Quantitative analysis of gains and catch-up saccades of video-head-impulse testing by age in normal subjects.

OBJECTIVES: To evaluate video-head-impulse test (vHIT) results in normal subjects, to determine the normative values of vHIT for the vestibulo-ocular reflex (VOR) and to characterise the catch-up saccades (CSs). DESIGN: Prospective cohort study. SETTING: Tertiary care academic referral centre. PARTICIPANTS: Fifty healthy subjects with no history of vestibular impairment, ten each in their 20's, 30's, 40's, 50's and 60's, underwent vHITs in the lateral semicircular canal plane. MAIN OUTCOME MEASURES: vHIT gains and the incidence and amplitudes of covert and overt CSs. RESULTS: The mean vHIT gain was 1.02 ± 0.07, and the mean gain asymmetry was 2.39 ± 1.96%, with no significant differences among age groups. CSs were observed during 22.6% of the trials and in 49% of the ears. The incidence of CSs was not associated with age. The mean velocity of CSs was 55.5 ± 16.9°/s, and its mean interaural difference was 11.8 ± 10.7°/s. CONCLUSIONS: vHIT gains were consistently equal to 1.0 in all age groups (20's to 60's), suggesting that abnormal criteria for vHIT gain (e.g. 0.8) and gain asymmetry (e.g. 8%) can be used, regardless of age. CSs were observed in about half of normal ears, suggesting that VOR is a hypometric system. The amplitudes and interaural difference of CSs were also similar in all age groups, suggesting that abnormal criteria for CS amplitude (e.g. 100°/s) and interaural difference (e.g. 40°/s) can be used, regardless of age.

An assessment of oropharyngeal airway position using a fibreoptic bronchoscope.

Selecting the appropriate oropharyngeal airway for safe and effective airway management is important in clinical practice. In this prospective observational study, we examined the position of the distal end of oropharyngeal airways using a fibreoptic bronchoscope. We enrolled 149 adults (72 men and 77 women). The correct airway size was determined by inserting four adult sizes Guedel airway (Hudson RCI; Teleflex Medical, Research Triangle, Park, NC, USA) (sizes 8, 9, 10 and 11) sequentially in anaesthetised patients. The 'best fit' airway was size 10 in 45 (62%) men, and size 9 in 58 (75%) women. However, when these airways were inserted, the distal end of the airway either touched or passed beyond the epiglottis tip in 20 (27%) men and six (8%) women, respectively. When a size-9 airway was inserted in men and a size-8 airway inserted in women, the distal ends were obstructed by the tongue in three (2%) patients. In conclusion, a size-9 airway in men and a size-8 airway in women are the most acceptable sizes for adults of average height.

Optimizing EEMCO guidance for the assessment of dry skin (xerosis) for pharmacies.

PURPOSE: People with dry skin (xerosis) are common in community pharmacies, but there is no consistent guidance for community pharmacists to evaluate and alleviate dry skin. Through evaluating any difference of the clinical scoring systems of EEMCO guidance between a dermatologist and pharmacists and the efficacy of moisturizers for the treatment of dry skin recommended by community pharmacists, we aim to validate a dry skin guidance through the help of community pharmacists. These results provide insight into how community pharmacists can help patients with dry skin. METHODS: The clinical scoring systems of EEMCO guidance used in this study comprised analog scales, the overall dry skin score (ODS), and the specific symptom sum score (SRRC) system. All pictures of the dry skin scored by pharmacists were visually evaluated by a dermatologist. The efficacy of the moisturizers was determined by the difference of the scales on day 0 and on day 28. RESULTS: In this study, 387 patients with dry skin from 157 community pharmacies were evaluated by pharmacists. Visual scale with divisions, ODS and SRRC that were evaluated by pharmacists on day 0 and day 28 were moderately reliable by a dermatologist. All parameters of dry skin were significantly improved by the moisturizers which were recommended by community pharmacists on day 28. CONCLUSION: Visual scale, ODS and SRRC can be generally measured to evaluate dry skin in community pharmacies with moderate degree of reliability. This finding has possible applications for investigating the assessment of the community pharmacists on clinical scoring system of dry skin and moisturizers.

The effect of combining dexamethasone with ondansetron for nausea and vomiting associated with fentanyl-based intravenous patient-controlled analgesia.

We investigated whether combined dexamethasone and ondansetron is more effective than ondansetron alone in preventing postoperative nausea and vomiting in patients with fentanyl-based intravenous patient-controlled analgesia. One hundred and thirty patients undergoing video-assisted thoracoscopic surgery were assigned to either an ondansetron group or a dexamethasone and ondansetron group. In all patients, ondansetron 4 mg was administered at the end of surgery and 12 mg was added to the patient-controlled analgesia solution. The dexamethasone and ondansetron group received dexamethasone 8 mg at the induction of anaesthesia. The overall incidence of nausea and vomiting during the first 48 h postoperatively did not differ between groups (34/61 (56%) vs 28/62 (45%) in the ondansetron group and dexamethasone and ondansetron groups, respectively). The incidence of severe nausea and vomiting (≥ 7 nausea on an 11-point verbal numerical rating scale, retching or vomiting) was higher in the ondansetron group than in the dexamethasone and ondansetron group (15/61 (25%) vs 6/62 (10%, respectively, p=0.028). Combined dexamethasone and ondansetron is more effective in reducing severe nausea and vomiting than ondansetron alone in patients receiving fentanyl-based intravenous patient-controlled analgesia.

Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery.

OBJECTIVES: The purpose of this study was to assess the diagnostic accuracy of the panoramic radiograph in the detection of carotid artery calcification using CT as the gold standard. METHODS: 110 dental patients (average age 65.2 years, range 50-82 years) with both panoramic radiographs and CT scans available were selected for the evaluation of carotid artery calcification. Two oral and maxillofacial radiologists interpreted the panoramic radiographs for the presence of carotid artery calcification. CT scans were independently interpreted by a neuroradiologist. RESULTS: The accuracy of panoramic radiographs in the detection of carotid artery calcification was 62.3%. The sensitivity and the specificity were 22.2% and 90.0%, respectively. CONCLUSIONS: Panoramic radiography has a moderate diagnostic accuracy in the detection of carotid artery calcification, but the sensitivity is low.

Cubic SiC nano-thin films and nano-wires: high vacuum metal-organic chemical vapor deposition, surface characterization, and application tests.

Single-crystalline and epitaxial cubic silicon carbide (beta-SiC) nano-thin films have been deposited on Si(100) substrates at a sample temperature of approximately 900 degrees C using single source precursors by the thermal metal-organic chemical vapor deposition (MOCVD) method. Diethylmethylsilane and 1,3-disilabutane, which contain Si and C atoms in the same molecule, were used as precursors without any carrier or bubbler gas. Upon increasing the deposition temperature from 900 to 950 degrees C, beta-SiC nano-thin films with relatively small crystals and smoother surfaces were created on Si(100) substrates. Moreover, beta-SiC nano-wires with 40 approximately 100 nm in diameter have also been grown selectively on nickel catalyzed Si(100) substrates with dichloromethylvinylsilane by the MOCVD method. The deposition temperature in this case was as low as 800 degrees C under the pressure of 5.0 x 10(-2) Torr. It is worth noting that the initial growth rates of deposited beta-SiC nano-thin films and nano-wires strongly depend on the deposition temperature rather than the time. In order to test the possibility of applications of these materials for electronic components such as field emitter, MEMS, and high-power transistor, we fabricated the nanoelectronic devices using both beta-SiC nano-wires and nano-thin films. With these preliminary application tests, it is expected that SiC nanowires can be used as field emitter and nanoelectronic high-power transistor, and application of the SiC nano-thin films to MEMS is promising as well.

Development of sequence characterized amplified region (SCAR) primers for the detection of Phyto.5.2, a major QTL for resistance to Phytophthora capsici Leon. in pepper.

Phytophthora capsici causes devastating disease on many crop species, including Capsicum. Resistance in Capsicum annuum is genetically and physiologically complex. A panel of Capsicum germplasm that included genotypes from both C. annuum and C. chinense showing highly resistant, highly susceptible and intermediate or tolerant responses to the pathogen, respectively, was screened with a series of randomly amplified polymorphic sequence primers to determine which genomic regions contribute to the highest level of resistance. One primer, OpD04, amplified a single band only in those C. annuum and C. chinense genotypes showing the highest level of resistance. The amplified product was cloned, sequenced and used to design longer primers in order to generate a sequence characterized amplified region marker which was then mapped in a reference mapping population and a screened population segregating for resistance to P. capsici. These primers were observed to define a locus on pepper chromosome 5 tightly linked to Phyto.5.2, one of six quantitative trait loci (QTL) previously reported to contribute to P. capsici resistance. These results indicate that the Phyto.5.2 QTL may be widely distributed in highly resistant germplasm and provide improved resolution for this QTL. This work also defines the first breeding tools for this system, allowing for the rapid selection of genotypes likely to be highly resistant to P. capsici.

A comparative study on cockroach and ovalbumin sensitizations and challenge responses in Hartley guinea-pigs.

The role of allergens in asthmatic inflammation is not clearly understood. To elucidate the mechanism of cockroach allergen (CRa)-induced airway disease, we studied three groups of Hartley guinea-pigs sensitized to control, ovalbumin (OA) or CRa. Parameters measured were anaphylactic antibodies by allergy skin test (AST), PCA assay and Western blot, changes in specific airway resistance (SRaw), analysis of bronchoalveolar lavage (BAL) and contracture responses of tracheal muscle (TSM) to non-specific and specific stimuli, in vitro. Both OA and CRa animals showed a similar allergic sensitization (AST and PCA), while Western blot identified several reaginic bands in CRa group compared to a single band in OA group. SRaw illustrated that CRa induce dual-asthmatic responses (4/6) in the CRa group, whereas OA induce only an early asthmatic response (3/6) in the OA group (P<0.01). The average total leukocytes in BALF of the CRa were 27.0x10(6), mostly neutrophils and eosinophils, while those of the OA showed 3.5x10(6), mostly eosinophils, respectively (P<0.0001). TSM responses to non-specific stimuli were similar in both groups (P>0.1), while the antigen-specific TSM contractions were more brisk in the OA group than those of CRa group (P<0.001). Thus, the study indicates that both CRa and OA sensitize guinea-pigs, yet CRa induces more severe and persistent late-phase inflammation than OA. This appears to be related to an influx of neutrophils rather than anaphylactic bronchospasm.

High-performance liquid chromatographic analysis and pharmacokinetics of terazosin in healthy volunteers.

A high-performance liquid chromatographic (HPLC) analysis of terazosin in 1 ml of human plasma was developed using prazosin as an internal standard. The plasma sample was extracted with dichloromethane and ethylether and a 100-microl aliquot was injected onto the reversed-phase column. The mobile phase, 0.02 M sodium phosphate buffer:acetonitrile:tetrahydrofuran = 720:220:60 (v/v/v), was run at a flow rate of 0.8 ml/min and the column effluent was monitored using a florescence detector set at 370 and 250 nm for the emission and excitation wave numbers, respectively. The retention times for terazosin and prazosin were approximately 6.4 and 9.8 min, respectively, and the coefficients of variation of terazosin were generally low, below 6.4%. The present HPLC method was successful for the pharmacokinetic study of terazosin in healthy volunteers. Following oral administration of terazosin, 2 mg, to 20 healthy male volunteers, the area under the plasma concentration-time curve from time zero to time infinity was 421 +/- 71.8 ng h/ml and terminal half-life was 9.83 +/- 1.29 h.

Preventive effect of epicatechin and ginsenoside Rb(2) on the inhibition of gap junctional intercellular communication by TPA and H(2)O(2).

The anticarcinogenic effects of epicatechin (EC) and ginsenoside Rb(2) (Rb(2)), which are major components of green tea and Korea ginseng, respectively, were investigated using a model system of gap junctional intercellular communication (GJIC) in WB-F344 rat liver epithelial cells. 12-O-tetradecanoylphorbol-13-acetate (TPA) and hydrogen peroxide, known as cancer promoters, inhibited GJIC in the epithelial cells as determined by the scrape loading/dye transfer assay, fluorescence redistribution assay after photobleaching, and immunofluorescent staining of connexin 43 using a laser confocal microscope. The inhibition of GJIC by TPA and H(2)O(2) was prevented with treatment of Rb(2) or EC. The effect of EC on GJIC was stronger in TPA-treated cells than in H(2)O(2)-treated cells, while the effect of Rb(2) was opposite to that of EC. EC, at the concentration of 27.8 microg/ml, prevented the TPA-induced GJIC inhibition by about 60%. Rb(2,) at the concentration of 277 microg/ml, recovered the H(2)O(2)-induced GJIC inhibition by about 60%. These results suggest that Rb(2) and EC may prevent human cancers by preventing the down-regulation of GJIC during the cancer promotion phase and that the anticancer effect of green tea and Korea ginseng may come from the major respective components, EC and Rb(2).

Pancreatic serous cystadenoma associated with islet cell tumour.

We report the case of a 29-year-old female patient with a diffuse type of serous cystadenoma involving the entire pancreas except for part of the head, which was replaced by islet cell tumour. Ultrasound and CT showed multiple cysts in the entire pancreas and a solid mass with calcification in the head. MRI characterized the fluid content of the cysts and the extent of disease.

Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer: correlation with the histopathology.

BACKGROUND: To evaluate the usefulness of dynamic and delayed magnetic resonance (MR) imaging in the T-staging of stomach cancer and to compare the enhancement pattern of the cancerous lesion and the normal wall. METHODS: We performed MR imaging in 46 patients with stomach cancer (including four early gastric cancers and 42 advanced gastric cancers). Axial, sagittal, or coronal two-dimensional fast low-angle shot) MR images for the water-distended stomach were obtained with dynamic protocol, including precontrast images and images obtained 30, 60, 90, and 240-300 s after intravenous injection of the 0.1 mM Gd-DTPA/kg solution. We evaluated the thickness, interruption (or not) of the low signal intensity bands, and enhancement pattern of the cancerous wall and normal gastric wall. We prospectively evaluated the depth of cancer invasion, perigastric infiltration (extraserosal invasion), perigastric organ invasion, and regional lymph nodes and determined tumor staging on MR images. These MR evaluations including MR-determined staging were correlated with the surgicopathologic findings. RESULTS: Stomach cancer was shown as having a thickened wall with a rapid enhancing pattern after intravenous Gd-DTPA administration. The mucosa (and/or submucosa) affected by stomach cancer showed an early enhancement pattern (30-90 s after Gd-DTPA administration) in 43 of 46 patients (93%). The normal gastric mucosa demonstrated a delayed peak enhancement pattern (> 90 s after Gd-DTPA administration) in 29 of 46 patients (63%) and variable enhancement pattern in 17 of 46 patients (37%). An interrupted low signal intensity band or highly enhanced tumorous lesion penetrating through the gastric wall was seen in 17 of 19 pT3 patients (90%). Consistency between MR-determined staging and surgicopathologic staging occurred in three of four pT1 tumors (75%), 10 of 13 pT2 tumors (77%), 17 of 19 pT3 tumors (90%), and eight of 10 pT4 tumors (80%); overall accuracy was 83%. Overall accuracy of regional lymph node involvement, as determined by enhanced MR, was 52%; 24 of 46 node groups were positive. CONCLUSIONS: Dynamic and delayed MR imaging can be useful for predicting depth of cancer invasion, perigastric infiltration (extraserosal invasion), and perigastric organ invasion by gastric cancer.

US and CT findings of tuberculosis of the thyroid: three case reports.

With two ultrasonographic and two CT films of three cases of thyroid tuberculosis, we evaluate the ultrasonographic and CT findings and correlate them with the pathologic findings. They are demonstrated as heterogeneous hypoechoic mass on ultrasonogram and peripheral-enhancing low-density abscess on CT scan with regional lymphadenopathy. Ultrasonography (US) and CT can help the diagnosis of thyroid tuberculosis.

A high dose of ionizing radiation induces tissue-specific activation of nuclear factor-kappaB in vivo.

Activation of the transcription factor nuclear factor-kappaB (NF-kappaB) is one of the important responses of cells to an external stress such as ionizing radiation. We studied radiation-induced NF-kappaB activation in vivo in male BALB/c mice. After the mice were exposed to 8.5 Gy total-body gamma irradiation, the spleen, mesenteric lymph nodes, thymus, liver, lung, colon, brain and bone marrow were harvested 1, 2.5, 5, 10 and 20 h postirradiation. NF-kappaB DNA-binding activity was analyzed in the nuclear protein extracts by a gel shift assay. When compared to the levels in untreated control mice, radiation induced activation of NF-kappaB in spleen, mesenteric lymph nodes and bone marrow but not in the other tissues examined. In contrast, an i.p. injection of a lethal dose (3 mg/kg) of lipopolysaccharide also increased activity of NF-kappaB in the liver and lung. The gel supershift assay with Nfkb1, Rela and/or Rel antibodies revealed that the specific molecular forms of NF-kappaB activated by radiation in the spleen were Nfkb1 homodimers and Nfkb1/Rela heterodimers. In mesenteric lymph nodes, the heterodimerized Rel/Rela NF-kappaB was also activated. In bone marrow, an NF-kappaB-like binding factor was induced that may be Nfkb1/Rela- and Rel/Rela-like heterodimers, but it exhibited a higher mobility than Nfkb1 homodimers. These results indicate that in vivo, ionizing radiation induces NF-kappaB activation that varies in both tissue distribution and moleoular composition.

Significance of resistive index in color Doppler ultrasonogram: differentiation between benign and malignant breast masses.

The objective of this article is to evaluate the significance of resistive index in differentiation between benign and malignant breast lesions on duplex ultrasonographic examination. Resistive indices obtained in 106 breast lesions of 104 patients were included. Sixty-four were benign (mean age: 32.4 +/- 11.1 years), and 42 were malignant lesions (mean age: 47.8 +/- 11.4 years). The resistive index was classified as follows: below 0.49, from 0.5 to 0.59, 0.6 to 0.69, 0.7 to 0.79, and above 0.8. We analyzed and defined the optimal threshold value of RI between benign and malignant lesions. The mean values of the RI of benign and malignant lesions were 0.62 +/- 0.095 (range 0.44-0.86) and 0.74 +/- 0.097 (range, 0.50-0.92), respectively. The resistive index exceeded 0.7 in 80% of malignant lesions. The difference of the RI between malignant and benign lesions was statistically significant when the threshold value was 0.7 (P < 0.001). A resistive index over 0.7 may suggest malignant lesions. Due to the considerable overlap of the range of the RI, it may not be diagnostic in any single patient; however, it may be helpful in conjunct with gray-scale image.

Post-traumatic arterial priapism: colour Doppler examination and superselective arterial embolization.

PURPOSE: To evaluate selective embolization for management of post-traumatic priapism and colour Doppler sonography for the diagnosis of the causative lesion and for planning embolization. MATERIALS AND METHODS: Six male patients with post-traumatic priapism underwent selective angiography and embolization. Colour Doppler sonography with grey-scale was performed in all six patients before angiography. RESULTS: Selective angiography showed intracavernosal arteriovenous fistulas in all patients and pseudoaneurysm of the cavernosal artery (or common penile artery) in three patients. After successful embolization, detumescence was achieved in all patients. Colour Doppler sonography enabled localization and characterization of the lesion causing priapism in four patients. Grey-scale ultrasonography showed the dilated cavernosal sinuses in all patients. CONCLUSION: Angiography with selective embolization is safe and effective method to correct post-traumatic priapism. Colour Doppler sonography with grey scale is a useful preangiographic study, as it allows for characterization and localization of the causative lesion except lesions at the proximal cavernosal or distal penile artery near the symphysis pubis.

Observer differentiation of mechanical defects versus natural dental caries cavitations on monitor-displayed images with imaging plate readout.

OBJECTIVE: The purpose of this study was to compare the ability of dentists to detect mechanically created defects vs natural dental caries cavitations on the proximal surfaces of extracted teeth by means of storage phosphor imaging plate technology. STUDY DESIGN: Fifty-two extracted molar and premolar teeth were blocked into sets for bitewing radiographs through use of the DIGORA digital imaging system. Sixteen natural caries cavities and 28 artificial lesions were present in the 80 proximal surfaces included in the study. A group of 16 dentists assessed proximal lesions on unenhanced images on the monitor and 1 month later on contrast-enhanced images. A different group of 16 dentists assessed proximal lesions on contrast-enhanced images and 1 month later on unenhanced images. The Mann-Whitney U test was used to check for a reading-order effect. The Zelen test of odds ratio was used to test for homogeneity, and the Mantel-Haenszel analysis or stratified logistic regression was used for inference about the common odds ratio. Alpha was set at P < .05. RESULTS AND CONCLUSIONS: With the DIGORA system, there was little difference between the detection rates of mechanical defects and natural carious cavities with unenhanced images, but the mechanical defects were more readily detected when contrast-enhanced images were used. Cavity depth positively affected the odds of diagnosis of lesions, with deeper lesions being more readily detected than more superficial ones irrespective of whether they were natural or artificial. In comparison with findings of previous studies in which film and a charge-coupled device detector were used, the overall detection rate for natural dental caries was remarkably constant across the modalities.

Contractile responses to allergen and cholinergic stimulation in bronchus and trachea of cockroach allergen-sensitized guinea pigs.

Airway hyperreactivity is a hallmark of asthma. Yet, the role of allergic sensitization in the hyperreactivity remains controversial. This study examined the effects of airborne cockroach allergen (CRa) sensitization on the contractility of bronchial (BSM) and tracheal (TSM) smooth muscle rings to cholinergic stimulations, and to specific antigen, in vitro. Guinea pigs were actively immunized with CRa, 5 mg (high dose, HD), 0.5 mg (low dose, LD), or saline aerosols (2x/day, 5 days/week, for 4 weeks) and challenged by CRa inhalation 5 days after last exposure. Twenty-four hours postchallenge, the contractions of the TSM and BSM to electrical field stimulation (EFS), acetylcholine (ACh), and to CRa were measured in vitro. In addition, the contraction to these stimuli were also examined in the passively sensitized TSM with the sera of CRa-immunized guinea pigs. The contractile responses of actively immunized and passively sensitized tissues to EFS and ACh were very similar to those of control tissues. CRa induced dose-dependent contractions in both actively immunized and passively sensitized, but not in control, tissues. The CRa-induced contraction was stronger in the HD group than in the LD group (p<0.0001). Leukotriene C4/D4 receptor antagonist LY-171883 inhibited the CRa-induced contraction by 86% in actively immunized TSM, and by 9% in the passively sensitized TSM. Pyrilamine inhibited the contraction by 57% in actively immunized TSM and 70% in passively sensitized TSM. The results indicate that CRa sensitization does not cause increased airway smooth muscle contractility to cholinergic stimulations, but induces antigen-specific contractions in vitro. Leukotrienes appear to play a significant role in the CRa-specific contractions, more in the actively immunized than those in the passively sensitized tissues, while histamine exerts a moderate effect on the CRa-induced contractions.