bluuebunny/crossref_metadata_2025 huggingface dataset:
Resuscitation at the limits of viability – an Irish perspective
Authors: Khan RA , Burgoyne L , O’Connell MP , Dempsey EM
Published: July 2009

Background:  Advances in neonatal care continue to lower the limit of viability. Decision making in this grey zone remains a challenging process.

Objective:  To explore the opinions of healthcare providers on resuscitation and outcome in the less than 28‐week preterm newborn.

Design/Methods:  An anonymous postal questionnaire was sent to health care providers working in maternity units in the Republic of Ireland. Questions related to neonatal management of the extreme preterm infant, and estimated survival and long‐term outcome.

Results:  The response rate was 55% (74% obstetricians and 70% neonatologists). Less than 1% would advocate resuscitation at 22 weeks, 10% of health care providers advocate resuscitation at 23 weeks gestation, 80% of all health care providers would resuscitate at 24 weeks gestation. 20% of all health care providers would advocate cessation of resuscitation efforts on 22–25 weeks gestation at 5 min of age. 65% of Neonatologists and 54% trainees in Paediatrics would cease resuscitation at 10 min of age. Obstetricians were more pessimistic about survival and long term outcome in newborns delivered between 23 and 27 weeks when compared with neonatologists. This difference was also observed in trainees in paediatrics and obstetrics.

Conclusion:  Neonatologists, trainees in paediatrics and neonatal nurses are generally more optimistic about outcome than their counterparts in obstetrical care and this is reflected in a greater willingness to provide resuscitation efforts at the limits of viability.
Effect of flask closure method and post‐pressing time on the upper denture base adaptation
Authors: Lira Andréa F. , Consani Rafael L. X. , Mesquita Marcelo F. , Correr‐Sobrinho Lourenço , Sinhoreti Mario A. C. , Henriques Guilherme E. P.
Published: July 2009

doi:10.1111/j.1741‐2358.2009.00307.x
 
Effect of flask closure method and post‐pressing time on the upper denture base adaptation

Objectives:  The purpose of this study was to evaluate the effect of flask‐closure methods, post‐pressing times and acrylic resins on denture base adaptation.

Materials and methods:  The resins were flasked using a hydraulic press and closed with the traditional clamp or RS system. Conventional heat‐cure resin was polymerised immediately or at 6 h post‐pressing at 74°C for 9 h. Rapid cycle heat‐cure resin was polymerised in boiling water for 20 min. After cooling, the bases were deflasked and the sets of cast‐base transversally sectioned in the regions distal to the canine, mesial to the first molar and in the posterior palatal zone. The adaptation was measured with an optical microscope (0.0005 mm) at five reference points for each section. Data were analysed using anova and Tukey’s test (α = 0.05).

Results:  Traditional clamp and immediate post‐pressing time improved base adaptation for conventional heat‐cure resin. Both post‐pressing times showed most accurate base adaptation for conventional heat‐cure resin when the traditional clamp was used. Immediate post‐pressing time improved base adaptation for conventional heat‐cure resin and the 6‐h delay in time was significant for the rapid cycle heat‐cure resin.

Conclusions:  Traditional clamp and immediate post‐pressing time improved base adaptation for conventional heat‐cure resin.
A Review of the Efficacy of the Self‐Management Model on Health Outcomes in Community‐Residing Older Adults with Arthritis
Authors: Nuñez Diane E. , Keller Colleen , Ananian Cheryl Der
Published: July 2009

Background: Chronic disease and disability have a significant impact on individuals, families, and society, resulting in limitations in personal care, premature loss of wages, higher mortality rates, and overall poor quality of life. Arthritis is a painful disease that limits physical activity, social functioning, and mental health and is hallmarked by an increasing prevalence in community‐dwelling older adults. Self‐management strategies reduce pain and disability while improving self‐efficacy and quality of life.

Aims: The purpose of this review is to evaluate the efficacy of the self‐management program in adults with arthritis on the outcome of functional disability.

Methods: Literature review. Search strategy included MEDLINE, CINAHL, and the Cochrane Library from 1985 to 2008 for studies using self‐management interventions.

Results: Across studies of chronic disease, effect sizes were moderate for most variables. Subgroup ana‐ lyses for arthritis only demonstrated a greater magnitude of effect in variables related to functional health.

Conclusions: While this review suggests small efficacy in the self‐management program, with improvement in certain cognitive‐behavioral markers for self‐management, the functional gains that can be achieved in a growing older adult population translate into a larger effect overall.
Structural insight into the evolutionary and pharmacologic homology of glutamate carboxypeptidases II and III
Authors: Hlouchova Klara , Barinka Cyril , Konvalinka Jan , Lubkowski Jacek
Published: July 2009

Glutamate carboxypeptidase III (GCPIII) is a metalloenzyme that belongs to the transferrin receptor/glutamate carboxypeptidase II (GCPII; EC 3.4.17.21) superfamily. GCPIII has been studied mainly because of its evolutionary relationship to GCPII, an enzyme involved in a variety of neuropathologies and malignancies, such as glutamatergic neurotoxicity and prostate cancer. Given the potential functional and pharmacological overlap between GCPIII and GCPII, studies addressing the structural and physiological properties of GCPIII are crucial for obtaining a deeper understanding of the GCPII/GCPIII system. In the present study, we report high‐resolution crystal structures of the human GCPIII ectodomain in a ‘pseudo‐unliganded’ state and in a complex with: (a) l‐glutamate (a product of hydrolysis); (b) a phosphapeptide transition state mimetic, namely (2S,3′S)‐{[(3′‐amino‐3′‐carboxy‐propyl)‐hydroxyphosphinoyl]methyl}‐pentanedioic acid; and (c) quisqualic acid, a glutamate biostere. Our data reveal the overall fold and quaternary arrangement of the GCPIII molecule, define the architecture of the GCPIII substrate‐binding cavity, and offer an experimental evidence for the presence of Zn2+ ions in the bimetallic active site. Furthermore, the structures allow us to detail interactions between the enzyme and its ligands and to characterize the functional flexibility of GCPIII, which is essential for substrate recognition. A comparison of these GCPIII structures with the equivalent GCPII complexes reveals differences in the organization of specificity pockets, in surface charge distribution, and in the occupancy of the co‐catalytic zinc sites. The data presented here provide information that should prove to be essential for the structurally‐aided design of GCPIII‐specific inhibitors and might comprise guidelines for future comparative GCPII/GCPIII studies.
Dissection of LolB function – lipoprotein binding, membrane targeting and incorporation of lipoproteins into lipid bilayers
Authors: Tsukahara Jun , Mukaiyama Keita , Okuda Suguru , Narita Shin‐ichiro , Tokuda Hajime
Published: July 2009

Escherichia coli cells express at least 90 species of lipoprotein. LolB is one of the essential outer membrane lipoproteins, being involved in the last step of lipoprotein sorting. It accepts lipoproteins from a periplasmic molecular chaperone, LolA, and mediates the outer membrane anchoring of lipoproteins through a largely unknown mechanism. It has been shown previously that a LolB derivative, mLolB, lacking an N‐terminal acyl chain, can bind lipoproteins. We examined how the lack of an N‐terminal anchor affects the outer membrane anchoring of lipoproteins. Surprisingly, mLolB compensates for LolB function and supports E. coli growth, indicating that the N‐terminal anchor is not essential for its function. Indeed, mLolB correctly localizes lipoproteins to either the inner or outer membrane depending on the sorting signal at the steady state. Furthermore, periplasmic mLolB enables the dissection of LolB function, namely lipoprotein binding, membrane targeting and lipoprotein anchoring. It mediates the transfer of lipoproteins from LolA to the outer membrane, but also the inner membrane and liposomes, indicating that mLolB exhibits no membrane preference and targets to phospholipids. Consequently, an outer membrane‐specific lipoprotein is transiently mislocalized to the inner membrane when cells express only mLolB. LolB anchored to the outer membrane does not cause such mislocalization and is more active than mLolB. Phosphatidylethanolamine has been found to stimulate the mLolB‐dependent membrane anchoring of lipoproteins. Taken together, these results indicate that lipoprotein binding, membrane targeting and membrane incorporation of lipoproteins are intrinsic functions of LolB.
Fast ferrous heme–NO oxidation in nitric oxide synthases
Authors: Tejero Jesús , Santolini Jérôme , Stuehr Dennis J.
Published: July 2009

During catalysis, the heme in nitric oxide synthase (NOS) binds NO before releasing it to the environment. Oxidation of the NOS ferrous heme–NO complex by O2 is key for catalytic cycling, but the mechanism is unclear. We utilized stopped‐flow methods to study the reaction of O2 with ferrous heme–NO complexes of inducible and neuronal NOS enzymes. We found that the reaction does not involve heme–NO dissociation, but instead proceeds by a rapid direct reaction of O2 with the ferrous heme–NO complex. This behavior is novel and may distinguish heme–thiolate enzymes, such as NOS, from related heme proteins.
Characterization of a membrane‐bound angiotensin‐converting enzyme isoform in crayfish testis and evidence for its release into the seminal fluid
Authors: Simunic Juraj , Soyez Daniel , Kamech Nédia
Published: July 2009

In the present study, an isoform of angiotensin‐converting enzyme was characterized from the testis of a decapod crustacean, the crayfish Astacus leptodactylus. Angiotensin‐converting enzyme cDNA, obtained by 3′‐ to 5′ RACE of testis RNAs, codes for a predicted one‐domain protein similar to the mammalian germinal isoform of angiotensin‐converting enzyme. All amino acid residues involved in enzyme activity are highly conserved, and a potential C‐terminus transmembrane anchor may be predicted from the sequence. Comparison of this testicular isoform with angiotensin‐converting enzyme from other crustaceans, namely Carcinus maenas, Homarus americanus (both reconstituted for this study from expressed‐sequence tag data) and Daphnia pulex, suggests that membrane‐bound angiotensin‐converting enzyme occurs widely in crustaceans, conversely to other invertebrate groups where angiotensin‐converting enzyme is predominantly a soluble protein. In situ hybridization and immunohistochemistry performed on testis sections show that angiotensin‐converting enzyme mRNA is mainly localized in spermatogonias, whereas protein is present in spermatozoids. By contrast, in vas deferens, immunoreactivity is detected in the seminal fluid rather than in germ cells. Accordingly, angiotensin‐converting enzyme activity assays of testis and vas deferens extracts demonstrate that the enzyme is present in the membrane fraction in testis, but in the soluble fraction in vas deferens. Taken together, the results obtained in the present study suggest that, during the migration of spermatozoids from testis to vas deferens, the enzyme is cleaved from the membrane of the germ cells and released into the seminal fluid. To our knowledge, this present study is the first to report such a maturation process for angiotensin‐converting enzyme outside of mammals.
Shaped by the environment – adaptation in plants
Authors: Siomos Maria F.
Published: July 2009

As sessile organisms that are unable to escape from inhospitable environments, plants are at the mercy of the elements. Nonetheless, plants have managed to adapt, evolve and survive in some of the harshest conditions on earth. The FEBS Workshop ‘Adaptation Potential in Plants’, held at the Gregor Mendel Institute of Molecular Plant Biology, Vienna, Austria from 19 to 21 March 2009, provided a forum (including 18 invited talks, 8 selected short talks and 69 posters) for about 100 plant biologists from 32 countries, working in the diverse fields of genetics, epigenetics, stress signalling, and growth and development, to come together and discuss adaptation potential in plants at all its levels.
Out with the old, in with the new: religion, charitable status and the Charities Act 2006
Authors: Iwobi Andrew
Published: July 2009

The enactment of the Charities Act 2006 is widely viewed as one of the most momentous events in the recent history of English charity law, and the impact of the Act on the pre-existing law is still being debated. This paper inquires into the operation of the Act within the religious sphere. It seeks to explore the basis upon which charitable recognition was accorded within this sphere before the Act and to assess how far the law that was previously in force has been preserved, modified or rendered inoperative by the provisions of the Act. Three fundamental dimensions of the legal regime governing religious charities are especially relevant to this inquiry. The first dimension encompasses the elusive quest for the meaning of religion in the charitable sense. The second focuses on the long-standing requirement that religious purposes must be beneficial to the public in order to be charitable. The third is concerned with the human rights implications of conferring or withholding charitable status within the religious domain. Each dimension is examined in turn with a view to providing an insight into the complexities and difficulties inherent in the pre-existing law and the extent to which these have been addressed by the reforms contemplated by the Act.
Taking due account of religion in sentencing
Authors: Bakalis Chara , Edge Peter
Published: July 2009

This paper explores the relationship between religion and sentencing. It considers what problems may arise when a judge fails to take proper account of a defendant's religious beliefs at the sentencing stage, or takes improper account. It highlights the need for more guidance to be given to judges in order to ensure greater consistency and fairness in sentencing outcomes.
Risk factors for post‐weaning mortality of Merino sheep in south‐eastern Australia
Authors: Campbell AJD , Vizard AL , Larsen JWA
Published: July 2009

Objective To measure associations between body weight, growth rate, sex, time of shearing and post‐weaning mortality of Merino sheep.

Design Uni‐ and multivariable survival analyses of sheep mortality during the first year after weaning, using records (n = 3657) from two field experiments conducted in Western Victoria from 1996 to 2003.

Results Overall mortality was 14.3% (range 4.5–26.8%) and mean maximum mortality rate was 29 deaths/1000 weaners/month. Increased mortality risk was associated with decreases in fleece‐free body weight and mean weaner growth rate, particularly at low weights and growth rates. Weaners in the lightest weaning weight quintile had a hazard ratio of 3.5, compared with the middle quintile. The hazard ratio for a 2‐kg decrease in weaning weight was 1.2 to 1.7 for weaners lighter than 22 kg. The hazard ratio for a reduction in mean weaner growth rate in the first 5 months after weaning of 0.25 kg/month was 1.1 to 6.8 if mean growth rate was less than 1 kg/month, but did not differ significantly from 1 at greater growth rates. The hazard ratio for wether weaners was approximately 1.5 compared with ewe weaners. The hazard ratio for weaners shorn between December and May, compared with unshorn weaners, was 1.2 to 3.5, with the greatest risk difference associated with shearing in March (45 deaths/1000 weaners/month).

Conclusion Improving the body weight and mean growth rate of weaner sheep is likely to reduce post‐weaning mortality. Lightweight weaners in a flock should be managed separately from the main portion after weaning. In southern Australia, not shearing spring‐born Merino weaners between December and May may assist in reducing overall post‐weaning mortality.
Comparison of transcutaneous ultrasound over the right flank with transrectal ultrasound for pregnancy diagnosis in the dairy cow
Authors: Hunnam JC , Parkinson TJ , Lopez‐Villalobos N , McDougall S
Published: July 2009

Objective  Evaluate the sensitivity and specificity of transrectal ultrasound and transcutaneous ultrasonography across the right flank between days 31 and 196 of pregnancy in the dairy cow.

Procedure  Pregnancy status and stage of gestation at date of pregnancy diagnosis by transcutaneous and transrectal ultrasonography were determined for 1570 dairy cattle. Sensitivity and specificity values and probabilities of a correct diagnosis for both techniques were determined and compared. Possible effects of gestational age, herd, method of transcutaneous ultrasound diagnosis, cow age, cow and bull breed, and calf sex on the determination of a correct diagnosis of pregnancy status were evaluated for both techniques.

Results  The overall sensitivity and probability of a correct diagnosis of pregnancy status from days 31 to 196 of gestation were significantly higher when using transrectal ultrasound relative to transcutaneous ultrasound over the right flank. However, the sensitivity of transcutaneous ultrasound changed over the course of pregnancy: it was low (7–8%) before day 84, increased to 89% between days 141 and 154, and was close to 100% thereafter. The specificity of both methods did not differ significantly. Herd and gestational age at date of pregnancy diagnosis were significantly associated with making a correct test result using transcutaneous ultrasound, although only the latter predictor was significantly associated with making a correct test result using transrectal ultrasound.

Conclusion  Transcutaneous ultrasound can not be recommended as an accurate method for early pregnancy diagnosis in the dairy cow, particularly on a whole‐herd basis. However, if pregnancy testing is undertaken in mid to late gestation, this technique could provide an accurate and rapid alternative to transrectal ultrasound or manual palpation per rectum.
Ultrasonographic characteristics of soft tissue tumours in dogs
Authors: Loh ZHK , Allan GS , Nicoll RG , Hunt GB
Published: July 2009

Objective  To identify and describe the ultrasonographic features of soft tissue tumours in dogs.

Procedure  Superficial soft tissue tumours of various histological types, including mast cell tumours (MCTs) and soft tissue sarcomas (STSs), were evaluated. Ultrasound was used to visualise internal characteristics of the tumour, including vascularity. Tumours were categorised according to size, shape, margin definition, tissue plane mobility, echogenicity, echotexture, acoustic shadowing or enhancement and vessel distribution. Objective measurements of intratumoural blood flow included velocities and maximal perfused cross‐sectional area (fractional area). Logistic regression models incorporating a variety of data were used in an attempt to predict the histopathological type of tumours.

Results   The logistic regression model defined by the parameters echotexture, margin definition and presence of subcapsular vessels was highly predictive of MCTs (> 73%; P = 0.024). Several other trends, including a larger size for STSs and less vascularity for both MCTs and STSs, were observed, but did not reach statistical significance.

Conclusion   This preliminary study has shown the potential diagnostic value of ultrasound in differentiating soft tissue tumours. However, at present, ultrasound cannot replace biopsy and histopathological evaluation for tumour diagnosis.
Clinical remission of idiopathic hypereosinophilic syndrome in a Rottweiler
Authors: James FE , Mansfield CS
Published: July 2009

Idiopathic hypereosinophilic syndrome (HES) is a rare syndrome for which Rottweilers appear to over‐represent the canine cases. A 6‐month‐old female entire Rottweiler presented with seizures following a traumatic incident. The dog was identified as having a marked, sustained eosinophilia and investigations did not identify an underlying cause. Concurrently, the dog had chronic eosinophilic hepatitis with impaired liver function and mesenteric eosinophilic lymphadenitis. The dog went on to have spontaneous resolution of HES and normal liver function was subsequently documented. To date, the dog is still alive, more than 4 years after initial presentation. The diagnosis of idiopathic HES in Rottweilers may not carry a poor prognosis and the condition may spontaneously resolve, even in cases with documented organ damage.
Scrub‐itch mite infestation in the endangered bridled nailtail wallaby
Authors: Old JM , Lowry J , Young LJ
Published: July 2009

Skin lesions on the ears and inguinal and axillary regions of a number of adult animals within a captive population of the endangered bridled nailtail wallaby (Onychogalea fraenata) were associated with the trombiculid mite, Eutrombicula hirsti. The local inflammatory response of these Australian marsupials is described.
Late onset cerebellar cortical degeneration in a koala
Authors: Kuwamura M , Murai F , Nishioka S , Aoki M , Ohashi F , Yamate J , Kotani T , Summers BA
Published: July 2009

A 10‐year‐old male koala started to fall from the tree while sleeping. Subsequently, the koala often fell down while walking and showed a gait abnormality, abnormal nystagmus and hypersalivation. At 12 years of age, the koala became ataxic and seemed blind. At 13 years of age, the koala exhibited signs of dysstasia and was euthanased. Necropsy revealed marked symmetrical atrophy of the cerebellum. Histopathologically, a severe loss of Purkinje and granule cells was evident in the cerebellum, while the molecular layer was more cellular than normal with cells resembling small neurons, which were positively stained with parvalbumin immunohistochemistry. Reactive Bergmann glial cells (astrocytes) were present adjacent to the depleted Purkinje cell zone. The very late onset and slow progression of the cerebellar cortical degeneration in this case is particularly interesting and appears to be the first report in the koala.
In this issue – August 2009
Authors: Jackson A
Published: July 2009

Post‐weaning mortality of Merino sheep ▪ Transcutaneous ultrasound over the right flank for pregnancy diagnosis in cows ▪ Right flank transcutaneous vs transrectal ultrasound for pregnancy diagnosis in cows ▪ Ultrasound of soft tissue tumours in dogs ▪ Idiopathic hypereosinophilic syndrome in a Rottweiler ▪ Toxicity from accidental oral dosing of a topical endectocide ▪ Scrub‐itch mite in an endangered wallaby ▪ Cerebellar cortical degeneration in a koala
JNC 8: Expectations, Challenges, and Wishes—A Primary Care Perspective
Authors: Wilford Germino F.
Published: July 2009

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) reports have dramatically shaped the treatment of hypertension in this country and beyond. The JNC recommendations have been the cornerstone in the detection, evaluation, and treatment of high blood pressure (BP) in this country since inception. Their periodic revisions have evolved with the publications of well‐designed outcome studies. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), as part of the evolutionary patterns of its predecessors, added prevention to its guidelines. But as we await JNC 8, it may be useful to speculate what changes may be incorporated in the JNC’s latest report. This brief commentary provides some expectations, challenges and wishes for JNC 8 from the perspective of a primary care physician.
Insulin Resistance and Risk of Incident Hypertension Among Men
Authors: Lai Tai‐Shuan , Curhan Gary C. , Forman John P.
Published: July 2009

The independent association between insulin resistance and the development of hypertension remains in doubt because insulin resistance correlates with other metabolic factors also proposed to be associated with hypertension. The authors examined the association between the insulin sensitivity index and incident hypertension in a prospective nested case‐control study among 1453 men (mean age, 61 years) who participated in the Health Professionals’ Follow‐up Study. The authors computed the insulin sensitivity index for each man in the study based on fasting insulin and triglyceride levels. Logistic regression was performed conditioned on age and adjusted for standard hypertension risk factors as well as renal function, cholesterol, and uric acid. The insulin sensitivity index was 6% lower in the cases compared with the controls (P<.001). The multivariable odds ratio for hypertension comparing the lowest with highest quartile of insulin sensitivity index was 1.09 (0.71–1.65) among the entire sample. However, the association between the insulin sensitivity index and incident hypertension differed significantly by age (P interaction <.001). Among men younger than 60 years, the multivariable odds ratio for the lowest compared with highest quartile was 1.93 (1.01–3.71) but was 0.67 (0.37–1.24) among older men. Insulin resistance is independently associated with incident hypertension among younger men.
Age‐Neutral Guidelines for the Primary Prevention of Cardiovascular Disease
Authors: Kostis William J. , Kostis John B.
Published: July 2009

Use of common guidelines for primary prevention of cardiovascular events based on 10‐year risk results in undertreatment of younger individuals, especially women, since age and sex are major determinants of global risk. Women in their late 40s have a 10‐year risk lower than the 10% threshold used for cholesterol‐lowering treatment even in the presence of marked elevations of blood pressure or cholesterol. Removal of age from risk algorithms and use of lifetime global risk to treat individuals according to the degree of their modifiable risk factors rather than demographics has been proposed. Initiation of therapy at younger ages, aiming at “primordial” prevention of atherosclerotic disease rather than focusing on cardiovascular events, will result in saving more quality‐adjusted life‐years. Generic medications can be obtained at an affordable cost, and concerns about long‐term safety and efficacy can be tested in a clinical trial of younger individuals at low 10‐year risk but high lifetime risk.
SKI knockdown inhibits human melanoma tumor growth in vivo
Authors: Chen Dahu , Lin Qiushi , Box Neil , Roop Dennis , Ishii Shunsuke , Matsuzaki Koichi , Fan Tao , Hornyak Thomas J. , Reed Jon A , Stavnezer Ed , Timchenko Nikolai A. , Medrano Estela E.
Published: July 2009

The SKI protein represses the TGF‐β tumor suppressor pathway by associating with the Smad transcription factors. SKI is upregulated in human malignant melanoma tumors in a disease‐progression manner and its overexpression promotes proliferation and migration of melanoma cells in vitro. The mechanisms by which SKI antagonizes TGF‐β signaling in vivo have not been fully elucidated. Here we show that human melanoma cells in which endogenous SKI expression was knocked down by RNAi produced minimal orthotopic tumor xenograft nodules that displayed low mitotic rate and prominent apoptosis. These minute tumors exhibited critical signatures of active TGF‐β signaling including high levels of nuclear Smad3 and p21Waf­1, which are not found in the parental melanomas. To understand how SKI promotes tumor growth we used gain‐ and loss‐of‐function approaches and found that simultaneously to blocking the TGF‐β‐growth inhibitory pathway, SKI promotes the switch of Smad3 from tumor suppression to oncogenesis by favoring phosphorylations of the Smad3 linker region in melanoma cells but not in normal human melanocytes. In this context, SKI is required for preventing TGF‐β‐mediated downregulation of the oncogenic protein c‐MYC, and for inducing the plasminogen activator inhibitor‐1, a mediator of tumor growth and angiogenesis. Together, the results indicate that SKI exploits multiple regulatory levels of the TGF‐β pathway and its deficiency restores TGF‐β tumor suppressor and apoptotic activities in spite of the likely presence of oncogenic mutations in melanoma tumors.
The role of skin and subcutaneous tissues in Dupuytren's contracture: an electron microscopic observation
Authors: Chen Wu , Zhou Hao , Pan Zhi‐jun , Chen Jian‐song , Wang Li
Published: July 2009

Objective:  To determine the relationship between the overlying tissues and recurrence of Dupuytren's contracture.

Methods:  Forty‐three patients (68 hands) who accepted surgical treatment were divided into two groups according to treatment methods: partial fasciectomy or dermofasciectomy and full‐thickness skin graft. Diseased palmar fascia, subcutaneous tissues and skin obtained during surgery were then assessed by electron microscopy.

Results:  All patients were followed up. None of the hands which accepted dermofasciectomy and full‐thickness skin grafting recurred, while 46.4% of the hands which accepted partial fasciectomy recurred. Under electron microscopic observation, myofibroblasts were found in the skin and subcutaneous tissues.

Conclusion:  The overlying tissues play an important role in Dupuytren's contracture, which may be a reason for recurrence of this condition after surgical treatment.
The clinical features and surgical treatment of degenerative lumbar scoliosis: A review of 112 patients
Authors: Liu Wei , Chen Xiong‐sheng , Jia Lian‐shun , Song Dian‐wen
Published: July 2009

Objective:  To investigate the clinical features, radiological characteristics and surgical results of degenerative lumbar scoliosis (DLS).

Methods:  One hundred and twelve cases of DLS treated surgically from June 2001 to February 2006 were retrospectively reviewed for clinical features, characteristics of nerve root compression and imaging presentations. According to the preoperative clinical manifestations and imaging findings, different surgical modalities were performed, including simple nerve decompression and decompression with short or long posterior fusion (less or more than three segments, respectively).

Results:  The mean age of 47 male and 65 female patients was 54.7 years. Clinical manifestations included lower back pain (76.8%), radiculopathy (79.5%) and claudication (48.2%). Plain lumbar radiograph showed right scoliosis in 87 and left scoliosis in the other 25 cases; the Cobb angle was 10°–46°; the apex of scoliosis mostly located at L3 (48.2%); L3 and L4 nerve roots were usually compressed on the concave side and L5 and S1 nerve roots on the convex side. The Cobb angle and physiologic lordosis angle of patients who underwent multi‐segment (>3 segments) fusion improved to a greater extent than did that of patients who had simple decompression without fusion. A mean 5.7‐year follow‐up showed that the average improvement in Oswestry disability index (ODI) scores was 32.6, 26.3 and 13.5 for long segment fusion, short segment fusion and simple decompression without fusion, respectively.

Conclusion:  Decompression surgery with or without fusion, the main purpose of which is to relieve nerve root compression and stabilize the spinal column, is an effective treatment for chronic DLS. The treatment should be individualized according to the patient's age, general and economic factors, severity of deformity and other coexisting lumbar degenerative disorders.
Measurement of rotational alignment of the distal femur in total knee arthroplasty
Authors: Luo Ji‐wei , Yu Bin , Qin Cheng‐he
Published: July 2009

Objectives:  To measure and compare the included angle between the surgical transepicondylar axis (STEA) and the posterior condylar line (PCL) and the included angle between the femoral anteroposterior line (APL) and PCL, and to discuss the value of STEA, APL, and PCL as rotational alignment landmarks of the distal femur in total knee arthroplasty (TKA).

Methods:  Seventy‐five normal femoral specimens from Chinese adult cadavers were randomly selected. An axial photograph of every femoral specimen was taken with a digital camera and put into a personal computer. Using Photoshop 7.0.1 software, the included angle between the perpendicular line of APL and the PCL, noted as APA, together with the posterior condylar angle (PCA) between STEA and PCL were measured and compared using a paired‐samples t‐test.

Results:  The value for PCA was 3.67°± 1.62° (range, 0.75°–5.90°) and for APA 3.50°± 1.40° (range, 1.34°–5.65°). There was no significant difference between these two angles (t= 0.949, P= 0.359). Considering their relatively small means, these two angles showed wide variations.

Conclusions:  The rotational alignment of the femoral component can not accurately be determined by using PCL as a landmark. In order to get a proper rotational alignment of the femoral component in most cases of TKA, APL and STEA should be used as a double check.
Surgical treatment of thoracolumbar fracture through an approach via the paravertebral muscle
Authors: Pang Wei , Zhang Gui‐lin , Tian Wei , Sun Du , Li Nan , Yuan Qiang , Zhang Bo , Wang Yong‐qing , Liu Wei
Published: July 2009

Objective:  To investigate the methods for, and clinical outcome of, the operative treatment of thoracolumbar fractures through an approach via the paravertebral muscle (PVM).

Methods:  From June 2005 to August 2006, 62 patients, comprising 48 men and 14 women with an average age of 45.2 years (range, 21–58) with thoracolumbar fractures without neurological involvement underwent surgical treatment. Twenty‐one fractures were located at T12, 24 at L1 and 17 at L2. The study comprised 15 compression and 47 burst fractures with an intact posterior column. Thirty‐four cases were selected randomly to undergo surgery through the above approach, while the other 28 cases underwent the traditional procedure. After making a posterior midline incision, which not only facilitates insertion of pedicle screws and fusion of the graft bone at facet joints, but spares the attachment of PVM, the interval between the longissimus and multifidus muscles was undermined. Drainage was not routinely needed and the patients became ambulant with a brace earlier post‐operatively.

Results:  The new approach had statistically significant advantages (P < 0.005) over the traditional one in regard to blood loss, drainage, duration of recumbency and visual analogue scale (VAS), although the time required was almost the same for the two procedures. Till August 2007, 56 patients were successfully followed up for 12 to 26 months (mean, 18.6) and bone fusion was identified in all cases. Neither reduction loss nor loosening or breakage of the fixation occurred.

Conclusion:  The technique of operating through an approach between the PVM is recommended for thoracolumbar fractures because it is much less invasive, can reduce blood loss and accelerates rehabilitation.
Subtrochanteric shortening with overlapping femoral resection in total hip arthroplasty for Crowe type IV adult dislocation of the hip
Authors: Sun Jun‐ying , Wei Li
Published: July 2009

Objective:  To summarize the surgical technique and clinical outcomes of subtrochanteric shortening with overlapping femoral resection in primary total hip arthroplasty (THA) for Crowe type IV adult dislocation of the hip (ADH).

Methods:  From January 2000 to December 2005, 12 patients with ADH (15 hips) were treated with primary cementless hip arthroplasty using the method of subtrochanteric shortening with overlapping femoral resection. There were three male and nine female patients (nine unilateral and three bilateral hips) with an average age of 56 years (range, 41–75). Subtrochanteric shortening with overlapping femoral resection and ‘V’ shaped derotational osteotomy were performed in all cases without soft tissue cutting release. Proximal femoral shaft splitting was performed as an adjunct in 10 hips.

Results:  The mean follow‐up time was 6 years (range, 3–8). There were no infections, nonunion, malunion, dislocation or nerve injury of traction. Postoperative X‐ray films showed that the acetabular cups were placed in anatomical position with 95% coverage of the acetabulum. Furthermore, initial stability of the femoral stem fixation was satisfactory and all osteotomies healed in 10–15 weeks. The Harris hip score had improved from 25–32 to 88–98 at one year after surgery (P < 0.01). All acetabular and femoral components were judged to be osteointegrated and well‐fixed during follow‐up. No components have needed revision.

Conclusions:  Subtrochanteric shortening osteotomy is a safe and predictable method for restoring the anatomic hip center in Crowe type IV ADH. The clinical outcomes of treating Crowe type IV ADH with THA were satisfactory.
Marginal resection for osteosarcoma with effective preoperative chemotherapy
Authors: Yu Xiu‐chun , Xu Ming , Song Ruo‐xian , Xu Song‐feng
Published: July 2009

Objective:  To present the clinical results of marginal resection with effective preoperative chemotherapy for treatment of osteosarcoma.

Methods:  Thirty‐eight patients (20 male and 18 female, average age 17 years), underwent marginal resection after confirmation of effective preoperative chemotherapy between 1999 and 2008 and the results were analyzed retrospectively. The distal femur was involved in 22 cases, proximal tibia in 11, proximal humerus in 4, and proximal fibula in 1. Thirty‐seven patients were stage IIB and one IIIB. Twenty‐nine patients were treated with the DIA, and 9 with the MMIA protocol. Twenty‐one patients underwent tumor resection and bone allograft transplantation. The epiphysis was preserved in 9 patients, and not in the other 12. Eleven patients underwent tumor resection and prosthetic replacement, and 4 tumor resection with autograft implantation. One patient underwent tumor resection and allograft with preservation of the epiphysis; another underwent marginal tumor resection only.

Results:  All patients received effective preoperative chemotherapy. At a median follow‐up of 52 months, local recurrence had developed in one patient (2.6% local recurrence rate). Pulmonary metastases developed in 9 patients (23.7%). Five patients died of metastases, one died of intracranial hemorrhage due to thrombocytopenia caused by postoperative chemotherapy. The overall 2‐year survival rate was 87.3%, and event‐free survival rate 75.5%. The overall 5‐year survival rate was 74.7%, and event‐free survival rate 60.8%. Excellent to good function of affected limbs was achieved in 60.5%.

Conclusions:  With careful preoperative evaluation and effective preoperative chemotherapy marginal resection of osteosarcoma can produce good results. Marginal resection of osteosarcoma should be performed by an experienced surgeon who is familiar with the limb salvage rules for osteosarcoma.
Association between adolescent idiopathic scoliosis with double curve and polymorphisms of calmodulin1 gene/estrogen receptor‐α gene
Authors: Zhao Dong , Qiu Gui‐xing , Wang Yi‐peng , Zhang Jian‐guo , Shen Jian‐xiong , Wu Zhi‐hong
Published: July 2009

Objective:  To investigate whether single nucleotide polymorphisms (SNP) of the calmodulin1 (CALM1) and estrogen receptor‐α genes correlate with double curve in adolescent idiopathic scoliosis (AIS).

Methods:  A total of 67 Chinese patients with AIS with double curve and 100 healthy controls were recruited. Curve pattern and Cobb angle of each patient were recorded. The Cobb angle is at least 30°. There were 60 patients with Cobb angle ≥ 40°. According to the apical location of the major curve, there were 40 thoracic curve patients. Four polymorphic loci, including rs12885713 (−16C > T) and rs5871 in the CALM1 gene and rs2234693 (Pvu II) and rs9340799 (Xba I) in the estrogen receptor 1 (ER1) gene were analyzed by the ABI3730 genetic analyzer.

Results:  The current study indicates that: (i) there are statistical differences between patients with double curve, with Cobb angle ≥ 40° and with thoracic curve and healthy controls in the polymorphic distribution of the rs2234693 site of the ER1 gene, (P= 0.014, 0.0128, 0.0184 respectively); (ii) there is a difference between patients with double curve and controls in the polymorphic distribution of the rs12885713 site in the CALM1 gene (P= 0.034); and (iii) there is a difference between thoracic curve patients and controls in the polymorphic distribution of the rs5871 site in the CALM1 gene (P= 0.0102).

Conclusions:  Different subtypes of AIS might be related to different SNP. A combination of CALM1 and ER1 gene polymorphisms might be related to double curve in patients with AIS. Further study is necessary to confirm these hypotheses.
Clinical experience and results of lumbar microendoscopic discectomy: a study with a five‐year follow‐up
Authors: Zhou Yue , Wang Min , Wang Jian , Chu Tong‐wei , Zhang Zheng‐feng , Li Chang‐qing
Published: July 2009

Objective:  To investigate the efficacy of microendoscopic discectomy (MED) for the treatment of lumbar disc herniation over a five‐year follow‐up period.

Methods:  Between January 2000 and December 2002, 275 patients were accepted for MED in our hospital. A retrospective review was carried out on 151 of these cases with a mean of five years follow‐up. The study helped us to assess the efficacy of this technique in the treatment of lumbar disc diseases. Modified MacNab criteria were used to assess the clinical outcome, and the disc‐height ratio was assessed radiographically according to the Mochida's method.

Results:  According to the modified MacNab criteria, 78.8% of patients were rated as excellent, 13.2% as good, 4.6% as fair, and 3.3% as poor. Complications included five revision surgeries due to recurrence of herniation, five dural lacerations during operation, and three cases of vertebral/disc infection. The average disc‐height ratio was 76.25%. Approximately 57% of the patients maintained their primary engagement.

Conclusion:  MED is both feasible and efficacious for the management of lumbar disc disease. On the basis of the present study it is concluded that MED is better than open discectomy (OD).
Phylogenetic analysis ofToxicodendron(Anacardiaceae) and its biogeographic implications on the evolution of north temperate and tropical intercontinental disjunctions
Authors: NIE Ze‐Long , SUN Hang , MENG Ying , WEN Jun
Published: July 2009

Abstract Toxicodendronis a genus in theRhuscomplex of Anacardiaceae with a disjunct distribution between eastern Asia and North America, extending to southeastern Asia and the neotropics. Nuclear (internal transcribed spacer, external transcribed spacer, andNIA‐i3) and chloroplast (ndhFandtrnL‐F) sequences were used to construct phylogenetic relationships ofToxicodendron. Phylogenetic analysis of these data strongly supportToxicodendronas a monophyletic group distinct from other genera of theRhuscomplex, and the phylogeny does not fully corroborate classification at the sectional level. Two temperate disjunct lineages were detected, one from sectionToxicodendronand the other between the eastern North AmericanToxicodendron vernixand the eastern AsianToxicodendron vernicifluum. Their divergence times were estimated to be 13.46 (7.95–19.42) and 7.53 (2.76–12.86) mya, respectively. The disjunction between sectionGriffithii(taxa from warm temperate to tropical Asia) andToxicodendron striatum(from the neotropics) was supported and their divergence time was estimated to be 20.84 (11.16–30.52) mya in the early Miocene. Our biogeographic results and the paleontological data support the Bering land bridge as the most likely route to explain the temperate disjunctions, yet the tropical disjunction inToxicodendronseems to be best explained by the North Atlantic land bridge hypothesis.
Political Parties in South Korea and Taiwan after Twenty Years of Democratization*
Authors: Hermanns Heike
Published: July 2009

South Korea and Taiwan are often cited as successful cases of third‐wave democracies where democracy has taken roots. However, electoral volatility is high and disenchantment among citizens is rising, especially regarding the performance of politicians and political parties. Since political parties play a vital role in the democratic process their institutionalization is seen as an indicator of democratic consolidation. An analysis of Taiwanese and South Korean parties in terms of age, organization and structure, as well as programs and leadership style of parties indicates that parties are weakly institutionalized. The Korean party system is a weak point in democratic deepening, as it is reminiscent of a carousel of party creations, mergers and dissolutions. Parties lack distinguishing ideological or programmatic markers and remain cadre parties, focusing on their charismatic leader and their home regions. In Taiwan, in contrast, a clear cleavage in the form of Taiwanese identity led to the appearance of two distinct political camps, each consisting of several parties. Taiwanese parties have progressed in their institutionalization in terms of longevity, organization and programmatic differences. However, membership numbers and party identification remain low and regular corruption scandals show the slow attitudinal change among Taiwanese politicians. In the light of politicians' behavior, citizens in both countries thus are feeling increasingly disenchanted with the ruling elite as well as the democratic system.
The Iitaka conjecture Cn,m in dimension six
Authors: Birkar Caucher
Published: July 2009

We prove that the Iitaka conjecture Cn,m for algebraic fibre spaces holds up to dimension six, that is, when n≤6.
Effects of prolonged walking on neural and mechanical components of stretch responses in the human soleus muscle
Authors: Cronin Neil J. , Ishikawa Masaki , Af Klint Richard , Komi Paavo V. , Avela Janne , Sinkjaer Thomas , Voigt Michael
Published: July 2009

After repeated passive stretching, tendinous tissue compliance increases in the human soleus (SOL) muscle–tendon unit. During movement, such changes would have important consequences for neural and mechanical stretch responses. This study examined the existence of such effects in response to a 75 min walking intervention. Eleven healthy subjects walked on a treadmill at 4 km h−1 with a robotic stretch device attached to the left leg. Ultrasonography was used to measure SOL fascicle lengths, and surface EMG activity was recorded in the SOL and tibialis anterior (TA) muscles. Perturbations of 6 deg were imposed at three different measurement intervals: Pre (immediately before the walking intervention), Mid (after approximately 30 min of walking) and Post (immediately after the intervention). Between the Pre–Mid and Mid–Post intervals, subjects walked for 30 min at a gradient of 3%. After the intervention, the amplitude and velocity of fascicle stretch both decreased (by 46 and 59%, respectively; P < 0.001) in response to a constant external perturbation, as did short (33%; P < 0.01) and medium (25%; P < 0.01) latency stretch reflex amplitudes. A faster perturbation elicited at the end of the protocol resulted in a recovery of fascicle stretch velocities and short latency reflex amplitudes to the pre‐exercise values. These findings suggest that repeated stretching and shortening of a muscle–tendon unit can induce short‐term structural changes in the tendinous tissues during human walking. The data also highlight the effect of these changes on neural feedback from muscle sensory afferents.