Comparison of Korean COPD Guideline and GOLD Initiative Report in Term of Acute Exacerbation: A Validation Study for Korean COPD Guideline

The purpose of this study was to compare the Korean COPD guideline to GOLD consensus report in terms of acute exacerbation. A total of 361 patients were enrolled in this study, and 16.9% of them experienced acute exacerbation during the follow-up. A total of 6.3% of patients in GOLD A, 9.5% in GOLD B, 7.7% in GOLD C and 17.0% of GOLD D experienced exacerbation during the first year of follow-up, respectively (P=0.09). There was no one who experienced exacerbation during the first year of follow-up in the Korean group ''ga''. The 12-month exacerbation rates of Korean group ''na'' and ''da'' were 4.5% and 16.0%, respectively (P<0.001). We explore the experience of exacerbation in patients with change of their risk group after applying Korean COPD guideline. A total of 16.0% of the patients who were reclassified from GOLD A to Korean group ''da'' experienced acute exacerbation,and 15.3% from GOLD B to Korean group ''da'' experienced acute exacerbation. In summary, the Korean COPD guideline is useful to differentiate the high risk from low risk for exacerbation in terms of spirometry. This indicates that application of Korean COPD guideline is appropriate to treat Korean COPD patients.     

Fathers' behaviors and children's psychopathology

The psychological literature on how fathers' behaviors may be related to children's psychopathology has grown substantially in the last three decades. This growth is the result of research asking the following three overarching questions: (1) what is the association between family structure, and particularly biological fathers' non-residence, and children's psychopathology, (2) what is the association between fathers' parenting and children's psychopathology, and (3) what is the association between fathers' psychopathology and children's psychopathology. The three broad theoretical perspectives relevant to this literature are the standard family environment model, the passive genetic model, and the child effects model. The evidence from studies comparing the first two models seems to suggest that the origin of the association between parental divorce and children's emotional and behavioral problems is largely shared environmental in origin, as is the association between resident fathers' parenting and children's emotional and behavioral problems, according to studies comparing the standard family environment model with the child effects model. However, research needs to compare appropriately all theoretical perspectives. The paper discusses this, and also points to the importance of considering theory-driven specificity in modeling effects.     

Euthyroid Graves' ophthalmopathy with negative autoantibodies

Graves'' disease is an autoimmune-based hyperthyroidism in which a number of different antibodies directed against thyroid tissue plays a role. Graves'' ophthalmopathy is thought to be a consequence of this autoimmune basis and occurs in some patients with Graves'' disease. On occasional cases, the disease may present only with ophthalmopathy without hyperthyroidism. A 32-year-old woman with euthyroid Graves'' ophthalmopathy and negative thyroid autoantibodies, including TSH receptor antibody, is presented here.     

Experimental Trypanosoma cruzi cardiomyopathy in BALB/c mice: histochemical evidence of hypoxic changes in the myocardium.

Mice inoculated three times at intervals of 15 days with epimastigote forms of an ''avirulent'' strain of Trypanosoma cruzi and challenged 30 days after the last inoculation with trypomastigote forms of the ''Colombia'' strain of T. cruzi develop a cardiomyopathy very similar to that observed in the chronic phase of Chagas'' disease in man. The most conspicuous histopathological finding in both human and experimental chagasic cardiomyopathy is focal myocardial necrosis and degeneration. Based on the nature of cell necrosis and degeneration, and the association of this lesion with intravascular platelet aggregation in the experimental model, we suggested that the microcirculation could be involved, via transient ischaemia, in the pathogenesis of chagasic cardiomyopathy. Additional support to this hypothesis is given by the results of the present study showing histochemical evidence of hypoxic changes in the myocardium of mice chronically infected with T. cruzi.     

Phantom limbs: The body in mind

Introduction. Advances in our knowledge of corporeal awareness is not limited to patients with amputations, however, until recently, the study of ''phantom limbs'' was neglected by comparison with less common disorders of body perception. Method. Reasons for the neglect of this potentially informative and common condition are conspicuous by their absence in previous reviews. Over the past decade, however, experimental investigations of phantom limbs have revealed the dynamic neural processes that provide for both phantom and normal corporeal embodiment. Moreover, these findings helped to overturn widely held scientific assumptions regarding the extent of neural plasticity in the adult brain. Results. It is suggested that throughout medical history, the construct of ''phantom limbs'' posed a challenge to fundamental folk assumptions regarding the assumed relationship between body and mind. Conclusion. Reluctance to entertain the counter-intuitive phenomenon of a ''limbless perception'' contributed to the comparative neglect of this fascinating phenomenon until the late 20th century.     

IMPRESSIONS OF ISABEL MENZIES LYTH

In this brief and personal appreciation, I have conveyed what seems to me a surprising diffidence in Isabel's assessment of her work. I have speculated that this reticence resulted in some small – but nevertheless quite significant – divergence from Elliott Jaques' original work, with which Isabel's is always closely linked. This divergence has relevance for Jaques' abandonment of the ‘social defence system’ theory, and Isabel's continuing allegiance to it.     

Identification of adulterated sheep and goat cheeses marketed in Romania by immunocromatographic assay

The authenticity of different animal food products has important attention in many countries received in the last few years. The majority of dairy products' authenticity identification methodologies are based on major milk proteins analysis. One of the main problems in cheese making is the adulteration of sheep and goats milk with cow's milk, because cow's milk is cheaper. The aim of this paper is to detect the presence of cow's milk in sheep's and goat's cheeses which are sold in the retail markets of Romania. For this purpose, a total of 73 sheep's and goat's cheese samples were purchased randomly from different markets. An immunochromatographic test kit was used to detect the presence of cow's milk in sheep and goat cheeses. No adulteration was found in 32.6% and 20.3% of sheep and goat cheese samples, respectively, while the presence of cow's milk was detected in 67.3% and 79.7% of samples, respectively. These results were considered to be unacceptable and routine controls on adulterated sheep and goat cheese should be performed in Romania.     

Lemierre's syndrome: An often missed life-threatening infection

Lemierre''s syndrome is an uncommon, but fatal infection of the internal jugular vein (IJV) that is usually caused by Fusobacteirum necrophorum although a wide range of bacteria has been reported as causative agents. Typical symptoms include fever, sore throat, neck swelling, pulmonary symptoms and arthralgia; however, the diagnosis of this infection is frequently overlooked as initial manifestation might be subtle and non-specific. Definite diagnosis requires positive blood culture and radiological evidence of thrombus in the IJV. We describe a case of a patient with Lemierre''s syndrome who was initially misdiagnosed with viral upper respiratory tract infection. High index of suspicion is pivotal to the diagnosis of this infection and Lemierre''s syndrome should always be considered as a potential cause of sepsis in an otherwise healthy patient.     

The immune system, amyloid-β peptide, and Alzheimer's disease

Summary: In this review, the case is made that amyloid‐β peptide in the brain of patients with Alzheimer's disease is a primary cause of the disease and that immunotherapy directed against this peptide has the potential to halt and/or reverse disease progression. This supposition is supported by the capacity of anti‐β‐amyloid peptide antibodies to prevent or reverse the disease in mouse models of Alzheimer's disease. Furthermore, preliminary results obtained in a small number of patients with Alzheimer's disease are consistent with the observations made in the mouse model of this disease. We review the relationship between the immune system, amyloid‐β peptide, and Alzheimer's disease and the progress made in applying immunotherapy to patients with Alzheimer's disease.     

Acute illness in infants: a general practice study

The character and frequency of acute illness in infants presenting to a general practice over a 16-week period was studied. Symptoms were classified as ''major'' or ''minor'' in accordance with the definitions used in a multicentre study in infant mortality.Of the 126 consultations reviewed, 106 (84 per cent) included at least one major symptom. None of the illnesses resulted in hospital admission or had a fatal outcome. It was concluded that this classification of symptoms into `major'' and `minor'' categories is not sufficiently discriminating to use in general practice. More specific definitions are required.     

Rejoining of DNA double-strand breaks after the introduction of chromosome 11 into a radiosensitive bladder carcinoma cell line

Insertion of a normal chromosome 11 into tumour cell lines can protect against a sensitivity to irradiation and oxidative stress. A possible mechanism underlying this effect is that there is a correction of a defect in the rejoining of double-strand breaks (dsb) by the chromosome insertion. In order to explore this hypothesis, three cell lines were evaluated for their ability to rejoin dsb: (1) a bladder carcinoma cell line (`parent') previously shown to be sensitive to irradiation and radical generating species; (2) a derivative of this cell line into which a normal chromosome 11 had been inserted by microcell fusion (`hybrid') showing corrected radiosensitivity; and (3) a `revertant' cell line that had spontaneously lost the insert and reverted to the radiosensitive phenotype. Nuclear extracts from the 3 lines were isolated and evaluated for their capacity to rejoin plasmid (pUC18) DNA broken at defined restriction sites (SalI, EcoRI, KpnI, SmaI) in the lacZ gene. The extent of rejoining was determined by gel electrophoresis and the fidelity of rejoining determined by expression of the lacZ gene in E. coli DH5α bacteria. Results suggest there is no difference between the `parent', `hybrid' and `revertant' nuclear extracts in the fidelity and the total extent of rejoining, regardless of the type of break. However, there is an alteration in the distribution of rejoined products. Nuclear extracts from `hybrid' cells tend to rejoin linear DNA into circular monomers with a greater efficiency than extracts from both `parent' and `revertant' cells. This alteration in distribution is observed when 3′- or 5′-protruding ends are rejoined but not in the rejoining of blunt ends. The results suggest that loci on chromosome 11 are involved in the rejoining of dsb, affecting the relative amount of the different rejoined products. Whether this alteration plays a role in the `parent' cell's radiosensitivity is yet to be determined.     

The relationship between cell-mediated immunity and cartilage degradation in antigen-induced arthritis in the rabbit.

The relative contributions of cellular and humoral immunity to cartilage destruction in chronic arthritis has been investigated in a model of chronic synovitis in the rabbit. In this model, antigen-induced arthritis, immunization with ovalbumin in Freund''s complete adjuvant (FCA) followed by intra-articular injection of this protein produces a chronic synovitis associated with loss of proteoglycan from articular cartilage. In addition, the synovial lining cell population is metabolically activated. Similar treatment of animals immunized with ovalbumin in Freund''s incomplete adjuvant (FIA) produced a resolving arthritis which initially (over the first 7 days) appears to be identical to that in FCA-immunized animals, apart from the lack of activation of synovial lining cells. Following this initial synovitis the joints return to apparent normality apart from a persistent ''low grade'' synovitis consisting mainly of a plasma cell infiltrate. The most striking finding in the FIA-immunized animals is the rapid loss (greater than 30% by day 7) and recovery of proteoglycan from the matrix of articular cartilage. These findings show that the perpetuation of chronic destructive synovitis in the rabbit requires the presence of active cellular immunity.     

Atypical presentation of Wilms' tumor: evaluation and early diagnosis.

Wilms'' tumor is a malignancy that most often affects children. It usually is discovered incidentally by a parent or family member in an asymptomatic child. The development of surgical techniques and the addition of adjuvant therapies have made this once incurable disease curable. The National Wilms'' Tumor Study group, developed in 1969, has done extensive research of the disease, and in an ongoing process, performs trials of various treatment modalities to improve the survival of patients with Wilms'' tumor. This article describes a patient with an atypical presentation of Wilms'' tumor.     

Moyer's method of mixed dentition analysis: a meta-analysis

Background

Mixed dentition analysis forms an essential part of an orthodontic assessment. Moyer''s method which is commonly used for this analysis is based on data derived from a Caucasian population. The applicability of tables derived from the data Moyer used to other ethnic groups has been doubted. However no meta-analyses have been done to statistically prove this.

Objective

To assess the applicability of Moyer''s method in different ethnic groups.

Study design

A meta-analysis of studies done on other populations using Moyer''s method.

Method

The seven articles included in this study were identified by a literature search of Medline (1966–June 2003) using predetermined key words, inclusion and exclusion criteria. 195 articles were reviewed and meta-analyzed.

Results

Overall the correlation coefficients were found to be borderline in variation with a p-value of 0.05. Separation of the articles into Caucasian and Asian groups also gave borderline p-values of 0.05.

Conclusion

Variation in the correlation coefficients of different populations using Moyer''s method may fall either side. This implies that Moyer''s method of prediction may have population variations. For one to be sure of the accuracy while using Moyer''s method it may be safer to develop prediction tables for specific populations. Thus Moyer''s method cannot universally be applied without question.     

Ageing and Parkinson's disease: Why is advancing age the biggest risk factor?

As the second most common age related neurodegenerative disease after Alzheimer's disease, the health, social and economic impact resulting from Parkinson's disease will continue to increase alongside the longevity of the population. Ageing remains the biggest risk factor for developing idiopathic Parkinson's disease. Although research into the mechanisms leading to cell death in Parkinson's disease has shed light on many aspects of the pathogenesis of this disorder, we still cannot answer the fundamental question, what specific age related factors predispose some individuals to develop this common neurodegenerative disease. In this review we focus specifically on the neuronal population associated with the motor symptoms of Parkinson's disease, the dopaminergic neurons of the substantia nigra, and try to understand how ageing puts these neurons at risk to the extent that a slight change in protein metabolism or mitochondrial function can push the cells over the edge leading to catastrophic cell death and many of the symptoms seen in Parkinson's disease. We review the evidence that ageing is important for the development of Parkinson's disease and how age related decline leads to the loss of neurons within this disease, before describing exactly how advancing age may lead to substantia nigra neuronal loss and Parkinson's disease in some individuals.     

Promotion of mental health through coaching competitive sports.

Competitive sports can have a negative or positive impact on an athlete''s mental health, and an athlete''s coach plays a large role in determining this. The coach''s goal should be to help athletes realize that developing human potential is equally as important as winning. This article highlights guidelines to assist coaches in instructing and mentoring athletes.     

Complementary Tube Cecostomy in the Management of Strangulated Right Richter's Inguinal Hernia of the Cecum

Strangulated right Richter''s inguinal hernia of the cecum is relatively rare. A case of this unusual hernia was successfully managed with a wedge resection and closure of the infarcted bowel wall in conjunction with complementary tube cecostomy. The procedure is easy to perform and relatively safe and is therefore recommended for use in selected cases of Richter''s hernia of the cecum.     

Of Distance and Desire: The Many Metamorphoses of George Michael and the Origins of his Creativity

This paper argues for George Michael's significance to contemporary culture, a significance that requires a radical reinterpretation of his life. My discussion suggests that what is at stake in understanding Michael's life is a pattern of internalized homophobia. The method of this paper is to trace the double structure of his consciousness – his awareness of his role as icon and his private state of despair – by isolating moments in both parts of his life. From these, I attempt to extract an understanding of Michael's inner world that found expression in his lyrics. These encounters I explore in light of Kohut's theory of narcissism and Winnicott's ideas of transitional objects. In addition, George Michael's later years were defined by two losses, that of his lover and that of his mother. Michael's relationship to his grief is the focus of this essay. Drawing upon the biographies that have been written about George Michael and the interviews he gave over his career, I attempt to trace the origin of his depression to his early encounters with loss. These losses, I maintain, were reactivated at the peak of Michael's fame and led ultimately to withdrawal and artistic silence in his final years.     

What is a meaningful result? Disclosing the results of genomic research in autism to research participants

Developments in genomics research have been accompanied by a controversial ethical injunction: that researchers disclose individually relevant research results to research participants. With the explosion of genomic research on complex psychiatric conditions such as autism, researchers must increasingly contend with whether – and which results – to report. We conducted a qualitative study with researchers and participants involved in autism genomics research, including 4 focus groups and 23 interviews with parents of autistic children, and 23 interviews with researchers. Respondents considered genomic research results ‘reportable'' when results were perceived to explain cause, and answer the question ‘why;'' that is, respondents set a standard for reporting individually relevant genetic research results to individual participants that is specific to autism, reflecting the metaphysical value that genetic information is seen to offer in this context. In addition to this standard of meaning, respondents required that results be deemed ‘true.'' Here, respondents referenced standards of validity that were context nonspecific. Yet in practice, what qualified as ‘true'' depended on evidentiary standards within specific research disciplines as well as fundamental, and contested, theories about how autism is ‘genetic.'' For research ethics, these finding suggest that uniform and context-free obligations regarding result disclosure cannot readily be specified. For researchers, they suggest that result disclosure to individuals should be justified not only by perceived meaning but also by clarity regarding appropriate evidentiary standards, and attention to the status of epistemological debates regarding the nature and cause of disorders.     

Neuroepidemiology of vascular and Alzheimer's dementia among African-American women.

To better understand risk factors for Alzheimer''s disease and vascular dementia, demographic, medical, and other epidemiological factors were compared for 83 African-American women with Alzheimer''s disease and 46 with vascular dementia. Overall, the risk-factor profiles for Alzheimer''s disease and vascular dementia were similar to those in other studies. However, Alzheimer''s patients had a high frequency of hypertension and a relatively high frequency of diabetes mellitus. The presence of such risk factors raises the possibility that there is a vascular component to the dementia in these African-American women with Alzheimer''s disease. Neuropathological studies are needed to help answer this question.