The volume-deficient orbit: clinical characteristics, surgical management, and results after extraperiorbital implantation of Silastic block.

The surgical techniques and results after extraperiorbital implantation of Silastic on the orbital floor of 70 patients are reviewed. In 11 patients the implant was through a subciliary approach and in 59 through an inferolateral cantholysis. The inferolateral cantholysis, a simplification of the McCord and Moses approach to the orbital floor, is particularly suited to this application. The implanted Silastic was retained in 66 patients, with an average follow up of 3.5 years (range less than 1 to 9.5 years), though six required surgery to debulk the anterior end of the implant. Further surgery was required in 27 patients, this generally being to correct the position of either the upper or the lower lid. Volume enhancement was effective in most cases, there being a significant reduction in the degree of recession of the prosthesis and the depth of the unsightly sunken sulci of the upper and lower lids. The mobility of the orbital contents, the prosthesis, and the upper lid was not improved.     

Response to a diet low in total fat in women with postmenopausal breast cancer: a pilot study

A feasibility study was instituted to determine if women with postmenopausal breast cancer would follow a low-fat diet (20% of kcal) for at least four months. Nineteen women, whose baseline food intake was 1,504 +/- 420 kcal with 56 +/- 16 g of fat, reported a decrease in fat intake to 21 +/- 6 g after two months of dietary intervention. Serum concentrations of cholesterol, HDL cholesterol, and estradiol were significantly reduced by the fifth month on the diet. We conclude that self-selected patients can adhere to a low-fat diet, and that serum cholesterol may serve as an indicator of dietary compliance.     

Tuberculosis prevention: cost-effectiveness analysis of isoniazid chemoprophylaxis

Isoniazid chemoprophylaxis is not recommended for all persons infected with tubercle bacilli. Because of the small but significant risk of isoniazid hepatotoxicity, chemoprophylaxis is reserved for only those at the highest risk of tuberculosis activation. To evaluate this policy, we performed a cost-effectiveness analysis of isoniazid chemoprophylaxis for two populations with positive tuberculin skin tests: recent tuberculin converters, who are at high risk for activation, and older tuberculin reactors, who have a low risk for activation and for whom chemoprophylaxis is not now recommended. The cost-effectiveness ratios found were stable, despite wide variations in model assumptions and probability estimates. For high-risk tuberculin reactors, chemoprophylaxis resulted in net medical care monetary savings, extended life expectancy, and fewer fatal illnesses. For low-risk tuberculin reactors, chemoprophylaxis resulted in positive, but small, health effects. Because the cost to gain these positive effects were also small, the resulting cost-effectiveness ratios were reasonable and in the realm of accepted prevention strategies: $12,625 to gain one year of life and $35,011 to avert one death. These findings suggest that the current policy is too restrictive and that many in the large population of low-risk tuberculin reactors should be considered for isoniazid chemoprophylaxis.     

Interactions between epidermal growth factor-mediated autocrine regulation and linoleic acid-stimulated growth of a human prostate cancer cell line.

Human prostate cancer (PC) cell lines possess epidermal growth factor (EGF) receptors and secrete EGF-related polypeptides. We used an EGF receptor-blocking antibody (anti-EGF.R) to demonstrate a functional autocrine loop, as well as the interaction between this and the effects of linoleic acid (LA), an omega-6 fatty acid, on PC cell growth. The anti-EGF.R competed effectively with [125I]EGF for receptors on DU145 PC cells, and on a high-passage DU145 variant (DU145M); when added to the culture medium, it suppressed both DU145 and DU145M cell growth in a dose-dependent manner. LA, a precursor for eicosanoid synthesis, had little effect on DU145 cell growth rate but stimulated DU145M growth in a concentration-related manner over a range of 0.25-2.0 micrograms/ml. anti-EGF.R (10(-9) M) caused suppression of LA-stimulated growth of DU145M cells in serum-free medium, which was prevented by the addition of 2 nM EGF. We conclude that an EGF.R-mediated autocrine loop is involved in PC cell growth regulation and that at least one site of action may be the synthesis of eicosanoids from their LA precursor.     

Uroscopy in the 21st century: high-field NMR spectroscopy

From the experiments described, it can be seen that there are different research approaches that can be taken and these are summarized in Table 1. Whereas much scientific research is principally hypothesis led, there remains, nevertheless, an important place for exploratory research. High resolution NMR can measure, directly and simultaneously, a wide range of endogenous metabolites in biological fluids and has the unique capability of providing structural information on the metabolites detected. It has proved to be a powerful research tool with which to study inherited metabolic diseases, renal disease, drug metabolism, and toxicity, and can be used to monitor the effects of drug therapy. For instance, by using a library of experimental toxins one can map the metabolic profile of site-specific nephron injury. With this approach in man one could eventually take an unknown disease such as Balkan nephropathy and predict the initial site of tubular injury, the mode of injury and therefore the kind of toxin capable of producing that injury. NMR spectroscopic techniques are still advancing rapidly, with ever increasing sensitivity and sophistication of NMR pulse sequences to enhance structural elucidation in complex mixtures. Given the advances in directly coupled HPLC-NMR and even HPLC-NMR-mass spectroscopy it is likely that these technologies in conjunction with pattern recognition will make major contribution to our understanding of renal processes and provide new diagnostic insights in the 21st century.      

The relationship among receptive and expressive vocabulary, listening comprehension, pre-reading skills, word identification skills, and reading comprehension by children with reading disabilities.

PURPOSE: Some researchers (F. R. Vellutino, F. M. Scanlon, & M. S. Tanzman, 1994) have argued that the different domains comprising language (e.g., phonology, semantics, and grammar) may influence reading development in a differential manner and at different developmental periods. The purpose of this study was to examine proposed causal relationships among different linguistic subsystems and different measures of reading achievement in a group of children with reading disabilities. METHODS: Participants were 279 students in 2nd to 3rd grade who met research criteria for reading disability. Of those students, 108 were girls and 171 were boys. In terms of heritage, 135 were African and 144 were Caucasian. Measures assessing pre-reading skills, word identification, reading comprehension, and general oral language skills were administered. RESULTS: Structural equation modeling analyses indicated receptive and expressive vocabulary knowledge was independently related to pre-reading skills. Additionally, expressive vocabulary knowledge and listening comprehension skills were found to be independently related to word identification abilities. CONCLUSION: Results are consistent with previous research indicating that oral language skills are related to reading achievement (e.g., A. Olofsson & J. Niedersoe, 1999; H. S. Scarborough, 1990). Results from this study suggest that receptive and expressive vocabulary knowledge influence pre-reading skills in differential ways. Further, results suggest that expressive vocabulary knowledge and listening comprehension skills facilitate word identification skills.