The long-term consequences of retrieval demands during working memory.

Although it is well known that distraction impairs immediate retrieval of items maintained in working memory (WM; e.g., during complex span tasks), some evidence suggests that these items are more likely to be recalled from episodic memory (EM) compared with items that were studied without any distraction (e.g., during simple span tasks). One account for this delayed advantage of complex span over simple span, or the McCabe effect (McCabe, Journal of Memory and Language, 58[2], 480-494, 2008), is that complex span affords covert retrieval opportunities that facilitate later retrieval from EM by cumulatively reactivating each successively presented item after distraction. This explanation focuses on the processing that occurs during presentation and maintenance of the items, but no work to date has explored whether the differential demands of immediate retrieval between simple and complex span may explain the effect. Accordingly, these experiments examined the impact of immediate retrieval demands on the McCabe effect by comparing typical immediate serial-recall instructions (i.e., recalling the words in their exact order of presentation) to immediate free-recall (Experiments 1-2) and no-recall (Experiments 2 and 3) instructions. The results suggested that the nature of retrieval may constrain the McCabe effect in some situations (Experiments 1-2), but its demands do not drive the McCabe effect given that it was observed in both serial-recall and no-recall conditions (Experiment 3). Instead, activities such as covert retrieval during the processing phase may underlie the McCabe effect, thus further evidencing the importance of processing in WM for the long-term retention of information.

Bronchoscopic extraction of a chicken bone 5 years after aspiration.

A 58-year-old man with a remote history of choking on a chicken bone 5 years earlier presented with chronic cough but had no remarkable clinical examination findings. He was being followed for recurrent pneumonias complicated by a resistant empyema, for which he had undergone thoracotomy and decortication. Imaging studies initially missed a foreign body (the chicken bone), which was found on follow-up studies and was removed with a flexible bronchoscope despite the fact that 5 years had passed since the aspiration.

Guidance for commissioning NHS England dental conscious sedation services: a framework tool.

Conscious sedation is an integral part of modern day dental care and should be delivered through a high quality, effective and evidence-based approach. Commissioning of NHS dental services in England is currently under review by NHS England and the National Dental Commissioning Group. This group has identified the management of vulnerable people including anxious patients, as one of its priorities. The Society for the Advancement of Anaesthesia in Dentistry (SAAD) believes this provides an opportunity to influence the commissioning of NHS conscious sedation services. With this aim in mind,"Guidance for Commissioning NHS England Dental Conscious Sedation Services: A Framework Tool" was developed. This guidance proposes a common approach to the organisation of NHS dental conscious sedation services in England, advocating the provision of Tier 1 and Tier 2 services in all regions. Its ethos is a"hub and spoke" model of service delivery with patient assessment delivered by experienced and well trained dental sedationists at its core. In line with the recent Francis Report fundamental standards for all aspects of dental conscious sedation practice are outlined, supported by a robust and predictable quality assurance process. This work has been shared with key stakeholders in NHS England including the Chief Dental Officer and the Head of Primary Care Commissioning.

Synchronous verrucous carcinoma and inverted papilloma of the lacrimal sac: case report and clinical update.

Inverted papilloma is a benign epithelial tumor of the nasal cavity. It is known to coexist with malignancy in 5 to 13% of cases, with squamous cell carcinoma being the most common malignancy. Another associated malignancy, one that is extremely rare, is verrucous carcinoma. To the best of our knowledge, no case of verrucous carcinoma occurring alone or in association with another neoplasm has been described in the nasolacrimal system. We report a case of synchronous verrucous carcinoma and inverted papilloma of the lacrimal sac in a 47-year-old man. The patient presented with epiphora, nasal obstruction, swelling of the left medial canthus, and drainage of a foul-smelling fluid from the left nostril. Computed tomography and magnetic resonance imaging detected the presence of a large mass occupying the left nasal cavity and sinuses with extension into the nasopharynx. In addition, bony invasion of the anteroinferomedial wall of the left orbit was noted with extension of the tumor into the orbit itself, which resulted in lateral displacement of the left medial rectus muscle. The patient underwent endoscopic debulking of the left sinonasal lesion. Of note, the surgery had to be completed in stages because of excessive blood loss. Histopathologic examination of the intranasal component of the tumor identified it as an inverted papilloma. One month after the intranasal resection, a left dacryocystectomy was performed; histopathologic examination revealed that an invasive verrucous squamous cell carcinoma had arisen within the inverted papilloma.

Cellular adaptive inflammation mediates airway granulation in a murine model of subglottic stenosis.

OBJECTIVE: To determine the contribution of B- and T-cell-mediated inflammation in a murine airway granulation model. STUDY DESIGN: Pilot study in a modified murine model. SETTING: Philadelphia VA Medical Center Research Building. SUBJECTS AND METHODS: Laryngotracheal complexes (LTCs) from 54 donor C57BL/6 mice were harvested and divided into 3 groups: (1) uninjured, (2) mechanically injured using a wire brush, and (3) chemically injured using hydrochloric acid. One donor LTC from each group was placed in deep dorsal subcutaneous pockets of either severe combined immunodeficiency (SCID)- or C57BL-recipient mice, for a total of 3 transplanted tracheas per recipient mouse. After 3 weeks, the transplanted LTCs were harvested from both C57BL- and SCID-recipient mice. Tissues were fixed, sectioned, and stained with hematoxylin and eosin. Representative slides were reviewed by a blinded pathologist to determine the formation of granulation tissue and graded as to the degree of formation of granulation tissue. RESULTS: Despite significant granulation formation in C57BL-recipient mice, direct airway injury did not induce the formation of granulation tissue under the disrupted epithelium of airway mucosa in SCID mice 3 weeks after injury. CONCLUSION: The data indicate that the immune response that results in the formation of granulation tissue is mediated by circulating B- and/or T-cell processes rather than resident airway immune cells. Further studies focusing on cellular adaptive immune processes in response to airway injury may provide a novel treatment modality for subglottic stenosis.

Efficacy of spirally filled versus injected non-setting calcium hydroxide dressings.

The aim of this study was to evaluate the adequacy of spirally filled vs injected non-setting calcium hydroxide (NS Ca(OH)(2)) in the management of traumatized permanent teeth undergoing endodontic treatment for apexification, control of infection or the management of root resorption. A random selection of patients with traumatized teeth undergoing endodontic procedures was made. A total of 100 cases were assigned for placement of NS Ca(OH)(2) by spiral filling and 50 cases by injection of the dressing directly into the canal. Post-operative radiographs were assessed for complete canal obturation and in particular, the density and length of the dressing within the canal. The results revealed that the injected NS Ca(OH)(2) dressing consistently produced better results than the spirally placed dressings. It also completely removed the chance of instrument fracture and as a result of this trial, the department of child dental health has now adopted the use of this injectable system.

Mesenchymoma: an unusual tumour of the lip.

The purpose of this paper is to present a case report of a benign mesenchymoma involving the lip. A brief review of relevant literature is presented.