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Conclusion: There is a worst case scenario involving a small risk of facial nerve injury and dysfunction of facial nerve monitoring. With regard to patient safety the use of a short-acting muscle relaxant and the analysis of neuromuscular blockade are necessary because these permit documentation of the temporal course of relaxation and the progress of surgery. Objectives: The use of muscle relaxant may disturb facial nerve monitoring during parotidectomy. The aim of the study was to analyze the duration of muscle relaxation in relation to the progress of surgery. Study design/Methods: Twenty-one patients who underwent parotidectomy were enrolled in this prospective study, where the short-acting muscle relaxant mivacurium (0.2 mg/kg) was used. The neuromuscular blockade was monitored on the basis of train-of-four (TOF) peripheral stimulation. The time of intubation, skin incision, facial nerve identification and the end of surgery were documented. Results: The mean times of the TOF ratios (2/4; 3/4; 4/4), skin incision, and facial nerve identification differed significantly (χ2=0.05; df = 1; p > 0.05). For the earliest skin incision (21 min), 14.3% of patients have a TOF ratio smaller than 2/4 at which a neuromuscular block of the facial nerve is possible. [ABSTRACT FROM AUTHOR]

Objective . Executive function in activities of daily living (ADL) were investigated in 10 patients with excised frontal lobe tumours. Method . The patients with frontal lesions were compared to 10 normal controls with a neuropsychological test battery, a script generation task and a realistic implementation of complex multi-task ADL (planning and preparing a meal). Results . The patients manifested numerous basic executive deficits on the paper-pencil tests, were unimpaired on the script generation task despite an aberrant semantic structure and manifested marked anomalies in the meal preparation task. Conclusion . Frontal lobe deficits in lengthy complex multi-task ADL can be explained by impairment of several executive functions, generalized slowness of performance and paucity of behaviour. [ABSTRACT FROM AUTHOR]

This paper describes the effect of steady-state heating on the electrical and thermal resistance of interconnects on GaAs. Examined is a typical dual-layer metal interconnect system, common to GaAs processing. The interconnect system is considered in three parts, the interconnect metals, the Si3N4 dielectric surrounding the metal, and the AlxGa1-xAs epitaxial substrate. Using a meandering line as a test structure, measurements show how the direct current (DC) resistance increases with both temperature and dissipated power. Thermal resistors are proposed to account for self-heating and thermal coupling. [ABSTRACT FROM AUTHOR]

Self-consistent fullband Monte Carlo simulations based on nonlocal empirical pseudopotential band structures including spin-orbit splitting are employed to estimate the on-current in nanoscale strained-Si p-MOSFETs. Effective gate lengths from L[subeff] = 75 nm down to L[subeff] = 25 nm and strain levels corresponding to germanium contents of up to x = 0.4 in the relaxed Si[sub1-x]Ge[subx] substrate are considered. It is found that the on-current continuously increases for growing substrate germanium contents. The strain-induced performance enhancement moderately decreases with scaling, but the improvement at L[subeff] = 25 nm still attains 20% for x = 0.4. In contrast to strained-Si n-MOSFETs, increasing the substrate germanium content beyond x = 0.2 is essential for p-MOSFET performance improvement by strain in the sub 0.1 μm regime. However, even for x = 0.4 the on-current in a strained-Si p-MOSFET is still smaller than in a corresponding unstrained-Si n-MOSFET. [ABSTRACT FROM AUTHOR]

The embryopathy underlying tethering of the filum terminale is poorly understood. Knowledge of normal filum development is the foundation upon which to compare normal fila to fila from patients with tethered cord syndrome. Thirty-four fila from patients with tethered cord syndrome were immunostained with caudal neural tube developmental markers H4C4 (CD44), VIN-IS-53, AC4, FP3 and NOT1, and a panel of mature neuroglial, neural crest epithelial and mesenchymal markers. H4C4 (CD44) and NOT1 exhibited significant alterations in immunoexpression in tethered fila compared to controls. The change in expression may be indicative of altered cell identity in the filum and constitute the predisposition to tethering. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: The reproducibility and clinical reliability of perioperative somatosensory-evoked potentials (SSEP) were prospectively evaluated in uneventful scoliosis surgery. The influence of anesthesia owing to induction of total intravenous anesthesia (TIVA) upon preoperative SSEP and the variability of intraoperative SSEP were calculated. The potential effect of spine surgery was assessed by comparing pre- to postoperative SSEP. METHODS:: A total of 2143 pre-, intra- and postoperative tibial and median SSEP recorded in 25 patients undergoing spine surgery owing to idiopathic scoliosis were analyzed. The anesthesia protocol consisted of a computerized target controlled infusion (TCI) device for propofol and intravenous application of an opioid. RESULTS:: Anesthesia induced a significant and comparable prolongation of the tibial SSEP onset, P40 and P60 latencies, while the N50 latency was less changed. Throughout anesthesia, latencies of median (onset, N20, P25 and N35) and tibial (onset, P40, N50 and P60) SSEP showed mean variations of less than 6%. The intraoperative SSEP amplitudes were less stable with a relative standard deviation of 30-40%. In uneventful spine surgery, the postoperative tibial SSEP were not significantly changed in comparison to preoperative recordings. CONCLUSIONS:: By using a standardized anesthesia protocol, the impact of anesthesia on preoperative SSEP can be predicted. Furthermore, the controlled application of sedatives and analgesics allows recording of stable SSEP parameters for intraoperative monitoring purposes. As in uneventful spine surgery pre- to postoperative SSEP are unchanged the latter comparison can be applied as an additional perioperative neuromonitoring procedure to assess the influence of spine surgery or other invasive interventions on spinal cord function.Spinal Cord (2003) 41, 483-489. doi:10.1038/sj.sc.3101493 [ABSTRACT FROM AUTHOR]

Purpose. The purpose of this study was to use primary cultured rat alveolar epithelial cell monolayers to examine the potential of using transferrin receptor (TfR)-mediated transcytosis for noninvasive systemic protein drug delivery via the pulmonary route.Methods. Freshly isolated rat type II pneumocytes were plated onto tissue culture-treated polycarbonate 12-mm Transwells. AEC monolayers (\G 2500 Ωcm2) were treated with keratinocyte growth factor (10 ng/mL) for maintenance of type II cell-like characteristics. Filgrastim (GCSF)-Tf conjugates were prepared using the linkers SPDP and DPDPB. TfR-specific binding and uptake were determined using 125I-Tf and 59Fe-Tf treatment, respectively. Apical-to-basolateral (A-to-B) transferrin receptor (TfR)-mediated transcytosis was determined by dosing the apical compartment with 1.5 μg/mL of 125I-Tf or 125I-GCSF-Tf. Nonspecific TfR-independent transport of 125I-Tf and 125I-GCSF-Tf was determined in parallel by including 150 μg/mL of nonradiolabeled Tf. Basolateral samples (500 μL) were taken at 2, 4, and 6 h post-dosing, subjected to 15% trichloroacetic acid precipitation, and assayed in a Packard gamma counter. TfR-specific transport was determined as the difference between total and nonspecifc transport. The effects of brefeldin-A (BFA) on TfR distribution and (A-to-B) transport of 125I-Tf, 125I-GCSF and 125I-GCSF-Tf was studied by including the agent in the apical fluid at 1 μg/mL.Results. BFA treatment resulted in a small significant reduction in TfR at the basolateral surface of type II cell-like monolayers, while it had no effect on TfR distribution in type I cell-like monolayers. In contrast, BFA treatment significantly altered the endocytosis of TfR, reducing the basolateral uptake of 59Fe-Tf while greatly increasing the apical uptake of 59Fe-Tf. BFA treatment, however, did not affect the TfR-specific uptake of 59Fe-Tf in type I cell-like monolayers. TfR-specific apical-to-basolateral transcytosis of 125I-Tf and 126I-GCSF-Tf conjugates was significantly enhanced in the presence of BFA in type II cell-like monolayers, whereas it had no effect on apical-to-basolateral transport of 125I-GCSF. BFA-enhanced transport of 125I-GCSF-Tf was approximately 3-fold higher than that of 125I-GCSF in the presence or absence of BFA. Moreover, 125I-GCSF transport in the presence of BFA was not significantly different from non-specific 125I-GCSF-Tf transport. Chromatographic analyses and bio-assays revealed that GCSF-Tf was not degraded during transport via TfR-specific processes, and that GCSF retained biologic activity when liberated from the conjugate via dithiothreitol reduction.Conclusion. This study suggests the possibility of using TfR-mediated transcytosis for systemic delivery of therapeutic proteins via the alveolar epithelium. [ABSTRACT FROM AUTHOR]

In this article, a fully integrated single photon detector including a silicon avalanche photodiode and a quenching circuit is presented. The low doping concentrations, inherent to the complementary metal-oxide-semiconductor (CMOS) high-voltage technology used, favor the absorption of red and infrared photons at the depletion region. The detection probability rapidly increases with excess bias voltages up to 5 V. At this value, the detection probability is larger than 20% between 420 nm and 620 nm and still 7% at 750 nm. The photosensitive area is 7 μm in diameter. Cointegration of the diode and the quenching resistor allows a drastic reduction of parasitic capacitances. Though passively quenched, the single photon detector exhibits a dead time as low as 75 ns. The avalanche current is quickly quenched in less than 3.5 ns leading to a relatively low afterpulsing probability of 7.5% at 5 V excess bias voltage. The afterpulses are located in the first microseconds after the avalanche event. At room temperature, the dark count rate is about 900 Hz at 5 V excess bias voltage. Cooling of the sensor below 0°C is of minor interest since the tunneling process becomes dominant. A remarkably short timing resolution has been obtained with values lower than 50 ps for excess bias voltage higher than 5 V. The industrial CMOS high-voltage technology used guarantees low production costs. In applications where the light can be focused on the small photosensitive area using a high magnification objective, the fabricated single photon avalanche photodiode overcomes the features of standard photomultiplier tubes. The CMOS integration opens the way to the fabrication of an extremely compact array. The design can be easily fitted to a dedicated application. Furthermore, by using an industrial CMOS process, the cointegration of data processing electronics to produce a smart sensor would be a feasible task. [ABSTRACT FROM AUTHOR]

STUDY DESIGN:: Cervical laminectomy with or without fusion, or laminoplasty, successfully address congenital or acquired stenosis, multilevel spondylosis, ossification of the posterior longitudinal ligament (OPLL), and ossification of the yellow ligament (OYL). To optimize surgical results, however, these procedures should be applied to carefully selected patients. OBJECTIVES:: To determine the clinical, neurodiagnostic, appropriate posterior cervical approaches to be employed in patients presenting with MR- and CT-documented multilevel cervical disease. To limit perioperative morbidity, dorsal decompressions with or without fusions should be performed utilizing awake intubation and positioning and continuous intraoperative somatosensory-evoked potential monitoring. SETTING:: United States of America. METHODS:: The clinical, neurodiagnostic, and varied dorsal decompressive techniques employed to address pathology are reviewed. Techniques, including laminectomy, laminoforaminotomy, and laminoplasty are described. Where preoperative dynamic X-rays document instability, simultaneous fusions employing wiring or lateral mass plate/screw or rod/screw techniques may be employed. Nevertheless, careful patient selection remains one of the most critical factors to operative success as older individuals with prohibitive comorbidities or fixed long-term neurological deficits should not undergo these procedures. RESULTS:: Short- and long-term outcomes following dorsal decompressions with or without fusions vary. Those with myelopathy over 65 years of age often do well in the short-term, but demonstrate greater long-term deterioration. Factors that correlated with greater susceptibility to deterioration include advanced age (>70 years at the time of the first surgery), severe original myelopathy, and recent trauma. CONCLUSIONS:: Success rates of laminectomy with or without fusion, or laminoplasty may be successfully employed to address multilevel cervical pathology in a... [ABSTRACT FROM AUTHOR]

Psychological literature on trauma usually focuses on pathology that results from trauma and pays little attention to positive outcomes. This article presents a phenomenological inquiry into the experiences of a profoundly traumatized group of people—parents whose son or daughter has been murdered—to assess if they were able to experience a positive outcome resulting from their trauma and to identify associated processes and resources. Of 65 parents who volunteered, 16 were selected to complete a questionnaire and were given in-depth, semistructured interviews. The interview data, analyzed qualitatively, affirm positive outcomes for these parents. Four processes—acceptance, finding meaning, personal decision making, and reaching out to others in compassion—and six resources—personal qualities, spirituality, continuing bond with the victim, social support, previous coping experience, and self-care—facilitate a positive outcome. [ABSTRACT FROM AUTHOR]

Intraoperative electrophysiologic monitoring can diminish the risk of neurologic injury by enabling the detection of injury at a time when it can be reversed or minimized. This report describes a 14-year,old girl with a Chiari's malformation type 1 and syringomyelia who underwent a suboccipital decompression and dural patch grafting with concurrent somatosensory evoked potentials. When the patient was turned into the prone position and the neck was flexed, the left-sided somatosensory evoked potential deteriorated. After the patient's neck was repositioned, the left median nerve potential improved but did not return to baseline. Postoperatively, the patient had decreased proprioception of her left arm, which completely resolved at 2-week follow-up. This single case report does not establish the need for routine somatosensory evoked potential monitoring. Nevertheless, deterioration of the potential in this case led directly to a change in the surgical positioning, which may have significantly reduced the chances of a permanent neurologic injury. (J Child Neurol 2001;16:936–939). [ABSTRACT FROM AUTHOR]

Provides information on a study which investigated various aspects of the polysilicon gate influence on the random dopant induced threshold voltage fluctuations in sub-100 nm metal oxide semiconductor field-effect transistors with ultrathin gate oxides. Devices and simulation procedure; Simulation results and analysis; Conclusion.

Discusses a study which presented a three-dimensional model for the feature scale simulation of continuum transport and reaction determined high-pressure chemical vapor deposition (HPCVD) processes. Description of the diffusion and reaction simulation; Discussion of the HPCVD of tungsten; Conclusion.

Somatosensory evoked potentials (SEPs) were used for continuous monitoring of 210 patients during anterior surgery for cervical myeloradiculopathy, to test how effectively they help avoid irreversible neurological damage during surgery. The pathologies differed in severity and were treated by diskectomy or by extended corporectomy using the Senegas technique. Intraoperative SEP changes were recorded in 84 patients (40%); in 13 (6.2%) of these, changes in SEP amplitude and latency were caused by mechanical stress. SEPs revealed transient episodes of regional ischaemia or neurophysiological anomalies during anaesthesia (mainly hypotension) in 27 patients (12.8%). The traces detected incipient and potentially dangerous mechanical pressure on, or metabolic anomalies of, the spinal cord during manipulation and placement procedures of spinal fixation devices. They were particularly sensitive indicators of ischaemia; one of the most common causes of irreversible injury. The traces of 44 patients (21.0%) improved markedly during surgery. There were no false-negatives in this series and, thanks to the fact that SEPs gave immediate warnings of incipient ischaemia to the surgical team, we had no case of irreversible medullary or nerve-root deficit. [ABSTRACT FROM AUTHOR]

Soon after corticosteroids were discovered to have therapeutic usefulness, it was noted that these agents could have a harmful effect on the course of some infections. Many drug manufacturers have warned against the use of topical corticosteroids in herpesvirus infections of the skin. This article attempts to examine information about the effects of systemic steroids in herpes simplex and zoster and topical corticosteroids in herpes infections of the eye. Despite disconcerting lack of clinical data, it is possible to draw some tentative conclusions based on available information about immune responses to herpes simplex infections and the effect of corticosteroids on these immune mechanisms.

The present study compares the coping styles of adolescents in two different cultures. Two carefully equated samples, consisting of 353 German and 187 Israeli adolescents, aged 15 to 17 years, were investigated. Coping styles were defined by a matrix of 20 coping strategies applied across eight different developmental areas. Factor analysis revealed comparable dimensional structures of coping styles. Both German and Israeli adolescents most frequently employed functional forms of coping. The samples differed with respect to their relative emphasis on direct action and help-seeking behavior as compared to internal reflection of possible solutions. In both cultures withdrawal was not used very often. In addition, significant main effects for age and gender were found. Coping behavior among German adolescents was more influenced by situational demands, with pronounced approach-avoidance behavior. Their Israeli counterparts showed less variability in coping behavior across situations, laid greater stress on cognitive factors, and showed a striking decrease in overall coping behavior with increasing age. The discussion focuses on cultural universals and differences in coping behavior and considers the impact of environmental and historical conditions. [ABSTRACT FROM PUBLISHER]

Though circumcision has long been known to cure Zoon's balanitis, this mode of treatment has been largely neglected by many leading authorities in recent times. In this report we describe two patients who failed to respond to recommended topical treatment but who were rapidly cured by circumcision. [ABSTRACT FROM AUTHOR]

This paper is a report of one year's participant observation in a heal chapter of Parents of Murdered Children, a self-help group. The already difficult grief after the death of a child is complicated after murder by four special issues, (a.) Anger is focused on the person who willfully caused the death and there is a drive for revenge. (b) The grief cannot be resolved until the legal processes have been completed and within the court system the parent are caught up in a procedural labyrinth in which they have no legal standing, (c) Parents are fearful about the safety of themselves and other members of their family, (d) Parent of a murdered child is a taboo social role. The self-help process of Parents of Murdered Children as it differs from other self-help for for bereaved parents is discussed. [ABSTRACT FROM PUBLISHER]

Homicide which occurs in intimate social relationships was studied using data front three Western Canadian cities. Variables which may be related to the relationship and homicide are also examined. Unstable relationships are clearly differentiated from other relationships and are snore likely to result in homicide. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

A sample of 50 homicide defendants acquitted by reason of insanity (NGRI) was compared with a group of 50 defendants who were evaluated for insanity and found to be criminally responsible (CR). Significant differences were found between the two groups in terms of prior psychiatric and criminal histories and nature of the homicide (i.e., relationship to victim). The dispositions of those found NGRI were also examined on the above variables. [ABSTRACT FROM AUTHOR]

The surgical treatment of a group of 24 patients with hydradenitis suppurativa is described and the clinical features, aetiological factors and other methods of treatment are reviewed. An abnormally high incidence of atopy is noted within the group. [ABSTRACT FROM AUTHOR]

Examines the life experiences of survivors of murder victims. Classifications of crime; Areas of survivors' personal worlds that were expanded as a result of the murder; Experiences that inhibit the survivor from accomplishing the task of grieving; Development of grounded theory studies of survivors' experiences.

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The review discusses acute and cumulative irritant, allergic contact dermatitis, contact urticaria, and exacerbation of atopic dermatitis due to the physical and chemical nature of textile fibers. [ABSTRACT FROM AUTHOR]

The interaction of noise with a variety of other agents and with some physical characteristics of the individual to produce noise-induced hearing loss is reviewed critically. The review is restricted, for the most part, to publications since 1970. Other agents interacting with steady-state noise that are reviewed here include: (1) ototoxic drugs (kanamycin, neomycin, ethacrynic acid, furosemide, and salicylates), (2) impulse noise, and (3) whole-body vibration. Physical characteristics of the individual that are reviewed are: (1) age, (2) presence of previous hearing loss from prior noise exposure, (3) eye color, and (4) race. Suggestions for future research in this general area are also made. Some of these suggestions are as follows: (1) to extend studies of the interaction of steady-state noise with impulse noise, salicylates, and whole-body vibration to encompass a broader range of exposure conditions, including exposure conditions typically encountered by the worker, (2) to develop an animal model of presbycusis to explore the interactions of noise-induced hearing loss and presbycusis, and (3) to explore the potential interactions resulting from concurrent exposure to multiple agents, such as impulse noise and ototoxic drugs, in younger, more susceptible animals. [ABSTRACT FROM AUTHOR]

Wilson and Daly (1992) examined spousal homicide samples from the United States, Canada, Australia, and Great Britain and concluded: "For every 100 U.S. men who kill their wives, about 75 women kill their husbands; this spousal 'sex ratio of killing' (SROK) is more than twice that in other Western nations" (p.189). In this paper we examine the SROK for the United States using data obtained from the Federal Bureau of Investigation's Supplementary Homicide Report (SHR) to determine if Wilson and Daly's conclusion can be supported. While confirming Wilson and Daly's summary findings, our results show that the SROK is an elastic measure, varying over time, race, and ethnicity. In many segments of the U.S. population, the SROK is comparable to the sex ratio of killing for other Western nations. Moreover, the differences between various racial groups in the United States are greater than the differences between the U.S. and Canada, Australia and Great Britain, respectively. We suggest that socioeconomic factors and family structure are the major reasons for the disparity in the SROK for different racial groups in the United States and abroad. The implications of our findings for future research are discussed. [ABSTRACT FROM PUBLISHER]

There is very little in the growing literature on domestic violence which addresses the special problems which racial, ethnic or cultural minority women might face in dealing with abuse from their partners. This paper examines and attempts to understand this gap in the research. It synthesizes the available information on abuse against women from a variety of minority groups, outlining some of the unique dilemmas faced by abused women of color and explaining why many of them may not be willing or able to make use of traditional helping agencies to escape their victimization. [ABSTRACT FROM PUBLISHER]

This literature review traces the occurrence of dermatological problems caused by textile fibers and dyes, with the focus on consumer rather than occupational exposure. Wool, silk, nylon, fiberglass, spandex, and rubber have a role in cumulative insult, allergic contact, atopic, or contact urticaria dermatitis. Thirty-one dyes, mainly disperse with anthraquinone or azo structures, cause allergic contact dermatitis. Phototoxic dye dermatitis is rare. Dermatological information necessary to understand the kind of dermatitis and characteristic skin eruptions has been included. The sensitization process is described. Incidence rates can only be deduced from studying scattered reported incidences. Until predictive testing is done, the extent of fiber and dye caused skin problems will remain unknown. [ABSTRACT FROM PUBLISHER]