bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supporting Limb Reconstruction Patients: A Fine-Wire Circular Fixator Support Group
Authors: Ede MP Newton , Malik Mha , Prudhoe L , Miller C , Khan SA , Wilkes RA 
Published: December 2008

INTRODUCTION External fixator frames are widely used in limb reconstruction surgery. They are used for relatively long periods and the multidimensional impact on patients is documented. We examined the role of a nurse-led specialist group when supporting patients both pre-operatively and postoperatively. PATIENTS AND METHODS All patients with external fixators were contacted via postal questionnaire. Questions asked covered regularity of attendance at the specialist group, information received and problems with the frames. RESULTS Thirty-seven patients replied. Twenty-one had attended the clinic and nearly all (32) had been offered the opportunity to attend. Most reported being well prepared for surgery and felt that the information given was satisfactory. Problems were generally addressed within the group and patients attended the group with frame-related problems before attending their general practitioner or the accident and emergency department. All patients found the group environment supportive. CONCLUSIONS We describe a unique patient support group. To our knowledge, it is the first in the country. It is a valuable resource in equipping patients prior to surgery as well as dealing with problems that arise with the frame in situ. We recommend it to other limb reconstruction units.
The Cost of Ignoring Acute Cholecystectomy
Authors: Garner JP , Sood SK , Robinson J , Barber W , Ravi K 
Published: December 2008

INTRODUCTION Biliary symptoms whilst awaiting elective cholecystectomy are common, resulting in hospital admission, further investigation and increased hospital costs. Immediate cholecystectomy during the first admission is safe and effective, even when performed laparoscopically, but acute laparoscopic cholecystectomy has only recently become increasingly commonplace in the UK. This study was designed to quantify this problem in our hospital and its cost implications. PATIENTS AND METHODS The case notes of all patients undergoing laparoscopic cholecystectomy in our hospital between January 2004 and June 2005 were examined for details of hospital admissions with biliary symptoms or complications whilst waiting for elective cholecystectomy. Additional bed occupancy and radiological investigations were recorded and these costs to the trust calculated. We compared the potential tariff income to the hospital trust for the actual management of these patients and if a policy of acute laparoscopic cholecystectomy on first admission were in place. RESULTS In the 18-month study period, 259 patients (202 females) underwent laparoscopic cholecystectomy. Of these, 147 presented as out-patients and only 11% required hospital admission because of biliary symptoms whilst waiting for elective surgery. There were 112 patients who initially presented acutely and were managed conservatively. Twenty-four patients were re-admitted 37 times, which utilised 231 hospital bed-days and repeat investigations costing over £40,000. There would have been a marginal increase in tariff income if a policy of acute laparoscopic cholecystectomy had been in place. CONCLUSIONS Adoption of a policy of acute laparoscopic cholecystectomy on the index admission would result in substantial cost savings to the trust, reduce elective cholecystectomy waiting times and increase tariff income.
A One-Stop Clinic for Men with Testicular Anxiety
Authors: Moore James A , O'Neil Cathy , Fawcett Derek 
Published: December 2008

INTRODUCTION Testicular lumps and orchialgia both cause considerable anxiety, usually related to concerns about possible cancer. PATIENTS AND METHODS We established a rapid-access testicular clinic staffed by a urologist and a specialist ultrasonographer in order to delay the time to a definitive diagnosis. RESULTS Over a 30-month period, 845 men underwent clinical examination and scrotal ultrasonography. Overall, 4% of men were found to have testicular cancer. The majority of men were found to have normal testes or minor abnormalities and could be re-assured. CONCLUSIONS This one-stop clinic reduces the time to a definitive diagnosis which may reduce anxiety suffered by men with testicular complaints and allows rapid identification of those harbouring a testicular malignancy.
Use of Benthic Oxygen Flux Measurements in Wasteload Allocation Studies
Authors: Davis WS , Brosnan TM , Sykes RM 
Published: December 2008

Effects of benthic activities on stream oxygen balances are often overlooked in municipal wasteload allocations (WLAs). To improve dissolved oxygen (DO) concentration predictions for the central Scioto River in Ohio, benthic oxygen flux (BOF) rates were incorporated into the QUAL-2e water quality model, by measuring the BOF rates in situ with opaque and translucent hemispherical chambers under the low-flow conditions of late September, 1985.
The average light and dark chamber BOF rates were 6.46 g O2/m2·d and −2.74 g O2/m2·d, respectively. The net BOF rate applied to the model was 1.74 g O2/m2·d, corrected for water column demands. Measurements conducted during variable weather conditions showed a strong influence of cloud cover on BOF rates. The inclusion of the BOF term in the calibrated model resulted in a predicted DO increase as high as 1.15 mg/L in some stream segments, compared with 0.08 mg/L for planktonic photosynthesis. The BOF rates used in the QUAL-2e WLA model improved the DO predictions for the Scioto River.
Chemical and Biological Characterization of Municipal Sludges, Sediments, Dredge Spoils, and Drilling Muds
Authors: Lichtenberg JJ , Winter JA , Weber CI , Fradkin L 
Published: December 2008

Description
Papers present the state of the art in sludge sampling, sample preservation, validated methods for monitoring, and strategies for monitoring and field assessment. USEPA representatives describe the status of regulations and analytical needs related to characterization and regulation of sludge, sediment, and waste streams. Topics include quality assurance, sampling, organic and inorganic chemical methods, aquatic biological microbiological, and virological methods and risk assessment.
A case of cocaine-induced panhypopituitarism with human neutrophil elastase-specific anti-neutrophil cytoplasmic antibodies
Authors: de Lange T E , Simsek S , Kramer M H H , Nanayakkara P W B 
Published: December 2008

ObjectiveTo describe a patient with cocaine-induced panhypopituitarism associated with human neutrophil elastase-anti-neutrophil cytoplasmic antibodies (HNE-ANCA).CaseA 41-year-old man presented with extreme fatigue, cold intolerance and anorexia with 20 kg weight loss in the last 6 months. His medical history was unremarkable. He snorted cocaine twice a week during the last 6 years. On examination, we saw a pale and skinny man, with a normal blood pressure. Because of the severity of symptoms central hypothyroidism was suspected and very low values of TSH, free thyroxine and free triiodothyronine were measured. His FSH, LH, ACTH, cortisol, prolactin and testosterone levels were also low. Magnetic resonance imaging and computed tomography scan showed a normal-sized pituitary gland entirely embedded in a dense, oedematous, contrast-enhancing mass, and a total destruction of the nasal septum with the absence of conchae and severely impaired sinus walls. A transnasal biopsy showed an acute necrotising, non-specific and non-granulomatous inflammation. Although cocaine-induced panhypopituitarism was suspected, Wegener's granulomatosis could not be excluded. Serology on ANCA showed a strongly positive C-ANCA titre (320 U/l) with specificity for HNE. A cocaine-induced HNE-ANCA-associated panhypopituitarism was diagnosed. Our patient was advised to quit using cocaine immediately and was initially treated with glucocorticoids and testosterone, followed by thyroxine. This led to a dramatic clinical response with an increase of appetite, weight gain and regained energy. After 2 years, the patient is well and his ANCA titre is no longer positive.ConclusionWe describe the first documented case of cocaine-induced panhypopituitarism associated with HNE-specific ANCA.
Molecular Spectrum of Spontaneous de Novo Mutations in Male and Female Germline Cells of Drosophila melanogaster
Authors: Watanabe Yutaka , Takahashi Aya , Itoh Masanobu , Takano-Shimizu Toshiyuki 
Published: December 2008

Abstract
We carried out mutation screen experiments to understand the rate and molecular nature of spontaneous de novo mutations in Drosophila melanogaster, which are crucial for many evolutionary issues, but still poorly understood. We screened for eye-color and body-color mutations that occurred in the germline cells of the first generation offspring of wild-caught females. The offspring were from matings that had occurred in the field and therefore had a genetic composition close to that of flies in natural populations. We employed 1554 F1 individuals from 374 wild-caught females for the experiments to avoid biased contributions of any particular genotype. From ∼8.6 million alleles screened, we obtained 10 independent mutants: two point mutations (one for each sex), a single deletion of ∼6 kb in a male, a single transposable element insertion in a female, five large deletions ranging in size from 40 to 500 kb in females, and a single mutation of unknown nature in a male. The five large deletions were presumably generated by nonallelic homologous recombination (NAHR) between transposable elements at different locations, illustrating the mutagenic nature of recombination. The high occurrence of NAHR that we observed has important consequences for genome evolution through the production of segmental duplications.
Isolation and Characterization ofcul1-7, a Recessive Allele ofCULLIN1That Disrupts SCF Function at the C Terminus of CUL1 inArabidopsis thaliana
Authors: Gilkerson Jonathan , Hu Jianhong , Brown Jessica , Jones Alexander , Sun Tai-ping , Callis Judy 
Published: December 2008

AbstractMany aspects of plant biology depend on the ubiquitin proteasome system for degradation of regulatory proteins. Ubiquitin E3 ligases confer substrate specificity in this pathway, and SCF-type ligases comprise a major class of E3s. SCF ligases have four subunits: SKP1, CUL1, RBX1, and an F-box protein for substrate recognition. The Aux/IAAs are a well-characterized family of SCF substrates in plants. Here, we report characterization of a mutant isolated from a genetic screen in Arabidopsis thaliana designed to identify plants defective in degradation of an Aux/IAA fusion protein, Aux/IAA1-luciferase (IAA1-LUC). This mutant exhibited fourfold slower IAA1-LUC degradation compared with the progenitor line, and seedlings displayed altered auxin responses. Experiments identified the mutant as an allele of CUL1, named cul1-7. The cul1-7 mutation affects the C terminus of the protein, results in reduced cul1-7 levels, and interferes with RBX1 interaction. cul1-7 seedlings are defective in degradation of an endogenous SCF substrate, Repressor of ga1-3 (RGA), and have altered responses to gibberellins. cul1-7 seedlings exhibit slower degradation of the light-labile red/far-red photoreceptor phytochrome A and are photomorphogenic in the dark. This mutation represents the first reported allele of CUL1 to directly affect subunit interactions at the CUL1 C terminus.
Does Pregnancy Have an Impact on the Subgingival Microbiota?
Authors: Adriaens Laurence M. , Alessandri Regina , Spörri Stefan , Lang Niklaus P. , Persson G. Rutger 
Published: December 2008

Background: We investigated clinical and subgingival microbiologic changes during pregnancy in 20 consecutive pregnant women ≥18 years not receiving dental care.Methods: Bacterial samples from weeks 12, 28, and 36 of pregnancy and at 4 to 6 weeks postpartum were processed for 37 species by checkerboard DNA‐DNA hybridization. Clinical periodontal data were collected at week 12 and at 4 to 6 weeks postpartum, and bleeding on probing (BOP) was recorded at sites sampled at the four time points.Results: The mean BOP at week 12 and postpartum was 40.1% ± 18.2% and 27.4% ± 12.5%, respectively. The corresponding mean BOP at microbiologic test sites was 15% (week 12) and 21% (postpartum; not statistically significant). Total bacterial counts decreased between week 12 and postpartum (P <0.01). Increased bacterial counts over time were found for Neisseria mucosa (P <0.001). Lower counts (P <0.001) were found for Capnocytophaga ochracea, Capnocytophaga sputigena, Eubacterium saburreum, Fusobacterium nucleatum naviforme, Fusobacterium nucleatum polymorphum, Leptotrichia buccalis, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Prevotella intermedia, Prevotella melaninogenica, Staphylococcus aureus, Streptococcus anginosus, Streptococcus intermedius, Streptococcus mutans, Streptococcus oralis, Streptococcus sanguinis, Selenomonas noxia, and Veillonella parvula. No changes occurred between weeks 12 and 28 of pregnancy. Counts of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), and Treponema denticola did not change. Counts of P. gingivalis and T. forsythia at week 12 were associated with gingivitis (P <0.001).Conclusions: Subgingival levels of bacteria associated with periodontitis did not change. P. gingivalis and T. forsythia counts were associated with BOP at week 12. A decrease was found in 17 of 37 species from week 12 to postpartum. Only counts of N. mucosa increased.
Long‐Term Histologic Analysis of Bone Tissue Alteration and Healing Following Er:YAG Laser Irradiation Compared to Electrosurgery
Authors: Yoshino Toshiaki , Aoki Akira , Oda Shigeru , Takasaki Aristeo Atsushi , Mizutani Koji , Sasaki Katia Miyuki , Kinoshita Atsuhiro , Watanabe Hisashi , Ishikawa Isao , Izumi Yuichi 
Published: December 2008

Background: The erbium‐doped:yttrium, aluminum, and garnet (Er:YAG) laser is reportedly useful for periodontal therapy. However, the potential thermal damage that Er:YAG laser irradiation can produce on bone tissue has not been fully clarified. The purpose of this study was to histologically examine the effects of the Er:YAG laser on bone tissue and subsequent wound healing compared to electrosurgery in a long‐term study.Methods: Calvarial bone from 30 rats was exposed to contact and non‐contact Er:YAG laser irradiation (115 mJ/pulse, 10 Hz) without water coolant, or electrode contact. The treated surfaces were analyzed by scanning electron microscopy (SEM), and the healing process was histologically observed until 12 months post‐surgery.Results: Contact irradiation resulted in substantial bone ablation, whereas non‐contact irradiation produced slight tissue removal. Histologic and SEM analyses of the lased surface showed no severe thermal damage, except for the production of a superficially affected layer with a microstructured surface. The layer did not inhibit new bone formation, and the ablated defect was repaired uneventfully. Although the thickness of the layer gradually decreased, it generally remained in the cortical bone through the observation period. Electrosurgery produced a large area of thermal necrosis without ablation, and the damaged area was not replaced with new bone.Conclusions: Unlike electrosurgery, Er:YAG laser irradiation without water coolant easily ablated bone tissue, and thermal alteration in the treated surface was minimal. The superficially affected layer did not interfere with the ensuing bone healing, resulting in favorable repair of the defect.
Clinical Effectiveness of Autologous Platelet‐Rich Plasma and Peptide‐Enhanced Bone Graft in the Treatment of Intrabony Defects
Authors: Pradeep A.R. , Shetty Sharath Kumara , Garg Garima , Pai Sujatha 
Published: December 2008

Background: The goal of periodontal therapy has always been the regeneration of lost attachment apparatus. The use of platelet‐rich plasma (PRP) plus anorganic bovine‐derived matrix and peptide 15 (ABM/P‐15) for periodontal regenerative therapy offers a potentially useful modality for treating periodontal osseous defects. However, it is unknown whether a combination of these materials enhances the outcome of periodontal regenerative therapy. Therefore, this study was carried out to compare the effectiveness of the two regenerative techniques (autologous PRP plus ABM/P‐15 versus autologous PRP) in treating intrabony defects in humans by analyzing the clinical and radiologic parameters.Methods: Using a split‐mouth design, 28 intrabony defects were treated with autologous PRP (control) or a combination of autologous PRP and ABM/P‐15 (test). Clinical parameters such as plaque index, sulcus bleeding index, probing depth, attachment level, and gingival marginal level were recorded at baseline and 9 months postoperatively. Hard tissue measurements such as defect fill, defect resolution, and change in alveolar crest height were also recorded using spiral computed tomography (CT).Results: A statistically significant difference was observed in all clinical parameters in the test group compared to the control group. Furthermore, spiral CT images revealed significantly greater bone fill in the test group.Conclusions: A combination of PRP plus ABM/P‐15 was more effective than PRP alone in the treatment of intrabony defects. Further studies using a larger sample size are necessary to confirm the results of the present study.
A Prediction Model for Chronic Kidney Disease Includes Periodontal Disease
Authors: Fisher Monica A. , Taylor George W. 
Published: December 2008

Background: An estimated 75% of the seven million Americans with moderate‐to‐severe chronic kidney disease are undiagnosed. Improved prediction models to identify high‐risk subgroups for chronic kidney disease enhance the ability of health care providers to prevent or delay serious sequelae, including kidney failure, cardiovascular disease, and premature death.Methods: We identified 11,955 adults ≥18 years of age in the Third National Health and Nutrition Examination Survey. Chronic kidney disease was defined as an estimated glomerular filtration rate of 15 to 59 ml/minute/1.73 m2. High‐risk subgroups for chronic kidney disease were identified by estimating the individual probability using β coefficients from the model of traditional and non‐traditional risk factors. To evaluate this model, we performed standard diagnostic analyses of sensitivity, specificity, positive predictive value, and negative predictive value using 5%, 10%, 15%, and 20% probability cutoff points.Results: The estimated probability of chronic kidney disease ranged from virtually no probability (0%) for an individual with none of the 12 risk factors to very high probability (98%) for an older, non‐Hispanic white edentulous former smoker, with diabetes ≥10 years, hypertension, macroalbuminuria, high cholesterol, low high‐density lipoprotein, high C‐reactive protein, lower income, and who was hospitalized in the past year. Evaluation of this model using an estimated 5% probability cutoff point resulted in 86% sensitivity, 85% specificity, 18% positive predictive value, and 99% negative predictive value.Conclusion: This United States population–based study suggested the importance of considering multiple risk factors, including periodontal status, because this improves the identification of individuals at high risk for chronic kidney disease and may ultimately reduce its burden.
Immediate Implant Placement Postextraction Without Flap Elevation
Authors: Chen Stephen T. , Darby Ivan B. , Reynolds Eric C. , Clement John G. 
Published: December 2008

Background: The aim of this retrospective study was to assess soft tissue and esthetic outcomes at single‐tooth immediate implants placed without flap elevation in maxillary central and lateral incisor sites.Methods: Photographic records of 85 consecutive patients with immediate single‐tooth implants in maxillary central and lateral incisors that were placed without elevation of surgical flaps were selected. The change in mucosal level was expressed as a percentage of the length of the reference central incisor.Results: Significant recession of the mesial papilla (−6.2% ± 6.8%), distal papilla (−7.4% ± 7.5%), and facial mucosa (−4.6% ± 6.6%) between surgical placement and 1 year was observed (P <0.001). Recession was greater for implants placed facially within the extraction socket compared to those placed lingually (P = 0.009). Sites with gingival margins initially coronal achieved mucosal levels close to the line of symmetry with the contralateral tooth. Sites initially level or apical failed to reach the line of symmetry and remained receded. For sites with initially level gingival margins, recession >10% occurred at six of 25 thin biotype sites compared to two of 19 thick biotype sites. Acceptable outcomes were achieved in the majority of sites; between 10% and 20% of sites had suboptimal esthetic results.Conclusions: Immediate implant placement without elevation of surgical flaps is associated with recession of the marginal mucosa that may fall within the threshold of visually detectable change. The orofacial position of the implant shoulder and the tissue biotype are important contributory factors.
Relationship Between the Presence of Certain Bacterial Pathogens and Periodontal Status of Urban Thai Adults
Authors: Torrungruang Kitti , Bandhaya Panwadee , Likittanasombat Khanchit , Grittayaphong Chorkaew 
Published: December 2008

Background: The association between Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia (previously T. forsythensis) and periodontal disease has been reported in Western populations. However, corresponding data in Asian populations are still lacking. The aim of this study was to determine the prevalence of these three bacteria and their relationship to periodontal status in a group of urban Thai adults.Methods: The study was conducted in 453 subjects, aged 39 to 59 years. The presence of bacteria in subgingival plaque was analyzed using polymerase chain reaction analysis. Subjects were classified as having chronic periodontitis if they had at least three sites with probing depths ≥5 mm. Logistic regression analysis was used to determine the degree of association between the target bacteria and periodontal status.Results: A. actinomycetemcomitans, P. gingivalis, and T. forsythia were found in 19.0%, 70.9%, and 77.5% of the subjects, respectively. About one‐third (36.2%) of subjects had chronic periodontitis. In univariate analysis, age, male gender, current smoking, diabetes, and the presence of A. actinomycetemcomitans or P. gingivalis were positively associated with chronic periodontitis, whereas education and income exhibited inverse associations with chronic periodontitis. In multivariate analysis, education, current smoking, diabetes, and the presence of A. actinomycetemcomitans and P. gingivalis remained significant. The adjusted odds ratios for having chronic periodontitis were 2.5 and 3.4 in subjects positive for A. actinomycetemcomitans and P. gingivalis, respectively. However, no significant association was observed between the presence of T. forsythia and periodontal status.Conclusion: The presence of A. actinomycetemcomitans and P. gingivalis, but not T. forsythia, in subgingival plaque was associated with chronic periodontitis in this group of Thai adults.