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The attachment styles and parental bonding by 64 patients (M age=43.2 yr., SD= 13.3) with Gastroesophageal Reflux Disease (GERD) were compared with those of 64 patients (M age = 42.2 yr., SD = 13.5) with Inflammatory Bowel Disease (IBD) and 126 Healthy participants (M age = 42.2 yr., SD = 12.1). Analysis of scores on the Attachment Style Questionnaire indicated insecure attachment in both the patient and control groups. The Parental Bonding scores indicated perceptions of Affectionless Control by parents in both patient groups. In particular, the mean Father-Protection subscale scores were significantly higher for in the GERD group than in the Healthy and IBD groups. DOI 10.2466/02.09.15.21.PMS.111.5.625-630

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.techfore.2008.02.008 Byline: Mario Coccia Keywords: R&D investment; Productivity growth; Optimization Abstract: Governments in modern economies devote much policy attention to enhancing productivity and continue to emphasize its drivers such as investment in R&D. This paper analyzes the relationship between productivity growth and levels of R&D investments. The econometric analysis shows that more than 65 per cent of productivity growth variance is due to its dependence on gross domestic expenditure on R&D expressed as percentage of GDP (GERD). Economic analysis shows that productivity growth = f(GERD) is a concave function downwards due to diminishing returns to research investments. In addition, the research shows that the range of GERD between 2.3 per cent and 2.6 per cent maximizes the long-run impact on productivity growth and it is the key to sustained productivity and technology improvements that are becoming more and more necessary to modern economic growth. Article History: Received 2 August 2007; Revised 5 February 2008; Accepted 25 February 2008

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.techfore.2008.02.008 Byline: Mario Coccia Keywords: R&D investment; Productivity growth; Optimization Abstract: Governments in modern economies devote much policy attention to enhancing productivity and continue to emphasize its drivers such as investment in R&D. This paper analyzes the relationship between productivity growth and levels of R&D investments. The econometric analysis shows that more than 65 per cent of productivity growth variance is due to its dependence on gross domestic expenditure on R&D expressed as percentage of GDP (GERD). Economic analysis shows that productivity growth = f(GERD) is a concave function downwards due to diminishing returns to research investments. In addition, the research shows that the range of GERD between 2.3 per cent and 2.6 per cent maximizes the long-run impact on productivity growth and it is the key to sustained productivity and technology improvements that are becoming more and more necessary to modern economic growth. Author Affiliation: National Research Council of Italy (CERIS-CNR) and Max Planck Institute of Economics, Germany Article History: Received 2 August 2007; Revised 5 February 2008; Accepted 25 February 2008

Byline: Ingrid Plantin (1), Einar Arnbjornsson (1), Lars-Torsten Larsson (1) Keywords: Gastrostomy; Laparoscopy; Gastroesophageal reflux; 24-h pH monitoring Abstract: The objective of the study was to assess the influence of a laparoscopic video-assisted gastrostomy on acid gastroesophageal reflux (GER). A prospective uncontrolled study included 23 neurologically disabled children, from 10 months to 15 years of age, all with severe nutritional problems and in need of a gastrostomy. They all had a history of clinical GER problems including vomiting, choking and chest infections. A 24-h pH monitoring was used for a quantitative assessment of GER the day before surgery and 12+-3 months (7--22 months) postoperatively. The gastrostomy was placed on the anterior wall of the stomach near the lesser curvature. The main outcome measure was the comparison of the pre- and postoperative 24-h pH monitoring and the reflux index (RI), i.e. the percentage of time with pH below 4. The results showed a non-significant reduction of RI from 6.8+-4.5 preoperatively to 3.7+-2.0 postoperatively. We conclude that a gastrostomy using the video-assisted technique and placing the stoma on the anterior wall of the stomach close to the lesser curvature does not cause aggravation of acid reflux. Author Affiliation: (1) Department of Paediatric Surgery, University Hospital, 221 85, Lund, Sweden Article History: Registration Date: 08/05/2006 Accepted Date: 08/05/2006 Online Date: 01/06/2006

Byline: A. Goessler (1,2), A. Huber-Zeyringer (1), M. E. Hoellwarth (1) Keywords: Gastroesophageal reflux; Spells; Epilepsy; Fundoplication; Recurrence; Neurologically impaired patients Abstract: In neurologically impaired patients (NIP), surgical management of gastroesophageal reflux disease (GERD) has become a widespread standard. Several follow-up studies have shown a high incidence of complications and recurrent reflux. As one of the possible causes epilepsy is mentioned repeatedly in the literature. The aim of this study was to determine the effective impact of epilepsy on the postoperative outcome by comparing results of our patients suffering from epilepsy to those without this disorder. From 1984 to 1999, a total of 45 NIP underwent antireflux surgery, including 20 patients suffering from epilepsy (EP) and 25 patients without this disorder (nEP). The existence of epileptic disorders, incidence of epileptic seizures and administration of anticonvulsatory drugs as well as results of diagnostic procedures, postoperative complications and incidence and time of recurrence of pathologic GER were recorded and analysed retrospectively. Preoperatively all patients had pathologic results in 24 h pH-monitoring. Median RI was 15.75 (EP, range 5.2--28.6) and 17.55 (nEP range 7.2--26.5). 12-months-postoperative 24 h pH-monitoring showed a median RI of 3.8 (EP range 1.3--25.6) versus a median RI of 3.3 (nEP range 0.7--26.3). During the long-term follow-up evaluation of 3.9 years, 17 EP suffered from persistent epileptic seizures despite medical treatment. 19 patients (42%) developed recurrent reflux. This included seven EP (35%) and 12 nEP (48%). The necessity of reoperation was higher in nEP (n = 5, 20%) than in EP (n = 1, 5%). This analysis did not show a significant correlation between recurrence of pathologic GER after fundoplication and the incidence of epileptic seizures. We consider our findings to strongly question the widespread opinion considering this correlation. We conclude, that cerebral seizures alone do not alter the operative outcome of antireflux surgery in NIP. Author Affiliation: (1) Department of Pediatric Surgery, University of Graz, Medical School, Auenbruggerplatz 34, 8036, Graz, Austria (2) Wilhelminenstrasse 100, 1160, Vienna, Austria Article History: Registration Date: 03/04/2006 Accepted Date: 03/04/2006 Online Date: 29/04/2006

Epidermal growth factor (EGF) is predominantly secreted by salivary glands and activates [Na.sup.+]/[H.sup.+] exchanger-1 (NHE-1), which regulates intracellular pH (p[H.sub.i]). We investigated the roles of EGF and NHE-1 in esophageal epithelial defense against acid using human esophageal epithelial cell lines and a rat chronic esophagitis model. Esophageal epithelial cells were incubated with acidified medium in the absence or presence of EGF. Cell viability and changes in p[H.sub.i] were measured. Chronic acid reflux esophagitis was induced in rats with and without sialoadenectomy. Esophageal lesion index, epithelial proliferation, and expression of EGF receptors and NHE-1 were examined. EGF protected esophageal epithelial cells against acid in a dose-dependent manner, and the cytoprotective effect of EGF was completely blocked by treatment with NHE-1 inhibitors. Tyrosine kinase, calmodulin, and PKC inhibitors significantly inhibited cytoprotection by EGF, whereas MEK, phosphatidylinositol 3-kinase, and PKA inhibitors had no effect. EGF significantly increased p[H.sub.i] recovery after N[H.sub.4]Cl pulse acidification, and this increase in p[H.sub.i] recovery was significantly blocked by inhibitors of calmodulin and PKC. Sialoadenectomy led to an increase in the severity of chronic esophagitis but affected neither epithelial proliferation nor expression of EGF receptors. Expression of NHE-1 mRNA was increased in esophagitis and upregulated in rats with sialoadenectomy. The increasing severity of esophagitis in rats with sialoadenectomy was prevented by exogenous administration of EGF. In conclusion, EGF protects esophageal epithelial cells against acid through NHE activation via [Ca.sup.2+]/calmodulin and the PKC pathway. Deficiency in endogenous EGF is associated with increased severity of esophagitis. EGF and NHE-1 play crucial roles in esophageal epithelial defense against acid. saliva; calmodulin; protein kinase C; gastroesophageal reflux disease

An analysis of three species to establish an appropriate animal model to determine the neural route and target organs of the esophagoglottal closure reflex confirmed that feline species possess such a reflex which is homologous to that of humans. The existence of this reflex in monkeys and opossums could not be established.