The high jugular bulb: report of five cases and a review of the literature

The jugular bulb varies widely in position and dimensions. A high jugular bulb is not an uncommon finding in temporal bones. Besides our five cases with different clinical manifestations, we review 52 cases diagnosed clinically and published previously in the English literature. The high jugular bulb occurs more often on the right temporal bone. Certain pathologic conditions, such as an abnormal bone formation, an aberrant sinusojugular system, or decreased pneumatization of the mastoid bone, may predispose an individual to its occurrence. Most people with this anatomical variation remain asymptomatic. However, various otologic problems and symptoms may be attributed to this condition. A high resolution computed tomography scan is the most convenient diagnostic tool at present. Law projection plain mastoid radiography may reveal a high jugular bulb in certain cases, providing a preoperative warning to an otologic surgeon. An exploratory tympanotomy is not suggested for those with a high jugular bulb with a conductive hearing loss, while jugular vein ligation has been reported to have good results in alleviating intractable pulsatile tinnitus. For most asymptomatic patients, regular long-term follow-up is recommended.     

Drag on two co-axial rigid spheres moving normal to a plane: Newtonian and Carreau fluids

The boundary effect and the presence of a nearby entity on the drag of a rigid entity is investigated by considering the movement of two identical, rigid, coaxial spheres normal to a plane in both a Newtonian and a Carreau fluid at a low to medium large Reynolds number. The parameters key to the phenomenon under consideration, including the nature of the fluid, the separation distance between two spheres, the distance between the near sphere and the plane, and the Reynolds number, on the drag coefficient are discussed. We show that the influence of a boundary on the drag coefficient is more important than that of the nature of a fluid and that of the separation distance between two spheres. The variation of the drag coefficient as a function of Reynolds number for a Carreau fluid is similar to that for a Newtonian fluid. Due to the shear-thinning nature of the former the drag coefficient in the former is smaller than that in the latter. The influence of the index parameter of a Carreau fluid becomes appreciable only if the Carreau number is sufficiently large. Correlations between the drag coefficient and the key parameters of a system are developed for the case when the Reynolds number is smaller than l.     

Random sampling, randomization, and equivalence of contrasted groups in psychotherapy outcome research.

Random sampling and random assignment (randomization) are some of the most popular methods of equating contrasted groups on pre-existing nuisance variables. However, the small samples typically used in psychotherapy outcome studies raise some questions about the extent to which these methods eliminate the pretreatment nonequivalence of groups in this area of research. This article identifies conditions under which equivalence is likely (and unlikely) to be attained with simple random sampling and randomization in psychotherapy efficacy studies of the kind examined in recent meta-analyses. Some consequences of nonequivalence are viewed as manifestations of Simpson's paradox. Misinterpretations of estimates of the relative efficacy of treatments are expected in view of belief in the law of small numbers. The minimum sample sizes needed to protect against nonequivalence are compared with those needed to satisfy several other criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An extended HLA-DQ-DR haplotype rather than DRB1 alone contributes to RA predisposition

A family with 1 case of retinitis pigmentosa (III-1) and 2 cases of Oguchi's disease (III-2, 3) was examined in terms of electrophysiology as well as molecular biology. The proband (III-3), a 42-year-old female, and 2 older brothers (III-1, 2, aged 52 and 45 years) and 2 unaffected members in the same family participated in this study. Corrected visual acuities of the individuals with Oguchi's disease (III-2, 3) were 1.2. On funduscopy, blood vessels stood out in relief against a metallic-appearing background and a Mizuo-Nakamura phenomenon was evident. Full-field electroretinograms (ERGs) recorded from the proband were indicative of rod dystrophy, but results of other electrophysiological examinations (multifocal ERG, pattern ERG and visual-evoked cortical potential recordings) were within normal limits. Patient III-1 had corrected visual acuities of RE 20 cm/m.m. and LE 30 cm/n.d., severe chorioretinal atrophy in both fundi, and full-field ERG revealed rod-cone dystrophy. Mutation of the arrestin gene (1147de1A) was detected in all 3 patients. Visual function in each patient coincides with that of retinitis pigmentosa or Oguchi's disease, respectively.     

Reduced serotonergic immunoreactive fibers in the forebrain of alcohol-preferring rats

Our previous study indicated that 5-hydroxytryptamine (5-HT) immunoreactive fiber densities were decreased in specific areas of the brain in alcohol-preferring rats (P) when compared with alcohol-nonpreferring rats (NP). The results of our current study show that there are quantitative and qualitative differences in 5-HT innervation in other selected regions of the forebrains of P rats. The 5-HT fiber density in the brains of young adult P and NP rats was measured by immunocytochemistry and quantitative image analysis. A routine error of two-dimensional quantitation of nerve fiber was addressed and an adjustment was made. The amount of 5-HT fibers was significantly lower in CA4 and fasciola cinereum of the dorsal hippocampus, caudate-putamen, and hypothalamus of the P as compared with NP rats (unpaired Student's t tests). In examining the fiber types, we found that, in the frontal cortical and hippocampal regions, where normally fine 5-HT fibers with small varicosities and thick 5-HT fibers with large varicosities coexist, fewer fine 5-HT fibers were seen in P rats as compared with NP rats. The fine fibers are known to be vulnerable to abusive drugs. These observations indicate that (a) there are quantitative differences in 5-HT innervation or that the 5-HT in some 5-HT fibers is reduced to a level undetectable by immunocytochemistry, and (b) the fine 5-HT fibers are specifically reduced to a greater degree in the selected brain regions of P rats when compared with that of NP rats. The involvement of the 5-HT system in the alcohol abuse is discussed.     

Synthesis and antitumor evaluation of 2,5-disubstituted-indazolo[4, 3-gh]isoquinolin-6(2H)-ones (9-aza-anthrapyrazoles)

The synthesis and antitumor evaluation of 2, 5-disubstituted-indazolo[4,3-gh]isoquinolin-6(2H)-ones (9-aza-APs) are described. The key intermediates in the synthesis are benz[g]isoquinoline-5,10-diones which are substituted at positions 6 and 9 with groups of different nucleofugacity for SNAr displacements. The initial displacement of fluoride by a substituted hydrazine leads to the pyrazole analogues. Substitution of the remaining leaving group by an amine or BOC-protected amines leads to the 9-aza-APs 12. These analogues were converted into their maleate or hydrochloride salts 13. In two cases, namely, 13x and 13z, sidearm buildup was also employed in the synthetic pathway. In vitro evaluation of 9-aza-APs against the human colon tumor cell line LoVo uncovered for most of the compounds a cytotoxic potency lower than that of DuP-941 or mitoxantrone and comparable to that of doxorubicin. Only analogues 13c, 13n, and 13ff were as cytotoxic as DuP-941. Interestingly, while DuP-941 was highly cross-resistant in the LoVo cell line resistant to doxorubicin (LoVo/Dx), the 9-aza-APs carrying a distal lipophilic tertiary amine moiety in both chains were capable of overcoming the MDR resistance induced in this cell line. The 9-aza-APs show outstanding in vivo antitumor activity against both systemic P388 murine leukemia and MX-1 human mammary carcinoma transplanted in nude mice. At their optimal dosages, congeners 13a-c, 13f, 13n, 13q, 13x, and 13dd were highly effective against P388 leukemia with T/C% of 200-381, while the T/C% value of DuP-941 was 147. In the MX-1 tumor model, 24 compounds elicited percentages of tumor weight inhibitions (TWI) ranging from 50% to 99%. Congeners 13d, 13k, 13l, 13x, 13z, and 13ee emerged as the most effective ones, with TWI% 96, simliar to that of DuP-941 (TWI% = 95). On the basis of their efficacy profile in additional experimental tumors and lack of cardiotoxicity in preclinical models, two congeners have surfaced as potential clinical candidates.     

A knowledge-based approach for retrieving images by content

A knowledge based approach is introduced for retrieving images by content. It supports the answering of conceptual image queries involving similar-to predicates, spatial semantic operators, and references to conceptual terms. Interested objects in the images are represented by contours segmented from images. Image content such as shapes and spatial relationships are derived from object contours according to domain specific image knowledge. A three layered model is proposed for integrating image representations, extracted image features, and image semantics. With such a model, images can be retrieved based on the features and content specified in the queries. The knowledge based query processing is based on a query relaxation technique. The image features are classified by an automatic clustering algorithm and represented by Type Abstraction Hierarchies (TAHs) for knowledge based query processing. Since the features selected for TAH generation are based on context and user profile, and the TAHs can be generated automatically by a clustering algorithm from the feature database, our proposed image retrieval approach is scalable and context sensitive. The performance of the proposed knowledge based query processing is also discussed     

New one-week, low-dose triple therapy for the treatment of duodenal ulcer with Helicobacter pylori infection

BACKGROUND: Antimicrobial therapy is the recommended treatment for duodenal ulcer associated with Helicobacter pylori infection. The eradication of bismuth-based triple therapy with bismuth subcitrate, metronidazole and amoxicillin is limited by low compliance, drug resistance and side-effects. Two-week proton pump inhibitor (PPI)-based triple therapy has a higher eradication rate but is costly. This study was designed to compare the efficacy, patient compliance and cost of short-term PPI-based triple therapy with those of bismuth-based triple therapy. METHODS: Ninety patients with active duodenal ulcer disease and H pylori infection, proven with the 13C-urea breath test and CLO test (Campylobacter-like organism test) were treated randomly in three therapeutic groups: Group A, DeNol 120 mg, amoxicillin 500 mg and metronidazole 250 mg four times a day orally for 14 days; Group B, omeprazole 20 mg plus clarithromycin 500 mg twice a day and amoxicillin 500 mg four times a day for 14 days; Group C, omeprazole 20 mg, clarithromycin 250 mg and metronidazole 500 mg twice a day for seven days. Nizatidine 150 mg twice a day was given continuously following the end of anti-H pylori therapy for each group. Two months later, endoscopy, the CLO test and 13C-urea breath test were repeated to assess the eradication rate of H pylori and the ulcer-healing rate. Drug tolerance was evaluated by patients themselves by daily recording of any side-effects. RESULTS: Eighty-four patients completed the entire course of therapy and evaluation for H pylori infection. The H pylori eradication rates in Groups A, B and C were 75% (21/28), 93% (26/28) and 89% (25/28), respectively (p = 0.466). The ulcer healing rate was 86% (24/28) in Group A and 89% (25/28) in Groups B and C (p = 0.764). A total of 74 patients (88%) were free from symptoms at the end of the triple therapy. Symptom relief was faster in patients with PPI-based triple therapy (Groups B and C) (days 3 and 4) than for patients with bismuth-based triple therapy (day 5). The cost of Group C therapy was lower than that for Groups A and B. There were no major side-effects in any of the patients. CONCLUSIONS: One-week triple therapy with omeprazole, clarithromycin and metronidazole is highly effected for the eradication of H pylori. A therapeutic regime of one week's duration with lower cost, good compliance and mild side-effects may offer a good choice for treatment of duodenal ulcer associated with H pylori infection in clinical practice.     

Pharmacokinetics of phenprobamate after oral administration to healthy subjects

Phenprobamate (CAS 673-31-4) is a centrally acting skeletal-muscle relaxant agent. There are only two studies in the literature about the pharmacokinetics of phenoprobamate in man. The inconsistency between the results of these studies can be attributed partly to the different analytical methodologies used. A sensitive, specific and reproducible HPLC-assay, which may increase the reliability of the pharmacokinetic studies of phenprobamate in plasma, has been developed recently. The objective of this investigation was to assess the single-dose kinetics of phenprobamate in human and to determine the pharmacokinetic parameters of clinical and regulatory concern. The plasma pharmacokinetics of phenprobamate have been investigated following single oral administration at a dose of 800 mg in eleven healthy volunteers.