Concurrent emphysematous cystitis and emphysematous pyelonephritis in a patient with extrarenal pelvis

We report co-occurrence of emphysematous cystitis and emphysematous pyelonephritis (EC/EPN) in a 64-year-old female with poor-controlled diabetes mellitus (DM) that presented with flank pain, fever, and hematuria that turned out to have a bilateral extrarenal pelvis. On examination, she was feverish, and the costovertebral angle was tender. By considering herhemoglobin A1C, her DM was out of control. Inflammatory markers elevated. Renal function tests were impaired. Urine culture was positive for extended-spectrum beta-lactamase Escherichia coli. Computed tomography scans (CT) confirmed the presence of air in the bladder and renal pelvis in favor of EC and unilateral EPN. We planned to use conservative treatments. Promptly intravenous antibiotics started; thereafter, the renal pelvis was drained via percutaneous catheter, and the bladder was drained via foley catheter, as well. After 14 days of hospitalization, clinical status improved, urine culture got negative, and emphysema in follow-up CT images wholly regressed. To our knowledge, co-occurrence of emphysematous cystitis (EC) and emphysematous pyelonephritis (EPN) in a patient with an extra renal pelvis never happened. We tend to convey messages, including (1) the extrarenal pelvis may contribute to predisposing the patient to pyelonephritis if it is considerably large; (2) the conservative plan and observation was a successful experience in treating extrarenal pelvis patients with EC/EPN.

Geometrical and physical effects of nanofillers on percolation and electrical conductivity of polymer carbon-based nanocomposites: a general micro-mechanical model

A micro-mechanical model was developed to describe the electrical percolation and effective electrical conductivity of nanocomposites containing fillers with different shapes such as graphene nanoplatelets, carbon black, and carbon nanotubes. The fillers are considered to be an oblate or short cylindrical shape for graphene nanoplatelets, a spherical or spheroidal shape for carbon blacks, and a prolate or long cylindrical shape for carbon nanotubes. The effects of the filler shape, filler size, filler aspect ratios, the thickness of the interphase layer, the conductivity of the filler, the conductivity of the interphase layer, the conductivity of the matrix, volume fractions, quantum tunneling distance, and tunneling barrier height have been examined. This modified mean field model well describes the electrical properties of nanocomposites in the whole range of volume fractions for a variety of experimental results with various reinforcements. Also, it reproduces the very sharp behavior of the percolation transition well around the percolation threshold. The results show that nanocomposites containing fillers with an aspect ratio of 10^-2 < M < 10² and a volume fraction of ϕ_f < 0.3 show an insulating behavior while exhibiting a metallic behavior in the ranges M < 10^-2 and M > 10². This model produces variations in the percolation threshold in terms of the aspect ratio as a parabolic curve that can be used to predict the percolation threshold of nanocomposites with various fillers. The present general model can provide a new insight to design conductive polymer nanocomposites with the desired features and specific applications.

Correlation between ultrasound bladder parameters with severity of symptoms and response to treatment in patients with benign prostatic hyperplasia under medical treatment

BACKGROUND

Benign prostatic hyperplasia (BPH) is the most common benign mass in men, there are not standard parameter for diagnosis of BPH based on ultrasound bladder parameter, so the aim of the study was correlation between ultrasound bladder parameters with severity of symptoms and response to treatment in patients with benign prostatic hyperplasia under medical treatment.

METHODS

This prospective cross-sectional study was performed on 100 men over 40 years of age with a diagnosis of BPH referred to the urology clinics of Al-Zahra and Khorshid hospitals, Isfahan, Iran in 2018-2020. The International Prostate Symptom Score (IPSS), bladder wall thickness, bladder weight, Intravesical prostatic protrusion (IPP) and response to treatment were examined before and after treatment. Patients underwent standard drug treatment with a Tamsulosin 0.4 mg daily and finasteride 5 mg daily for BPH and followed for a period of 3-6 months.

RESULTS

There were significant differences between severity of symptoms before treatment with age, bladder was thickness, bladder weight and IPP (P<0.001). The symptoms of 76 patients were recovered and 24 patients not changed After treatment, so the patients were compared based on outcomes to treat, all patients with mild symptoms, 28 patients with moderate symptoms and 18 patients with severe symptoms were recovered, so the treatment outcome was significant based on symptoms (P<0.001). The means of age, bladder wall thickness and bladder weight in recovered group was significantly lower than not changed group (P<0.001). Also the frequency of IPP in the recovered group was significantly lower than not changed group (P<0.001).

CONCLUSION

The use of ultrasound parameters has a high value in determining the response to treatment in BPH patients and the diagnostic value of IPSS, IPP, bladder wall thickness and bladder weight were important determined response to treatment and severity of disease. Also relation between bladder weight with response to treatment and severity of disease were evaluated for first time in the current study.

Efficacy of Probiotic Prophylaxis After The First Febrile Urinary Tract Infection in Children With Normal Urinary Tracts

BACKGROUND

Growing antibiotic resistance and debates over their efficacy for urinary tract infection (UTI) recurrence warrants studying nonantibiotic prophylaxis for preventing UTI recurrences.

METHODS

We randomly assigned 181 children, aged 4 months to 5 years, with a normal urinary tract after recovery from their first febrile UTI in a 1:1 ratio to receive a probiotic mixture of Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, and Bifidobacterium lactis (n = 91) or placebo (n = 90) for a total of 18 months of therapy. The primary objective was to show the superiority of probiotic prophylaxis to placebo. The primary end point was composite cure (UTI-free survival) at 18 months, and the secondary end point was the median time to first UTI recurrence.

RESULTS

The probiotics were superior to placebo with respect to the primary efficacy end point. At 18 months, composite cure was observed in 96.7% (3 of 91) of the patients in the probiotic group and 83.3% (15 of 90) of those in the placebo group (P = .02). The median time to the first incidence of UTI recurrence was 3.5 months (range, 1-4 months) and 6.5 months (range, 2-14 months) in the probiotic and placebo groups, respectively (P = .04). The main microorganism that caused recurrent UTI was Escherichia coli, followed by Klebsiella pneumoniae, and these results were not significantly different between the 2 groups. We found no specific adverse events among the participants who received the probiotic mixture during the course of therapy.

CONCLUSIONS

The probiotics were more effective than placebo at reducing the risk of recurrent UTI in children with a normal urinary tract after their first episode of febrile UTI.

Effect of ventilation strategies and air purifiers on the children's exposure to airborne particles and gaseous pollutants in school gyms

Indoor school gyms are environments characterized by high concentrations of different airborne particulate and gaseous pollutants. In particular, like other naturally-ventilated school environments, in addition to indoor pollutants children can be exposed to sub-micron particles and gaseous pollutants emitted by outdoor sources and penetrating the building envelope; moreover, high concentrations of super-micron particles can be reached due to the resuspension phenomena related to the physical activity performed therein. The present paper aims to evaluate the effect of different ventilation methods (natural ventilation, manual airing) and the use of air purifiers in reducing the indoor concentrations of different airborne particles and gaseous pollutants in school gyms. To this end, an experimental campaign was performed in two naturally-ventilated school gyms in Barcelona (Spain) of different volumes and different distance to major urban roads. Indoor and outdoor measurements of particle number, black carbon and PM_1-10 concentrations were performed as well as indoor measurements of CO₂ and NO₂ concentrations. The study revealed that the use of air purifiers with windows kept closed (natural ventilation) can lead to a significant reduction in terms of indoor-to-outdoor concentration ratios. In the smaller gym (air changes per hour of the purifiers, ACH, equal to 9.2 h^-1) the I/O ratios were reduced by 93% and 95% in terms of particle number and PM_1-10, respectively; whereas in the larger school gym (ACH = 1.7 h^-1) the corresponding reductions were 70% and 84%. For manual airing scenarios, the effect of the air purifiers on outdoor-generated sub-micron particles is reduced; in particular, for low ACH values (i.e. ACH = 1.7 h^-1), the reduction is quite negligible (6%).

Airborne ultrafine particles in a Pacific Island country: Characteristics, sources and implications for human exposure

The Pacific Islands carry a perception of having clean air, yet emissions from transport and burning activities are of concern in regard to air quality and health. Ultrafine particle number concentrations (PNCs), one of the best metrics to demonstrate combustion emissions, have not been measured either in Suva or elsewhere in the Islands. This work provides insight into PNC variation across Suva and its relationship with particle mass (PM) concentration and composition. Measurements over a short monitoring campaign provide a vignette of conditions in Suva. Ambient PNCs were monitored for 8 day at a fixed location, and mobile PNC sampling for two days. These were compared with PM concentration (TSP, PM₁₀, PM_2.5, PM₁) and are discussed in relation to black carbon (BC) content and PM_2.5 sources, determined from elemental concentrations; for the October 2015 period and longer-term data. Whilst Suva City PM levels remained fairly low, PM_2.5 = 10-12 μg m^-3, mean PNC (1.64 ± 0.02 × 10⁴ cm^-3) was high compared to global data. PNCs were greater during mobile sampling, with means of 10.3 ± 1.4 × 10⁴ cm^-3 and 3.51 ± 0.07 × 10⁴ cm^-3 when travelling by bus and taxi, respectively. Emissions from road vehicles, shipping, diesel and open burning were identified as PM sources for the October 2015 period. Transport related ultrafine particle emissions had a significant impact on microscale ambient concentrations, with PNCs near roads being 1.5 to 2 times higher than nearby outdoor locations and peak PNCs occurring during peak traffic times. Further data, particularly on transport and wet-season exposures, are required to confirm results. Understanding PNC in Suva will assist in formulating effective air emissions control strategies, potentially reducing population exposure across the Islands and in developing countries with similar emission characteristics. Suva's PNC was high in comparison to global data; high exposures were related to transport and combustion emissions, which were also identified as significant PM_2.5 sources.

Airborne particles in indoor environment of homes, schools, offices and aged care facilities: The main routes of exposure

It has been shown that the exposure to airborne particulate matter is one of the most significant environmental risks people face. Since indoor environment is where people spend the majority of time, in order to protect against this risk, the origin of the particles needs to be understood: do they come from indoor, outdoor sources or both? Further, this question needs to be answered separately for each of the PM mass/number size fractions, as they originate from different sources. Numerous studies have been conducted for specific indoor environments or under specific setting. Here our aim was to go beyond the specifics of individual studies, and to explore, based on pooled data from the literature, whether there are generalizable trends in routes of exposure at homes, schools and day cares, offices and aged care facilities. To do this, we quantified the overall 24h and occupancy weighted means of PM₁₀, PM_2.5 and PN - particle number concentration. Based on this, we developed a summary of the indoor versus outdoor origin of indoor particles and compared the means to the WHO guidelines (for PM₁₀ and PM_2.5) and to the typical levels reported for urban environments (PN). We showed that the main origins of particle metrics differ from one type of indoor environment to another. For homes, outdoor air is the main origin of PM₁₀ and PM_2.5 but PN originate from indoor sources; for schools and day cares, outdoor air is the source of PN while PM₁₀ and PM_2.5 have indoor sources; and for offices, outdoor air is the source of all three particle size fractions. While each individual building is different, leading to differences in exposure and ideally necessitating its own assessment (which is very rarely done), our findings point to the existence of generalizable trends for the main types of indoor environments where people spend time, and therefore to the type of prevention measures which need to be considered in general for these environments.

Association analysis of rs1049255 and rs4673 transitions in p22phox gene with coronary artery disease: A case-control study and a computational analysis

BACKGROUND

The p22phox gene encodes the main subunit of NADH/NADPH-oxidase. This enzyme is expressed in smooth muscle cells of arteries, and it produces the reactive oxygen species. On the other hand, oxidative stress plays a main role in the pathogenesis of coronary artery disease (CAD).

AIM

The aim of this study is to evaluate the association between rs4673 and rs1049255 polymorphisms of p22phox gene with CAD in an Iranian population which was followed with a computational analysis approach.

METHODS

In a cross-sectional study, we collected blood samples of 302 Iranian Caucasian including 143 patients and 159 healthy controls. Genotype of the polymorphisms was detected through PCR-RFLP method. A computational analysis was also performed using SNAP, Polyphen-2, Chou-Fasman, RNAsnp, and miRNA SNP databases.

RESULTS

Data of case control study demonstrated that CT genotype (R = 1.84, 95% CI = 1.13-3.00, p = 0.014) and T allele (OR = 1.53, 95% CI = 1.09-2.15, p = 0.013) of rs4673 polymorphism, have a significant association with enhanced risk of CAD. But rs1049255 analysis demonstrated the absence of such an association with CAD. Indeed, in silico data analysis demonstrated that rs4673 transition could impact on function of p22phox protein (SNAP score 56, expected accuracy 75%; Polyphen-2 score 0.99, sensitivity 0.09, specificity 0.99). Data derived from miRNA SNP database demonstrated that rs1049255 polymorphism increases the affinity of attachment between has-miR-3689a-3b with 3'-UTR of p22phox gene.

CONCLUSION

Our data demonstrated that rs4673 transition may be involved in susceptibility to CAD and could be applied as a potential biomarker for this disease.

A pilot study of traditional indoor biomass cooking and heating in rural Bhutan: gas and particle concentrations and emission rates

Although many studies have reported the health effects of biomass fuels in developing countries, relatively few have quantitatively characterized emissions from biomass stoves during cooking and heating. The aim of this pilot study was to characterize the emission characteristics of different biomass stoves in four rural houses in Bhutan during heating (metal chimney stove), rice cooking (traditional mud stove), fodder preparation (stone tripod stove), and liquor distillation (traditional mud stove). Three stage measurements (before, during, and after the activity had ceased) were conducted for PM_2.5 , particle number (PN), CO, and CO₂ . When stoves were operated, the pollutant concentrations were significantly elevated above background levels, by an average of 40 and 18 times for PM_2.5 and CO, respectively. Emission rates (mg/min) ranged from 1.07 × 10² (PM_2.5 ) and 3.50 × 10² (CO) for the stone tripod stove during fodder preparation to 6.20 × 10² (PM_2.5 ) and 2.22 × 10³ (CO) for the traditional mud stove during liquor distillation. Usable PN data were only available for one house, during heating using a metal chimney stove, which presented an emission rate of 3.24 × 10¹³ particles/min. Interventions to control household air pollution in Bhutan, in order to reduce the health risks associated with cooking and heating, are recommended.

Factors influencing the outdoor concentration of carbonaceous aerosols at urban schools in Brisbane, Australia: Implications for children's exposure

This comprehensive study aimed to determine the sources and driving factors of organic carbon (OC) and elemental carbon (EC) concentrations in ambient PM2.5 in urban schools. Sampling was conducted outdoors at 25 schools in the Brisbane Metropolitan Area, Australia. Concentrations of primary and secondary OC were quantified using the EC tracer method, with secondary OC accounting for an average of 60%. Principal component analysis distinguished the contributing sources above the background and identified groups of schools with differing levels of primary and secondary carbonaceous aerosols. Overall, the results showed that vehicle emissions, local weather conditions and secondary organic aerosols (SOA) were the key factors influencing concentrations of carbonaceous component of PM2.5 at these schools. These results provide insights into children's exposure to vehicle emissions and SOA at such urban schools.

Epidermal growth factor receptor gene expression evaluation in colorectal cancer patients

Background: Colorectal cancer is one of the most common causes of death in the world and third and fourth most common cancer among men and women in Iran respectively. Epidermal growth factor receptor (EGFR) is a tyrosine kinase receptor that shows over expression in epithelial tumors and regulates important processes in tumorigenesis. Incidence and characteristics of colorectal cancer are based on the geographic region and race. Aim: In this research work, the over expression of EGFR in formalin fixed paraffin-embedded (FFPE) colorectal cancer tumor tissue of patients was studied. Materials and Methods: Fifteen FFPE colorectal cancer tumor tissues (10 women and 5 men; 25-65 years old and stage IV) and 15 non-patients (nine women and six men; 25-65 years old) that were collected during 2006-2012. EGFR gene expression level was analyzed by real-time quantitative reverse transcriptase polymerase chain reaction (PCR). All PCR reactions were performed in triplicate for both target gene and internal control (18s ribosomal ribonucleic acid) with the 2-ΔΔCT method. Gene expression differences in patients and controls were evaluated with t-test. Results: The results were showed EGFR gene over expression in 12 (80%) of 15 patients. There was a statistically significant difference in the prevalence of EGFR expression between patients and control (P < 0.05). Conclusion: Our results demonstrated EGFR gene over expression in colorectal cancer tumor tissue compared with controls.

Application of a novel method for optimization of bioemulsan production in a miniaturized bioreactor

A novel and economical method was used to optimize bacterial growth and bioemulsan production. Acinetobacter calcoaceticus PTCC 1641 was applied in an innovated synthetic medium comprised whey and mineral salt medium (MSM) in ratio of 1:1 in a shaken flask bioreactor. The optimum inoculum size, shaking frequency rate and filling volume (V(L)) using ventilation flasks were investigated that resulted in 5 vol.%, 300 rpm and 15 ml), respectively. The surface tension decreased around 48% during bioemulsan production. Due to determine bioemulsan properties, the reliability of blood agar method was confirmed as well.

Overall, and specific life satisfaction domains: preliminary Iranian students norms

BACKGROUND

The WHOQOL-BREF is one of the best-known instruments that have been developed for cross-cultural comparisons of quality of life and currently it is available in more than 40 languages. Current study was done to provide: (1) the psychometrics properties of the Iranian version of WHOQOL-BREF and (2) the norm scores for satisfaction with life overall and satisfaction with specific Life domains of Iranian students.

METHODS

A sample of 1000 Iranian undergraduate students, (Males= 490 and Females= 510) were pooled using multi-stage random method and asked to complete the Iranian version of the WHOQOL-BREF.

RESULTS

The results of current study indicated that a good internal consistency (α = 0.89) for WHOQOL-BREF (26 items) as well as four domain ratings. Our findings also showed no floor or ceiling effect for the 4 domains as well overall QOL and general health facets. Moreover, General norms for the satisfaction with life overall, general health and satisfaction with specific life domains (physical health, psychological well-being, social relationships, and environmental support) were obtained using WHOQOL-BREF.

CONCLUSION

The Iranian version of WHOQOL-BREF was deemed reliable in assessing the quality of life of a student population in Iran. Our results of calculating and presenting norm scores for satisfaction ratings can be used as preliminary Iranian students' norms for those researchers who are interested in measuring and interpreting satisfaction ratings using WHOQOL-BREF.

Reliability and validity of the Persian version of Foot and Ankle Ability Measure (FAAM) to measure functional limitations in patients with foot and ankle disorders

OBJECTIVE

To translate the Foot and Ankle Ability Measure (FAAM) into Persian and to evaluate the psychometric properties of the Persian version of FAAM.

METHODS

93 patients with a range of foot and ankle disorders, completed the Persian version of the FAAM and Short-Form 36 Health Survey (SF-36) in the test session. With an interval of 2-6 days, 60 patients filled out the FAAM in the retest session. The FAAM is composed of two subscales including activities of daily living (ADL) and SPORTS. Internal consistency was assessed using Cronbach's alpha, test-retest reliability using intraclass correlation coefficient (ICC) and standard error of measurement (s.e.m.), item internal consistency and discriminant validity using Spearman's correlation coefficient and construct validity using Spearman's correlation coefficient and Independent t-test.

RESULTS

Cronbach's alpha coefficient of 0.97 and 0.94 was obtained for ADL and SPORTS subscales, respectively. The ICC and s.e.m. were 0.98 and 3.13 for ADL and 0.98 and 3.53 for SPORTS subscale. Items were stronger measures of their hypothesized subscale than of other subscale. The ADL and SPORTS subscales had stronger correlation with SF-36 physical function (r=0.60, 0.53) and physical health summary measure (r=0.61, 0.48) than with SF-36 mental health (r=0.21, 0.10) and mental health summary measure (r=0.36, 0.27). A high correlation was found between FAAM scores and global scale of functional status for SPORTS (r=0.73) but not for ADL (r=0.42). FAAM scores were greater in individuals who rated their function as normal or nearly normal compared with those who rated as abnormal or severely abnormal for SPORTS (P=0.04) but not for ADL (P=0.15).

CONCLUSION

The Persian version of FAAM is a reliable and valid measure to quantify physical functioning in patients with foot and ankle disorders.

Immobilized Saccharomyces Cerevisiae as a potential aflatoxin decontaminating agent in pistachio nuts

In this study, we investigated the binding ability of Saccharomayces cerevisiae to aflatoxin in pistachio nuts. The obtained results indicate that S. cerevisiae has an aflatoxin surface binding ability of 40% and 70% (with initial aflatoxin concentrations of 10 and 20 ppb) in the exponential phase. Acid treatments increase this ability to approximately 60% and 73% for the two concentrations of aflatoxin, respectively. Heat treatments also enhance surface binding to 55% and 75%, respectively. Binding appears to be a physical phenomenon that saturates within the first 2–3 hours of the process. The obtained results indicate that yeast immobilization for toxin reduction on aflatoxin-contaminated pistachios had no effect on qualitative characteristics, such as color, texture, and peroxide value. Yeast cells, viable or nonviable, are effective for aflatoxin binding, and this property could lead to a promising solution to aflatoxin contamination in high-risk foods.

Application of bag sampling technique for particle size distribution measurements

Bag sampling techniques can be used to temporarily store the aerosol and therefore provide sufficient time to utilize sensitive but slow instrumental techniques for recording detailed particle size distributions. Laboratory based assessment of the method was conducted to examine size dependant deposition loss coefficients for aerosols held in Velostat bags conforming to a horizontal cylindrical geometry. Deposition losses of NaCl particles in the range of 10 nm to 160 nm were analysed in relation to the bag size, storage time, and sampling flow rate. Results of this study suggest that the bag sampling method is most useful for moderately short sampling periods of about 5 minutes.

Key elements for discriminating selective estrogen receptor modulators and selective receptor estrogen down regulators: a molecular approach to classify antiestrogens

Abstract #3036

Breast cancer is the most common type of malignancy among women in the world. About 60% of breast tumours express the oestrogen receptor alpha (ERα) and are considered hormone-responsive. Thus endocrine therapies have been the treatment of choice. However, the estrogen-like agonist effect of the available selective estrogen receptor modulators such as tamoxifen and the development of resistances require the development of new treatments that act through different mechanisms.&#x2028; The objective of our study is to design new anti-estrogens and tools that can help to understand the molecular mechanisms involved in ligand dependent modulation or degradation of ERα. It has been proposed that ligand dependent ERα degradation of antagonist may result from the presence of an aliphatic side chain on a steroidal body. Our aim is to exploit the structural characteristics of anti-estrogens to create new compounds with different lateral side chains for the study of the relationship between structure and activity of antiestrogens.&#x2028; We selected the following compounds: RU 39411, RU 58668, which have similar structures of the steroid body, but different side-chain motifs: RU 39411 has a side chain similar to that of Tamoxifen, while RU 58668 has one similar to Faslodex. The third compound, EM 652, has a body of intermediate structure between stilbestrol and oestradiol while the side chain is similar to that of Raloxifen.&#x2028; First, we analysed the degradation of ERα in the presence of the different ligands: Fulvestrant and RU 58668 induce degradation of ERα,in a protasome dependent manner, while RU 39411 and EM 652 have the same effect as Tamoxifen and stabilize ERα. To further analyze the molecular mechanism we generated three mutants of ERα; L540Q (in H12 of ligand binding domain), K362A (interaction with co-activators,) and A350V-D351Y (interaction with side chain of antiestrogens).&#x2028; Using transient transfection of the different mutant constructs of MDA-MB231(ER-negative) cells, we tested the effect of the ligands on gene expression of a luciferase reporter gene under the control of an estrogen inducible promoter and ligand-induced degradation of ER. Our results demonstrate that antiestrogens can be classified into two groups based on structure and function: Tamoxifen and RU39411 fall into a first group, and Faslodex and RU58668 into a second group. However EM 652 has an intermediate behavior. Preliminary results on stable cell lines show that results from transient transfections can be reproduced.and confirm the importance of the integrity of H12 for antagonist activity. Molecular modelisation demonstrates that variations in the structure of the ER ligand binding domain in the presence of different antiestrogens correlate with functional differences.&#x2028; We have used molecular studies to screen and classify antiestrogen compounds into SERM or SERD with the aim to develop novel molecules for endocrine treatment of breast cancer.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3036.

Particle and gaseous emissions from commercial aircraft at each stage of the landing and takeoff cycle

A novel technique was used to measure emission factors for commonly used commercial aircraft including a range of Boeing and Airbus airframes under real world conditions. Engine exhaust emission factors for particles in terms of particle number and mass (PM2.5), along with those for CO2 and NOx, were measured for over 280 individual aircraft during the various modes of landing/takeoff (LTO) cycle. Results from this study show that particle number, and NOx emission factors are dependent on aircraft engine thrust level. Minimum and maximum emissions factors for particle number, PM2.5, and NOx emissions were found to be in the range of 4.16 x 10(15)-5.42 x 10(16) kg(-1), 0.03-0.72 g.kg(-1), and 3.25-37.94 g.kg(-1), respectively, for all measured airframes and LTO cycle modes. Number size distributions of emitted particles for the naturally diluted aircraft plumes in each mode of LTO cycle showed that particles were predominantly in the range of 4-100 nm in diameter in all cases. In general, size distributions exhibit similar modality during all phases of the LTO cycle. A very distinct nucleation mode was observed in all particle size distributions, except for taxiing and landing of A320 aircraft. Accumulation modes were also observed in all particle size distributions. Analysis of aircraft engine emissions during LTO cycle showed that aircraft thrust level is considerably higher during taxiing than idling suggesting that International Civil Aviation Organization (ICAO) standards need to be modified as the thrust levels for taxi and idle are considered to be the same (7% of total thrust) (Environmental Protection, Annex 16, Vol. II, Aircraft Engine Emissions, 2nd ed.; ICAO--International Civil Aviation Organization: Montreal, 1993).

The Effectiveness of Little Bird Programme on Improvement of Mental Health and Decrease Parental Stress in Mothers of Autistic Children

This study was a trail of an intervention named Little Bird aimed to decrease parental stress and improve mental health in mothers of autistic children. The sample was 24 mothers of autistic children. The intervention compared across two groups, an intervention group and non-intervention control group. The result indicate that, compared with the control group, mothers in intervention group reported significant improvement in mental health and significant decrease in parental stress following the intervention, at the end of programme and 1 month follow-up.

Validation of a Persian-version of Knee injury and Osteoarthritis Outcome Score (KOOS) in Iranians with knee injuries

OBJECTIVE

To adapt culturally and validate Persian-version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in a sample of Iranians with knee injuries.

METHODS

Cultural adaptation included providing of forward and backward translations, quality rating and pilot testing. A sample of 147 patients with anterior cruciate ligament (ACL), meniscus and combined (ACL and meniscus) injuries was asked to complete two questionnaires including the KOOS and Short-Form 36 Health Survey (SF-36). The KOOS was readministered to 54 patients 6-8 days after the first visit. Test-retest reliability and internal consistency were assessed, using Intraclass Correlation Coefficient (ICC) and Cronbach's alpha, respectively. Dimensionality was assessed, using item-scale correlation after correction for overlap and construct validity, using a priori hypothesized correlations with the SF-36.

RESULTS

All patients found the Persian-version of the KOOS to be clear and unambiguous in pilot testing. Minimum ICC level of 0.70 was exceeded by all subscales with the exception of Sport and Recreation (Sport/Rec) subscale. Minimum Cronbach's alpha level of 0.70 was exceeded by all subscales with the exception of Symptoms and Knee-related Quality of Life (QoL). Minimum Spearman correlation coefficient of 0.40 for each item-scale was exceeded by 34 items. All priori hypotheses were supported by the presence of higher correlations between similar constructs than between dissimilar constructs of the KOOS and SF-36.

CONCLUSION

The Persian-version of the KOOS is a culturally-adapted, reliable and valid outcome measure to be used in Iranian patients with knee injuries, with its psychometric properties in agreement with the original versions.

A plume capture technique for the remote characterization of aircraft engine emissions

A technique for capturing and analyzing plumes from unmodified aircraft or other combustion sources under real world conditions is described and applied to the task of characterizing plumes from commercial aircraft during the taxiing phase of the Landing/Take-Off (LTO) cycle. The method utilizes a Plume Capture and Analysis System (PCAS) mounted in a four-wheel drive vehicle which is positioned in the airfield 60 to 180 m downwind of aircraft operations. The approach offers low test turnaround times with the ability to complete careful measurements of particle and gaseous emission factors and sequentially scanned particle size distributions without distortion due to plume concentration fluctuations. These measurements can be performed for individual aircraft movements at five minute intervals. A Plume Capture Device (PCD) collected samples of the naturally diluted plume in a 200 L conductive membrane conforming to a defined shape. Samples from over 60 aircraft movements were collected and analyzed in situ for particulate and gaseous concentrations and for particle size distribution using a Scanning Particle Mobility Sizer (SMPS). Emission factors are derived for particle number, NO(x), and PM2.5 for a widely used commercial aircraft type, Boeing 737 airframes with predominantly CFM56 class engines, during taxiing. The practical advantages of the PCAS include the capacity to perform well targeted and controlled emission factor and size distribution measurements using instrumentation with varying response times within an airport facility, in close proximity to aircraft during their normal operations.

Quantitative 3D maxillary arch evaluation of two different infant managements for unilateral cleft lip and palate

OBJECTIVE

A two-institution retrospective study was undertaken to determine whether two different prepalatoplasty protocols quantitatively affect maxillary arch morphology in infants with complete unilateral cleft lip and palate (UCLP).

DESIGN

Serial maxillary dental casts, obtained at regular intervals through the first 18 months of life from preintervention until palatoplasty were evaluated quantitatively using computer-assisted three-dimensional digitization and analysis for three populations: institution 1 (protocol 1), institution 2 (protocol 2), and unaffected individuals (neither cleft nor treatment). Sequential UCLP patients from institution 1 were matched for age and initial alveolar cleft width, sex and cleft side having been demonstrated to be nonsignificant, with UCLP patients from institution 2 and to unaffected individuals for age for the analysis.

SETTING

Both treatment institutions are well-established regional interdisciplinary cleft centers. Institution 1 is located in a tertiary, academic children's hospital in a metropolis within a primarily agrarian region of the Midwest; institution 2 is a freestanding private clinic located in a small city within a primarily agrarian region of an eastern state; the unaffected population is a historic archive acquired in the 1930s. Data acquisition (model digitization) and computer processing were performed at institution 1.

PATIENTS

Eighty-five casts of 28 infants from institution 1, 106 casts of 31 infants from institution 2, and 68 casts of 29 unaffected infants were analyzed. All infants had alginate impressions taken prior to intervention and at several additional 6-month intervals after that, consistent with each institution's treatment protocol.

INTERVENTIONS

At institution 1, patients with UCLP underwent lip adhesion and placement of a passive alveolar molding plate at 7 weeks of age, definitive cheiloplasty at 7 months of age, and one-stage palatoplasty at 14 months of age. At institution 2, patients with UCLP underwent definitive cheiloplasty at 3 months of age, had no maxillary orthopedics, and had vomer flap hard palate repair at 12 months of age and soft palate repair at 18 months of age.

MAIN OUTCOME MEASURES

The outcome measures included directly digitized (cleft segment and hemialveolar ridge lengths) and derived (alveolar base width, alveolar cleft gap, maxillary frenum-alveolar base perpendicular angle, and rates of change over time of digitized cleft segment and hemialveolar ridge lengths) features. The data were assessed by comparing simple linear regression lines and an unpaired, two-tailed t test.

RESULTS

Prior to initiating therapy, there were no statistically significant differences between the two populations with clefts. However, both populations with clefts differed significantly from unaffected individuals (p < .001), with increased maxillary base widths and larger perpendicular/frenum angles. At the time of palatoplasty, the two populations with clefts had statistically significant differences between them in the maxillary base width (p < .01) and the cleft gap distance (p < .05). The base width of institution 1 did not differ significantly from that of widths of unaffected children, and that of institution 2 was significantly less, although the latter had already received first-stage palate repair. Alveolar segment growth rates were similar for the greater and lesser segments, respectively, and the left side hemialveolus of both groups. The growth rate for the noncleft side hemialveolus of institution 2 exceeded (p < .05) that of both institution 1 and unaffected patients.

CONCLUSION

Two different regimens for the initial management of UCLP can significantly affect maxillary alveolar arch growth with respect to the treatment used and in comparison with unaffected controls.

Confirmation of linkage of Van der Woude syndrome to chromosome 1q32: evidence of association with STR alleles suggests possible unique origin of the disease mutation

Van der Woude syndrome (VWS) is an autosomal dominant craniofacial disorder with high penetrance and variable expression. Its clinical features are variably expressed, but include cleft lip and/or cleft palate, lip pits and hypodontia. All VWS families studied to date map the disease gene to a < 2 cM region of chromosome 1q32, with no evidence of locus heterogeneity. The aim of this study is to refine the localization of the VWS gene and to further assess possible heterogeneity. We analyzed four multiplex VWS families. All available members were clinically assessed and genotyped for 19 short tandem repeat markers on chromosome 1 in the VWS candidate gene region. We performed two-point and multipoint limit of detection (LOD) score analyses using a high penetrance autosomal dominant model. All families showed positive LOD scores without any recombination in the candidate region. The largest two-point LOD score was 5.87. Our assay method for short tandem repeat (STR) markers provided highly accurate size estimation of marker allele fragment sizes, and therefore enabled us to determine the specific alleles segregating with the VWS gene in each of our four families. We observed a striking pattern of STR allele sharing at several closely linked loci among our four Caucasian VWS families recruited at three different locations in the US. These results suggest the possibility of a unique origin for a mutation responsible for many or most cases of VWS.

Topical aminocaproic acid facilitates reepithelialization of persistent epithelial defects

PURPOSE

After corneal injury, persistent epithelial defects (PED's) may occur due to the chronic failure of the regenerating epithelium to adhere to the underlying stroma. The aim of this study was to examine the potential of epsilonaminocaproic acid (EACA) as a topical treatment for PED's. EACA inhibits the activation of plasmin, which metabolizes fibronectin. Fibronectin, a glycoprotein, anchors corneal epithelium to the basement membrane and the underlying stroma.

METHODS

In anesthetized rabbits, PED's were induced with sodium hydroxide (1 N). Seven days later, during the late healing phase, treatment began with administration of EACA (30%) to the right eye and administration of vehicle alone to the left eye three times daily. A control group received neither EACA nor vehicle. Rabbits were treated for 19 days. PED's were visualized by fluorescein staining. Their size was mapped using digital planimetry.

RESULTS

After 11 days of treatment with EACA, treated PED's were 50% smaller than in corneas treated with vehicle alone. Following treatment for 15 days, corneas treated with EACA had significantly greater re-epithelialization than vehicle-treated or control corneas. Frozen sections stained immunofluorescently for fibronectin appeared to qualitatively contain more adherent fibronectin in treated corneas. Transmission and scanning electron microscopy indicated that the epithelium was more polymorphic, thinner and vacuolated in untreated controls compared to EACA treated eyes. Light microscopy demonstrated more continuous adherent epithelium after EACA treatment.

CONCLUSIONS

Topically administered EACA decreases both the severity and incidence of persistent epithelial defects produced by alkali bums to the cornea. EACA appears to promote adherence of the regenerating epithelium to the underlying stroma. Thus, topically administered EACA may be an effective treatment for this chronic condition.

Comparison of velopharyngeal growth patterns between cleft lip and/or palate patients requiring or not requiring pharyngeal flap surgery

This investigation compares the patterns of velopharyngeal growth in cleft lip and/or palate patients. Those who had velopharyngeal competence and acceptable speech are compared with those who presented with velopharyngeal incompetence requiring pharyngeal flap surgery or prosthesis later. Lateral cephalograms of 30 cleft palate only (CPO), 35 unilateral cleft lip and palate (UCLP), and 20 bilateral cleft lip and palate (BCLP) children of the Lancaster Cleft Palate Clinic were studied. These records were taken at 6 month intervals during the first 2 postnatal years and annually thereafter up to 6 years of age. Soft tissue landmark points in the velopharyngeal region were digitized. Length and thickness of the soft palate and height and depth of the nasopharynx were measured. Evaluation of the growth curves of these four cephalometric variables indicated only two significant differences between children who later required pharyngeal flap surgery and those who did not. These differences were found in the growth in length of the soft palate of the CPO group and in the growth in depth of the nasopharynx of the BCLP group. Based on the present cephalometric data, it is impossible to predict at an early age those cleft lip and/or palate patients who will later require pharyngeal flaps.

Evaluation of maxillary dental arch form in unilateral clefts of lip, alveolus, and palate from one month to four years

This study evaluated the early changes of maxillary alveolar arches of operated unilateral cleft lip and palate patients. Dental casts were available at four age increments. Triangular flap cheiloplasty was carried out at an early age. Two-stage palatoplasty by vomer flap and soft palate closure took place later. Prior to lip repair, the alveolar arches were classified according to the relationship between greater and lesser segments. Almost a quarter had overlap of the alveolar segments with no contact between the alveolar ridges at the cleft site; some had no overlap with contact of the alveolar segments in the cleft region; almost a quarter had both overlap of the alveolar segments and contact; and almost half had no overlap of the segments and the alveolar ridges were not in contact at the cleft site. After lip repair, the arch relationships were examined and the percentage of patients in each of the four groups indicated a moulding effect of lip repair on the alveolar segments. This moulding effect caused the alveolar segments in most patients to be in contact at the cleft site. Most of these also had segment overlap. All patients were re-examined shortly after palatal repair. The trend for segment overlap and contact continued after palate surgery. However, when all patients were seen at age 4, percentages of patients in each group indicated that previous overlap of segments improved to a more desirable nonoverlapped relationship in approximately half of the patients. The other half continued to demonstrate arch collapse, in excess of what would be considered ideal ridge relationship.

Frontal cephalometric evaluation of transverse dentofacial morphology and growth of children with isolated cleft palate

The transverse dentofacial morphology and growth of 64 children operated on for clefting of the hard and soft palate was studied by means of a frontal proportional cephalometric analysis and was compared to a normal sample at the ages 3-4, 8-9 and 12 years. The cross-sectional comparison of the cleft palate and normal samples at the three periods indicated: (a) The presence in the cleft group of significantly increased ratios of the inner orbital width to the interorbital width and of the width of the nasal cavity to the interorbital width; (b) the absence of any significant differences in the ratio of the maxillary intermolar width to the interorbital width; and (c) the presence of almost identical ratios of the intergonial width of the mandible to the interorbital width and of the width of the maxilla to the intergonial width of the mandible. Evaluation of the changes of all cephalometric variables during the period 8-12 years showed the absence of any significant difference between the cleft palate and normal groups.

Frontal cephalometric study of dentofacial morphology in children with bilateral clefts of lip, alveolus and palate

The transverse dentofacial morphology of 36 children with bilateral cleft lip, alveolus and palate was studied by means of a frontal proportional cephalometric analysis at the ages of three, eight and twelve years. Comparison of the variables of the cleft group was made with the normal dimensions as obtained from the Bolton cephalometric templates. The results indicated that the BCLP group presented characteristics and significant differences from the normal in the dimensions of the nasal septum width and the mandibular intergonial width as they are both related to the interorbital width, the maxillary intermolar width as it is related to the mandibular intermolar width and the maxillary width as it is related to the mandibular intergonial width at all three ages. The maxillary base and intermolar widths, although significantly different at the ages of three and eight years, showed no significant deviation from normality at the age of twelve years. Following orthodontic treatment between the ages of seven to twelve years, the maxillary intermolar width of the treated subgroup was significantly larger than in the untreated subjects.

Otolaryngologic findings in whistling face syndrome

Craniocarpotarsal dysplasia or whistling face syndrome is rare with only 60 cases having been reported in the literature. More than 60 anatomic anomalies of the head, hands, and feet, in addition to the face, have been noted. Although the literature contains numerous case reports describing in detail the various features and abnormalities of the syndrome, the otolaryngologic findings in these patients have yet to be summarized. We present two additional cases in a mother and daughter with an extended follow-up period of 30 and 17 years, respectively, and summarize the otolaryngologic findings in all previously reported cases of this rare syndrome. Also, the principal clinical features and associated features are described.

Dental arch dimensions in patients with unilateral cleft lip and palate

In this investigation, dental arch dimensions during different ages were studied in 72 children with unilateral cleft of the lip, alveolar process, and palate and were compared with those of normal children. All the children with clefts were treated surgically by surgeons of the Lancaster Cleft Palate Clinic. The dental arch dimensions were studied with the use of dental casts during the time of full deciduous dentition (3 to 4 years of age), mixed dentition (8 to 9 years of age), and permanent dentition (12 years of age). The major findings were: (1) all maxillary interdental widths and lengths were significantly smaller than the normal dimensions at all ages, except for intermolar width at age 12 years; and (2) the mandibular arch dimensions seemed to be related to changes in the maxillary arch; however, the influence of surgical procedures in the maxillary arch is not reflected severely in mandibular arch dental position.

Longitudinal analysis of growth of the soft palate and nasopharynx from six months to six years

Between the ages of six months and six years, longitudinal lateral headfilms were taken on 54 patients with palatal clefts or with unilateral and bilateral clefts of the lip and palate. They were measured and were compared to data on both normals and subjects with clefts of the lip only. The objectives of the study were: 1. To sutdy the effects of palatal surgery on the growth of the soft palate. 2. To compare the growth of the soft palate and nasopharynx among the patients with various types of clefts and normals. 3. To study the growth acceleration or so-called catch-up growth after palatal surgery at various ages. (Anterior palatal surgery at 14 months +/- 2 months. Posterior palatal surgery at 16 months +/- 2 months.) 4. To evaluate the relationship between velopharyngeal growth in cleft groups and voice quality.

A longitudinal study of morphological craniofacial patterns via P-A x-ray headfilms in cleft patients from birth to six years of age

652 P-A X-ray headfilms of 51 unilateral cleft lip and palat, UCLP; 27 bilateral cleft lip and palate, BCLP; and 62 isolated cleft palate, CP were studied longitudinally at 0-3 months, 4-6 months, and annually from 1:0-6:0 years. Breadth change, height change, and growth direction of nine paired landmarks were investigated by means of the rectangular coordinate system with right to left zygomatico-frontal suture (Zf) point line as the X-axis and the perpendicular line to this X-axis at the mid-point between the right and left Zf points as the X-axis. Major findings were: (1) Study of Sphenoid body, interorbital, bizygomatico-frontal suture, and bizygomatic arch breadths showed that BCLP had a significantly broader face than either UCLP or CP. An apparent tendency to hypertelorism still remained at 6:0 in this group while UCLP and CP groups were both close to the Bolton Standards. (2) Nasal and maxillary bredths of BCLP and UCLP were significantly wider during the first year than in CP, but they showed only a slight growth change after the age of one year, compared to constant growth in CP. (3) All marked structural differences disappeared by 6:0 suggesting the effects of lip and/or palate surgery. (4) A slight cross-bite was found in UCLP and BCLP, but there was no such cross-bite in CP. (5) The effect of clefting was seen in mandibular dimensions where the bigonial notch was slightly broader than in non-cleft averages. (6) Upper facial height occlusal height, and posterior total facial height in each cleft group seemed to be larger than the Standard, though both maxillary height and gonial notch height approximated the Standard by 6:0 (7) From 0:3-6:0, there was no noteworthy difference among the cleft groups in either growth direction or facial symmetry of upper face and mandible. It was only in the mid-facial and dental areas that notable characteristics peculiar to the type of cleft were found. The landmarks of nasal aperture, maxilla, and dental arch showed a slight medial displacement on the affected side, although the degree and amount depended on the cleft-type.

Prosthodontic aspects of palatal elevation and palatopharyngeal stimulation

The prosthodontic aspects of palatal elevation and palatopharyngeal stimulation were discussed. Following are important factors that must be considered. (1) Elevation of the soft palate should be gradual to avoid placing pressure upon the teeth retaining the prosthesis and to reduce mucosal irritation. (2) Prosthetic stimulation should be initiated as soon as palatal paralysis is noted to prevent palatal disuse atrophy. (3) The palatal lift prosthesis may be used as a temporary or definitive treatment for palatal incompetency. When adequate elevation of the soft palate has been achieved, the prosthesis may be discarded. Otherwise, the patient would wear the prosthesis as a permanent supportive device. (4) The construction of the combined palatal lift/pharyngeal section prosthesis includes the gradual palatal elevation and molding of the pharyngeal section to reduce the gag reflexes and to increase palatopharyngeal muscle adaptation to the prosthesis. After the initial placement, adjustment to the pharyngeal section is easier for the patient. (5) Speech and myofunctional therapy should be instituted in conjunction with prosthetic treatment. (6) The palatal lift and combination prostheses are more effective for patients with less severe neurologic impairment and speech articulatory problems. (7) The palatal lift prosthesis is more effective for those patients with palatal incompetency who have no involvement of the other oropharyngeal muscles. The combination type of prosthesis is more effective for patients with palatopharyngeal insufficiency without marked speech articulatory disorders. There are still several questions which require further investigation. These include: (1) What is the relationship between the palatal stimulation and the degree of neuromuscular function and recovery? (2) What is the relationship between the palatal stimulation and the degree of palatal disuse atrophy? (3) What is the relationship between pharyngeal stimulation and muscle contraction? (4) What is the degree of stability of palatopharyngeal function and muscle contraction after stimulation?

Craniofacial serial dimensions related to age, sex, and cleft-type from six months of age to two years

The first two postnatal years are a time of rapid craniofacial growth. We selected 30 cleft lip/palate children, each seen at 6, 12, 18, 24 months, at which time lateral X-ray headfilms were taken. There were five boys, five girls, in each of three cleft-types: cleft palate only (CP), unilateral cleft lip/palate (UCLP), and bilateral cleft lip/palate (BCLP). Three dimensions were selected: 1) anterior cranial base (S-N); 2) upper face height (N-Pt.A); 3) maxillary depth (Pt.A-Ptm). All were in the midsagittal plane. This is a repeated measures study on the factor patient age, so that for each combination of sex and cleft-type the same subject was measured at the four levels of patient age. The multiple comparison technique utilized was the Newman-Keuls Procedure. There is no significant joint effect in the 6-24 months period. The factors seem to operate singly. There is no main effect due to the factor sex. Dimensions N-Pt.A. and Pt.A-Ptm show a significant main effect due to the factor cleft-type. There is a highly significant main effect due to the patient age factor.