bluuebunny/crossref_metadata_2025_split huggingface dataset:
GAINING FACE OR LOSING FACE? FRAMING THE DEBATE ON FACE TRANSPLANTS
Authors: HUXTABLE RICHARD , WOODLEY JULIE 
Published: October 2005

ABSTRACTAn American surgical team has announced its intention to perform the first human facial transplantation. The team has, however, invited further analysis of the ethical issues before it proceeds and in this paper we take up that challenge in seeking to frame the debate with a particular focus on the recipients of the transplant. We address seven related areas of concern and identify numerous questions that require answers or, perhaps, better answers. We start by examining the nature of the procedure and its intended benefits, why the procedure is being developed, and whether or not this should be viewed as experimental. Having concluded that this is experimental in nature, we then consider the broad question, who is the patient? Here we perceive difficulties in terms of the autonomy of the recipient, the unpredictable effects of receiving the transplant, and the role and influence of society. We conclude by asking whether the question should be ‘whether or not?’ rather than ‘when?’, particularly while the risks of losing face appear to far outweigh the likelihood of gaining face.
Urogynaecology: Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse
Authors: Phillips Christian H , Anthony Fred , Benyon Chris , Monga Ash K 
Published: October 2005

Objective  To compare tissue markers of collagen metabolism in the uterosacral ligaments with those in vaginal tissue in women with uterine prolapse.Design  Prospective observational experimental study.Setting  A tertiary urogynaecology unit.Population  Women referred for hysterectomy for prolapse or benign gynaecological disease.Methods  Matrix metalloproteinase (MMP)‐2 and ‐9 expression, tissue inhibitors of metalloproteinase (TIMP)‐2 expression and hydroxyproline content were measured in the uterosacral ligaments and vaginal tissue from 14 women with prolapse compared with 14 controls.Main outcome measures  Levels of MMP, TIMP and hydroxyproline in the uterosacral ligaments and vaginal tissue of women with prolapse and controls.Results  Fourteen women with prolapse and 14 women without prolapse (controls) were included. A significant increase in pro MMP‐2 expression was seen in vaginal tissue from women with prolapse (P < 0.05) but not activated MMP‐2, MMP‐9 and TIMP‐2. For uterosacral ligaments, the differences were not statistically significant. No significant difference in hydroxyproline content was found between control and prolapse in either tissue. Significant correlations exist in expression of pro‐MMP‐2, activated MMP‐2, MMP‐9 and TIMP‐2 in vaginal tissue with that in uterosacral ligaments.Conclusions  Correlations existed between markers of collagen metabolism in the vaginal and uterosacral tissues. This suggests vaginal tissue reflects the endopelvic fascia. The changes which are more pronounced in vaginal tissue may be as a result of prolapse rather than cause.
Body Mass Index Is Inversely Related to Mortality in Older People After Adjustment for Waist Circumference
Authors: Janssen Ian , Katzmarzyk Peter T. , Ross Robert 
Published: October 2005

Objectives: To examine the individual and combined influence of body mass index (BMI) and waist circumference (WC) on mortality risk in older people.Design: Longitudinal cohort study.Setting: Cardiovascular Health Study, a longitudinal study of cardiovascular disease and its risk factors in older people.Participants: Five thousand two hundred men and women aged 65 and older.Measurements: BMI and WC were measured at baseline. The risks of all‐cause mortality associated with BMI and WC were examined using Cox proportional hazards models over 9 years of follow‐up.Results: When examined individually, BMI and WC were both negative predictors of mortality, but when BMI and WC were examined simultaneously, BMI was a negative predictor of mortality, whereas WC was a positive predictor of mortality. After controlling for WC, mortality risk decreased 21% for every standard deviation increase in BMI. After controlling for BMI, mortality risk increased 13% for every standard deviation increase in WC. The patterns of associations were consistent by sex, age, and disease status.Conclusion: Higher BMI values indicated a lower mortality risk once the risk attributable to WC was accounted for, whereas higher WC values indicate a higher mortality risk once the risk attributable to BMI was accounted for. Both BMI and WC should be measured in the clinical setting, but in older adults higher BMI is associated with lower mortality rates.
QT Dispersion and Heart Rate Variability Abnormalities in Alzheimer's Disease and in Mild Cognitive Impairment
Authors: Zulli Roberto , Nicosia Franco , Borroni Barbara , Agosti Chiara , Prometti Paola , Donati Paolo , De Vecchi Massimiliano , Romanelli Giuseppe , Grassi Vittorio , Padovani Alessandro 
Published: October 2005

Objectives: To investigate the effect of cardiovascular changes (i.e., QT interval, QT dispersion (QTD), heart rate variability (HRV), and other cardiovascular measures) in subjects with Alzheimer's disease (AD) and mild cognitive impairment (MCI).Design: Each subject underwent clinical and cognitive examination, a structural brain imaging study, echocardioDoppler, electrocardiogram (ECG), HRV analysis using 24‐hour ECG monitoring, and 24‐hour blood pressure monitoring.Setting: Community population‐based sample of patients admitted to an AD center for investigation of cognitive disturbances.Participants: Thirty‐three subjects with AD, 39 subjects with MCI, and 29 cognitive healthy subjects (controls) matched for demographic characteristics, hypertensive condition, smoking habits, and laboratory parameters were enrolled consecutively.Measurements: Clinical and cognitive examination, structural brain imaging study, echocardioDoppler, ECG, HRV analysis using 24‐hour ECG monitoring, and 24‐hour blood pressure monitoring.Results: QTD and QT corrected dispersion mean values were significantly higher in patients with AD than in patients with MCI and controls and higher in patients with MCI than in controls. HRV time and domain parameters were lower in patients with AD than in patients with MCI and controls. No difference in other cardiovascular measures was found. QTD and HRV were found to be significantly correlated with the degree of cognitive impairment.Conclusion: These findings support the presence of a peculiar neuroanatomic dysfunction in patients with AD and MCI that parallels the disease progression. These noninvasive parameters might prove to be powerful predictive tools in the worsening of cognitive function and mortality risk.
Relative sensitivities of licensed nucleic acid amplification tests for detection of viremia in early human immunodeficiency virus and hepatitis C virus infection
Authors: Busch Michael P. , Glynn Simone A. , Wright David J. , Hirschkorn Dale , Laycock Megan E. , McAuley Joan , Tu Yongling , Giachetti Cristina , Gallarda James , Heitman John , Kleinman Steven H. ,   National Heart, Lung, Blood Institute Nucleic Acid Test Study Group
Published: October 2005

BACKGROUND: Screening donors for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) RNA is primarily performed on minipools (MPs) with one of two commercial nucleic acid amplification tests (NAT; Roche Molecular Systems; or Gen‐Probe/Chiron). We compared these assays with respect to detection of RNA in early HIV and HCV infection.STUDY DESIGN AND METHODS: Twelve HIV plasma donor panels (116 serial samples) and 12 HCV panels (180 serial samples) were selected to optimally represent early viremia. Initial testing was performed in singlicate or triplicate on separately coded aliquots, both neat and at dilutions corresponding to MP screening (1:16 for Gen‐Probe; 1:24 for Roche); 20 additional replicates were performed when discordant results were observed. Odds ratios (ORs) comparing detection of RNA by different assays were derived with logistic regression models. Differences in window‐period closure and yields of assays in MP or individual‐donation (ID) format were estimated.RESULTS: Differences in detection rates between Roche and Gen‐Probe NAT assays were small and only observed with samples with very‐low‐level viremia. ORs for detecting RNA by the Gen‐Probe versus the Roche assay were significant for HIV if conducted on MPs (1.8; 95% confidence interval [CI], 1.3‐2.5) but not neat (1.0; 95% CI, 0.72‐1.4). Odds of detecting HCV RNA were higher if the Gen‐Probe assay was conducted either neat (2.3; 95% CI, 1.6‐3.2) or on MPs (4.0; 95% CI, 2.8‐5.8). These differences translated to <1 day window‐period closure and ≤1 infection per 20 million donations. In contrast, comparisons of ID versus MP assays were highly significant for both viruses (ORs for ID vs. MP ranged from 45.3 to 93.4), with projected yields of one to two additional infections per 10 million donations.CONCLUSIONS: Differences in sensitivities of licensed NAT assays for HIV and HCV are very small and clinically insignificant, particularly when compared to differences of MP versus ID NAT screening.
Amelogenin control over apatite crystal growth is affected by the pH and degree of ionic saturation
Authors: Habelitz S , DenBesten PK , Marshall SJ , Marshall GW , Li W 
Published: October 2005

Structured AbstractAuthors –  Habelitz S, DenBesten PK, Marshall SJ, Marshall GW, Li WObjective –  To study the mechanisms which promote the interactions of amelogenin proteins with the forming mineral to establish suitable conditions for the biomimetic synthesis of enamel in vitro.Design –  Saturated calcium phosphate solutions were used in conjunction with recombinant amelogenin proteins to induce mineral formation on glass‐ceramics substrates containing oriented fluoroapatite crystals (FAP). The height of mineral layers formed on these substrates within 24 h was measured by atomic force microscopy (AFM).Experimental Variables –  The effect of protein concentration, pH and degree of saturation (DS) on the growth of apatite mineral was evaluated. Mineralization experiments were performed at 0, 0.4 and 1.6 mg/ml amelogenin concentrations. Mineralization solutions were used at pH values of 6.5, 7.4, 8.0 and 8.8 and DS of calcium and phosphate between 9 and 13.Outcome Measure –  Height and morphology of mineralized layer formed on glass‐ceramic substrates as determined from AFM measurements.Results –  Homogeneous nucleation and crystal growth of thin layers on the FAP were observed, when calcium and phosphate ions were added. The height of these layers grown on (001) planes of FAP was strongly dependent on the protein concentration and pH. At concentrations of 0 and 0.4 mg/ml crystal grew 5–15 nm on the FAP, while they grew approximately to 200 nm at 1.6 mg/ml. The enhanced crystal growth was observed only at pH 6.5, 7.4 and 8.0, while layers only 20 nm thick were obtained at pH 8.8. An increase in DS resulted in uncontrolled growth of calcium phosphate mineral covering large areas of the substrate.Conclusions –  Protein concentration, pH and the saturation of the mineralizing solution need to be considered carefully to provide suitable conditions for amelogenin‐guided growth of apatite crystals.
Tooth developmental biology: disruptions to enamel‐matrix assembly and its impact on biomineralization
Authors: Paine ML , Snead ML 
Published: October 2005

AbstractAuthors – Paine ML, Snead MLDental enamel is a composite bioceramic material that is the hardest tissue in the vertebrate body, containing long, thin crystallites of substituted hydroxyapatite (HAP). Over a lifetime of an organism, enamel functions under repeated and immense loads, generally without catastrophic failure. Enamel is a product of ectoderm‐derived cells called ameloblasts. Recent investigations on the formation of enamel using cell and molecular approaches are now being coupled to biomechanical investigations at the nanoscale and mesoscale levels. For amelogenin, the principal structural protein for forming enamel, we have identified two domains that are required for its proper self‐assembly into supramolecular structures referred to as nanospheres. Nanospheres are believed to control HAP crystal habit. Other structural proteins of the enamel matrix include ameloblastin and enamelin, but little is known about their biological importance. Transgenic animals have been prepared to investigate the effect of overexpression of wild‐type or mutated enamel proteins on the developing enamel matrix. Amelogenin transgenes were engineered to contain deletions to either of the two self‐assembly domains and these alterations produced significant defects in the enamel. Additional transgenic animal lines have been prepared and studied and each gives additional insights into the mechanisms for enamel biofabrication. This study summarizes the observed enamel phenotypes of recently derived transgenic animals. These data are being used to help define the role of each of the enamel structural proteins in enamel and study how each of these proteins impact on enamel biomineralization.
Bone induction in craniofacial defects1
Authors: Nacamuli RP , Longaker MT 
Published: October 2005

AbstractAuthors – Nacamuli RP, Longaker MTReconstruction of craniofacial bony deficiencies, whether acquired through trauma or as a result of treatment for disease, is a chronic problem. Although numerous approaches utilizing a wide array of materials ranging from alloplastic materials to autogenous bone grafts have been employed to achieve bony replacement, no ideal clinical approach exists. In this brief review, we will provide an overview of current approaches to treating craniofacial bony defects. We will then discuss advances being made in the design of scaffolding materials and potential candidate cell types with which to design tissue‐engineered constructs for craniofacial skeletal repair.
Tissue engineering of bone: search for a better scaffold
Authors: Mastrogiacomo M , Muraglia A , Komlev V , Peyrin F , Rustichelli F , Crovace A , Cancedda R 
Published: October 2005

Structured AbstractAuthors –  Mastrogiacomo M, Muraglia A, Komlev V, Peyrin F, Rustichelli F, Crovace A, Cancedda RBackground –  Large bone defects still represent a major problem in orthopedics. Traditional bone‐repair treatments can be divided into two groups: the bone transport (Ilizarov technology) and the graft transplant (autologous or allogeneic bone grafts). Thus far, none of these strategies have proven to be always resolving. As an alternative, a tissue engineering approach has been proposed where osteogenic cells, bioceramic scaffolds, growth factors and physical forces concur to the bone defect repair. Different sources of osteoprogenitor cells have been suggested, bone marrow stromal cells (BMSC) being in most cases the first choice.Methods and Results –  In association with mineral tridimensional scaffolds, BMSC form a primary bone tissue which is highly vascularized and colonized by host hemopoietic marrow. The chemical composition of the scaffold is crucial for the osteoconductive properties and the resorbability of the material. In addition, scaffolds should have an internal structure permissive for vascular invasion. Porous bioceramics [hydroxyapatite (HA) and tricalcium phosphate] are osteoconductive and are particularly advantageous for bone tissue engineering application as they induce neither an immune nor an inflammatory response in the implanted host. Earlier, we first reported a cell‐based tissue engineering procedure to treat three patients with long bone segmental defects. Cells were loaded on a 100% HA porous ceramic. These scaffolds proved to have good osteoconductive properties resulting in a good functional recovery, but they have not been resorbed after more than 5 years from the implant. In addition, due to the high density of the mineral and the relatively low porosity (50–60%), it was very difficult to monitor the patient recovery during the post‐surgery time using X‐rays.Conclusions –  We report here some pre‐clinical testing of new scaffolds. To compare these second generation ceramic scaffolds more suitable for a tissue engineering approach we had to first establish animal models and analysis procedures including the use of X‐ray‐computed microtomography associated with X‐rays synchroton radiation.
Methylene Blue-Guided Repair of Fractured Penis
Authors: Shaeer Osama 
Published: October 2005

ABSTRACT

Introduction
Fracture of the penis is a condition where excessive force applied to the long axis of the penis in the erect state results in rupture of the tunica albuginea of the corpus cavernosum. Surgical management can be confusing and time-consuming due to the concealment of the tear in organized blood and edematous tissue, necessitating extensive dissection in friable traumatized tissues, especially if the tear is a small one, or if there are multiple tears.

Aim
The present work investigates the value of methylene blue in aiding the localization of tunical and urethral tears in such cases.

Patients and Methods
Twelve cases with delayed presentation of fracture penis were managed. In six patients, methylene blue was injected into the corpora cavernosa and through the urethral meatus to point out tears. In the other six patients, methylene blue was not used.

Main Outcome Measures
Operative time and complication rate.

Results
Operative time was considerably less in the group that received methylene blue, and the repair was more straightforward. Complications issued only in the group that did not receive methylene blue considering the extensive lengthy dissection.

Conclusion
Methylene blue-guided repair for trauma of the penis is an easy, reliable, safe, and fast method for spotting tears in the tunica albuginea of the corpora cavernosa or in the urethra, eliminating the need for unnecessary lengthening.
Early Photo-Illustration of a Hermaphrodite by the French Photographer and Artist Nadar in 1860
Authors: Schultheiss Dirk , Herrmann Thomas R.W. , Jonas Udo 
Published: October 2005

ABSTRACT
As early as 1860 the French photographer Gaspard Félix Tournachon, called Nadar (1820–1910), took a series of nine photographs depicting a young intersex patient. These illustrations were not published at their time and little is known about the patient and the role of the physicians involved in this case. The article discusses the available information on these artworks that today belong to the photographic collection of the Musée d’Orsay in Paris.
The Correlation Between Erectile Function and Patient Satisfaction
Authors: Teloken Patrick , Valenzuela Rolando , Parker Marilyn , Mulhall John 
Published: October 2005

ABSTRACT

Introduction
The International Index of Erectile Function (IIEF) has become the gold standard inventory for the assessment of sexual function in drug trials and in clinical research. Normalization of the erectile function domain (EFD) score, an end of treatment score of 26 or higher, is an end-point that is currently being used routinely in drug trials. It has been our experience that some men with scores less that 26 on a sexual pharmaceutical are content with their sexual function. We undertook this study to define what proportion of men with EFD scores &lt;26 are satisfied with their therapeutic response.

Methods
100 consecutive patients who had presented to a sexual health clinic and who had used sildenafil citrate on at least 4 occasions completed the IIEF pertaining to their sildenafil response. They were also asked questions, pertaining to their ability to have sexual intercourse (Q1), their satisfaction with their erectogenic medication (Q2), the ability of the medication to improve erectile rigidity (Q3), and the ability of the medication to improve their ability to have sexual intercourse (Q4). Patients were subcategorized into 4 groups based on treatment IIEF scores (≥26, 22–25, 18–21, and 11–17). The IIEF scores were compared to the responses to the global assessment questions.

Main Outcome Measures
The mean patient age was 58 ± 22 years. For Q1 and Q2, for each subcategory, there was a significant difference in the percentage of men answering definitely, somewhat, or not at all. In the group with EFD scores 22–25, 67% agreed at least somewhat with Q1 and 66% with Q2. In this group 84% and 78% responded in the affirmative to Q3 and Q4, respectively. No patient with an EFD score &lt;22 definitely agreed with Q1 or Q2.

Conclusion
These data indicate that a significant proportion of patients with EFD scores 21–25 can have sexual relations that are satisfactory and that they are satisfied with their erectogenic medication.
Sexual Behaviors and Mental Perception, Satisfaction and Expectations of Sex Life in Men and Women in France
Authors: Colson Marie-Hélène , Lemaire Antoine , Pinton Philippe , Hamidi Karim , Klein Patrick 
Published: October 2005

ABSTRACT

Aim
To analyze behaviors, mental perception, satisfaction, and expectations relating to sexuality in France.

Methods
A total of 1,002 subjects (483 men and 519 women) aged 35 years and over in a representative sample of the French population were surveyed by phone using a dedicated questionnaire in November 2003.

Main Outcome Measures
Sexual behaviors and mental perception, satisfaction and expectations concerning sexual life.

Results
Of the population, 80.2% reported having a sexual partner. The mean number of times subjects had sex per week was 1.8 (2.0 in men, 1.6 in women). The decision preceded the act by a few seconds or minutes in 82.7% of subjects. Thinking about sex was “frequent” in 47.1% of subjects, especially for men (60.8%). Regardless of gender, sexuality was more synonymous with pleasure (44.0%) and love (42.1%) than with procreation, children, or motherhood (7.8%). During sexual intercourse, simultaneous orgasms and feelings of closeness were important for the majority of subjects, 35.8% (41.6% of men) and 22.8%, respectively; foreplay, enjoyment, and vaginal penetration were the most important accomplishments for 13.1%. Regardless of gender, 83.0% of subjects expressed relative or full satisfaction with their sex life. However, only 38.7% of subjects (31.6% of men and 45.2% of women) did not wish to change anything, while 17.2% would like to have more time for it. Of the subjects, 63.0% reported a decrease in sexual desire during periods of work-related stress, especially in women (72.3%). The main sexual complaints reported by men were diminution of sexual desire (24.9%), early ejaculation (23.7%), and erectile problems (14.4%). In women, they were diminution of sexual desire (45.7%), orgasm disorders (15.5%), and dyspareunia (15.5%).

Conclusions
This survey showed that the attitude of subjects, especially men, toward sexuality is changing through years and highlighted the extent of sexual problems in the general population.