Differences in Epstein-Barr virus expression between primary and secondary cutaneous angiocentric lymphomas. French Study Group of Cutaneous Lymphomas

OBJECTIVE: The aim of this investigation was to report on the radiographic interpretation of the hard palate and nasal fossa floor in panoramic radiographs by studying different skulls, x-ray machines, and head positions in relationship to the Frankfort plane before and after ostectomy. STUDY DESIGN: Twenty dry human skulls were radiographed with three different panoramic x-ray machines in three different positions. Three of the skulls were submitted to different ostectomies. RESULTS: Multiple images of the hard palate and nasal fossa floor were present in 96.12% of the radiographs. Single images (3.88%) occurred only in the "chin up" position. CONCLUSIONS: The lower image represents the nasal fossa floor, especially its lateral and anterior limits. The upper images are double real images mainly formed by the junction of the nasal septum with the nasal fossa floor and possibly by posterior parts of the hard palate and nasal fossa floor. All images overlap in the "chin up" position becoming a single image. The most common shape of the anatomic landmark was wide angle "W" (58.33%). Other shapes present in positions "chin up" and "chin down" indicate patient positioning errors. The x-ray machines did not influence the results.     

Congenital fibrosis of the extraocular muscles type 2, an inherited exotropic strabismus fixus, maps to distal 11q13

The extraocular fibrosis syndromes are congenital ocular-motility disorders that arise from dysfunction of the oculomotor, trochlear, and abducens nerves and/or the muscles that they innervate. Each is marked by a specific form of restrictive paralytic ophthalmoplegia with or without ptosis. Individuals with the classic form of congenital fibrosis of the extraocular muscles (CFEOM1) are born with bilateral ptosis and a restrictive infraductive external ophthalmoplegia. We previously demonstrated that CFEOM1 is caused by an autosomal dominant locus on chromosome 12 and results from a developmental absence of the superior division of the oculomotor nerve. We now have mapped a variant of CFEOM, exotropic strabismus fixus ("CFEOM2"). Affected individuals are born with bilateral ptosis and restrictive ophthalmoplegia with the globes "frozen" in extreme abduction. This autosomal recessive disorder is present in members of three consanguineous Saudi Arabian families. Genetic analysis of 70 individuals (20 affected individuals) reveals linkage to markers on chromosome 11q13, with a combined LOD score of 12.3 at the single nonrecombinant marker, D11S1314. The 2.5-cM CFEOM2 critical region is flanked by D11S4196/D11S4162 and D11S4184/1369. Two of the three families share a common disease-associated haplotype, suggesting a founder effect for CFEOM2. We hypothesize that CFEOM2 results from an analogous developmental defect to CFEOM1, one that affects both the superior and inferior divisions of the oculomotor nerve and their corresponding alpha motoneurons and extraocular muscles.     

Purification and properties of beta-N-Acetylhexosaminidase from cabbage

beta-N-Acetylhexosaminidase was purified from the extract of cabbage by sequential steps of ammonium sulfate fractionation, chromatofocusing, DEAE-Sepharose CL-6B ion exchange chromatography and Sephacryl S-200 HR gel filtration. By these steps, the purity of the enzyme increased by 256 fold with a recovery of 8%. The purified enzyme was homogeneous as examined by native PAGE. It showed an optimal pH of 4, an optimal temperature of 60 degrees C and a Km of 0.94 mM for hydrolysis of pNp-beta-GlcNAc. The molecular mass of the enzyme determined from filtration through Sephacryl S-200 was 150 kDa. Three subunits with molecular mass of 64, 57 and 51 kDa were observed as determined by SDS-PAGE. NBS (0.025 mM), DEPC (3 mM) and WRK (30 mM) significantly inhibited the activity of the enzyme. The enzyme also showed activity toward pNp-beta-GalNAc, N,N'-diacetylchitobiose, N,N',N"-triacetylchitotriose and N,N',N",N"'-tetraacetyl chitotetraose but showed no activity toward pNp-alpha-GlcNAc, chitin and ethylene glycol chitin.     

Radiotherapy of plantar heel spurs: indications, technique, clinical results at different dose concepts

BACKGROUND: In a retrospective study the efficacy of orthovoltage radiotherapy for refractory painful plantar heel spur was analyzed for 3 different radiation dose concepts. PATIENTS AND METHODS: From 1.1 1984 through 1.3.1994, 182 patients with refractory painful heel symptoms and radiologically proven plantar heel spur received radiotherapy. A total of 141 patients and 170 heels (due to double-sided symptoms) were completely documented in long-term follow-up. Clearly defined semi-quantitative criteria (9-point score) were used to analyze heel pain and ankle function prior to RT, 6 to 12 weeks post-radiation, and at last follow-up. The treatment outcome, i.e. (un)favourable response, of 3 radiation dose concepts were compared: Group A (n = 72 heels) received 12 Gy total radiation dose in 3 fractions per week and 2 series (6 x 1 Gy per series) separated by 6 weeks; group B (n = 98 heels) received 3 Gy total radiation dose in 10 fractions of 0.3 Gy (n = 50) or 5 Gy (10 x 0.5 Gy) (n = 48) with conventional fractionation in 1 series. RESULTS: Radiotherapy was very effective: at last follow-up 67% (group A) and 71% (group B) remained completely free of pain. The rate of "complete pain relief" (i.e. free of any pain symptoms) was not different between the 3 radiation concepts. However, significant differences were observed with regard to "incomplete or insufficient pain relief", i.e. a subjective pain relief of less than 80%, a delayed pain relief after more than 4 weeks or a relapse of pain symptoms in long-term follow-up. More favourable results were achieved in patients receiving 5 Gy or 12 Gy total dose, while patients with 3 Gy total dose had significantly worse results. Prognostic factors for "complete pain relief" were short duration of pain symptoms and acute pain symptoms prior to radiotherapy; with regard to "in-complete or insufficient pain relief" the total dose was found to be a prognostic parameter. CONCLUSIONS: Patients with refractory heel pain can yield a high response to radiotherapy even after failing various conventional treatments previously. Thus, radiotherapy should not be solely regarded as a last resort due to its low costs and high efficacy at low radiation doses.     

Progressive subretinal fibrosis and blindness in patients with multifocal granulomatous chorioretinitis

Since women with a first-degree relative with breast cancer are at increased risk for breast cancer, it is of special importance that they adhere to early detection programs. In this study, women with (389) and without (3295) a family history of breast cancer were compared with respect to risk perception, breast cancer anxiety, and early detection behavior. Special attention was paid to the role of knowing that family history is a breast cancer risk factor. It was found that 46% of "family history positives" did not know that their risk was increased by their family history. Still, family history positives had increased risk perception; our results suggest that this was partly caused by their knowing they belonged to a risk group and partly by their having experienced the disease at close range. Although family history positives had higher risk perceptions, no differences in early detection behavior were found. This could not be attributed to high anxiety levels. Implications for health education are discussed.     

Generalized modal satisfiability

It is well known that modal satisfiability is PSPACE-complete (Ladner (1977) [21]). However, the complexity may decrease if we restrict the set of propositional operators used. Note that there exist an infinite number of propositional operators, since a propositional operator is simply a Boolean function. We completely classify the complexity of modal satisfiability for every finite set of propositional operators, i.e., in contrast to previous work, we classify an infinite number of problems. We show that, depending on the set of propositional operators, modal satisfiability is PSPACE-complete, coNP-complete, or in P. We obtain this trichotomy not only for modal formulas, but also for their more succinct representation using modal circuits. We consider both the uni-modal and the multi-modal cases, and study the dual problem of validity as well.     

Development of clinical indicators for performance measurement and improvement: an HMO/purchaser collaborative effort

This article describes a collaborative effort between a major health care purchaser, three area health maintenance organizations, and a state Medicaid agency to develop clinical indicators as the basis for a comparison database. Some of the difficulties in developing a "common yardstick" of quality and value are candidly discussed.     

Ethanol-induced gastrointestinal damage. Influence of endogenous antioxidant components and gender

This study compared the effects of undiluted and 8% ethanol administered orally on gastrointestinal antioxidant components of male and female rats. Eight percent ethanol increased the activities of duodenal glutathione peroxide (29% in males, 14% in females) and superoxide dismutase in female gastric (24%) and male duodenal (15%) mucosa. This dose of ethanol also increased the glutathione content of gastric mucosa (12% in males, 13% in females). Undiluted ethanol decreased glutathione levels in gastric mucosa (22% in males, 11% in females) and increased glutathione peroxide activity in gastric mucosa (14% in males, 9% in females). Undiluted alcohol also produced decreases in the activity of glutathione reductase in stomach (14% in males, 9% in females) and duodenum (16% in males, 12% in females). Undiluted ethanol caused mucosal damage in the body of the stomach in both genders, accompanied by an increase in luminal pH and fluid accumulation in the stomach; these changes were absent in rats given 8% ethanol. The increase in gastrointestinal antioxidant capacity associated with the administration of 8% ethanol may be a factor in the reported cytoprotective effect of lower doses of ethanol.     

Tensile stresses in the edges of injection moldings: Roles of packing pressure,machine compliance,and resin compression

The slow spontaneous development of cracks in the edges of injection moldings under “field” conditions has been observed for 30 years or more. While environmental stress cracking agents have long been implicated, the magnitude and distribution of the stresses associated with cracking have been obscure. The current study of these stresses involved polycarbonate as a model test material that was molded under systematically varied molding conditions. Surface tensile stresses, though rarely great enough alone to cause “dry” crazing or cracking were revealed through exposure to environmental stress crazing and cracking (ESC) agents. Using an old technique involving a set of calibrated ESC liquids, edge tensile stresses as great as 18 MPa were found in the edges of the moldings. Other, independent methods of stress assessment gave results in semiquantitative agreement with those of the ESC tests. Packing force, machine compliance, injection hold time, and mold flashing emerged as major variables either raising or mitigating stress levels. The root cause of the edge tensions is the mismatch in the times and pressures at which the skins and cores of moldings solidify. In short, skins quench at low pressure first, while cores solidify later during the packing stage. Upon release from the mold, elastic recovery of the core stretches the skin. More importantly, machine and mold compliances allow expansion of the part in the packing stage, during which certain areas of the skin are stretched. Solidifying the core during the packing preserves part of the skin extension as elastic strain. These effects are capable of outweighing the classical tendency of quenching to generate skin compression and core tension. A number of other effects, including release from the mold before the core has solidified, and flashing of the mold, have been found to limit the rise of skin tension.