Description and comparison of brain distribution of oxytocin receptors in Rhabdomys pumillio and Rhabdomys dilectus.

Oxytocin receptor (OXTR) distribution in the brain has been associated with different reproductive and social strategies of species. Rhabdomys pumilio (R. pumilio) and Rhabdomys dilectus (R. dilectus) are two sister rodent species that live in large/medium (but flexible) or small (mostly solitary) social groups respectively. In this study, we describe and compare the distribution of OXTR in these two species. OXTR binding in the brain of R. pumilio (8 females and 5 males) and R. dilectus (8 females and 5 males) adults was determined using autoradiography. Our results revealed significant differences in the nucleus accumbens, diagonal band, medial preoptic area, lateral habenula, superior colliculus, periaqueductal area and anterior paraventricular nucleus (higher in R. dilectus), and the dorsal lateral septum and anterior bed nucleus of the stria terminalis (higher in R. pumilio). OXTR density in other brain regions, such as the amygdala nuclei and hippocampus, did not differ between the two species. Sex differences were found in the medial preoptic area and ventral region of the lateral septum in R. pumilio (OXTR density higher in males) and in the anterior paraventricular thalamic nucleus, ventromedial nucleus of the hypothalamus and basolateral amygdala of R. dilectus (OXTR density higher in females). A sex difference in the density of OXTR was also found in the posterior region of the bed nucleus of the stria terminalis, where it was higher in males than in females of both species. This study shows species-specific brain distribution of OXTR in R. pumilio and R. dilectus that are unique, but with similarities with other polygynous or promiscuous rodent species that live in variable size groups, such as R. norvergicus, C. sociabilis, S. teguina and M. musculus.

Helium cluster dissolution in molybdenum.

Helium retention and diffusion in molybdenum is studied on an atomistic scale with ab initio methods. The thermal stability of helium-vacancy clusters is quantified within the framework of density functional theory. Calculated helium emission rates are used to derive a desorption spectrum which is compared with experimental results. The agreement between the current calculations and available experiments is satisfactory except in the high temperature end of the spectrum. The current results indicate that above 1100 K He migration is assisted by lattice defects such as vacancies, rather than through interstitial diffusion.

Vacancies in metals: from first-principles calculations to experimental data

We have revealed, and resolved, an apparent inability of density functional theory, within the local density and generalized gradient approximations, to describe vacancies in Al accurately and consistently. The shortcoming is due to electron correlation effects near electronic edges and we show how to correct for them. We find that the divacancy in Al is energetically unstable and we show that anharmonic atomic vibrations explain the non-Arrhenius temperature dependence of the vacancy concentration.

Five-year follow-up results of instep plantar fasciotomy for chronic heel pain.

The results of a 5-year follow-up of patients who underwent surgical partial release of plantar fascia with plantar skin incision for treatment of chronic heel pain are presented. Evaluation included survey results from both a modified Mayo Scoring System and a list of specific questions developed by the authors. Thirty-three feet of 30 patients are evaluated. Thirty of the 33 feet studied achieved good or excellent results, scoring 80 or better on a 100-point scale. Ninety percent pain relief was achieved in 27 of the 33 feet studied (81.8%). A satisfaction rate of 90% or better was found with 30 of the 33 feet studied (90.9%). Long-lasting complications were described by five patients, including opposite foot pain, dorsal foot pain after extended activity, scar tissue discomfort, callus at scar area, and continued heel pain.

The medial instep plantar fasciotomy.

A review of the anatomy, etiology, and conservative and surgical treatments of plantar fasciitis are presented and a simple surgical technique is introduced. The medial instep plantar fasciotomy was performed by the authors on 50 feet previously untreated by surgery (41 patients). The follow-up results (average length of time to follow-up was 11.3 months) revealed that 82.6% of the patients experienced at least 90% pain relief and 97.8% experienced at least 80% pain relief. Overall, 91.3% of the patients related at least 80% satisfaction with the results of the surgery and all but one of the patients stated that they would recommend and/or have the procedure performed again if the need arose. Complications arising from the instep procedure were limited, and the most frequent complaint was scar formation. Stress was placed on exhausting conservative measures before attempting surgical correction, and the average patient utilized five different modalities of conservative treatment over an average period of 13 months. Postoperatively, patients were encouraged to continue, or begin using, orthotics/arch supports to avoid problems such as arch pain.

Does massive obesity promote abnormal gastroesophageal reflux?

Fifty consecutive massively obese patients referred for gastroplasty operations were prospectively studied to determine the existence of gastroesophageal reflux disease by means of a standardized questionnaire, 24-hr ambulatory pH-metry, and endoscopy (27 females, mean age 48 years, range 38-57 years). These patients had a body mass index (BMI) of 42.5 +/- 5.2 kg/m2 and an actual weight of 125.5 +/- 17 kg. Heartburn and acid regurgitation was reported by 37% and 28%, respectively, mostly of a mild degree (22% and 20%). Dysphagia was reported by 2%, but none had odynophagia. No patient had any macroscopic esophagitis. The pH data were compared with those obtained in 29 age- and sex-matched, symptom-free, healthy controls (15 females, mean age 47.6 years, range 30-63 years). During ambulatory pH-metry, we recorded a predominance of daytime reflux (7.2 +/- 8.2% and total acid exposure of 5.3 +/- 6.4%) in the obese patients, but neither the weight, BMI, nor the waist-hip ratio were significantly correlated with any of the reflux variables. The pH data obtained from these patients did not, however, differ significantly from those recorded in the control population, although a somewhat lower daytime acid reflux was found in the latter group. These results suggest that massive overweight is not associated with an increased prevalence of gastroesophageal reflux disease.

Scintigraphic detection of gastro-pulmonary aspiration in patients with respiratory disorders.

The scintigraphic detection of small nocturnal aspirations of radio-labelled gastric contents is difficult in the presence of high remaining activity in the abdomen, causing a non-uniform background activity. This problem was examined in phantom experiments and a technique for interpolative background correction was further developed. The accuracy of this technique was found to be influenced by the distance between the lung and the abdominal source of activity, and the minimum detectable 'aspirated' activity was determined as 0.1 MBq at a distance of 15 cm and 1 MBq at 5 cm. The interpolative technique for background correction was evaluated on healthy volunteers and laryngectomized patients, examined 10 h after intragastric instillation of 200 MBq of 99Tcm-pertechnetate. After background subtraction, their calculated pulmonary mean net count value was comparable to that registered before the radioactive tracer was administered. No localized accumulation of activity was found in any of these controls. The technique was then applied clinically to 55 patients with chronic respiratory disorders and symptoms of gastroesophageal reflux. Aspiration was detected in 11 patients (20%). Five aspirators had asthma, two a chronic cough of unknown origin, two recurrent pulmonary infections, and one chronic bronchitis and chronic laryngitis respectively. Aspiration was detected among patients with and without demonstrated pathological gastroesophageal reflux.

The prevalence of symptoms suggestive of esophageal disorders.

A questionnaire study was conducted to assess the prevalence and severity of symptoms suggestive of esophageal disorders in a general population. The study included 407 randomly selected subjects, evenly distributed in terms of sex and age, within the age span of 20-79 years. A total of 337 subjects replied (85%). Symptoms suggestive of gastroesophageal reflux were found among 25% of the participants. Cough on swallowing was common (27%), as was globus (16%) and chest pain (13%). In addition, dysphagia was reported by 10% and vomiting by 9%. The symptoms were usually mild, and moderate to severe symptoms were reported only occasionally (1-4%). No statistical correlation was found between esophageal symptoms and age, sex, or the reported consumption of tobacco, alcohol, or non-steroidal anti-inflammatory drugs. The frequency of heartburn and/or acid regurgitation was twice as common among those with symptoms of respiratory disease as among those with no respiratory complaints. A stepwise logistic regression analysis showed that a chronic cough and/or breathing difficulties were significantly related to the presence of symptoms suggestive of gastroesophageal reflux.

Swallowing problems in rheumatoid arthritis.

Twenty-nine female patients with definite or classical rheumatoid arthritis (RA) and 30 controls were investigated in order to evaluate oral symptoms, particularly xerostomia, and swallowing difficulties in RA by means of a questionnaire, physical examination, stimulated saliva secretion, labial salivary gland biopsy, esophageal manometry and laboratory blood tests. Xerostomia was reported by 6 patients (21%), compared with no-one in the control group. Four of these 6 patients had decreased stimulated saliva secretion, compared with 2 of the remaining 23 patients. Dysphagia was experienced by 8 patients (28%), compared with one control subject. Dysphagia was associated with disease severity. Esophageal manometry revealed a decrease of the amplitude of the peristaltic pressure complex in the proximal part of esophagus in the RA group, indicating dysfunction of the striated muscles. No correlation was found between dysphagia and esophageal manometry results.

Primary radiotherapy for glottic laryngeal carcinoma stage I and II. A retrospective study with special regard to failure patterns.

A retrospective study has been made of 302 patients with vocal cord carcinoma stage I and II treated between 1963 and 1983, emphasizing treatment failure patterns. The primary treatment modalities were radiotherapy for 266 patients and surgery for 36 patients. The minimum follow-up was 4 years. After primary radiotherapy there were 63 local recurrences and 7 neck lymph node recurrences, all appearing outside the target volume. The actuarial loco-regional recurrence-free rates at 5 years were 78% for T1, 76% for T2a (normal cord mobility) and 60% for T2b (impaired cord mobility) tumors. The actuarial regional lymph node recurrence-free rates at 5 years were 99, 100 and 93% for T1, T2a and T2b tumors respectively. The actuarial corrected survivals at 5 years were 95, 96 and 79% for T1, T2a and T2b tumors with primary radiotherapy and salvage surgery for recurrence. Salvage surgery was less successful in T2b compared to T1 and T2a tumors. In conclusion, after primary radiotherapy with salvage surgery the loco-regional control rate was high and very similar for glottic cancer T1 and T2a but less satisfactory for T2b tumors. Regional lymph node metastases were not a large problem in any of the subgroups. More effective radiotherapy with higher dose levels or an altered fractionation might increase the local control rate for T2 tumors with impaired cord mobility.

Lower esophageal sphincter characteristics and esophageal acid exposure following partial or 360 degrees fundoplication: results of a prospective, randomized, clinical study.

In a prospective, randomized, clinical trial, we compared a partial (180-200 degrees, Toupet) with a total fundoplication (360 degrees, Rossetti) in the surgical treatment of gastroesophageal reflux disease. Seventy-one patients entered the trial; 33 were allocated to a partial fundoplication and 38 to a 360 degrees fundic wrap. Each patient was investigated prior to as well as 3 and/or 6 months after the operation, including an endoscopic and clinical assessment. Manometry was carried out via a triple lumen catheter and the pressure in the high pressure zone (HPZ) in the distal esophagus was measured as well as the length of the intraabdominal segment by a "station pull-through" technique. Acid exposure of the esophageal mucosa was evaluated by ambulatory 24-hour pH measurements. Acid exposure of the esophageal mucosa was "normalized" by the 2 operations. In addition, the length of the HPZ was increased to a "normal" level by both operations. The pressure of the HPZ was, however, "normalized" only in patients allocated to a Rossetti fundoplication, whereas patients operated on with a partial fundoplication had a significantly lower HPZ pressure (p less than 0.01). The clinical assessment revealed excellent results in both groups with no significant differences between the 2 operations except for a higher incidence of dysphagia at 3 months after a Rossetti fundoplication (p less than 0.01), which disappeared during the subsequent 3 months.

Glottic laryngeal carcinoma with fixed vocal cord treated with full-dose radiation, total laryngectomy or combined treatment.

The results of the therapy of 46 patients with glottic squamous cell cancer with a fixed vocal cord and without regional lymph nodes (glottic T3N0) are reported. Primary surgery (total laryngectomy) in combination with preoperative irradiation gave significantly higher loco-regional control rate and survival rate than surgery alone. Primary radiotherapy with doses of 70 Gy or more and adequate follow-up was found to be an alternative to preoperative radiation and laryngectomy. The result of different treatment modalities speaks in favour of primary irradiation allowing preservation of the larynx and a good voice function. In case of recurrence salvage surgery with total laryngectomy is preferred.

Laryngeal obstruction assessed by computed tomography.

The aim of this study was to find out if laryngeal obstruction could be assessed by measuring the glottic area using computed tomography (CT). Results from model studies were compared with those from twelve patients with laryngeal diseases. Determination of the orolaryngeal airway resistance (Rol) was used as a reference method. The correlation between airway resistance and area in both the model and among the patients was consistent, with a curvilinear relationship. The results indicate that it is possible to measure the area of a short obstruction by CT and that this area determines the degree of obstruction.

The effect of omeprazole or ranitidine treatment on 24-hour esophageal acidity in patients with reflux esophagitis.

Twenty-two consecutive patients with gastroesophageal reflux and erosive or ulcerative esophagitis entered a double-blind, randomized study comparing the effect of 20 mg omeprazole once daily with that of 150 mg ranitidine twice daily on esophageal acidity. Ambulatory 24-h esophageal pH measurements were performed within 1 month before inclusion and after 3 weeks of medication. Omeprazole significantly (p less than 0.05) reduced the number of reflux (pH less than 4) episodes, the number of refluxes lasting greater than 5 min, and the total reflux time. In contrast, ranitidine significantly reduced only the total reflux time. When the two treatment groups were compared, a significant difference in favor of omeprazole was found for daytime and total reflux values, except for the longest reflux and the number of reflux episodes lasting greater than 5 min. Substantial differences, also in favor of omeprazole, were found with regard to the effect on endoscopic healing of the esophagitis.

Severe airway obstruction caused by laryngeal rheumatoid arthritis.

Ankylosis of the cricoarytenoid joints due to rheumatoid arthritis (RA) may cause upper airway obstruction by fixation of the vocal cords in the midline. In early stages, this condition usually results in minor symptoms which are easily overlooked. It may, however, very rapidly, e.g., in association with an upper respiratory tract infection, become life-threatening. It is essential to diagnose this condition early to avoid emergency situations. In 5 patients with classic RA and in one patient with juvenile RA severe laryngeal obstruction was operated on using a new simple technique consisting of a mobilization of the arytenoid cartilages and laterofixation of one of the vocal cords.

Instrumental perforation of the oesophagus. A ten year study from two ENT clinics.

During the 10-year period 1972-1981, 3,688 and 867 oesophagoscopies were performed at two ENT clinics of a university hospital and of a county hospital with an incidence of oesophageal perforation of 0.8 per cent and 1.1 per cent respectively. Rigid instruments were used in all cases, most often in combination with dilatation of a benign stricture.

New mobilization and laterofixation procedure for cricoarytenoid joint ankylosis in rheumatoid arthritis.

Ankylosis of the cricoarytenoid joints due to rheumatoid arthritis can cause severe laryngeal obstruction. With a mobilization and laterofixation procedure, five of six patients were successfully operated upon. Documented improvement of breathing was achieved and the voice function was acceptable after decannulation.