Nasal implants

In this article, options for nasal implantation during rhinoplasty are discussed. The range of implant options currently available to the nasal surgeon is considered in detail. Various types of autografts, homografts, and alloplasts commonly used in the nose are introduced and described. Indications for each nasal implant type are considered, as are the advantages and limitations of each option.     

Mother-daughter communication and college women's confidence to communicate with family members and doctors about the human papillomavirus and sexual health

Study Objective

In this study, we examined whether mother-daughter sexuality communication in midadolescence contributes to young women’s self-efficacy to consult with family members about sexual health problems, and to talk with physicians about the human papillomavirus (HPV).

Participants and Setting

Young European American, Latina, and Asian Pacific Islander college women reported on how confident they felt talking to their family members and doctors about HPV and sexual health issues.

Main Outcome Measures

We gathered retrospective data regarding the nature of mother-daughter communication, including sexuality communication, in midadolescence. Other variables included physician trust, knowledge about HPV, and reports of current sexual activity.

Results

More openness in past general communication with their mothers, more perceived comfort in past sexuality communication, and a greater number of reproductive health topics discussed was linked to greater confidence in communicating with family members about sexual health problems. In addition, higher levels of sexual activity, more knowledge about HPV, and the number of reproductive health topics discussed with mothers in midadolescence, were associated with increased confidence talking to doctors about HPV and sexual health.

Conclusion

Positive communication experiences with mothers in the early years may reduce the shame, embarrassment, and anxiety associated with talking to physicians about sensitive sexuality issues.     

The role of religious involvement on depression, risky behavior, and academic performance among Korean American adolescents

Structural equation modeling was used to test a theoretical path model of church engagement, personal spirituality, and mentoring relationships on depressive symptoms, involvement in risky behaviors, and self-reported grades among Korean American adolescents. It was hypothesized that personal spirituality and mentoring relationship quality would mediate the relation between church engagement and adolescent outcomes. Data were obtained through a self-report survey from 248 Korean American adolescents in grades 7 through 12. High levels of church engagement, as characterized by years of attendance, choice to attend, and participation in activities, predicted deeper personal spirituality and better mentoring relationships. Personal spirituality, as measured by one’s daily religious experiences, beliefs, and private spiritual practices, was a mediator of the relationship between church engagement and adolescent outcomes. Specifically, higher levels of church engagement was linked to stronger personal spirituality, which in turn predicted less depressive symptoms for girls and higher grades for boys.     

Three-dimensional rotational angiography of the left atrium and esophagus—A virtual computed tomography scan in the electrophysiology lab?

BACKGROUND: Three-dimensional (3D) reconstruction of the heart and surrounding structures has been supplementing traditional two-dimensional imaging to guide diagnostic and therapeutic electrophysiologic procedures. Current methods using computed tomography (CT)/magnetic resonance imaging (MRI) reconstruction have certain limitations. OBJECTIVE: We investigated the feasibility of rotational angiography (RA) combined with simultaneous esophagogram to create an intraprocedural 3D reconstruction of the left atrium (LA) and the esophagus. METHODS: Rotational angiography was performed. Contrast was injected via a pigtail catheter positioned in the left or right pulmonary artery to achieve a levophase venous cycle opacification of the ipsilateral pulmonary veins and adjacent LA. Simultaneous administration of oral contrast allowed a 3D reconstruction of the esophagus in the same image. Qualitative and quantitative comparison between the intraprocedural 3D RA and a remote CT scan was performed in 11 consecutive patients undergoing ablation for atrial fibrillation. RESULTS: Adequate visualization of the pulmonary veins, adjacent posterior LA, and esophagus was achieved in 10 patients. Determination of pulmonary transit time to guide the initiation of RA resulted in better-quality imaging. A close correlation between 3D RA and CT was found. Based on close proximity between the LA and esophagus, the ablation procedure was modified in three patients. CONCLUSIONS: Three-dimensional RA of the LA and esophagus is a promising new method allowing intraprocedural 3D reconstruction of these structures comparable in quality to a CT scan. Further studies refining the method are justified because it could eliminate the need for CT/MRI scans before ablation.     

Selective output-discriminative signals in the motor cortex of waking monkeys.

Monkeys and humans have similar capacities to discriminate between the frequencies of mechanical sinusoids delivered to the glabrous skin of their hands. Combined psychophysical-electrophysiological experiments in monkeys discriminating in the range of flutter provided evidence that this capacity depends upon differences in the cycle lengths in the sets of periodically entrained activity, evoked by the stimuli discriminated, in neurons of areas 3b and 1 of the (sensory) hemisphere opposite the stimulated hand. Identical experiments have now been made, in similarly trained and discriminating monkeys, in the motor cortex (area 4) of the hemisphere opposite the arm projecting selectively to one of two targets, to indicate discrimination (five hemispheres, 1137 neurons studied). We observed a selective signal of the upcoming correct discrimination in about 25% of the neurons of area 4 active in the task. The neuronal discharge occurs selectively for stimuli either lower or higher in frequency than that of the base stimulus, and commonly begins within 200-300 msec after onset of the comparison stimulus. These neuronal discharges are aperiodic, with no sign of the stimulus frequencies. EMG recording during performance of the discrimination showed that the muscles of the arm opposite the side of recording were silent during the period of stimulus presentations. Recordings during trials in which the animal made errors showed most commonly that the output of the discrimination operation was itself in error, followed by an appropriate arm projection to the wrong target. We interpret the selective response during the comparison stimulus to be a postdiscrimination signal projected transcallosally from the sensory hemisphere to the motor area of the hemisphere controlling the responding arm. We obtained no evidence that the discrimination operation is localized to any particular area, and we surmise it to occur in the dynamic activity within the distributed system linking the sensory cortex of one hemisphere and the motor cortex of the other. One-third of the neurons of the motor cortex responded to indentation of the skin of the ipsilateral hand, at trial onset. These responses varied from those closely linked to that sensory stimulus to those linked to the upcoming movement of the contralateral hand. These onset responses did not occur when similar sequences of mechanical stimuli were delivered to alert but idling monkeys.     

The vaccination-challenge trial: the gold standard test to evaluate the protective efficacy of infectious coryza vaccines

Infectious coryza is an upper respiratory tract disease of chickens with the major impact occurring in multi-age flocks. We investigated the relationship between the level of antibodies, as detected by a haemagglutination-inhibition (HI) assay, in infectious coryza-vaccinated chickens and the protection against challenge in those chickens. In one experiment, chickens given a single dose of either of two infectious coryza vaccines lacked a detectable HI response to vaccination but showed significant levels of protection 11 weeks after vaccination. In contrast, in chickens given two doses of an infectious coryza vaccine and challenged 3 weeks after the second vaccine dose, there was a strong serological response with 36/40 birds having a HI titre of 1/20 or greater. In this trial there was an apparent relationship between titre and subsequent protection, with none of the 32 chickens with a titre of 1/40 or 1/80 showing any clinical signs and only one of the same group yielding the challenge organism on culture. In contrast, three of the four vaccinated chickens with a HI titre less than 1/5 developed the typical clinical signs of coryza and yielded the challenge organism on culture. Overall, our results suggest that HI titres cannot be regarded as a definitive predictor of vaccine efficacy. We suggest that the vaccination-challenge trial is the gold standard for the evaluation of the immune response to infectious coryza vaccines.     

Glycoprotein Ib–IX-mediated activation of integrin αIIbβ3: effects of receptor clustering and von Willebrand factor adhesion

Summary. The interaction between the platelet glycoprotein (GP) Ib–IX complex and von Willebrand factor (VWF) initiates both hemostasis and pathological thrombosis. This interaction is not only the first adhesive event of platelets at sites of vessel injury, but also facilitates fibrinogen binding to α_IIbβ₃, which subsequently results in platelet aggregation. Since it has been suggested that GP Ib–IX clustering may promote platelet activation, we investigated the effect of such clustering on both VWF–GP Ib–IX and fibrinogen–α_IIbβ₃ bonds using optical tweezers. In our system, fusion of tandem repeats of FK506‐binding protein (FKBP) to the cytoplasmic tail of the GP IX subunit of the GP Ib–IX complex allowed subsequent receptor clustering within the plasma membrane by the bivalent, cell‐permeant small molecule ligand AP20187. We measured binding forces between polystyrene beads coated with either plasma‐derived VWF or the VWF A1 domain and GP Ib–IX(FKBP)₂, and those between fibrinogen‐coated beads and α_IIbβ₃ expressed on Chinese hamster ovary cells. The minimal detachment force between GP Ib–IX(FKBP)₂ and A1 or plasma‐derived VWF doubled after AP20187 was added. The binding force between immobilized fibrinogen and α_IIbβ₃ was not changed by the clustering agent; however, the strength of single fibrinogen–α_IIbβ₃ bonds increased significantly after ligation of GP Ib–IX(FKBP)₂ by A1. These results demonstrate that GP Ib–IX clustering increases the overall strength of its interaction with VWF. Furthermore, signals from GP Ib–IX can activate α_IIbβ₃, thereby increasing the strength of its interaction with fibrinogen.