care, and the treatment of these, through appropriate drug therapy, is therefore of great importance in the continuation of satisfactory care in the home. Copyright © 2002 John Wiley & Sons, Ltd.
Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study
Authors: Holmes Clive , Hopkins Vivienne , Hensford Christine , MacLaughlin Vanessa , Wilkinson David , Rosenvinge Henry
Published: October 2002

Objective

To determine whether aromatherapy with lavender oil is effective in the treatment of agitated behaviour in patients with severe dementia.

Design

A placebo controlled trial with blinded observer rater.

Setting

A long‐stay psychogeriatric ward.

Patients

Fifteen patients meeting ICD‐10 diagnostic criteria for severe dementia and suffering from agitated behaviour defined as a minimum score of three points on the Pittsburgh Agitation Scale (PAS).

Intervention

A 2% lavender oil aromatherapy stream was administered on the ward for a two hour period alternated with placebo (water) every other day for a total of ten treatment sessions.

Assessments

For each subject 10 total PAS scores were obtained. Five during treatment and five during placebo periods.

Results

Nine patients (60%) showed an improvement, five (33%) showed no change and one patient (7%) showed a worsening of agitated behaviour during aromatherapy compared with placebo. A comparison of the group median PAS scores during aromatherapy showed a significant improvement in agitated behaviour during aromatherapy compared with placebo (median PAS scores 3 c.f. 4; Wilcoxon Signed‐Ranks test p = 0.016 (one‐tailed)).

Conclusions

Lavender oil administered in an aroma stream shows modest efficacy in the treatment of agitated behaviour in patients with severe dementia. Copyright © 2002 John Wiley & Sons, Ltd.
Ten‐point clock test: a correlation analysis with other neuropsychological tests in dementia
Authors: Moretti Rita , Torre Paola , Antonello Rodolfo M. , Cazzato Giuseppe , Bava Antonio
Published: October 2002

Background

Neuropsychology can be useful for differentiating patients with fronto‐temporal dementia (FTD) from those with Alzheimer disease (AD) and those with Vascular Dementia (VaD).

Objectives

The purpose of this study was twofold: to explore possible employment of the Ten‐Point Clock Test in early identification of different types of cognitive distribution and to relate to its execution to other specific impairment, bound to the selected pathology.

Method

We compared 30 patients with FLD, to a group of 30 probable‐AD patients accordingly to the NINCDS‐ADRDA criteria, and to a group of 30 probable VaD patients, according to the NINDS‐AIREN criteria.

Results

AD group showed the worst results in Clock Drawing Test. On the contrary, FLD group did produce the worst performances in Proverb Interpretation Tasks. VaD worst performance was that of phonological fluency. Our data seem to demonstrate that in mild dementia, stated by the MMSE score (around 22) and confirmed by the data derived from the other neuropsychological evaluation, the Clock Drawing Test is quite sensitive to detect cognitive impairment, even if of different origins.

Conclusions

Ten‐Point Clock Test is a strong tool, in order to identify early forms of Alzheimer, and to help differential diagnosis when frontal or vascular dementia have been taken into account. More data will be necessary to give to this speculative interpretation, a neuroimaging and neuroanatomical support. However, this report may encourage the wider use of this parametric test, easily applicable and well accepted by the population in order to implement data concerning cognitive disruption. Copyright © 2002 John Wiley & Sons, Ltd.
Predictive factors of acute hospitalization in 134 patients with Alzheimer's disease: a one year prospective study
Authors: Andrieu Sandrine , Reynish Emma , Nourhashemi Fati , Shakespeare Annabelle , Moulias Sophie , Ousset Pierre Jean , Sagnier Pierre , Richard Alain , Albarede Jean‐Louis , Vellas Bruno
Published: October 2002

Objective

To evaluate the frequency of and determine predictive factors for acute hospitalization in a prospective study of patients with Alzheimer's disease (AD).

Design

A one year prospective study.

Participants

134 patients recruited from the memory clinic in Toulouse University Hospital, with AD diagnosed using the NINCDS‐ADRDA criteria.

Measures

A comprehensive geriatric and neuropsychological assessment was conducted 6 monthly.

Results

Among the 134 patients included in this study, at one year follow up, 32 patients had at least one acute hospitalization. Patient‐related variables predictive of acute hospitalization in the univariate analysis were: level of education, ADL‐bathing, ADL‐toileting, ADL‐feeding, total ADL score, IADL A scale (daily upkeep), history of falls, and level of behavioural disorder as measured by the Cohen scale. In the multivariate regression model, two variables were associated with acute hospitalization: dependency for ADL‐bathing [Odds Ratio (OR) = 5.65, 95% Confidence Intervals (CI): 2.3–14.4] and low level of education.

Conclusion

The results of this study demonstrate that acute hospitalization is frequent in AD patients resulting in considerable cost implications. Interventions that support patients and their cares to manage their loss of ADL may be a practical approach to reducing the need for acute hospital admissions. Copyright © 2002 John Wiley & Sons, Ltd.
Sodium valproate in the treatment of aggressive behavior in patients with dementia—a randomized placebo controlled clinical trial
Authors: Sival Rob C. , Judith Haffmans P. M. , Jansen Paul A. F. , Duursma Sijmen A. , Eikelenboom Piet
Published: October 2002

Objectives

The efficacy and tolerability of sodium valproate 2×240 mg compared to placebo were investigated in aggressive behavior in dementia.

Design

A randomized, placebo controlled, double‐blind cross‐over design. The trial included a baseline period (one week); a placebo period (three weeks); a wash‐out period with placebo (one week); and a treatment period with sodium valproate (three weeks).

Setting

A psychogeriatric short‐stay ward at a psychiatric teaching hospital.

Participants

Demented patients who met Patel's criteria for aggressive behavior and had a score of ≥3 on at least one of the items of the Social Dysfunction and Aggression scale‐9 (SDAS‐9).

Intervention

A fixed dose of sodium valproate 2×6 ml of a 40 mg/ml suspension (daily defined dose of 480 mg) was compared to placebo.

Measurements

Primary outcome variables were changes of the score of SDAS‐9 and Clinical Global Impression scale (CGI) performed at the last week of each treatment period.

Results

Data of 42 patients (F=25 and M=17; age 80.4±6.8 years) were analyzed. Treatment with sodium valproate showed no differences compared to placebo on aggressive behavior. The mean plasma level of sodium valproate was 40.9±10.8 μg/ml. Regression analysis showed a trend for improvement between the plasma levels of sodium valproate and the SDAS‐9 and the CGI scores. Adverse events were not related to the plasma levels of sodium valproate. Secondary outcome measurements showed significant improvement on restless, melancholic and anxious behavior; a trend for improvement was found on suspicious and dependent behavior.

Possible limitations of this study are the low dose of sodium valproate, the relatively short treatment period (three weeks), and the absence of statistical corrections for multiple comparisons.

Conclusion

This study showed no effect of sodium valproate 2×240 mg over placebo on aggressive behavior in dementia. Copyright © 2002 John Wiley & Sons, Ltd.
Mismatch responses to randomized gradient switching noise as reflected by fMRI and whole‐head magnetoencephalography
Authors: Mathiak Klaus , Rapp Alexander , Kircher Tilo T.J. , Grodd Wolfgang , Hertrich Ingo , Weiskopf Nikolaus , Lutzenberger Werner , Ackermann Hermann
Published: October 2002

The central auditory system of the human brain uses a variety of mechanisms to analyze auditory scenes, among others, preattentive detection of sudden changes in the sound environment. Electroencephalography (EEG) and magnetoencephalography (MEG) provide a measure to monitor neuronal cortical currents. The mismatch negativity (MMN) or field (MMNm) reflect preattentive activation in response to deviants within a sequence of homogenous auditory stimuli. Functional magnetic resonance imaging (fMRI) allows for a higher spatial resolution as compared to the extracranial electrophysiological techniques. The image encoding gradients of echo planar imaging (EPI) sequences, however, elicit an interfering background noise. To circumvent this shortcoming, the present study applied multi‐echo EPI mimicking an auditory oddball design. The gradient trains (SOA = 800 msec, 94.5 dB SPL, stimulus duration = 152 msec) comprised amplitude (−9 dB) and duration (76 msec) deviants in a randomized sequence. Moreover, the scanner noise was recorded and applied in a whole‐head MEG device to validate the properties of this specific material. Robust fMRI activation patterns emerged in response to the deviant gradient switching. Changes in amplitude activated the entire auditory cortex, whereas the duration deviants elicited right‐lateralized signal increase in secondary areas. The recorded scanner noise evoked reliably right‐lateralized mismatch MEG responses. Source localization was in accordance with activation of secondary auditory cortex. The presented paradigm provides a robust and feasible tool to study the functional anatomy of early cognitive auditory processing in clinical populations such as schizophrenia. Hum. Brain Mapping 16:190–195, 2002. © 2002 Wiley‐Liss, Inc.
Phosphorus‐containing dendrimers: From material science to biology
Authors: Majoral Jean‐Pierre , Caminade Anne‐Marie , Laurent Régis , Sutra Pierre
Published: October 2002

Various methods of synthesis of phosphorus‐containing dendrimers are described. The reactivity of several of these macromolecules is then studied at several levels, mainly on the surface, and also at the level of the branches and of the core. Functionalizations confer to these macromolecules interesting properties, and allow the development of new applications, which are emphasized in this review. © 2002 Wiley Periodicals, Inc. Heteroatom Chem 13:474–485, 2002; Published online in Wiley Interscience (www.interscience.wiley.com). DOI 10.1002/hc.10075
Asymmetric synthesis of alkaloids using polyfunctionalized chiral building blocks
Authors: Davis Franklin A. , Chao Bin , Andemichael Yemane W. , Mohanty Pradyumna K. , Fang Tianan , Burns David M. , Rao Ashwin , Szewczyk Joanna M.
Published: October 2002

Enantiopure N‐sulfinyl‐δ‐amino‐β‐ketoesters and isoquinolones, prepared from sulfinimines (N‐sulfinyl imines) are a new class of polyfunctionalized chiral building blocks. These building blocks provide easy access to enantiomerically pure, functionalized piperidines and tetrahydroisoquinolines with a minimum of chemical manipulation and protecting‐group chemistry. © 2002 Wiley Periodicals, Inc. Heteroatom Chem 13:486–492, 2002; Published online in Wiley Interscience (www.interscience.wiley.com). DOI 10.1002/hc.10090
Social risk management options for medical care in Indonesia
Authors: Pradhan Menno , Prescott Nicholas
Published: October 2002

This paper investigates the extent to which price subsidies for medical care are a suitable instrument to reduce household's exposure to catastrophic financial risks associated with ill‐health in Indonesia. Using the 1995 SUSENAS household survey, the observed distribution of user fees and health expenditures is used to derive a distribution of ‘needed’ medical expenditures. The trade‐off between the tax burden and effectiveness in reducing the exposure to catastrophic risk is analyzed for two existing price regimes along with a number of hypothetical regimes.

We find that the existing regimes significantly reduce the exposure to catastrophic shocks but do not eliminate them. Simulations suggest that further reductions could be achieved if a larger proportion of government subsidies were directed to inpatient care. Subsidizing outpatient treatment is a cost effective policy to reduce exposure to catastrophic risks only for the very poor. Copyright © 2002 John Wiley & Sons, Ltd.
Supraomohyoid neck dissection in the management of cervical lymph node metastases of squamous cell carcinoma of the lower lip
Authors: Gooris Peter J. J. , Vermey Albert , de Visscher Jan G. A. M. , Burlage Fred R. , Roodenburg Jan L. N.
Published: October 2002

Background

Supraomohyoid neck dissection (SOHND) is generally considered an adequate staging procedure in selected patients with squamous cell carcinoma (SCC) of the lip and oral cavity, with clinically negative nodes in the neck that are at increased risk for occult metastatic disease. The potential role of SOHND as a therapeutic surgical procedure for cervical metastasis limited to level I is controversial.

Methods

A series of 44 patients with clinical cervical lymph node metastases at level I from SCC of the lower lip is reported to evaluate the results of a treatment protocol consisting of therapeutic SOHND on indication followed by radiotherapy.

Results

Regional recurrences were observed in four (9%) patients. All recurrences developed within the SOHND dissected area only.

Conclusions

A therapeutic SOHND, on indication followed by radiotherapy, can be an oncologically sound and effective procedure in the management of regional lymph node metastases at level I from SCC of the lower lip. © 2002 Wiley Periodicals, Inc. Head Neck 24: 678–683, 2002
Pendred's syndrome with goiter and enlarged vestibular aqueducts diagnosed by PDS gene mutation
Authors: Ishinaga Hajime , Shimizu Takeshi , Yuta Atsushi , Tsukamoto Koji , Usami Shin‐ichi , Majima Yuichi
Published: October 2002

Background

Pendred's syndrome (PS) is an autosomal recessive disorder characterized by goiter and congenital sensorineural hearing loss. Recent advances in molecular biology revealed the gene responsible for PS (PDS) and provided an important aid for the diagnosis of this condition.

Methods

A case of PS with huge goiter and congenital hearing impairment was diagnosed by mutational analysis of the PDS gene.

Results

Physical examination and computer tomography CT revealed a diffuse swelling of the thyroid gland. Thyroid function tests were normal, and the perchlorate discharge test was negative. Audiologic examination confirmed sensorineural hearing loss, and temporal bone CT revealed bilateral enlarged vestibular aqueducts. The mutational analysis revealed that the patient was homozygous for His 723 Arg (2168A→G) in exon 19, a missense mutation.

Conclusions

The results of thyroid function tests in PS patients are usually normal, and the positive perchlorate discharge test has been used for the diagnosis. However, this is a nonspecific test and is not sensitive enough for PS. In our case, despite a negative perchlorate test, the patient was diagnosed by mutational analysis and received total thyroidectomy to relieve respiratory distress caused by thyroid enlargement. This is the first report of a mutation detected in the thyroid tissue and clearly shows that the mutation caused histopathologic change in that gland. © 2002 Wiley Periodicals, Inc.
Swallow function and perception of dysphagia in patients with head and neck cancer
Authors: Pauloski Barbara Roa , Rademaker Alfred W. , Logemann Jerilyn A. , Lazarus Cathy L. , Newman Lisa , Hamner Annette , MacCracken Ellen , Gaziano Joy , Stachowiak Linda
Published: October 2002

Background

The relationship between subjective complaints of dysphagia and objective measures of swallow function in patients with cancers of the oral cavity, pharynx, or larynx, treated with radiotherapy ± chemotherapy has not been well documented in the literature.

Methods

Swallowing function in 132 patients with various lesions was evaluated using videofluoroscopy and analyzed by patient complaint of dysphagia grouping.

Results

Patients with complaints of dysphagia demonstrated significantly worse swallow function as indicated by lower oropharyngeal swallow efficiency (OPSE), longer transit times, larger residues, and more swallows with aspiration. Patients with complaints of dysphagia also tended to take less of their nutrition by mouth and less variety of food consistencies in their diet compared with those without complaint.

Conclusions

Patients were able to perceive decrements in their swallowing function as dysphagia and may have limited their oral intake in response to that perception. The ability to accurately perceive swallowing function may be useful for self‐monitoring changes in dysphagia status during a course of swallow therapy. © 2002 Wiley Periodicals, Inc. Head Neck 24: 555–565, 2002
Prognostic factors of clinically stage I and II oral tongue carcinoma—A comparative study of stage, thickness, shape, growth pattern, invasive front malignancy grading, martinez‐gimeno score, and pathologic features
Authors: Po Wing Yuen Anthony , Lam King Yin , Lam Lai Kun , Ho Chiu Ming , Wong Anna , Chow Tam Lin , Yuen Wah Fun , Wei William Ignace
Published: October 2002

Purpose

This study aims at evaluation of the different prognostic models, including stage, tumor thickness, shape, malignancy grading of tumor invasive front, Martinez‐Gimeno score, and pathologic features in the prediction of subclinical nodal metastasis, local recurrence, and survival of early T1 and T2 oral tongue squamous cell carcinoma. The results will have important implication for the management of patients.

Patients and Methods

Seventy‐two clinically T1 and T2 glossectomy specimens of oral tongue carcinoma were serially sectioned in 3‐mm thickness for the evaluation of various pathologic features. The prognostic value in the prediction of subclinical nodal metastasis, local recurrence, and survival of different models were compared.

Results

Among all the tumor parameters and predictive models being evaluated, tumor thickness was the only significant factor that had significant predictive value for subclinical nodal metastasis, local recurrence, and survival. With the use of 3‐mm and 9‐mm division, tumor of up to 3‐mm thickness has 8% subclinical nodal metastasis, 0% local recurrence, and 100% 5‐year actuarial disease‐free survival; tumor thickness of more than 3 mm and up to 9 mm had 44% subclinical nodal metastasis, 7% local recurrence, and 76% 5‐year actuarial disease‐free survival; tumor of more than 9 mm had 53% subclinical nodal metastasis, 24% local recurrence, and 66% 5‐year actuarial disease‐free survival.

Conclusions

Tumor thickness should be considered in the management planning of patients with early oral tongue carcinoma. © 2002 Wiley Periodicals, Inc. Head Neck 24: 513–520, 2002
Interval pathologic assessments in patients treated with concurrent hyperfractionated radiation and intraarterial cisplatin (HYPERRADPLAT)
Authors: Valentino Joseph , Spring Paul M. , Shane Matthew , Arnold Susanne M. , Regine William F.
Published: October 2002

Background

To minimize surgical morbidity, surgery should be performed within 2 to 3 months of completion of radiation therapy with or without chemotherapy. Pathologic demonstration of cancer at this interval is commonly used to justify early surgical salvage of residual primary head and neck cancer. These assumptions regarding head and neck cancer in patients treated with concurrent hyperfractionated radiation therapy and intraarterial supradose cisplatin (HYPERRADPLAT) have never been evaluated.

Methods

Post‐HYPERRADPLAT clinical and pathologic findings in 42 patients with stage III and IV head and neck cancer were compared with their disease outcomes. All patients underwent an interval analysis of response at 6 to 10 weeks after completion of therapy, 28 of these patients had biopsies of the primary tumor site performed.

Results

Clinical findings of cancer with pathologic confirmation up to 4 months after therapy can be associated with eventual complete response (CR). Pathologic CR's from deep incisional biopsies can be associated with recurrent disease within 2 months. Six HYPERRADPLAT‐treated patients underwent interval surgical resection of primary disease, and only the four patients with cancer identified in the resection specimen died of recurrent disease.

Conclusion

In patients treated with HYPERRADPLAT, interval clinical and pathologic assessments may be misleading. Only observation of progressive disease is an accurate predictor of local failure. New evaluation techniques such as metabolic imaging and molecular analysis warrant exploration as tools for interval cancer evaluations. © 2002 Wiley Periodicals, Inc. Head Neck 24: 539–544, 2002
An ex vivo study exploring the diagnostic potential of 1H magnetic resonance spectroscopy in squamous cell carcinoma of the head and neck region
Authors: El‐Sayed Samy , Bezabeh Tedros , Odlum Olva , Patel Rakesh , Ahing Stephen , MacDonald Kelly , Somorjai Ray L. , Smith Ian C. P.
Published: October 2002

Background

Definitive diagnosis of head and neck cancer is generally made by histopathologic evaluation. Management and prognosis largely depend on accurate and timely diagnosis. We have explored the use of 1H magnetic resonance spectroscopy in search of a better or complementary diagnostic technique.

Methods

Tumor and adjacent normal tissue specimens (n = 135) from untreated head and neck cancer patients (n = 40) were obtained and subjected to spectroscopic evaluation followed by histopathologic analysis. Data were partitioned into training and test sets and subjected to multivariate analysis.

Results

The resonances from taurine, choline, glutamic acid, lactic acid, and lipid were found to have diagnostic potential by our optimal region selection algorithm. Multivariate analysis of the spectral data differentiated between normal and malignant tissues, with an overall accuracy of 92.6% (training set, 97.3%; test set, 87.3%), an overall sensitivity of 93% (test set, 90%), and an overall specificity of 92% (test set, 82.6%).

Conclusions

1H magnetic resonance spectroscopy combined with multivariate methods of analysis can distinguish between normal and malignant squamous cell tissue, and this may lead to the development of an objective and noninvasive diagnostic procedure. © 2002 Wiley Periodicals, Inc. Head Neck 24: 766–772, 2002
Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue
Authors: Kurokawa Hideo , Yamashita Yoshihiro , Takeda Shinobu , Zhang Min , Fukuyama Hiroshi , Takahashi Tetsu
Published: October 2002

Background

Many histopathologic parameters in squamous cell carcinoma of the tongue have been identified as predictive factors for cervical lymph metastasis. However, predictive factors for occult cervical lymph node metastases and the criterion for elective therapy remain inconclusive. This study analyzed the clinicopathologic factors associated with late cervical lymph node metastases in patients with carcinoma of the tongue.

Methods

The clinicopathologic features of 50 consecutive patients seen between January 1985–December 1996 with previously untreated stage I or II squamous cell carcinoma of the tongue were reviewed. All patients were treated with partial glossectomy without elective neck dissection. Their mean age was 54.5 y (range, 23–90 y) and the male–female ratio was 1.2:1 (27 men and 23 women); 30 cases were stage I, and 20 cases were stage II. Clinicopathologic factors were analyzed to determine factors predicting late cervical lymph node metastasis.

Results

The overall cervical lymph node metastasis rate was 14.0% (7 of 50). Clinicopathologic factors significantly associated with the development of cervical lymph node metastasis were tumor size (≥30 mm), tumor depth (≥4 mm), differentiation, mode of invasion, microvascular invasion, and histologic grade of malignancy. In a multivariate logistic regression analysis, moderately differentiated squamous cell carcinoma of the tongue with tumor depth ≥4 mm had predictive value for late cervical lymph node metastasis and diminished overall survival (odds ratio, 10.0;p= .02; hazards ratio, 7.0;p= .039).

Conclusions

The findings of this study demonstrate tumor depth ≥4 mm moderately differentiated squamous cell carcinoma of the tongue have a substantially higher rate of late cervical metastases. In the basis of these data, it is our recommendation that this be used in the decision to electively treat the neck. © 2002 Wiley Periodicals, Inc. Head Neck 24: 731–736, 2002
Enhancement of temporal and spatial synchronization of entorhinal gamma activity by phase reset
Authors: Dickson Clayton T. , de Curtis Marco
Published: October 2002

The synchronization of cortical gamma oscillatory activity (25–80 Hz) is thought to coordinate neuronal assemblies in the processing and storage of information. The mechanism by which independently oscillating and distantly located cortical zones become synchronized is presumed to involve activity in corticocortical connections, although evidence supporting this conjecture has only been indirect. In the present study, we show that activation of synaptic inputs within and to the medial entorhinal cortex (mEC) of the in vitro isolated guinea pig brain preparation resets the phase of ongoing gamma activity induced by muscarinic receptor agonism with carbachol (frequency: 24 ± 2 Hz at 32°C). Phase reset was associated with a transient enhancement of the synchronization of gamma activity recorded at distant (>1 mm) mEC sites, across which low coherence (>0.75) was observed before stimulation. This increase in synchronization, as measured by cross‐correlation analysis, was restricted to a maximal period of 200 ms after either local mEC or CA1 afferent stimulation. The results provide direct evidence that synaptic activation can enhance the rhythmic synchronization of spatially remote, independently oscillating neuronal assemblies in the mEC through a mechanism of synaptically evoked phase reset. Dynamic functional grouping of oscillatory discharges across long distances in the mEC may underlie coding processes involved in the integration and storage of incoming information and thus may be important for the role of this region in memory processes. Hippocampus 2002;12:447–456. © 2002 Wiley‐Liss, Inc.
Prediction of the capacity of a heat exchanger by a thermal network method: Modified effective specific heat model considering the influence of static pressure distributions of refrigerants
Authors: Kaga Kunihiko , Yamada Kenichi , Kotoh Satoru , Ogushi Teturo
Published: October 2002

In this paper, we proposed a method to predict the capacity of a heat exchanger by considering static pressure distributions of refrigerants. The thermal network method was modified by adding an equivalent heat generation term into a heat balance equation that was connected with calculated 1D static pressure distributions of refrigerants. An experiment was performed with a heat exchanger having two rows and two passes to verify the accuracy of the proposed method. The result showed the error of the predicted capacity to be less than 1% for an evaporator and less than 2% for a condenser. © 2002 Wiley Periodicals, Inc. Heat Trans Asian Res, 31(5): 376–390, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/htj.10039
Numerical study of radiation‐convection heat transfer
Authors: Taniguchi Hiroshi , Ohmori Toshiaki , Iwata Misao , Arai Norio , Hiraga Kenji , Yamaguchi Shun‐ichi
Published: October 2002

In this study, the authors attempted to introduce a simulation technique for radiation‐convection heat transfer in the high‐temperature fields of industrial furnaces, boilers, and gas turbine combustors. The convection effect was analyzed by a differential equation, but the radiation effect was analyzed by an integral equation. Thus, it was not easy to arrange both effects using the same type of equations. Then, the authors introduced the zone method and Monte Carlo method for the integral equation of the radiation effect and the finite difference method for the differential equation of the convection effect. A three‐dimensional analysis of the high‐temperature furnace was performed by this simulation technique to obtain its temperature distribution. Furthermore, another radiation‐convection heat transfer analysis in the low‐temperature living room was performed by the same technique. Finally, the authors tried to develop a computer software for radiation‐convection heat transfer and described their idea of software construction for the above. © 2002 Wiley Periodicals, Inc. Heat Trans Asian Res, 31(5): 391–407, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/htj.10042
A review of the pharmacokinetics, tolerability and pharmacodynamics of amisulpride in healthy volunteers
Authors: Rosenzweig P. , Canal M. , Patat A. , Bergougnan L. , Zieleniuk I. , Bianchetti G.
Published: October 2002

Amisulpride binds selectively to dopamine D2 and D3 receptors in the limbic system. Low doses of amisulpride preferentially block presynaptic D2/D3‐dopamine autoreceptors, thereby enhancing dopaminergic transmission, whereas higher doses block postsynaptic receptors, thus inhibiting dopaminergic hyperactivity. Amisulpride is clinically effective on the negative symptoms of acute schizophrenia exacerbations at low dosages (50–300 mg/day), and also on the positive symptoms of the disease at high dosages (400–800 mg/day). Nineteen clinical studies involving 358 volunteers have investigated the pharmacokinetics, pharmacodynamics and tolerability of amisulpride. Amisulpride shows linear pharmacokinetics, a bioavailability of 48%, low protein binding (17%) and an elimination half‐life of ∼12 h. It is predominantly eliminated in the urine as the parent compound. It exhibits no significant detrimental effects in psychometric or memory tests up to the dose of 400 mg/day, inducing only mild impairment at high doses, whereas EEG data suggest an alertness‐enhancing effect at low doses (≤ 50 mg). Moreover, amisulpride does not potentiate the depressant effects on the central nervous system of alcohol and lorazepam. This tolerability profile is clearly better than that of haloperidol 4 mg/day and is consistent with a weak blocking effect on striatal D2 receptors. In summary, studies in humans have shown that amisulpride is free of behavioural toxicity at doses exerting clear antipsychotic efficacy and confirm that its CNS effects may vary with the dose administered. Copyright © 2002 John Wiley & Sons, Ltd.
Fluvoxamine augmentation in risperidone‐resistant schizophrenia: an open trial
Authors: Takashi Hitoshi , Sugita Takio , Higuchi Hisashi , Shimizu Tetsuo
Published: October 2002

We investigated the efficacy and safety of augmenting risperidone with fluvoxamine for the treatment of residual positive and negative symptoms in patients with chronic schizophrenia who had shown an incomplete response to risperidone. A total of 30 patients completed the open trial over a 12‐week period during which fluvoxamine was added to risperidone. The result from the positive and negative syndrome scale (PANSS) and Simpson‐Angus extrapyramidal effects (S‐A) scale were examined at baseline, 1, 2, 4, 8 and 12 weeks of treatment. There were no significant differences in PANSS positive, negative and general psychopathology scores, or in S‐A scale scores at any point during the treatment. These results suggest that fluvoxamine appears to be ineffective in augmenting the risperidone treatment response in chronic schizophrenic patients. Further controlled trials will be needed to confirm this observation. Copyright © 2002 John Wiley & Sons, Ltd.
Modelling plumes of overland flow from logging tracks
Authors: Hairsine P. B. , Croke J. C. , Mathews H. , Fogarty P. , Mockler S. P.
Published: October 2002

Most land‐based forestry systems use extensive networks of unsealed tracks to access the timber resource. These tracks are normally drained by constructing cross‐banks, or water bars, across the tracks immediately following logging. Cross‐banks serve three functions in controlling sediment movement within forestry compartments:

they define the specific catchment area of the snig track (also known as skid trails) so that the overland flow does not develop sufficient energy to cause gullies, and sheet and rill erosion is reduced;

they induce some sediment deposition as flow velocity reduces at the cross‐bank;

they redirect overland flow into the adjacent general harvesting area (GHA) so that further sediment deposition may take place.

This paper describes a simple model that predicts the third of these functions in which the rate of runoff from the track is combined with spatial attributes of the track and stream network. Predictions of the extent of the overland flow plumes and the volume of water delivered to streams is probabilistically presented for a range of rainfall‐event scenarios with rainfall intensity, time since logging and compartment layout as model inputs. Generic equations guiding the trade‐off between intercross‐bank length and flow path distance from cross‐bank outlet to the stream network needed for infiltration of track runoff are derived. Copyright © 2002 John Wiley & Sons, Ltd. Copyright © 2002 John Wiley & Sons, Ltd.
A hydrological tracer experiment with LiCl in a high mountain lake
Authors: Thies Hansjörg , Nickus Ulrike , Arnold Christoph , Psenner Roland
Published: October 2002

The water residence time of the high mountain seepage lake Gossenköllesee (2413 m, Tyrol, Austria) was determined by measuring the flushing rate of a tracer substance. During holomixis in July 1997, when circulation occurred throughout the entire water column, a dilute lithium chloride solution was injected into the lake causing the lithium concentration to rise from the background value of 0·06 to 3·1 μg L−1. The water residence time was derived from the exponential decline of the lithium mass in the lake between July and October holomixis. The water residence time was about 2 months, i.e. the lake volume was exchanged twice between the two periods of holomictic conditions. Copyright © 2002 John Wiley & Sons, Ltd.
Reservoir operation using grey fuzzy stochastic dynamic programming
Authors: Chang Fi‐John , Hui Shyh‐Chi , Chen Yen‐Chang
Published: October 2002

This paper presents an optimal regulation programme, grey fuzzy stochastic dynamic programming (GFSDP), for reservoir operation. It is composed of a grey system, fuzzy theory and dynamic programming. The grey system represents data by covering the whole range without loss of generality, and the fuzzy arithmetic takes charge of the rules of reservoir operation. The GFSDP deals with the multipurpose decision‐making problem by fuzzy optimization theorem. The practicability and effectiveness of the proposed approach is tested on the operation of the Shiman reservoir in Taiwan. The current M5 operating rule curves of this reservoir also are evaluated. The simulation results demonstrate that this new approach, in comparison with the M5 rule curves, has superior performance with regard to the total water deficit and number of monthly deficits. Copyright © 2002 John Wiley & Sons, Ltd.
Kinematic wave solutions for pollutant transport over an infiltrating plane with finite‐period mixing and mixing zone
Authors: Singh V. P.
Published: October 2002

Kinematic wave solutions are derived for transport of a conservative non‐point‐source pollutant during a rainfall‐runoff event over an infiltrating plane for two cases: (i) finite‐period mixing and (ii) soil‐mixing zone. Rainfall is assumed to be steady, uniform and finite in duration, and it is assumed to have zero concentration of pollutants. Infiltration is assumed constant in time and space. Prior to the start of rainfall, the pollutant is distributed uniformly over the plane. In the first case, when rainfall occurs, the mixing of pollutant in the runoff water occurs in a finite period of time. In the second case, the chemical concentration is assumed to be a linearly decreasing function of rainfall intensity and overland flow. The solute concentration and discharge are found to depend on the flow characteristics as well as the solute concentration parameters. The characteristics of solute concentration and discharge graphs seem to be similar to those reported in the literature and observed in laboratory experiments. Copyright © 2002 John Wiley & Sons, Ltd.