Urologists


604 James Trimble Blvd
Suite 2
Paintsville, KY 41240
606-789-7950
Locations and availability (2)

Awards & Distinctions ?

Associations
American Urological Association

Publications & Research

Dr. Harris has contributed to 127 publications.
Title Correlation of Left Ventricular Count Rate with Patient Weight in Tc-99m Myocardial Perfusion Imaging.
Date June 2011
Journal Nuclear Medicine Communications
Excerpt

The aim of this retrospective investigation was to devise a protocol for obtaining consistent myocardial counts for patients attending myocardial perfusion imaging.

Title Assessing the Acceptability and Usability of an Interactive Serious Game in Aiding Treatment Decisions for Patients with Localized Prostate Cancer.
Date May 2011
Journal Journal of Medical Internet Research
Excerpt

Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers.

Title Temporally Distinct Neural Coding of Perceptual Similarity and Prototype Bias.
Date March 2011
Journal Journal of Vision
Excerpt

Psychological models suggest that perceptual similarity can be divided into geometric effects, such as metric distance in stimulus space, and non-geometric effects, such as stimulus-specific biases. We investigated the neural and temporal separability of these effects in a carry-over, event-related potential (ERP) study of facial similarity. By testing this dual effects model against a temporal framework of visual evoked components, we demonstrate that the behavioral distinction between geometric and non-geometric similarity effects is consistent with dissociable neural responses across the time course of face perception. We find an ERP component between the "face-selective" N170 and N250 responses (the "P200") that is modulated by transitions of face appearance, consistent with neural adaptation to the geometric similarity of face transitions. In contrast, the N170 and N250 reflect non-geometric stimulus bias, with different degrees of neural adaptation dependent upon the direction of transition within the stimulus space. These results suggest that the neural coding of perceptual similarity, in terms of both geometric and non-geometric representations, occurs rapidly and from relatively early in the perceptual processing stream.

Title Prospective Randomized Double-blind Pilot Study of Site-specific Consensus Atlas Implementation for Rectal Cancer Target Volume Delineation in the Cooperative Group Setting.
Date January 2011
Journal International Journal of Radiation Oncology, Biology, Physics
Excerpt

Variations in target volume delineation represent a significant hurdle in clinical trials involving conformal radiotherapy. We sought to determine the effect of a consensus guideline-based visual atlas on contouring the target volumes.

Title Emergency Laparoscopic Cholecystectomy in an Unselected Cohort: a Safe and Viable Option in a Specialist Centre.
Date January 2011
Journal International Journal of Surgery (london, England)
Excerpt

Patients presenting acutely with symptomatic gallstone-related disease have historically had their laparoscopic cholecystectomy (LC) deferred due to perceived increased operative risks in the acute setting, particularly conversion to open surgery. The aim of this study was to compare morbidity and mortality between unselected cohorts of patients undergoing elective and 'emergency' LC in a District General Hospital.

Title Enterobius Vermicularis Infestation of the Appendix and Management at the Time of Laparoscopic Appendectomy: Case Series and Literature Review.
Date January 2011
Journal International Journal of Surgery (london, England)
Excerpt

Enterobius vermicularis infestation of the vermiform appendix can mimic appendicitis. In these cases, laparoscopic appendicectomy runs a risk of contamination of the peritoneal cavity with worms. We reviewed our practice to suggest changes that will reduce the release of worms and propose methods to use in case contamination occurs.

Title Transomental Defects As a Cause of Chronic Abdominal Pain, the Role of Diagnostic Laparoscopy: a Case Series.
Date January 2011
Journal Cases Journal
Excerpt

Transomental herniation is a rare but recognised clinical condition, which usually presents as an emergency with bowel obstruction. It accounts for 1-4% of intra-abdominal herniations. We reviewed 3 patients found to have a transomental defect during elective diagnostic laparoscopy performed for chronic abdominal pain. To our knowledge, there is no case series reported in the literature on transomental defect in the non-emergency situation.

Title Maxillary Canine Management in the Pre-adolescent: a Guideline for General Practitioners.
Date December 2010
Journal Sadj : Journal of the South African Dental Association = Tydskrif Van Die Suid-afrikaanse Tandheelkundige Vereniging
Excerpt

This paper focuses on the identification of ectopic eruption patterns of the maxillary canines from the dental ages of approximately 8 to 12 years. The timing and suitability of interceptive treatment in pre-adolescents are discussed.

Title Incidence of Contralateral Occult Inguinal Hernia Found at the Time of Laparoscopic Trans-abdominal Pre-peritoneal (tapp) Repair.
Date December 2010
Journal Hernia : the Journal of Hernias and Abdominal Wall Surgery
Excerpt

Trans-abdominal laparoscopic inguinal hernia repair allows rapid assessment and exploration of the contralateral groin and repair of an occult hernia. Although previous studies have shown that the totally extra-peritoneal (TEP) hernia repair can be used to assess the contralateral groin, there is little data pertaining to the trans-abdominal pre-peritoneal (TAPP) approach. The aim of this study was to document the incidence of occult contralateral hernia at the time of TAPP hernia repair.

Title Toward the Development of a Stable, Freeze-dried Formulation of Helicobacter Pylori Killed Whole Cell Vaccine Adjuvanted with a Novel Mutant of Escherichia Coli Heat-labile Toxin.
Date February 2010
Journal Vaccine
Excerpt

No vaccine exists for the prevention of infection with the ubiquitous gastric pathogen Helicobacter pylori, and drug therapy for the infection is complicated by poor patient compliance, the high cost of treatment, and ineffectiveness against drug-resistant strains. A new medical advancement is required to reduce the incidence of peptic ulcer disease and stomach cancer, two conditions caused by infection with H. pylori. Clinical trials have been performed with a formalin-inactivated H. pylori whole cell (HWC) vaccine, given orally in combination with the mucosal adjuvant mLT(R192G), a mutant of Escherichia coli heat-labile toxin. Following the initial dose of this vaccine, some subjects experienced gastrointestinal side effects. To reduce side effects and potentially further increase the amount of adjuvant that can safely be administered with the HWC vaccine, experiments were performed with a form of LT that carried two mutations in the A subunit, a substitution of G for R at position 192, and A for L at position 211. The double mutant LT (dmLT) adjuvant stimulated immune responses as effectively as the single mutant LT in mice. Additionally, following a challenge infection, the dmLT-adjuvanted vaccine was as effective as single mutant LT in reducing gastric urease levels (diagnostic for H. pylori infection), and H. pylori colonization in the stomach as assessed by quantitative analysis of stomach homogenates. A lyophilized formulation of HWC was developed to improve stability and to potentially reduce reliance on cold chain maintenance. It was observed that a dmLT-adjuvanted lyophilized vaccine was equally as protective in the mouse model as the liquid formulation as assessed by gastric urease analysis and analysis of stomach homogenates for viable H. pylori. No readily detectable effect of tonicity or moisture content was observed for the lyophilized vaccine within the formulation limits evaluated. In an accelerated stability study performed at 37 degrees C the lyophilized vaccine remained equally as protective as vaccine stored at 2-8 degrees C. The formulation selected for clinical development consisted of 2.5 x 10(10) formalin-inactivated cells per ml in 6.5% trehalose, 0.5% mannitol, and 10mM citrate buffer at pH 6.8.

Title Memory T-cell Responses to Vibrio Cholerae O1 Infection.
Date November 2009
Journal Infection and Immunity
Excerpt

Vibrio cholerae O1 can cause diarrheal disease that may be life-threatening without treatment. Natural infection results in long-lasting protective immunity, but the role of T cells in this immune response has not been well characterized. In contrast, robust B-cell responses to V. cholerae infection have been observed. In particular, memory B-cell responses to T-cell-dependent antigens persist for at least 1 year, whereas responses to lipopolysaccharide, a T-cell-independent antigen, wane more rapidly after infection. We hypothesize that protective immunity is mediated by anamnestic responses of memory B cells in the gut-associated lymphoid tissue, and T-cell responses may be required to generate and maintain durable memory B-cell responses. In this study, we examined B- and T-cell responses in patients with severe V. cholerae infection. Using the flow cytometric assay of the specific cell-mediated immune response in activated whole blood, we measured antigen-specific T-cell responses using V. cholerae antigens, including the toxin-coregulated pilus (TcpA), a V. cholerae membrane preparation, and the V. cholerae cytolysin/hemolysin (VCC) protein. Our results show that memory T-cell responses develop by day 7 after infection, a time prior to and concurrent with the development of B-cell responses. This suggests that T-cell responses to V. cholerae antigens may be important for the generation and stability of memory B-cell responses. The T-cell proliferative response to VCC was of a higher magnitude than responses observed to other V. cholerae antigens.

Title Somatization Increases Disability Independent of Comorbidity.
Date November 2009
Journal Journal of General Internal Medicine
Excerpt

Somatoform disorders are an important factor in functional disability and role impairment, though their independent contribution to disability has been unclear because of prevalent medical and psychiatric comorbidity.

Title A Comparison of the In-vitro Properties of Ceftazidime with Those of New Broad-spectrum Cephalosporins and Gentamicin.
Date October 2009
Journal The Journal of Antimicrobial Chemotherapy
Title Antigen-specific Memory B-cell Responses to Vibrio Cholerae O1 Infection in Bangladesh.
Date September 2009
Journal Infection and Immunity
Excerpt

Cholera, caused by Vibrio cholerae, is a noninvasive dehydrating enteric disease with a high mortality rate if untreated. Infection with V. cholerae elicits long-term protection against subsequent disease in countries where the disease is endemic. Although the mechanism of this protective immunity is unknown, it has been hypothesized that a protective mucosal response to V. cholerae infection may be mediated by anamnestic responses of memory B cells in the gut-associated lymphoid tissue. To characterize memory B-cell responses to cholera, we enrolled a cohort of 39 hospitalized patients with culture-confirmed cholera and evaluated their immunologic responses at frequent intervals over the subsequent 1 year. Memory B cells to cholera antigens, including lipopolysaccharide (LPS), and the protein antigens cholera toxin B subunit (CTB) and toxin-coregulated pilus major subunit A (TcpA) were enumerated using a method of polyclonal stimulation of peripheral blood mononuclear cells followed by a standard enzyme-linked immunospot procedure. All patients demonstrated CTB, TcpA, and LPS-specific immunoglobulin G (IgG)and IgA memory responses by day 90. In addition, these memory B-cell responses persisted up to 1 year, substantially longer than other traditional immunologic markers of infection with V. cholerae. While the magnitude of the LPS-specific IgG memory B-cell response waned at 1 year, CTB- and TcpA-specific IgG memory B cells remained significantly elevated at 1 year after infection, suggesting that T-cell help may result in a more durable memory B-cell response to V. cholerae protein antigens. Such memory B cells could mediate anamnestic responses on reexposure to V. cholerae.

Title Complications Following Limb-threatening Lower Extremity Trauma.
Date February 2009
Journal Journal of Orthopaedic Trauma
Excerpt

Our objective is to report the nature and incidence of major complications after severe lower extremity trauma.

Title Large Caecal Intussusception Associated with Three Jejunal Intussusceptions in a Child with Cystic Fibrosis.
Date December 2008
Journal International Journal of Colorectal Disease
Title Measurement of Daily Activity in Restrictive Type Anorexia Nervosa.
Date April 2008
Journal The International Journal of Eating Disorders
Excerpt

OBJECTIVE: The assessment of daily activity in patients with restrictive type anorexia nervosa is limited by an absence of accurate and precise technology. We wanted to test a daily activity detecting device named, the physical activity monitoring system (PAMS). METHOD: Women participants with restrictive type anorexia nervosa (n = 8, 36 +/- 11 years, 17 +/- 2 kg/m(2)) and healthy women participants (n = 8, 30 +/- 11 years, 27 +/- 7 kg/m(2)) were asked to lie, sit, and stand motionless, and walk at 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mph while wearing PAMS. RESULTS: For all restrictive type anorexia nervosa and healthy participants, body posture was correctly detected for all measurements (300/300). There was excellent correlation of an individual's body acceleration with walking velocity and walking energy expenditure (r(2) > .99). CONCLUSION: The PAMS technology could serve as a tool for lending insight into the pathophysiology of restrictive type anorexia nervosa; and potentially measuring compliance with activity recommendations for medical professionals treating individuals with restrictive type anorexia nervosa.

Title Rabson-mendenhall Syndrome: Medullary Sponge Kidney, a New Component.
Date January 2008
Journal Pediatric Nephrology (berlin, Germany)
Excerpt

Rabson-Mendenhall syndrome is a rare genetic disorder characterized by severe insulin resistance, extreme hyperinsulinemia, postprandial hyperglycemia, growth retardation, and dysmorphisms. Enlargement of the kidneys and nephrocalcinosis have been described previously. We report a 10-year-old boy who presented with gross hematuria, unilateral hydronephrosis, and the initial diagnosis of bilateral extensive medullary nephrocalcinosis. Medullary sponge kidney (MSK) was included in the differential diagnosis given the ultrasound findings. Further evaluation by intravenous pyelogram confirmed the suspected bilateral MSK. Given the patient's history of hydronephrosis due to an obstructing renal stone and MSK, urine calcium excretion was assessed and found to be markedly increased at 9.5 mg/kg per day. To our knowledge, this is the first report of Rabson-Mendenhall syndrome and an association with MSK. We recommend evaluation for nephrocalcinosis, MSK, and hypercalciuria in all children diagnosed with Rabson-Mendenhall syndrome.

Title Assessment of Physician Preparedness and Response Capacity to Bioterrorism or Other Public Health Emergency Events in a Major Metropolitan Area.
Date November 2007
Journal Disaster Management & Response : Dmr : an Official Publication of the Emergency Nurses Association
Excerpt

The role of physicians in the detection, reporting, and response to infectious disease outbreaks, anomalous biologic events, or other public health emergencies is critical to the community's safety.

Title Effect of Alpha1-adrenoceptor Antagonist Exposure on Prostate Cancer Incidence: an Observational Cohort Study.
Date November 2007
Journal The Journal of Urology
Excerpt

PURPOSE: The quinazoline based alpha1-adrenoceptor antagonists doxazosin and terazosin suppress prostate tumor growth via the induction of apoptosis and decrease in tissue vascularity. To assess the effect of alpha1-blocker exposure on the incidence of prostate cancer we performed an exploratory, observational cohort study. MATERIALS AND METHODS: The medical records of all male patients enrolled at Lexington Veterans Affairs Medical Center were searched to identify men treated with quinazoline based alpha1-adrenoreceptor antagonists between January 1, 1998 and December 31, 2002 for hypertension and/or benign prostatic enlargement. Medical records were subsequently linked to the Markey Cancer Center Kentucky Cancer Registry, a statewide population based central cancer registry that is part of the National Cancer Institute Surveillance, Epidemiology and End Results Program, to identify all incident prostate cancer cases diagnosed. All newly diagnosed prostate cancer cases unexposed to alpha1-adrenoreceptor antagonists in the total male Veterans Affairs population during this period were also identified from the Kentucky Cancer Registry database. Measures of disease incidence, relative risk and attributable risk were calculated to compare the risk of prostate cancer in alpha1-blocker exposed vs unexposed men. Kaplan-Meier curves and Cox regression models were used to compare overall survival between alpha1-blocker exposed and unexposed prostate cancer cases. RESULTS: Our analysis revealed a cumulative incidence of 1.65% in alpha1-blocker exposed men compared to 2.41% in the unexposed group. These data yielded an unadjusted RR of 0.683 (95% CI 0.532, 0.876) and a risk difference of -0.0076, indicating that 7.6 fewer prostate cancer cases developed per 1,000 exposed men. Thus, exposure to quinazoline alpha1-blockers may have prevented 32 prostate cancer cases among the 4,070 treated men during the study period. Therefore, men exposed to quinazoline alpha1-adrenoceptor antagonists were at 1.46 times lower RR and 31.7% lower attributable risk for prostate cancer than unexposed men. There was no association between alpha1-adrenoceptor antagonist exposure and overall survival. CONCLUSIONS: These data suggest that exposure to quinazoline based alpha1-adrenoceptor antagonists significantly decreases the incidence of prostate cancer. This evidence suggests that the apoptotic and anti-angiogenic effects of these drugs may prevent the development of prostate cancer.

Title Laparoscopic Management of Difficult Recurrent Choledocholithiasis.
Date August 2007
Journal Jsls : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Excerpt

The management of common bile duct stones has traditionally required open laparotomy and bile duct exploration. With the advent of endoscopic and laparoscopic technology in the latter half of the last century, endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration has become the mainstream treatment for common bile duct stones in most medical centers around the world. However, in some patients, endoscopic retrograde cholangiopancreatography is difficult and laparoscopy is challenging because of previous surgery. These facts are highlighted in this report.

Title Infraocclusion of Primary Molars: a Review of the Literature.
Date July 2007
Journal Sadj : Journal of the South African Dental Association = Tydskrif Van Die Suid-afrikaanse Tandheelkundige Vereniging
Excerpt

Infraocclusion of primary molar teeth is a relatively common clinical finding and decision-making concerning the successful management of such cases can present a challenge to the general dental practitioner. This paper reviews the epidemiology, aetiology, diagnosis, treatment rationale and includes flow charts for easy reference to the various treatment options for infraoccluded primary molar teeth.

Title Nonexercise Movement in Elderly Compared with Young People.
Date May 2007
Journal American Journal of Physiology. Endocrinology and Metabolism
Excerpt

The association between free-living daily activity and aging is unclear because nonexercise movement and its energetic equivalent, nonexercise activity thermogenesis, have not been exhaustively studied in the elderly. We wanted to address the hypothesis that free-living nonexercise movement is lower in older individuals compared with younger controls matched for lean body mass. Ten lean, healthy, sedentary elderly and 10 young subjects matched for lean body mass underwent measurements of nonexercise movement and body posture over 10 days using sensitive, validated technology. In addition, energy expenditure was assessed using doubly labeled water and indirect calorimetry. Total nonexercise movement (acceleration arbitrary units), standing time, and standing acceleration were significantly lower in the elderly subjects; this was specifically because the elderly walked less distance per day despite having a similar number of walking bouts per day compared with the young individuals. The energetic cost of basal metabolic rate, thermic effect of food, total daily energy expenditure, and nonexercise activity thermogenesis were not different between the elderly and young groups. Thus, the energetic cost of walking in the elderly may be greater than in the young. Lean, healthy elderly individuals may have a biological drive to be less active than the young.

Title Dentoskeletal and Soft-tissue Changes in Growing Class Ii Malocclusion Patients During Nonextraction Orthodontic Treatment.
Date April 2007
Journal Sadj : Journal of the South African Dental Association = Tydskrif Van Die Suid-afrikaanse Tandheelkundige Vereniging
Excerpt

An investigation was conducted to determine the outcome of nonextraction edgewise orthodontic treatment of thirty-five caucasian patients with Class II molar relationships (13 division 1 and 22 division 2 cases). Twenty-three females and 12 males aged between 10 and 16 years old were treated using Class II intermaxillary elastics worn with 0.016" x 0.022" stainless steel archwires and without extra-oral traction. Thirty cephalometric landmarks were identified and digitized, and used to calculate 41 parameters. Space analyses were conducted on pretreatment study models. Most of the cases had between 0-4 mm space shortage in both maxillary and mandibular dentitions. Results of this study indicated that the mean SNA angle decreased by 1.580 degrees, and that this change was largely due to posterior movement of point A. The mean pre-treatment ANB value was 4.490 degrees which decreased to a mean posttreatment value of 2.810 degrees (p<0.05). No significant changes in the growth direction of the jaws were found, showing that the use of Class II intermaxillary elastics in this sample had no detrimental effect on this parameter (p<0.05). The SNB angle increased by a mean of 0.110 degrees, which can be attributed to anterior mandibular growth. The dentoalveolar changes included a mean overjet reduction of 3.816mm (mean posttreatment overjet was 2.2mm) and proclination of the lower incisors relative to the APo line and the mandibular plane, probably caused by the use of Class II intermaxillary elastics. The lower lip advanced relatively more than the upper lip, and this contributed to an improvement of the lip relationship. The amount of nose growth observed during the study was normal for this age group, and compared favourably with other data in the literature.

Title Prosopagnosia.
Date March 2007
Journal Current Biology : Cb
Title Weekly Changes in Basal Metabolic Rate with Eight Weeks of Overfeeding.
Date November 2006
Journal Obesity (silver Spring, Md.)
Excerpt

OBJECTIVE: The contribution of basal metabolic rate (BMR) to weight gain susceptibility has long been debated. We wanted to examine whether BMR changes in a linear fashion with overfeeding. Our hypothesis was that BMR does not increase linearly with 1000-kcal/d overfeeding in lean healthy subjects over 8 weeks. The null hypothesis states that BMR increases linearly with 1000-kcal/d overfeeding in lean healthy subjects. RESEARCH METHODS AND PROCEDURES: Initially, 16 lean healthy sedentary subjects completed 2 weeks of weight maintenance feeding at the General Clinical Research Center. The subjects were then overfed by 1000 kcal/d over 8 weeks. BMR was measured under standard conditions each week using indirect calorimetry. RESULTS: Baseline BMR was 1693 +/- 154.5 kcal/d. BMR increased from 1711 +/- 201.3 kcal/d at week 1 of overfeeding to 1781 +/- 171.65 kcal/d at the second week of overfeeding (p = 0.05). BMR fell during the third week of overfeeding to 1729 +/- 179.5 kcal/d (p = 0.05). After 5 weeks of overfeeding, BMR reached a plateau. Thereafter, there was no further change. Comparison of BMR with weeks of overfeeding was significantly different compared with the linear model (p < 0.05). DISCUSSION: Increases in BMR in lean sedentary healthy subjects with 1000-kcal/d overfeeding are not linear over 8 weeks. There seems to be a short-term increase in BMR in the first 2 weeks of overfeeding that is not representative of longer-term changes.

Title Surgery Versus Conservative Therapy in Carpal Tunnel Syndrome in People Aged 70 Years and Older.
Date October 2006
Journal Plastic and Reconstructive Surgery
Excerpt

BACKGROUND: Carpal tunnel syndrome is common in the general population, with a prevalence that increases with age. Although good satisfaction has been described after carpal tunnel release, little is known about the long-term outcome of treatment in elderly individuals with carpal tunnel syndrome. METHODS: The authors reviewed data from a population-based sample of 102 patients aged 70 years and older with carpal tunnel syndrome. They used valid and sensitive mailed follow-up outcome [Boston Carpal Tunnel, satisfaction (American Academy of Orthopaedic Surgeons), and health status (Short Form-36) questionnaires to assess symptoms, functional status, expectations of treatment, and satisfaction with the results at a minimum of 2 years after initial diagnosis. RESULTS: Seventy patients with a mean age of 77.0 years (range, 70.2 to 88.5 years) responded to the survey, with a mean follow-up of 4.8 years. Patients who had surgery were more likely to have had more severe disease than those treated nonoperatively (Mantel-Haentzel test, p < 0.001).Satisfaction was 93 percent after surgical treatment and 54 percent after nonsurgical treatment. Patients who had surgery had significantly better relief of symptoms (t test, p < 0.01), functional status (t test, p < 0.05), satisfaction (t test, p < 0.001), and expectations with treatment (t test, p < 0.05) scores as compared with those who had nonsurgical treatment. CONCLUSIONS: In patients over the age of 70, surgery appears to be associated with better symptom relief, functional status, satisfaction, and expectations with treatment than nonoperative therapy does. Age should not be considered a contraindication for carpal tunnel surgery, nor should nonoperative therapy be favored in this age group.

Title Results and Outcomes After Operative Treatment of High-energy Tibial Plafond Fractures.
Date June 2006
Journal Foot & Ankle International / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society
Excerpt

BACKGROUND: The purposes of this study were to evaluate the clinical and radiographic results and the functional outcomes after operative treatment of tibial plafond fractures treated with internal or external fixation. METHODS: A retrospective review identified 76 patients with 79 fractures (OTA 43-B or 43-C) of the tibial plafond. Their average age was 45 years. Twenty-one fractures (27%) were open, and 43 (54%) were type 43-C3. Five were type 43-B1, four were 43-B2, two were 43-B3, 15 were 43-C1, and 10 were 43-C2. Patients were treated with open reduction and internal fixation (ORIF) (n = 63) or limited open articular reduction and wire ring external fixation (EF) (n = 16). Tibial fixation was performed at a mean of 7.6 days after injury, with staged reconstruction in 56 fractures (71%). Bone graft was used initially in 32 fractures (41%). Early and late complications, secondary procedures, and radiographic evidence of post-traumatic arthritis were evaluated. Foot Function Index (FFI) and Musculoskeletal Function Assessment (MFA) questionnaires were administered. RESULTS: Seventy-nine fractures were followed clinically and radiographically for a mean of 26 (range 24 to 38) months, and 33 patients completed outcomes questionnaires at a mean of 98 months after surgery. Early complications included two superficial wound problems and three deep infections. Late complications included two nonunions and four malunions. Thirty-one fractures (39%) developed post-traumatic arthritis. Complications occurred after six of 21 open fractures and after 11 of 43 type C3 fractures (p = 0.007). Patients treated with EF more frequently had type C3 fractures (88% versus 46%, p = 0.004) compared with patients treated with ORIF. The EF patients developed more complications (six of 16, p = 0.007) and post-traumatic arthritis (11 of 16, p = 0.01) when compared with ORIF. Patients treated with EF (88% were type C3 fractures) had lower FFI and MFA scores. The greatest impairment in outcome was noted after type C3 fractures, regardless of the method of treatment. CONCLUSIONS: Tibial plafond fractures are difficult to manage and may have serious complications. We identified more complications, more secondary procedures, and worse outcomes in patients with articular and metaphyseal comminution (type C3). ORIF was associated with fewer complications and less post-traumatic arthritis when compared to EF, possibly reflecting a selection bias for open injuries and more severely comminuted fractures to be managed with EF. ORIF with appropriate soft tissue handling resulted in acceptable results in most patients. Severely damaged soft tissues and highly comminuted C3 fractures may be safely treated with EF. Loss of function and progression to post-traumatic arthritis are common after tibial plafond fractures. Assessment of long-term results and the efficacy of additional reconstructive procedures will refine the treatment algorithms for these fractures.

Title Posterior Ankle Pain Diagnosed by Positional Mri of the Ankle: a Unique Case of Posterior Ankle Impingement and Osteonecrosis of the Talus.
Date June 2006
Journal Foot & Ankle International / American Orthopaedic Foot and Ankle Society [and] Swiss Foot and Ankle Society
Title Transcriptional Changes During Neuronal Death and Replacement in the Olfactory Epithelium.
Date April 2006
Journal Molecular and Cellular Neurosciences
Excerpt

The olfactory epithelium has the unusual ability to replace its neurons.We forced replacement of mouse olfactory sensory neurons by bulbectomy. Microarray, bioinformatics, and in situ hybridization techniques detected a rapid shift in favor of pro-apoptotic proteins, a progressive immune response by macrophages and dendritic cells, and identified or predicted 439 mRNAs enriched in olfactory sensory neurons, including gene silencing factors and sperm flagellar proteins. Transcripts encoding cell cycle regulators, axonogenesis proteins, and transcription factors and signaling proteins that promote proliferation and differentiation were increased at 5-7 days after bulbectomy and were expressed by basal progenitor cells or immature neurons. The transcription factors included Nhlhl, Hes6, Lmycl, c-Myc, Mxd4, Idl,Nmycl, Cited2, c-Myb, Mybll, Tead2, Dpl, Gata2, Lmol, and Soxll. The data reveal significant similarities with embryonic neurogenesis and make several mechanistic predictions, including the roles of the transcription factors in the olfactory sensory neuron lineage.

Title Concomitant Fractures of the Acetabulum and Spine: a Retrospective Review of over 300 Patients.
Date April 2006
Journal The Journal of Trauma
Excerpt

BACKGROUND: The incidence and spectrum of concomitant acetabulum and spine trauma has not been clearly defined. METHODS: We retrospectively reviewed 307 acetabulum fracture patients over 5 years, and evaluated this cohort for concomitant spine injuries. Patient and injury demographics, spine and neurologic injury and delay in diagnosis were examined. RESULTS: Complete data were available for 275 (90%) of the cohort, and 55 spine injuries (54 fractures and 1 traumatic disc herniation) were identified in 34 patients. Thus, the incidence of concomitant acetabulum and spine fractures was approximately 13% (34 of 275). Four percent of the patients sustained significant thoracolumbar fractures (burst, flexion-distraction, or dislocation). An average 8.6-day delay in diagnosis occurred in three spine fracture patients. One suffered progressive neurologic injury. CONCLUSIONS: It is essential that the traumatologists have a high index of suspicion for spine injury, particularly thoracolumbar injury in patients who sustain fractures of the acetabulum. We recommend early thoracolumbar computed tomography imaging in patients with fractures of the acetabulum if plain radiographs are not possible or inadequate.

Title Normal and Abnormal Face Selectivity of the M170 Response in Developmental Prosopagnosics.
Date February 2006
Journal Neuropsychologia
Excerpt

Developmental prosopagnosia is a lifelong impairment in face recognition despite normal low-level visual processing. Here we used magnetoencephalography (MEG) to examine the M170 response, a component occurring approximately 170 ms after stimulus onset, in a group of five developmental prosopagnosics. In normal subjects, the M170 is "face-selective", with a consistently higher amplitude to faces than to a wide variety of other visual stimulus categories; the N170, a component recorded using event-related potentials (ERP) and thought to be analogous to the M170, also shows this "face selectivity". Two previous ERP studies with developmental prosopagnosics have found attenuation or absence of face selectivity in the N170 response of these subjects [Bentin, S., Deouell, L. Y., and Soroker, N. (1999). Selective visual streaming in face recognition: Evidence from developmental prosopagnosia. Neuroreport, 10, 823-827; Kress, T., and Daum, I. (2003). Event-related potentials reflect impaired face recognition in patients with congenital prosopagnosia. Neuroscience Letters, 352, 133-136]. Three of our developmental prosopagnosic group showed this non-selective pattern at the M170 while the remaining two prosopagnosics were indistinguishable from normal controls. Thus, impaired face recognition is not necessarily correlated with an absence of the "face-selective" M170. Furthermore, ERP recordings collected simultaneously in the two developmental prosopagnosics with seemingly selective M170s also showed N170s within the same normal selective range, demonstrating that the face-selective signals found with MEG are not due to differences between MEG and ERP. While the presence of face selectivity at these neurophysiological markers is insufficient for predicting normal behavioral performance with faces, it could help to distinguish different classes of face recognition deficits.

Title Transcriptional Changes During Neuronal Death and Replacement in the Olfactory Epithelium.
Date November 2005
Journal Molecular and Cellular Neurosciences
Excerpt

The olfactory epithelium has the unusual ability to replace its neurons. We forced replacement of mouse olfactory sensory neurons by bulbectomy. Microarray, bioinformatics, and in situ hybridization techniques detected a rapid shift in favor of pro-apoptotic proteins, a progressive immune response by macrophages and dendritic cells, and identified or predicted 439 mRNAs enriched in olfactory sensory neurons, including gene silencing factors and sperm flagellar proteins. Transcripts encoding cell cycle regulators, axonogenesis proteins, and transcription factors and signaling proteins that promote proliferation and differentiation were increased at 5--7 days after bulbectomy and were expressed by basal progenitor cells or immature neurons. The transcription factors included Nhlh 1, Hes 6, Lmyc 1, c-Myc, Mxd 4, Id 1, Nmyc 1, Cited 2, c-Myb, Mybl 1, Tead 2, Dp 1, Gata 2, Lmo 1, and Sox1 1. The data reveal significant similarities with embryonic neurogenesis and make several mechanistic predictions, including the roles of the transcription factors in the olfactory sensory neuron lineage.

Title Office Reconditioning of Stainless Steel Orthodontic Attachments.
Date July 2005
Journal European Journal of Orthodontics
Excerpt

An investigation was conducted to determine a simple, effective method for reconditioning stainless steel orthodontic attachments in the orthodontic office. In total, 100 new brackets were bonded to premolar teeth, then debonded and the bond strength recorded as a control for the reconditioning process. The debonded brackets were divided into six groups and each group reconditioned using different techniques as follows: attachments in four groups were flamed and then either (1) sandblasted, (2) ultrasonically cleaned, (3) ultrasonically cleaned followed by silane treatment, (4) rebonded without further treatment. Of the two remaining groups, one was sandblasted, while the brackets in the other were roughened with a greenstone. The brackets were rebonded to the premolar teeth after the enamel surfaces had been re-prepared, and their bond strengths measured. The results indicated that sandblasting was the most effective in removing composite without a significant change in bond strength compared with new attachments. Silane application did not improve the bond strength values of flamed and ultrasonically cleaned brackets. Attachments that had only been flamed had the lowest bond strength, followed by those that had been roughened with a greenstone.

Title Isorhythmic Interaction Between a Dual-chamber Pacemaker and an Intrinsic Rhythm: Pacemaker Malfunctioning or Not?
Date June 2005
Journal Heart Rhythm : the Official Journal of the Heart Rhythm Society
Excerpt

A patient underwent cardiac surgery (including a biatrial maze procedure) for congenital heart disease and paroxysmal atrial tachycardia. Previously, a dual-chamber pacemaker was inserted for bradycardia. Postoperative ECG showed a narrow complex rhythm interspersed with pacing stimuli that appeared premature and unable to capture. The phenomenon was due to isorhythmic interaction between the pacemaker and the patient's own intrinsic rhythm, which is compatible with normal pacemaker functioning. The different patterns possible for the phenomenon and the necessary conditions for their occurrence are elucidated.

Title Pneumonitis Following Grease Gun Injury.
Date February 2005
Journal Injury
Excerpt

Grease gun trauma often involves subcutaneous injection of the grease because of the high pressures required for its industrial application. The case is presented of a man who developed a pneumonitis shortly after sustaining a grease gun injury, with injection of grease into his upper thigh associated with significant vascular damage. Pneumonitis has not previously been reported with this type of injury, and is likely to represent a systemic reaction to the local inflammatory response. Management of these injuries should incorporate early debridement with anticipation of underlying vascular trauma, and also an awareness of the potential systemic complications.

Title Outcome of Women with Inadequate Cervical Smears Followed Up for Five Years.
Date September 2003
Journal Journal of Clinical Pathology
Excerpt

The clinical and prognostic significance of "inadequate" cervical smear is unknown, even though women with repeated inadequate smears are referred for colposcopy in the National Health Service (NHS) Cervical Screening Programme. Aim: To follow up a cohort of women with inadequate cervical smears over the following five years to examine outcomes, including detection of high grade cervical intraepithelial neoplasia (CIN).

Title Colorectal Cancer Screening with Ct Colonography, Colonoscopy, and Double-contrast Barium Enema Examination: Prospective Assessment of Patient Perceptions and Preferences.
Date July 2003
Journal Radiology
Excerpt

To prospectively assess and compare perceptions of and preferences for computed tomographic (CT) colonography, colonoscopy, and double-contrast barium enema examination (DCBE) by asymptomatic patients undergoing colorectal cancer screening.

Title Postoperative Taste and Smell Deficit After Upper Gastrointestinal Cancer Surgery--an Unreported Complication.
Date March 2003
Journal Journal of Surgical Oncology
Excerpt

Patients undergoing upper gastrointestinal cancer surgery were noted to suffer loss of taste and/or smell, a previously unreported problem. Our aim was to investigate the extent of this phenomenon, quantify recovery time, and identify potentially associated factors.

Title A Prospective Radiological Analysis of Fragment Displacement in Fractures of the Mandibular Condyle: Evaluation of 96 Consecutive Cases.
Date October 2002
Journal Sadj : Journal of the South African Dental Association = Tydskrif Van Die Suid-afrikaanse Tandheelkundige Vereniging
Excerpt

A prospective radiological study of 96 patients with mandibular condylar neck fractures was undertaken to assess frequency and nature of mandibular condylar displacement. Data collected included age, gender, aetiology, and anatomical site of fracture and direction of displacement. Men aged 20-29 years sustained the majority of condylar fractures. Assault was the major cause of condylar fracture, followed by motor vehicle accidents and sport accidents. No anterior or posterior displacement of the condyle was noted. Medial displacement of the superior fragment was most frequently observed.

Title Does the Lead Apron and Collar Always Reduce Radiation Dose?
Date May 2002
Journal Sadj : Journal of the South African Dental Association = Tydskrif Van Die Suid-afrikaanse Tandheelkundige Vereniging
Excerpt

The possibility that personal lead shielding devices can increase absorption of radiation has not been entertained. The purpose of the present investigation specifically was to determine whether pituitary dose might be increased when a leaded apron and thyroid collar are used. Thermoluminescent dosimeters (TLDs) were used to measure absorbed dose. They were calibrated at the kVp used in the clinical situation and a calibration curve relating light output to dose was generated. Lithium fluoride TLD discs were placed in the pituitary gland region of a Rando-Alderson female human phantom. The equivalent of 100 transpharyngeal exposures were delivered. The resultant light output from recovered dosimeters was converted to a uGy value using the calibration curve. The experiment was repeated using a 0.25 mm lead equivalent collar and apron fitted to the phantom in the customary manner. The entire process was repeated in order to have 30 dosimeters for the unshielded and 30 dosimeters for the shielded conditions. A further 30 dosimeters were sham irradiated and served as controls. A statistical comparison between unshielded and shielded conditions was performed. When the leaded apron and thyroid collar were used the absorbed dose to the pituitary gland was increased significantly (P < 0.05). Following this a second group, using a different dosimetry system and a male phantom repeated the experiment. In both cases, the shielded phantom received significantly higher dose to the pituitary region than the unshielded.

Title Adrenal Masses: the Investigation and Management of Adrenal Incidentalomas.
Date September 2001
Journal Annals of the Royal College of Surgeons of England
Excerpt

Most general surgeons will face at sometime in their career an 'incidentaloma' of the adrenal gland. How should a surgeon approach an incidentaloma found during routine investigation for other unrelated disease processes? This paper discusses the investigation and management of adrenal incidentalomas and includes guidelines for the non-specialist.

Title Molar Distalization with a Modified Distal Jet Appliance.
Date June 2001
Journal Journal of Clinical Orthodontics : Jco
Title The Structural Failure of a Multi-hole Collimator.
Date February 2001
Journal Nuclear Medicine Communications
Excerpt

During measurements of the extrinsic spatial resolution of a gamma camera, it was noted that there was a variation with the position in the field of view. The problem was traced to the collimator, and this was confirmed by inspection of the parallel hole structure. Removal of the cover showed that the lead foil honeycomb had become detached from its surround. The fault could have had serious implications for the quality of patient investigations and could also have caused damage to the crystal if it had gone undetected. As a result of this investigation, the quality assurance procedures within this department have been updated to include a visual check of all collimator cores.

Title Endogenously Expressed Estrogen Receptor and Coactivator Aib1 Interact in Mcf-7 Human Breast Cancer Cells.
Date January 2001
Journal Proceedings of the National Academy of Sciences of the United States of America
Excerpt

Coactivators are believed to mediate estrogen-induced gene responses via interaction with estrogen receptors (ER). Currently, a major challenge is to determine the importance of each coactivator in a specific cell type and promoter context in response to a particular ligand. The potential of ER to interact with a growing list of coactivators has been shown in a variety of in vitro and gene transfer assays, yet very few data have demonstrated the interaction of endogenous coactivators with ER in intact cells. We report here a ligand-specific interaction of endogenous human ER (hER) and the AIB1 coactivator in MCF-7 human breast cancer cells by using immunoprecipitation analyses. Complexes between endogenously expressed hER and AIB1 were detected in estradiol-treated cells and to a much lesser extent in cells treated with the partial agonist, monohydroxytamoxifen. We were unable to detect an hER-SRC-1 complex in our immunoprecipitations from MCF-7 cells. The in vitro-binding affinity for mouse ER interaction with AIB1 was estimated to be 40-120 nM. We conclude that AIB1 is a major coactivator for hER in MCF-7 human breast cancer cells.

Title Absorption, Disposition, and Metabolism of Rosiglitazone, a Potent Thiazolidinedione Insulin Sensitizer, in Humans.
Date August 2000
Journal Drug Metabolism and Disposition: the Biological Fate of Chemicals
Excerpt

Rosiglitazone is a potent peroxisome proliferator-activated receptor gamma agonist that decreases hyperglycemia by reducing insulin resistance in patients with type 2 diabetes mellitus. The disposition of (14)C-labeled rosiglitazone was determined after oral and i.v. dosing of rosiglitazone solution, and the disposition of nonradiolabeled rosiglitazone was determined after oral dosing of tablets in this open-label, three-part, semirandomized, crossover study. The absorption of rosiglitazone was rapid and essentially complete, with absolute bioavailability estimated to be approximately 99% after oral tablet dosing and approximately 95% after oral solution dosing, and clearance was primarily metabolic. The time to maximal concentration of radioactivity and the elimination half-life for two metabolites in plasma were significantly longer than for rosiglitazone itself (4-6 h versus 0. 5-1 h, and ca. 5 days versus 3-7 h). Radioactivity was excreted primarily via the urine ( approximately 65%) and was excreted similarly after oral and i.v. dosing. The major routes of metabolism were N-demethylation and hydroxylation with subsequent conjugation, of which neither was affected by the route of drug administration. The major metabolites, those of intermediate importance, and nearly all of the trace metabolites in humans have been identified previously in preclinical studies. Rosiglitazone was well tolerated in all formulations.

Title Recruitment of House Staff into Anesthesiology: Factors Responsible for House Staff Selecting Anesthesiology As a Career and Individual Training Program.
Date August 1999
Journal Journal of Clinical Anesthesia
Excerpt

STUDY OBJECTIVE: To identify factors responsible in the selection of anesthesiology as a career by Mayo Clinic house staff (i.e., residents and clinical fellows); to evaluate their level of satisfaction with their choice of career and training program, and their perceptions of the future for anesthesiology trainees. DESIGN: Cross-sectional analysis using a questionnaire survey of 67 house staff enrolled in the anesthesiology training program during the 1995-1996 academic year. SETTING: Mayo Clinic, Rochester, MN. MEASUREMENTS AND MAIN RESULTS: Forty-eight (72%) of those surveyed responded to the questionnaire. Data were analyzed using the Chi-square and Mann-Whitney rank sum tests. A p-value less than or equal to 0.05 was considered statistically significant. The most frequently cited reasons for selecting anesthesiology as a career included the following: it is a "hands-on" specialty, it involves clinical application of physiology and pharmacology, and it provides immediate gratification in one's work. The most frequently cited reasons for selecting our training program were the diversity of training experience, prestige associated with Mayo Clinic, and employment opportunities following training. Forty-four (92%) felt downsizing of anesthesiology training programs was a national trend, 26 (54%) anticipated difficulty obtaining a job following training, and 16 (33%) felt they had future job security. Overall, 47 (98%) were happy with their career choice, and 40 (83%) would choose anesthesiology as a career if they were now graduating from medical school. All 1996 graduates found suitable employment without difficulty. CONCLUSIONS: Our data indicate that selection of a career in anesthesiology and training program are strongly associated with concerns regarding educational experiences and postgraduate employment opportunities.

Title Malocclusion in Patients Presenting for Orthodontic Treatment.
Date August 1998
Journal The Journal of the Dental Association of South Africa = Die Tydskrif Van Die Tandheelkundige Vereniging Van Suid-afrika
Excerpt

The Angle and Steiner classifications are used extensively in orthodontics. The prevalence of malocclusions in Caucasian patients living in the Western Cape was determined using both classifications and the degree of concordance of the data thus obtained was ascertained. A high prevalence of Angle Class I and II was found. No statistically significant differences could be demonstrated between the data obtained from the two systems although there were discrepancies. The implications of the findings are discussed and it is concluded that each classification system used on its own does not provide enough information for accurate diagnostic and treatment planning purposes.

Title Biostereometric Quantification of Clinical Denture Tooth Wear.
Date February 1997
Journal Journal of Oral Rehabilitation
Excerpt

In this study the wear of mandibular acrylic resin teeth opposed by porcelain maxillary teeth arranged in a lingualized occlusal scheme over a period of 3 years was measured. Six edentulous subjects received complete dentures as above and with three baseline markers of amalgam. At yearly intervals casts were made of the mandibular occlusal surfaces, including markers, and plotted by stereophotogrammetry. Volumetric loss of material was quantifiable. Ranges of 0.62-3.33 mm3/mm2 on the left side and 0.71-1.64 mm3/mm2 on the right were recorded. Friedman two-way ANOVA test indicated significant wear on teeth 35, 36, 45 and 46 but not on 34 and 44. A one-sided chewer displayed greater wear on the contralateral side, a finding difficult to explain.

Title The Relationship Between Clinical Denture Tooth Abrasion and Morphologic Features of the Mandible.
Date April 1995
Journal The Journal of Prosthetic Dentistry
Excerpt

Biostereometric evaluation of denture tooth wear in 25 subjects was used to determine whether there was a relationship between the gonial angle, mandibular length, Frankfort-mandibular angle, and abrasion of denture teeth. The results of this study indicated no correlation could be demonstrated between any of the factors.

Title Construction and Characterization of Isogenic O-antigen Variants of Salmonella Typhi.
Date January 1995
Journal Molecular Microbiology
Excerpt

A 7.5 kb KpnI-generated fragment, from within the rfb cluster of Salmonella typhimurium LT2 that encodes abequose synthase (the rfbJ gene) which is necessary for O4 antigen synthesis, and flanking sequences, was inserted into a suicide vector. Using allelic exchange techniques, these rfb sequences of S. typhimurium were integrated into the rfb clusters of wild-type Salmonella typhi Vi-positive strain ISP 1820 (i.e. serotype O9,12; Vi+; H-d), S. typhi Vinegative strain H400 (i.e. serotype O9,12; Vi-; H-d), and a double aro mutant of S. typhi ISP 1820, strain CVD 906, resulting in the isolation of strains H325, H404 and CVD 906-O4, respectively. Immunoblot analysis of lipopolysaccharide (LPS) purified from H325, H404 and CVD 906-O4 demonstrated that these strains express the O4 antigen (an abequose residue) in place of the O9 antigen (a tyvelose residue) in the LPS molecule. Hence, the serotype of H325 is O4,12; Vi+; H-d and the serotype of H404 is O4,12; Vi-; H-d. DNA hybridization analysis of chromosomal DNA from H325, H404 and CVD 906-O4 confirmed that a precise recombination event within sequences flanking rfbSE of S. typhi (which encodes the enzymes necessary for cytidine diphosphate-tyvelose synthesis) resulted in replacement of rfbSE with rfbJ (which encodes abequose synthase and is necessary for O4 synthesis) of S. typhimurium in strains H325, H404 and CVD 906-O4. The resistance of each strain to the bactericidal effects of guinea-pig serum (GPC) was assessed. Whereas ISP 1820, H325 and H404 exhibit similar resistance patterns in GPC, strain H400 is sensitive to the bactericidal effects of GPC.(ABSTRACT TRUNCATED AT 250 WORDS)

Title Adaptive Acid Tolerance Response by Salmonella Typhi and Candidate Live Oral Typhoid Vaccine Strains.
Date December 1994
Journal Vaccine
Excerpt

The data presented here demonstrate that Salmonella typhi is capable of expressing an acid tolerance response (ATR) and that effective induction of this response (in nutrient-rich medium) occurs at pH 5.0 in anaerobic conditions. The candidate live oral S. typhi vaccine strains made by precise genetic methods and which carry auxotrophic mutations were CVD 906 (carries defined attenuating deletion mutations: delta aroC, delta aroD), CVD 908 (carries defined attenuating deletion mutations: delta aroC, delta aroD), 541Ty (carries attenuating deletion mutations: aroA, purA), and galE, Vi-negative (via) strain EX462. All generate an effective ATR. In contrast, nitrosoguanidine-derived live oral typhoid vaccine strain Ty21a only weakly expresses acid tolerance. This further demonstrates that the non-specific mutagenesis process used to produce Ty21a affects genetic loci outside the intended target genes for mutagenesis, galE and via, and further emphasizes the importance of using precise genetic techniques when developing live oral S. typhi vaccines.

Title National and International Aspects of Susceptibility Testing.
Date January 1994
Journal The Journal of Antimicrobial Chemotherapy
Title Heck's Disease (focal Epithelial Hyperplasia): a Longitudinal Study.
Date June 1993
Journal Community Dentistry and Oral Epidemiology
Excerpt

A 3-year longitudinal study on Heck's disease among school children was undertaken in 2 communities which are similar geographically, socioeconomically and ethnically. The variations in the annual prevalence rates (7% to 13%), the incidence rates per 1000 (38 to 68), the female to male ratios (1:0.4 to 1:1) and the average ages of the affected pupils did not differ between communities and from year to year. Lesions varied in number, size and duration. Some were seen only at one of the examinations, while others remained during the whole study. The majority were situated on the mucosae of the lower lips and cheeks. The prevalence of lesions amongst school children in these two communities was noticeably higher than that of another community of similar ethnicity studied earlier. The clinical behaviour of the lesions is in keeping with what is expected of some HPV infections. The relatively high prevalence rate and the anatomical distribution of the lesions indicate the infectious nature of the disease, which we believe is influenced to a large extent by the lifestyle in these communities.

Title Stereometric Evaluation of the Enamel-stripping Effect of Hydrochloric Acid.
Date May 1993
Journal Journal of Clinical Orthodontics : Jco
Title Caring for Older Texans: Assessing Nutritional Status.
Date January 1993
Journal Texas Nursing
Title Ceftazidime Disc Content Recommendation and Susceptibility Testing.
Date December 1992
Journal The Journal of Antimicrobial Chemotherapy
Title Shear Peel Bond Strengths of Esthetic Orthodontic Brackets.
Date September 1992
Journal American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics
Excerpt

Anecdotal reports of bracket fracture and tooth damage associated with the use of certain esthetic orthodontic brackets have been reported in the literature. With the advent of new esthetic orthodontic brackets, the need has arisen to test the claims of the manufacturers. The objectives of this study were to determine: (1) shear peel bond strengths (SPBS) of various debonded orthodontic brackets, (2) SPBS of these rebonded esthetic brackets with and without use of silane, and (3) fracture sites of all groups examined. Seventy-five noncarious human premolar teeth were randomly divided into five groups (A through E). The teeth were cleaned, stored in 70% ethyl alcohol, and mounted for testing in the Instron machine. The following brackets were bonded to the teeth with Ortho-Concise bonding resin: (A) metal brackets, (B) Silkon brackets, (C) Transcend 2000 brackets, (D) debonded Transcend 2000 brackets, and (E) debonded silanized Transcend 2000 brackets. After wet storage at 37 degrees C for 7 days, the SPBS of brackets were recorded, and fracture sites observed. There were statistically significant differences between the SPBS of metal brackets when compared with the Transcend 2000 and the Silkon brackets. These groups exhibited clinically acceptable SPBS. Debonded silanized Transcend 2000 brackets showed clinically unacceptable SPBS. Fracture sites of metal and Transcend 2000 brackets were resin-bracket, whereas Silkon brackets fracture sites were predominantly resin-enamel.

Title Evaluation in Volunteers of a Candidate Live Oral Attenuated Salmonella Typhi Vector Vaccine.
Date September 1992
Journal The Journal of Clinical Investigation
Excerpt

Candidate vector vaccine strain CVD 906 (aroC- and aroD- derivative of virulent Salmonella typhi strain ISP1820) was evaluated in phase 1 clinical trials. The first nine volunteers ingested a single dose of 5 x 10(7) CVD 906 bacilli. At this dose CVD 906 stimulates remarkable systemic and mucosal immune responses, inasmuch as 89% of volunteers developed marked serum antibody levels to S. typhi antigens and high numbers of antigen-specific gut-derived antibody-secreting cells. Four (44%) volunteers developed asymptomatic vaccinemia 4-10 d after immunization and all volunteers excreted CVD 906 on at least one occasion. However, two volunteers developed febrile adverse reactions, one on the day of vaccination and the other on day 4. Of 11 volunteers who ingested a single dose of 5 x 10(3) CVD 906 bacilli, none displayed side effects but 27% developed significant serum responses to S. typhi LPS. In vitro, CVD 906 replicates for only nine generations in pooled human serum, indicating that CVD 906 growth is limited in this physiologically relevant medium. In phorbol myristate acetate-induced U937 human macrophage-like cells, CVD 906 replicates intracellularly to a lesser extent than parent strain ISP1820. Although, strain CVD 906 is attenuated and highly immunogenic, the occasional febrile reactions at high doses indicate that further attenuation of this strain is necessary.

Title Variability in Response to a Low-fat, Low-cholesterol Diet in Children with Elevated Low-density Lipoprotein Cholesterol Levels.
Date June 1992
Journal Pediatrics
Excerpt

The reduction of dietary cholesterol and fat lowers low-density lipoprotein cholesterol (LDL-C) and reduces risk of coronary heart disease in adults. The purpose of this study was to determine the individual variability of response of serum lipid and lipoprotein levels to a low-fat, low-cholesterol diet in children with elevated LDL-C levels. Thirty-two children (2 to 16 years of age) enrolled in a diet modification program, who had LDL-C levels of at least 110 mg/dL but normal triglyceride levels for their ages, were studied. Lipid levels and dietary nutrients were analyzed at the time of admission, and final assessments were made at least 3 months after entry. There was a significant correlation, for the group as a whole, between change in LDL-C concentration and change in grams of dietary saturated fat; however, there was marked individual variability in LDL-C response. There were no significant correlations between changes in LDL-C levels and changes in either total fat, polyunsaturated fat, or cholesterol intake. It is concluded that modest decreases in dietary saturated fat coincide with a lowering of LDL-C concentration, over a short term, in many children, but the degree of lowering varies considerably from one child to another. This variability is consistent with the concept that response of serum lipid levels to dietary changes is modified by genetic, metabolic, and other, as of yet, undefined variables.

Title Atrial Fibrillation and Interatrial Septal Aneurysm in a Patient with Marfan's Syndrome.
Date April 1992
Journal International Journal of Cardiology
Excerpt

A 25-year-old male, with Marfan's syndrome, had asymptomatic atrial fibrillation. Echocardiography revealed an interatrial septal aneurysm. Electrical cardioversion restored sinus rhythm. Relevant aspects of interatrial septal aneurysm are reviewed.

Title Assistant Head Nurse: Today's Catalytic Manager.
Date February 1992
Journal Nursing Management
Title Comparison of the Safety and Immunogenicity of Delta Aroc Delta Arod and Delta Cya Delta Crp Salmonella Typhi Strains in Adult Volunteers.
Date February 1992
Journal Infection and Immunity
Excerpt

Three attenuated Salmonella typhi strains have been constructed by introducing deletions in aroC and aroD or deletions in cya and crp into one of two wild-type parent strains, Ty2 or ISP1820. These mutant strains were designated CVD 906 (ISP1820 delta aroC delta aroD), CVD 908 (Ty2 delta aroC delta aroD), and chi 3927 (Ty2 delta cya delta crp). Two studies were conducted with 36 healthy adult inpatient volunteers to determine in a double-blind fashion the safety and immunogenicity of approximately 5 x 10(4) and 5 x 10(5) CFU of each of these three vaccine candidates given as a single dose. No statistically significant difference in the incidence of reactions among vaccinees was observed. Fever (oral temperature greater than or equal to 38.2 degrees C) occurred in 2 of 12 volunteers who received CVD 906, in 0 of 12 who received CVD 908, and in 1 of 12 who received chi 3927. Vaccine bacteremia without symptoms occurred in 1 of 12 vaccinees who received CVD 906, in 0 of 12 who received CVD 908, and in 2 of 12 who received chi 3927. Overall, 19 (53%) of 36 vaccinees developed immunoglobulin G antibody to S. typhi lipopolysaccharide after vaccination, with no statistically significant differences in the rate of seroconversion among volunteers in the three groups. We conclude that defined mutations in the aromatic biosynthetic pathway and in the cyclic AMP global regulatory system attenuate S. typhi. Mutant strains CVD 906, CVD 908, and chi 3927 are highly (and approximately equally) immunogenic but possibly differ in their propensity to induce fever. Further studies are needed to document the apparent relative safety of CVD 908 as a typhoid vaccine and as a vaccine carrier of foreign antigens.

Title Characterization of Effector Functions of V-raf/mil- and V-myc-transformed Murine Splenic Macrophage Cell Lines.
Date September 1991
Journal Cellular Immunology
Excerpt

We have characterized several of the cytocidal effector functions of a series of cell lines derived by recombinant retroviral transformation of individual clones of C3H/HeJ mouse splenic macrophages. The three cell lines described in this report (4.01, 4.07, 4.14) all expressed equivalent tumoricidal activity against P815 tumor target cells. However they differed in their high avidity binding of tumor cells (4.01 = 4.14 greater than 4.07), as well as in the killing of Leishmania major (4.01 = 4.07 greater than 4.14), the expression of antibody-dependent cellular cytotoxicity against chicken erythrocytes (4.14 greater than 4.01 greater than 4.07), and finally, in the tumor-stimulated release of tumor necrosis factor-alpha (4.01 = 4.14 greater than 4.07). The stable and restricted expression of distinct effector functions among these three cell lines makes them particularly valuable as models for establishing the precise mechanisms by which cytocidal functions are effected. In addition, they should also prove of value in understanding the basis for macrophage functional diversity.

Title Hiv Infection in Female Intravenous Drug Abusers (ivdas) of Childbearing Age in Nyc Drug Clinics and Their Demographic Profile.
Date September 1991
Journal Nida Research Monograph
Title The Leaded Apron Revisited: Does It Reduce Gonadal Radiation Dose in Dental Radiology?
Date July 1991
Journal Oral Surgery, Oral Medicine, and Oral Pathology
Excerpt

A tissue-equivalent anthropomorphic human phantom was used with a lithium fluoride thermoluminescent dosimetry system to evaluate the radiation absorbed dose to the ovarian and testicular region during dental radiologic procedures. Measurements were made with and without personal lead shielding devices consisting of thyroid collar and apron of 0.25 mm lead thickness equivalence. The radiation absorbed dose with or without lead shielding did not differ significantly from control dosimeters in vertex occlusal and periapical views (p greater than 0.05). Personal lead shielding devices did reduce gonadal dose in the case of accidental exposure (p less than 0.05). A leaded apron of 0.25 mm lead thickness equivalent was permeable to radiation in direct exposure testing.

Title The Effects of Diet on Serum Cholesterol in Children.
Date July 1991
Journal Annals of the New York Academy of Sciences
Title Comparison of Shear Bond Strengths of Orthodontic Resins to Ceramic and Metal Brackets.
Date July 1991
Journal Journal of Clinical Orthodontics : Jco
Title Efficacy of a Report-form Template for Radiological Interpretation.
Date May 1991
Journal Dento Maxillo Facial Radiology
Title Mode of Action of Gr69153, a Novel Catechol-substituted Cephalosporin, and Its Interaction with the Tonb-dependent Iron Transport System.
Date March 1991
Journal Antimicrobial Agents and Chemotherapy
Excerpt

GR69153 is a novel cephalosporin incorporating a catechol-substituted 7-aminothiazolyl-oxime. The antibiotic is actively transported into gram-negative cells via iron-regulated outer membrane proteins regulated by the tonB product. This transport enhances bactericidal activity most significantly at low concentrations, essentially removing the permeability barrier for antibiotic uptake.

Title Delayed Diagnosis of Thyrotoxic Heart Disease.
Date April 1990
Journal The British Journal of Clinical Practice
Title Critical Care Voices: Application of Research in Clinical Practice.
Date April 1990
Journal Dimensions of Critical Care Nursing : Dccn
Excerpt

The primary value of clinical research is implementation in clinical practice to improve the quality of nursing care: yet application of research in many clinical settings remains difficult. Here are six different opinions from critical care nurses on why it is difficult to implement the research in clinical practice and what can be done to assist in this research application.

Title The Radiologic Features of True Ankylosis of the Temporomandibular Joint. An Analysis of 25 Cases.
Date March 1990
Journal Dento Maxillo Facial Radiology
Title Gender and Ethnic Differences of the Radiographic Image of the Frontal Region.
Date December 1989
Journal The Journal of Forensic Odonto-stomatology
Title Patterns of Stress Among Dentists.
Date October 1989
Journal The Journal of the Dental Association of South Africa = Die Tydskrif Van Die Tandheelkundige Vereniging Van Suid-afrika
Title Retention Strategies That Work.
Date August 1989
Journal Nursing Management
Title Morphologic Alterations of the Temporomandibular Joint in a Patient with Sotos' Syndrome: Report of a Case.
Date November 1988
Journal Annals of Dentistry
Title Deep Venous Thrombosis: a Misdiagnosis of Popliteal Aneurysms.
Date September 1988
Journal British Journal of Hospital Medicine
Title Periostitis Ossificans Versus Garrè's Osteomyelitis. Part I. What Did Garrè Really Say?
Date August 1988
Journal Oral Surgery, Oral Medicine, and Oral Pathology
Excerpt

In 1893, C. Garrè published an article dealing with the manifestations of acute osteomyelitis. Since then, his name has been associated with diseases such as Garrè's osteomyelitis, chronic sclerosing osteomyelitis, and periostitis ossificans, among others. Scrutiny of a translated version of the original article reveals that Garrè was not responsible for the description of the disease that now bears his name.

Title Deliberately Inflicted, Penetrating Injuries of the Maxillofacial Region (jael's Syndrome). Report of 4 Cases.
Date April 1988
Journal Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-maxillo-facial Surgery
Excerpt

Four cases of intentional knife wounds of the maxillofacial region are presented. In all instances the patients were conscious at the time of admission, with a knife blade in situ. Treatment consisted of simple removal of the knife. Post surgical recovery was rapid and uneventful. No fatalities resulted and no permanent vascular or neurological damage occurred.

Title Fatal Hemorrhage Following Rubber Band Ligation of Hemorrhoids.
Date March 1988
Journal Diseases of the Colon and Rectum
Title The Use of an Endotracheal Tube for Cannulation of Left Superior Vena Cava Via Coronary Sinus for Repair of a Sinus Venosus Atrial Septal Defect.
Date March 1988
Journal British Heart Journal
Excerpt

A reinforced cuffed endotracheal tube was used to drain blood from a left superior vena cava via the coronary sinus during patch repair of a sinus venosus defect in a 65 year old patient. This approach produced good drainage and a bloodless operative field.

Title Radiologic Interpretation of Radiopaque Foreign Bodies of the Maxillofacial Region--a Review.
Date December 1987
Journal The Journal of Forensic Odonto-stomatology
Title The Frontal Sinus: Forensic Fingerprint? A Pilot Study.
Date December 1987
Journal The Journal of Forensic Odonto-stomatology
Title Some Effects of Radiation Therapy During Early Childhood on Facial Growth and Tooth Development.
Date July 1987
Journal The Journal of the Dental Association of South Africa = Die Tydskrif Van Die Tandheelkundige Vereniging Van Suid-afrika
Title Maxillo-facial Radiology in Forensic Dentistry: a Review.
Date January 1987
Journal The Journal of Forensic Odonto-stomatology
Title Haemorrhagic, Traumatic Tenosynovitis.
Date September 1986
Journal Journal of Hand Surgery (edinburgh, Scotland)
Title Clinical Features and Repair of Ventricular Septal Defect and Left Ventricular Aneurysm Complicating Myocardial Infarction.
Date July 1986
Journal British Heart Journal
Excerpt

A 52-year-old man developed a ventricular septal defect and ventricular aneurysm after myocardial infarction. The two defects were repaired through the left ventricular aneurysm using hypothermic techniques. Only two similar cases have been previously reported.

Title Human Mononuclear Phagocyte Antiprotozoal Mechanisms: Oxygen-dependent Vs Oxygen-independent Activity Against Intracellular Toxoplasma Gondii.
Date March 1985
Journal Journal of Immunology (baltimore, Md. : 1950)
Excerpt

To determine if the oxygen-dependent and -independent antiprotozoal mechanisms with which the human mononuclear phagocyte is equipped to act against Leishmania donovani operate against other intracellular parasites, oxidatively intact and deficient cells were challenged with Toxoplasma gondii. Fresh monocytes and lymphokine- or gamma-interferon (IFN-gamma)-activated macrophages from normal individuals killed 35% and 50% of T. gondii within 6 hr, respectively, and each of these cell populations inhibited the replication of surviving parasites 20 hr after infection. This activity was associated with the capacity to release large amounts of H2O2 (572 to 971 nmol/mg) and to respond to toxoplasma ingestion with respiratory burst activity. Impairing the ability to generate oxygen intermediates by glucose deprivation or treatment with superoxide dismutase, catalase, or mannitol inhibited toxoplasmacidal activity by greater than 80% and permitted a 2.6- to 4.3-fold increase in the number of intracellular toxoplasmas. In contrast to normal cells, fresh monocytes from patients with chronic granulomatous disease (CGD) killed less than 8% of toxoplasmas and exerted 50% less toxoplasmastatic activity. However, although associated with the induction of only modest toxoplasmacidal effects (18 to 20% killing), lymphokine stimulation did induce CGD monocytes and macrophages as well as oxidatively inactive human endothelial cells to display near normal levels of toxoplasmastatic activity. Similar to oxygen-dependent mechanisms, the enhancement of oxygen-independent activity by crude lymphokines could be abolished by a monoclonal anti-IFN-gamma antibody and could be achieved by treatment with recombinant IFN-gamma alone. Unstimulated CGD monocytes, however, were found to lose all antitoxoplasma activity after two days in culture, whereas normal cells continued to effectively inhibit T. gondii replication, suggesting that oxygen-independent responses may not actually be required for the normal monocyte to act against T. gondii. Taken together with previous findings with L. donovani, these results indicate that the human mononuclear phagocyte possesses an oxygen-independent antiprotozoal mechanism and that its effects can be enhanced by lymphokines (IFN-gamma), but that nevertheless this cell's primary response to intracellular protozoa is largely oxygen dependent.

Title Dmso Therapy for Posterior Paralysis.
Date August 1982
Journal Journal of the American Veterinary Medical Association
Title The Mayo Three-community Hypertension Control Program. V. Cost-effectiveness of Intervention.
Date March 1981
Journal Mayo Clinic Proceedings. Mayo Clinic
Excerpt

This paper compares the costs of a categorical clinic model for community hypertension intervention with the costs of two less resource-intensive hypertension programs. Three categories of costs are measured for each program: program costs, patient costs, and time costs. Total costs are expressed in terms of costs per hypertensive patient controlled under each program. When adjusted for differences in hypertension prevalence and screening costs in the three community programs, the cost-effectiveness of the categorical clinic model is questionable. These results suggest that careful analyses of the categorical clinic model in other communities should be conducted before public resources are committed to the establishment of such models on a widespread basis.

Title Impact of Population-based Cardiovascular Disease Prevention Programs on Ambulatory Care Demand in Rural Populations.
Date January 1981
Journal Journal of the South Carolina Medical Association (1975)
Title Cancer Health Education.
Date November 1979
Journal Radiography
Title A Controlled Evaluation of Metoprolol.
Date June 1979
Journal The Practitioner
Title Factors Affecting the Intramuscular Absorption of Cefuroxime.
Date April 1979
Journal The Journal of Antimicrobial Chemotherapy
Title The Treatment of Clinical Mastitis with Cephoxazole and Penicillin.
Date September 1977
Journal The Veterinary Record
Title The Effects of Three Halogenated Alkanes on Excitation and Contraction in the Isolated, Perfused Rabbit Heart.
Date December 1976
Journal Toxicology and Applied Pharmacology
Title Identification of Beta-lactamases by Analytical Isoelectric Focusing: Correlation with Bacterial Taxonomy.
Date August 1976
Journal Journal of General Microbiology
Excerpt

beta-Lactamases (EC. 3.5.2.6) can be directly compared by analytical isoelectric focusing. Using this technique, 242 strains from five Gram-positive and 16 Gram-negative genera were examined. A preparation of each strain focused as a single group of bands which did not match the pattern of any R factor-associated beta-lactamase. None of the strains was known to carry an R factor and resistance transfer experiments were unsuccessful. The enzymes studied were therefore thought to be chromosomally mediated. The isoelectric points ranged from 3.9 to 8.7 and were not related to the substrate profiles or other biochemical properties. The chromosomal beta-lactamases appeared to be specific for genus, species and sub-species, and strains that produced identical beta-lactamases had identical bacterial characteristics. Correlation of bacteriological differences with differences in beta-lactamase patterns is discussed with particular reference to strains of Escherichia coli and Klebsiella spp. Since beta-lactamases may be universally produced by bacteria, separation of the enzymes by analytical isoelectric focusing could be used in bacterial taxonomy.

Title Antibiotic Selection in Clinical Mastistis.
Date December 1975
Journal The Veterinary Record
Title The Use of Analytical Isoelectric Focusing for Detection and Identification of Beta-lactamases.
Date November 1975
Journal Journal of General Microbiology
Excerpt

BETA-Lactamases (EC. 3.5.2.6) from strains of Gram-negative bacteria have been studied using analytical isoelectric focusing. This permits a visual comparison of the patterns of beta-lactamase bands produced by enzymes from different organisms. Purification of crude intracellular preparations is unnecessary and the technique is sufficiently sensitive to demonstrate beta-lactamase in mutants previously reported to lack the enzyme. R that have not been distinguished from one another biochemically or immunologically can be differentiated by isoelectric focusing. Conversely, the enzymes specified by the R factors RTEM, R1 and RGN14, with identical isoelectric focusing patterns have the same biochemical properties. Chromosomal and R-factor-mediated beta-lactamases from single strains have been separated and their identities confirmed by immunoisoelectric focusing. R factor-mediated enzymes gave identical isoelectric focusing patterns irrespective of the host strain. Isoelectric focusing can therefore be used to observe the transfer of beta-lactamases carried by R factors.

Title Versatile, Protective Jacket for Chronically Instrumented Dogs.
Date October 1975
Journal Laboratory Animal Science
Excerpt

A versatile nylon jacket was designed for mixed-breed dogs to permit easy access to cardiac instrumentation and to protect the leads when not in use.

Title The Treatment of Ethylene Glycol Toxicosis with Pyrazole.
Date June 1975
Journal The Journal of Pharmacology and Experimental Therapeutics
Excerpt

Rats and dogs were protected from the effects of lethal doses of ingested ethylene glycol (EG) with pyrazole (P), an inhibitor of liver alcohol dehydrogenase. Rats given 1.35 ml/100 g of EG followed by 2.2 mmol/kg of P i.p. at 6 and 30 hours postingestion survived. Untreated control animals died. Dogs were given either 10.0 or 12.5 ml/kg of EG and treatment was begun 6 hours later. The control treatment consised of NaHC03 administered i.v. according to the calculated base deficit, B-complex vitamins with ascorbic acid, hydrocortisone, and 5 per cent glucose in water. The addition postexposure to this treatment of 0.9 mmol/kg of P and 0.5 mmol/kg of P at 6 and 30 hours, respectively, constituted the experimental therapy. In summary: with 10 ml/kg of EG, no P, 2 of 5 dogs survived; 12.5 ml/kg of EG, no P, 0/1; 10 ml/kg of EG plus P, 9/11; 12.5 ml/kg of EG plus P, 12/22. Dogs that succumbed had large numbers of oxalate crystals in their kidneys at necropsy. The surviving dogs had few oxalate crystals in their kidneys at the time of unilateral nephrectomy (2 weeks postexposure) or necropsy (30 days postexposure). Several clinical factors were identified as useful prognostic indicators in the treatment of EG poisoning. The results suggested that pyrazole, despite its marked toxicity, may be of clinically significant value in the treatment of ethylene glycol poisoning when therapy is initiated withing 6 hours of exposure.

Title Physician's Assistants and Rural Health Care: a Study of Physician's Attitudes.
Date March 1975
Journal Journal of the Medical Association of the State of Alabama
Title American Board for Occupational Health Nurses, Inc.--a Progress Report.
Date September 1974
Journal Occupational Health Nursing
Title The Determination of the Inotropic Effect of Exposure of Dogs to Bromotrifluoromethane and Bromochlorodifluoromethane.
Date March 1974
Journal Toxicology and Applied Pharmacology
Title Certification of Occupational Health Nurses.
Date December 1973
Journal Occupational Health Nursing
Title Comparison of Assay Techniques for Beta-lactamase Activity.
Date October 1973
Journal Analytical Biochemistry
Title Comparison of the Substrate Specificities of the -lactamases from Klebsiella Aerogenes 1082e and Enterobacter Cloacae P99.
Date June 1972
Journal Applied Microbiology
Excerpt

A potent beta-lactamase (EC 3.5.2.6) produced by a strain of Klebsiella aerogenes (K. pneumoniae), 1082E, isolated from a hospital patient, has been examined. Its properties were different from those of most gram-negative beta-lactamases previously reported. The enzyme has been partly purified, and its activity against a range of substrates has been compared with that of the enzyme from Enterobacter cloacae (Aerobacter cloacae) P99. The K. aerogenes enzyme, although predominantly a penicillinase, had a wide range of specificity. In addition to hydrolyzing the cephalosporins, it attacked the normally beta-lactamaseresistant compounds methicillin and cloxacillin as well as cephalosporin analogues with the same acyl substituents. The results obtained with the E. cloacae enzyme confirmed its cephalosporinase activity and showed that, unlike the enzyme from K. aerogenes, it was relatively inactive against the penicillins.

Title Why Bother?
Date March 1972
Journal Occupational Health Nursing
Title Problems with Long-term Endocardial Pacing in Children.
Date June 1970
Journal Thorax
Title T-wave Changes After Artificial Pacing.
Date May 1969
Journal Lancet
Title Pacemaker Clicks Clarified.
Date March 1969
Journal Annals of Internal Medicine
Title Pre-irradiation Annealing of Tld Lithium Fluoride.
Date January 1969
Journal Health Physics
Title Measuring the Nurse's Effectiveness.
Date December 1968
Journal American Association of Industrial Nurses Journal
Title S O S.
Date August 1968
Journal Transactions. National Safety Council. National Safety Congress
Title Endocardial Pacing.
Date October 1966
Journal American Heart Journal
Title Cardiac Pacing.
Date January 1966
Journal Thoraxchirurgie Und Vaskuläre Chirurgie
Title Bidirectional Release of Ammonium by the Kidneys in Patients with Respiratory Failure. Effect of Increasing the Concentration of Inspired Oxygen.
Date January 1966
Journal Nephron
Title Achalasia: Management, Outcome and Surveillance in a Specialist Unit
Date
Journal The British Journal of Surgery
Excerpt

AIMS: The management and surveillance of achalasia remains controversial at the present time. The aim of this study was therefore to evaluate the results of endoscopic management and subsequent surveillance of patients with achalasia presenting to a specialist unit. METHODS: A prospective cohort of 40 patients with a radiological and manometric diagnosis of achalasia who presented to this unit between 1991 and 1998 were studied; the male : female ratio was 1 : 1 and the median age 38 (range 15-84) years. Twenty-one patients presented de novo, seven had previously undergone cardiomyotomy and 12 were referred following unsuccessful dilatation. RESULTS: Some 36 patients were treated with balloon dilatation (Microvasive achalasia balloon, 35/40 mm). Results were graded 1-4 (1, asymptomatic; 2, symptomatic but significantly improved; 3, symptomatic with no change; and 4, symptomatic but worse); 29 of 36 patients were grade 1 at subsequent follow-up and the remaining seven were grade 2 (median follow-up 17 (range 5-96) months). There was a single complication of oesophageal perforation which was treated conservatively with full recovery. Following intervention, patients were enrolled in a prospective surveillance programme of chromoendoscopy at 2-year intervals; in a total of 74 patient-years' follow-up, two superficial squamous cell carcinomas (SCCs) and one adenocarcinoma (following cardiomyotomy) were detected, giving a relative risk of one cancer in 25 patient-years. CONCLUSIONS: Balloon dilatation is a safe and effective treatment for achalasia even in patients who have had previous unsuccessful dilatations or cardiomyotomy. There is a high risk of SCC and the adenocarcinoma may have resulted from previous refluxogenic therapy, so all patients with achalasia should be followed up with surveillance endoscopy.

Title Detecting Spatiotemporal Clusters of Accidental Poisoning Mortality Among Texas Counties, U.s., 1980 - 2001.
Date
Journal International Journal of Health Geographics
Excerpt

BACKGROUND: Accidental poisoning is one of the leading causes of injury in the United States, second only to motor vehicle accidents. According to the Centers for Disease Control and Prevention, the rates of accidental poisoning mortality have been increasing in the past fourteen years nationally. In Texas, mortality rates from accidental poisoning have mirrored national trends, increasing linearly from 1981 to 2001. The purpose of this study was to determine if there are spatiotemporal clusters of accidental poisoning mortality among Texas counties, and if so, whether there are variations in clustering and risk according to gender and race/ethnicity. The Spatial Scan Statistic in combination with GIS software was used to identify potential clusters between 1980 and 2001 among Texas counties, and Poisson regression was used to evaluate risk differences. RESULTS: Several significant (p < 0.05) accidental poisoning mortality clusters were identified in different regions of Texas. The geographic and temporal persistence of clusters was found to vary by racial group, gender, and race/gender combinations, and most of the clusters persisted into the present decade. Poisson regression revealed significant differences in risk according to race and gender. The Black population was found to be at greatest risk of accidental poisoning mortality relative to other race/ethnic groups (Relative Risk (RR) = 1.25, 95% Confidence Interval (CI) = 1.24 - 1.27), and the male population was found to be at elevated risk (RR = 2.47, 95% CI = 2.45 - 2.50) when the female population was used as a reference. CONCLUSION: The findings of the present study provide evidence for the existence of accidental poisoning mortality clusters in Texas, demonstrate the persistence of these clusters into the present decade, and show the spatiotemporal variations in risk and clustering of accidental poisoning deaths by gender and race/ethnicity. By quantifying disparities in accidental poisoning mortality by place, time and person, this study demonstrates the utility of the spatial scan statistic combined with GIS and regression methods in identifying priority areas for public health planning and resource allocation.

Title Does Non-exercise Activity Thermogenesis Contribute to Non-shivering Thermogenesis?
Date
Journal Journal of Thermal Biology
Excerpt

We wanted to examine if spontaneous physical activity contributes to non-shivering thermogenesis. Ten lean, healthy male subjects wore a physical activity, micro-measurement system whilst the room temperature was randomly altered at two hourly intervals between thermoneutral (72°F), cool (62°F) and warm (82°F) temperatures. Physical activity measured during the thermoneutral, cooling and warming periods was not significantly different. Cooling, increased EE above basal and thermoneutral values 2061 ± 344 kcal/day (p <0.01). Thus, the increase in energy expenditure associated with short-term environmental cooling in lean, healthy males does not appear to be due to increased spontaneous physical activity or fidgeting.

Title Simultaneous Anterior and Posterior Approaches for Complex Acetabular Fractures.
Date
Journal Journal of Orthopaedic Trauma
Excerpt

Simultaneous Kocher-Langenbeck and iliofemoral exposures of the acetabulum are a safe and useful alternative to other extensile exposures and can be performed with similar morbidity. The advantages of simultaneous anterior and posterior approaches over extensile exposures include the absence of a trochanteric osteotomy. The combined approach is most useful in transverse, transverse posterior wall fractures with wide anterior displacement, T type fractures with significant anterior-inferior displacement, or both column fractures with posterior wall involvement.

Title Biliary Peritonitis Caused by a Leaking T-tube Fistula Disconnected at the Point of Contact with the Anterior Abdominal Wall: a Case Report.
Date
Journal Journal of Medical Case Reports
Excerpt

ABSTRACT: INTRODUCTION: Operations on the common bile duct may lead to potentially serious complications such as biliary peritonitis. T-tube insertion is performed to reduce the risk of this occurring postoperatively. Biliary leakage at the point of insertion into the common bile duct, or along the fistula, can sometimes occur after T-tube removal and this has been reported extensively in the literature. We report a case where the site at which the T-tube fistula leaked proved to be the point of contact between the fistula and the anterior abdominal wall, a previously unreported complication. CASE PRESENTATION: A 36-year-old sub-Saharan African woman presented with gallstone-induced pancreatitis and, once her symptoms settled, laparoscopic cholecystectomy was performed, common bile duct stones were removed and a T-tube was inserted. Three weeks later, T-tube removal led to biliary peritonitis due to the disconnection of the T-tube fistula which was recannulated laparoscopically using a Latex drain. CONCLUSION: This case highlights a previously unreported mechanism for bile leak following T-tube removal caused by detachment of a fistula tract at its contact point with the anterior abdominal wall. Hepatobiliary surgeons should be aware of this mechanism of biliary leakage and the use of laparoscopy to recannulate the fistula.

Title Spectrographic Determination of Gold and Platinum Metals in Geological and Other Materials by Fire-assay Preconcentration.
Date
Journal Talanta
Excerpt

A method is described for the determination of gold, platinum, palladium, rhodium and iridium at microgram levels in geological and other materials by a combination of fire-assay preconcentration and emission spectrography. The noble metals are collected into 4-mg silver or platinum prills by a normal fire-assay technique. These prills are arced between graphite electrodes at 12 A d.c. No buffer is required to prevent ejection of the prill. Gold, platinum and palladium are determined in the silver prills and gold, palladium, rhodium and iridium in the platinum prills. Low, but reproducible, results are found for iridium. At the 0.08 ppm level an overall coefficient of variation of 11% is found. This technique is simple and rapid for the determination of the precious metals.

Title Shifting Prevalence of Major Diarrheal Pathogens in Patients Seeking Hospital Care During Floods in 1998, 2004, and 2007 in Dhaka, Bangladesh.
Date
Journal The American Journal of Tropical Medicine and Hygiene
Excerpt

Bangladesh experienced severe flooding and diarrheal epidemics in 2007. We compared flood data from 2007 with 2004 and 1998 for diarrheal patients attending the ICDDR,B hospital in Dhaka. In 2007, Vibrio cholerae O1 (33%), rotavirus (12%), and enterotoxigenic Escherichia coli (ETEC) (12%) were most prevalent. More severe dehydration was seen in 2007 compared with 2004 and 1998 (P < 0.001). In 2007, V. cholerae O1 Inaba (52%) and Ogawa (48%) were seen, whereas in 2004 and 1998 it was primarily Inaba and the Ogawa types, respectively (P < 0.001). In 2007, 51% of ETEC produced the heat labile toxin (LT) (P < 0.001 compared with 2004), 22% expressed the heat stable (ST) (P < 0.001), and 27% were ST/LT positive (P = 0.231). The CS7 colonization factor (CF) was the most prevalent in 2007 (20% compared with 6% in 2004; P = 0.05). Our findings demonstrate alterations in clinical features and phenotypic changes of major bacterial pathogens in the recent Bangladesh flood.

Title The Mayo Dysphagia Questionnaire-30: Documentation of Reliability and Validity of a Tool for Interventional Trials in Adults with Esophageal Disease.
Date
Journal Dysphagia
Excerpt

The aim of this study was to develop the Mayo Dysphagia Questionnaire-30 Day (MDQ-30), a tool to measure esophageal dysphagia, by adapting items from validated instruments for use in clinical trials, and assess its feasibility, reproducibility, and concurrent validity. Outpatients referred to endoscopy for dysphagia or seen in a specialty clinic were recruited. Feasibility testing was done to identify problematic items. Reproducibility was measured by test-retest format. Concurrent validity reflects agreement between information gathered in a structured interview versus the patients' written responses. The MDQ-30, a 28-item instrument, took 10 min (range = 5-30 min) to complete. Four hundred thirty-one outpatients [210 (49%) men; mean age = 61 years] participated. Overall, most concurrent validity kappa values for dysphagia were very good to excellent with a median of 0.78 (min 0.28, max 0.95). The majority of reproducibility kappa values for dysphagia were moderate to excellent with a median kappa value of 0.66 (min 0.07, max 1.0). Overall, concurrent validity and reproducibility kappa values for gastroesophageal reflux disease (GERD) symptoms were 0.81 (95% CI = 0.72, 0.91) and 0.66 (95% CI = 0.55, 0.77), respectively. Individual item percent agreement was generally very good to excellent. Internal consistency was excellent. We conclude that the MDQ-30 is an easy-to-complete tool to evaluate reliably dysphagia symptoms over the last 30 days.

Title Decreased Risk of Bladder Cancer in Men Treated with Quinazoline-based Alpha1-adrenoceptor Antagonists.
Date
Journal Gene Therapy & Molecular Biology
Excerpt

Previous studies documented that human bladder cancer cells are sensitive to the apoptotic effects of quinazoline-derived alpha1-adrenoreceptor antagonists and bladder tumors exhibit reduced tissue vascularity in response to terazosin. More recent evidence suggests that exposure to quinazoline alpha1-adrenorecptor antagonists leads to a significant reduction in prostate cancer incidence. This retrospective observational cohort study was conducted to determine whether male patients treated with quinazoline alpha1-adrenoceptor antagonists for either benign prostate hyperplasia (BPH) or hypertension have a decreased risk of developing bladder cancer. Review of the medical records of all male patients enrolled at the Lexington Veterans Administration (VA) Medical Center identified men exposed to quinazoline-based alpha1-adrenoceptor antagonists (Jan 1, 1998-Dec 31, 2002) for either hypertension and/or benign prostate obstructive symptoms. The whole group of 27,138 male patients was linked to the Markey Cancer Center's Kentucky Cancer Registry (KCR), part of the NCI's Surveillance, Epidemiology, and End Results (SEER) Program, to identify all incident bladder cancer cases diagnosed in this population. Measures of disease incidence, relative risk, and attributable risk were calculated to compare the risk of developing bladder cancer for alpha1-blocker-exposed versus unexposed men. A two-by-two contingency table of alpha1-antagonist exposure versus bladder cancer diagnoses was constructed and the relative risk was calculated. Our analysis revealed a cumulative bladder cancer incidence of 0.24% among the alpha1-blocker-exposed men compared to 0.42% in the unexposed group. Thus, there was a risk difference of -0.0018, which indicates that 1.8 fewer bladder cancer cases developed per 1000 exposed men. Alternatively stated, 556 men would need to be treated with quinazoline alpha1-blockers to prevent one case of bladder cancer. Exposure to quinazoline alpha1-blockers thus may have prevented 7 to 8 bladder cancer cases among the 4173 treated men during the study period. The data yield an unadjusted risk ratio of 0.57 (95% CI: 0.30, 1.08) and therefore, men treated with alpha1-adrenoreceptor antagonists have a 43% lower relative risk of developing bladder cancer than unexposed men (p=0.083). Our inability to determine person-years at risk of developing bladder cancer for each unexposed control patient, was a limitation for calculating an incidence ratio and rate difference. These results offer an initial indication that exposure to doxazosin and terazosin decreases the incidence of bladder cancer. This is the first epidemiological evidence that the anti-tumor action of quinazoline-based alpha1-antagonists may potentially translate into a protective effect from bladder cancer development.


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