bluuebunny/crossref_metadata_2025 huggingface dataset:
Incontinence rates after cutting seton treatment for anal fistula
Authors: Ritchie R. D. , Sackier J. M. , Hodde J. P.
Published: June 2009

Objective  To determine the incidence of anal incontinence after the use of cutting seton treatment for anal fistula.

Method  Literature searches were performed on PubMed, MEDLINE and Google™ Scholar using the words ‘cutting seton(s)’, ‘seton(s)’ and ‘anal fistula’. An analysis of the data in the collected references was performed.

Results  The average rate of incontinence following cutting seton use was 12%. The rate of incontinence increased as the location of the internal opening of the fistula moved more proximally. In the studies that described the types of incontinence, liquid stool was the most common followed closely by flatus incontinence. Incontinence associated with the treatment of fistulas defined as nonspecific cryptoglandular in nature was 18%.

Conclusion  The high incontinence rates that result from the use of cutting setons suggest that this commonly used therapy can damage the continence musculature. Other techniques that do not involve cutting the sphincter, when available, should be preferred, especially for higher fistulas.
Radical cystectomy for urothelial carcinoma of the bladder: an analysis of perioperative and survival outcome
Authors: Manoharan Murugesan , Ayyathurai Rajinikanth , Soloway Mark S.
Published: June 2009

OBJECTIVE

To review the outcomes in a large group of patients treated with radical cystectomy (RC) for urothelial cancer (UC) of the bladder, by one surgical team.

PATIENTS AND METHODS

In all, 504 patients had RC for UC of the bladder between 1992 and 2007; 432 met the inclusion criteria and were analysed for survival and disease recurrence.

RESULTS

Of the 432 patients, (mean age 69 years; mean follow‐up 38 months, range 1–172), 240 (56%) and 179 (41%) had an ileal conduit and orthotopic neobladder for urinary diversion, respectively. The mortality rate within 30 days of RC was 2%; 105 (24%) patients developed local and/or distant recurrence with a mean interval of 13.6 months. The overall survival, recurrence‐free survival (RFS) and disease‐specific survival (DSS) at 5 years was 58%, 64% and 74%, respectively, and 43%, 62% and 68% at 10 years. The 5‐year RFS and DSS for those with organ‐confined, node‐negative tumours was 81% and 91%, compared to 46% and 56% in those with extravesical extension and lymph node‐negative tumours. The RFS and DSS of patients with lymph node metastasis at 5 years was 29% and 40%, respectively.

CONCLUSION

Our study reaffirms that RC with bilateral pelvic lymph node dissection offers a reasonable possibility of disease control at 5 years, with a DSS of 74%. However, there is a need for an earlier diagnosis and effective systemic therapy if additional gains in survival are to be delivered.
Initial experience of robotic nephroureterectomy: a hybrid‐port technique
Authors: Park Sung Yul , Jeong Wooju , Ham Won Sik , Kim Won Tae , Rha Koon Ho
Published: June 2009

OBJECTIVE

To report a new technique of robot‐assisted laparoscopic nephroureterectomy (RANU) using a hybrid port, as RANU has recently become a minimally invasive treatment option for upper tract transitional cell carcinoma (TCC).

PATIENTS AND METHODS

Eleven consecutive patients underwent RANU by one surgeon. The first six patients were repositioned after the nephrectomy, from flank to lithotomy position, and the robot was re‐docked for excision of the distal ureter and bladder cuff. The last five patients were treated by a new RANU technique that did not require a change of position or movement of the patient cart. We analysed data obtained before, during and after RANU.

RESULTS

The total operative duration was reduced by ≈50 min in last five patients. There was no improvement in hospital stay or estimated blood loss. There were no transfusions and positive surgical margins in any patient. Maintaining the patient in a flank position allows gravity to displace the bowel away from the distal ureter, not only shortening the surgery but also improving exposure of the distal ureterectomy and closure of the bladder cuff.

CONCLUSIONS

The new RANU technique is a safe and feasible treatment option for upper tract TCC.
Minimally invasive surgical management of pelvic‐ureteric junction obstruction: update on the current status of robotic‐assisted pyeloplasty
Authors: Uberoi Jayant , Disick Grant I.S. , Munver Ravi
Published: June 2009

BACKGROUND

Pelvi‐ureteric junction (PUJ) obstruction is characterized by a functionally significant impairment of urinary transport caused by intrinsic or extrinsic obstruction in the area where the ureter joins the renal pelvis. The majority of cases are congenital in origin; however, acquired conditions at the level of the ureteropelvic junction may also present with symptoms and signs of obstruction. Historically, open pyeloplasty and endoscopic techniques have been the main surgical options with the intent of complete excision or incision of the obstruction. The advent of laparoscopy and robotic‐assisted applications has allowed for minimally invasive reconstructive surgery that mirrors open surgical techniques.

AIMS

We review the current status of robotic‐assisted laparoscopic pyeloplasty and report on the result, continuing evolution, and potential role for this surgical procedure.

MATERIALS AND METHODS

A review of the recent literature encompassing laparoscopic and robotic‐assisted pyeloplasty was conducted with particular attention to operative techniques, surgical outcomes, and complication rates.

RESULTS

Laparoscopic and robotic‐assisted approaches are able to duplicate the open technique, and not surprisingly, are now being shown to be as efficacious as the gold standard open approach. The laparoscopic remains technically challenging due to the high proficiency level required for intracorporeal suturing, although added experience has resulted in shorter operative times. The advent of robotics has further expanded the breadth of this reconstructive procedure while preserving the benefits of decreased pain, shorter hospitalization, rapid convalescence, and an improved cosmetic result.

DISCUSSION

The introduction of robotics to the field of minimally invasive surgery facilitates this procedure and may allow for more widespread implementation by surgeons of varying skill levels. These benefits must be balanced against the increased costs of the robotic platform.

CONCLUSION

Clinical reports have demonstrated that robotic‐assisted pyeloplasty is a safe, feasible, and effective technique for treating ureteropelvic junction obstruction in short term studies. Additional studies with prolonged follow‐up will ultimately provide valuable information as to the long‐term efficacy of robotic‐assisted laparoscopic pyeloplasty.
Websites offer helpful information concerning consultation with headache specialists
Authors: Imai N , Yagi N , Konishi T , Serizawa M , Kobari M
Published: June 2009

Patients with severe primary headache may benefit from consultation with headache specialists, but doctor attendance rates in Japan are very low. More headache patients might consult headache specialists if these specialists were more widely recognized by the public. To determine what information prompted patients to seek consultation with a headache specialist, we questioned 256 primary headache patients about the source of the helpful information concerning consultation with headache specialists. From 191 patients, a total of 235 responses to the questionnaire were obtained. The most common response was ‘websites’ (33.2%), followed by ‘professionals’ (23.8%), ‘acquaintances’ (20.9%), ‘print media’ (6.8%) and ‘TV/radio’ (3.4%). Patients who indicated websites showed the most severe pain and highest impact of headache, and accounted for 52.4% of those with cluster headaches. Development of websites concerning headache specialists would seem likely to increase doctor attendance rates for patients with primary headache.
‘Brain circulation’ and transnational knowledge networks: studying long‐term effects of academic mobility to Germany, 1954–2000
Authors: JÖNS HEIKE
Published: June 2009

‘Brain circulation’ has become a buzzword for describing the increasingly networked character of highly skilled migration. In this article, the concept is linked to academics' work on circular mobility to explore the long‐term effects of their research stays in Germany during the second half of the twentieth century. Based on original survey data on more than 1800 former visiting academics from 93 countries, it is argued that this type of brain circulation launched a cumulative process of subsequent academic mobility and collaboration that contributed significantly to the reintegration of Germany into the international scientific community after the Second World War and enabled the country's rise to the most important source for international co‐authors of US scientists and engineers in the twenty‐first century. In this article I discuss regional and disciplinary specificities in the formation of transnational knowledge networks through circulating academics and suggest that the long‐term effects can be fruitfully conceptualized as accumulation processes in ‘centres of calculation’.
Transnational sexual and gendered violence: an application of border sexual conquest at a Mexico—US border
Authors: MORALES MARIA CRISTINA , BEJARANO CYNTHIA
Published: June 2009

Drawing on transnational and postcolonial feminism, we discuss the phenomenon of border sexual conquest to highlight structural sexual and gendered violence that is exacerbated by the subjugation of local place and by the global political economy. While we have gained important insights from the literature on gender and transnationalism, the processes of sexual violence and gendered violence are underdeveloped. We focus our analysis on the Mexico—US border cities of Cuidad Juárez, Chihuahua, Mexico and El Paso, Texas, USA. We argue that what we call border sexual conquest confronts the feminicides in Juárez and the female proletariats on both sides of the border. Moreover, while structural violence approaches under theorize struggles over power, the perspective of border sexual conquest highlights how processes of conquest intertwine with women's resistance.
Neuroprotective effect ofScutellaria baicalensison spinal cord injury in rats
Authors: Yune Tae Y. , Lee Jee Y. , Cui Chun M. , Kim Ho C. , Oh Tae H.
Published: June 2009

Inflammation has been known to play an important role in the pathogenesis after spinal cord injury (SCI). Microglia are activated after injury and produce a variety of proinflammatory factors such as tumor necrosis factor‐α, interleukin‐1β, cyclooxygenase‐2, and reactive oxygen species leading to apoptosis of neurons and oligodendrocytes. In this study, we examined the neuroprotective effects of total ethanol extract ofScutellaria baicalensis(EESB),after SCI. Using primary microglial cultures, EESB treatment significantly inhibited lipopolysaccharide‐induced expression of such inflammatory mediators as tumor necrosis factor‐α, IL‐1β, IL‐6, cyclooxygenase‐2, and inducible nitric oxide synthase. Furthermore, reactive oxygen species and nitric oxide production were significantly attenuated by EESB treatment. Forin vivostudy, rats that had received a moderate spinal cord contusion injury at T9 received EESB orally at a dose of 100 mg/kg. EESB inhibited expression of proinflammatory factors and protein carbonylation and nitration after SCI. EESB also inhibited microglial activation at 4 h after injury. Furthermore, EESB significantly inhibited apoptotic cell death of neurons and oligodendrocytes and improved functional recovery after SCI. Lesion cavity and myelin loss were also reduced following EESB treatment. Thus, our data suggest that EESB significantly improve functional recovery by inhibiting inflammation and oxidative stress after injury.
The cyclophilin inhibitor Debio 025 normalizes mitochondrial function, muscle apoptosis and ultrastructural defects inCol6a1−/−myopathic mice
Authors: Tiepolo T , Angelin A , Palma E , Sabatelli P , Merlini L , Nicolosi L , Finetti F , Braghetta P , Vuagniaux G , Dumont J‐M , Baldari CT , Bonaldo P , Bernardi P
Published: June 2009

Background and purpose: We have investigated the therapeutic effects of the selective cyclophilin inhibitor D‐MeAla3‐EtVal4‐cyclosporin (Debio 025) in myopathicCol6a1−/−mice, a model of muscular dystrophies due to defects of collagen VI.

Experimental approach: We studied calcineurin activity based on NFAT translocation; T cell activation based on expression of CD69 and CD25; propensity to open the permeability transition pore in mitochondria and skeletal muscle fibres based on the ability to retain Ca2+and on membrane potential, respectively; muscle ultrastructure by electronmicroscopy; and apoptotic rates by terminal deoxynucleotidyl transferase‐mediated dUTP nick end labelling assays inCol6a1−/−mice before after treatment with Debio 025.

Key results: Debio 025 did not inhibit calcineurin activity, yet it desensitizes the mitochondrial permeability transition porein vivo. Treatment with Debio 025 prevented the mitochondrial dysfunction and normalized the apoptotic rates and ultrastructural lesions of myopathicCol6a1−/−mice.

Conclusions and implications: Desensitization of the mitochondrial permeability transition pore can be achieved by selective inhibition of matrix cyclophilin D without inhibition of calcineurin, resulting in an effective therapy ofCol6a1−/−myopathic mice. These findings provide an important proof of principle that collagen VI muscular dystrophies can be treated with Debio 025. They represent an essential step towards an effective therapy for Ullrich Congenital Muscular Dystrophy and Bethlem Myopathy, because Debio 025 does not expose patients to the potentially harmful effects of immunosuppression.
Dramatic Response of Scarring Scalp Discoid Lupus Erythematosus (DLE) to Intravenous Methylprednisolone, Oral Corticosteroids, and Hydroxychloroquine in a 5‐Year‐Old Child
Authors: Miettunen Paivi M.H. , Bruecks Andrea , Remington Todd
Published: June 2009

Abstract:  Discoid lupus erythematosus (DLE) is rare in childhood. We report the case of a 5‐year‐old girl who presented with erythematous scaly plaques, with scarring alopecia, involving approximately 40% of her scalp. Histopathology confirmed the diagnosis of DLE. Treatment with intravenous methylprednisolone, hydroxychloroquine, oral prednisone, topical corticosteroids, and sunscreen lead to reversal of scarring alopecia and re‐growth of hair.
Thin Primary Cutaneous Melanoma in Childhood and Adolescence: Report of 12 Cases
Authors: MANGANONI AUSILIA MARIA , FARISOGLIO CAMILO , TUCCI GIOVANNA , FACCHETTI FABIO , UNGARI MARCO , CALZAVARA‐PINTON PIER GIACOMO
Published: June 2009

Abstract:  Approximately, 1–4% of all new melanoma cases occur in patients younger than 20 years. The clinical presentation of melanoma in the young is often challenging. We report the experience of the Melanoma Unit of University Hospital Spedali Civili of Brescia, Italy. Study subjects were drawn from 1470 patients with histologically confirmed melanoma. From this group, melanoma developed in 12 patients younger than 19 years. For each melanoma diagnosed, histologic characteristics, treatment, and outcomes were evaluated. Of the 12 patients described in this study, four were men and eight were women. The average age was 15.6 years ranging from 11 to 18 years. Regarding invasive melanomas, Breslow thickness ranged from 0.15 to 0.66 mm with a mean thickness of 0.36 mm. Primary treatment of 12 patients included wide local excision of their primary lesions. In many cases reported in literature lesions are amelanotic, nodular, and resemble pyogenic granuloma. From our case studies it was found that the clinical characteristics detected in melanomas diagnosed in childhood and adolescence have been the same as those described in adults and that the ABCDE clinical criteria may be helpful basics of melanoma.
Successful Management of Kaposiform Hemangioendothelioma with Kasabach‐Merritt Phenomenon Using Vincristine and Ticlopidine
Authors: LÓPEZ VERÓNICA , MARTÍ NURIA , PEREDA CAROLINA , MARTÍN JOSÉ MARÍA , RAMÓN DOLORES , MAYORDOMO EMPAR , JORDÁ ESPERANZA
Published: June 2009

Abstract:  Kaposiform hemangioendothelioma is a rare locally aggressive vascular tumor that usually occurs in skin and retroperitoneum of infants and young children. We present a case of a newborn with a rapid tumor growth and a life‐threatening Kasabach‐Merritt syndrome with a progressive remission after treatment with vincristine and ticlopidine.
The Biological Responses to Resveratrol and Other Polyphenols From Alcoholic Beverages
Authors: Brown Lindsay , Kroon Paul A. , Das Dipak K. , Das Samarjit , Tosaki Arpad , Chan Vincent , Singer Manfred V. , Feick Peter
Published: June 2009

Although excessive consumption of ethanol in alcoholic beverages causes multi‐organ damage, moderate consumption, particularly of red wine, is protective against all‐cause mortality. These protective effects could be due to one or many components of the complex mixture of bioactive compounds present in red wine including flavonols, monomeric and polymeric flavan‐3‐ols, highly colored anthocyanins as well as phenolic acids and the stilbene polyphenol, resveratrol. The therapeutic potential of resveratrol, firstly in cancer chemoprevention and then later for cardioprotection, has stimulated many studies on the possible mechanisms of action. Further indications for resveratrol have been developed, including the prevention of age‐related disorders such as neurodegenerative diseases, inflammation, diabetes, and cardiovascular disease. These improvements are remarkably similar yet there is an important dichotomy: low doses improve cell survival as in cardio‐ and neuro‐protection yet high doses increase cell death as in cancer treatment. Fewer studies have examined the responses to other components of red wine, but the results have, in general, been similar to resveratrol. If the nonalcoholic constitutents of red wine are to become therapeutic agents, their ability to get to the sites of action needs to be understood. This mini‐review summarizes recent studies on the possible mechanisms of action, potential therapeutic uses, and bioavailability of the nonalcoholic constituents of alcoholic beverages, in particular resveratrol and other polyphenols.
Persistent Deficits in Heart Rate Response Habituation Following Neonatal Binge Ethanol Exposure
Authors: Morasch Katherine C. , Hunt Pamela S.
Published: June 2009

Background:  We have previously shown that the rate of habituation of the heart rate orienting response to a novel odor in rats is negatively affected by neonatal ethanol exposure. Thus far, however, only young rats (16 days of age) have been tested. Given the persistence of attention and memory problems evident in humans exposed to ethanol in utero, the purpose of this experiment was to examine the longer‐term consequences of ethanol exposure on response habituation.

Methods:  Ethanol (5.25 g/kg/d) was administered intragastrically to male and female Sprague‐Dawley rats on postnatal days (PD) 4 to 9, and controls were given sham intubations. Animals were tested for heart rate orienting and response habituation to a novel olfactory stimulus (amyl acetate) on PD 16, 23, or 30.

Results:  Animals tested on PD 16 or 23 showed normal heart rate deceleration to the novel odor, a measure of the orienting response. However, ethanol‐treated subjects showed impaired response habituation compared with sham controls. While controls exhibited complete habituation within 4 to 5 trials, ethanol‐treated animals continued to respond throughout the testing session, with little decrement in heart rate response magnitude across 10 stimulus presentations. A different pattern of responding was observed in animals tested during adolescence (PD 30). Control animals failed to show the typical heart rate decrease indicative of orienting, and instead showed a tendency toward tachycardia. In contrast, ethanol‐treated animals tested on PD 30 showed orienting bradycardia that persisted for several trials.

Conclusions:  These data suggest that there are relatively long‐term consequences of neonatal ethanol exposure on nonassociative memory. This impairment in habituation may be relevant to the distractibility and poor focused attention that is pervasive among humans diagnosed with fetal alcohol spectrum disorders.
Effect of Alcohol Consumption on CpG Methylation in the Differentially Methylated Regions of H19 and IG‐DMR in Male Gametes—Implications for Fetal Alcohol Spectrum Disorders
Authors: Ouko Lillian A. , Shantikumar Katpaham , Knezovich Jaysen , Haycock Philip , Schnugh Desmond J. , Ramsay Michèle
Published: June 2009

Background:  Exposure to alcohol in utero is the main attributable cause of fetal alcohol spectrum disorders (FASD) which in its most severe form is characterized by irreversible behavioral and cognitive disability. Paternal preconception drinking is not considered to be a significant risk factor, even though animal studies have demonstrated that chronic paternal alcohol consumption has a detrimental effect on the physical and mental development of offspring even in the absence of in utero alcohol exposure. It has been documented that alcohol can reduce the levels and activity of DNA methyltransferases resulting in DNA hypomethylation and that reduced methyltransferase activity can cause activation of normally silenced genes. The aim of this study was to establish a link between alcohol use in men and hypomethylation of paternally imprinted loci in sperm DNA in genomic regions critical for embryonic development, thus providing a mechanism for paternal effects in the aetiology of FASD.

Methods:  Sperm DNA from male volunteers was bisulfite treated and the methylation patterns of 2 differentially methylated regions (DMRs), H19 and IG‐DMR, analyzed following sequencing of individual clones. The methylation patterns were correlated with the alcohol consumption levels of the volunteer males.

Results:  There was a pattern of increased demethylation with alcohol consumption at the 2 imprinted loci with a significant difference observed at the IG‐DMR between the nondrinking and heavy alcohol consuming groups. Greater inter‐individual variation in average methylation was observed at the H19 DMR and individual clones were more extensively demethylated than those of the IG‐DMR. CpG site #4 in the IG‐DMR was preferentially demethylated among all individuals and along with the H19 DMR CpG site #7 located within the CTCF binding site 6 showed significant demethylation in the alcohol consuming groups compared with the control group.

Conclusion:  This study demonstrates a correlation between chronic alcohol use and demethylation of normally hypermethylated imprinted regions in sperm DNA. We hypothesize that, should these epigenetic changes in imprinted genes be transmitted through fertilization, they would alter the critical gene expression dosages required for normal prenatal development resulting in offspring with features of FASD.
Prenatal Alcohol Exposure and Interhemispheric Transfer of Tactile Information: Detroit and Cape Town Findings
Authors: Dodge Neil C. , Jacobson Joseph L. , Molteno Christopher D. , Meintjes Ernesta M. , Bangalore Sumana , Diwadkar Vaibhav , Hoyme Eugene H. , Robinson Luther K. , Khaole Nathaniel , Avison Malcolm J. , Jacobson Sandra W.
Published: June 2009

Background:  Previous research has demonstrated that heavy prenatal alcohol exposure affects the size and shape of the corpus callosum (CC) and compromises interhemispheric transfer of information. The aim of this study was to confirm the previous reports of poorer performance on a finger localization test (FLT) of interhemispheric transfer in a cohort of heavily exposed children and to extend these findings to a cohort of moderately exposed young adults.

Methods:  In Study 1, the FLT was administered to 40 heavily exposed and 23 nonexposed children from the Cape Coloured community of Cape Town, South Africa, who were evaluated for fetal alcohol syndrome (FAS) dysmorphology and growth. Anatomical images of the CC were obtained using structural MRI on a subset of these children. In Study 2, the FLT was administered to a cohort of 85 moderate‐to‐heavily exposed young adults participating in a 19‐year follow‐up assessment of the Detroit Prenatal Alcohol Exposure cohort, whose alcohol exposure had been ascertained prospectively during gestation.

Results:  In Study 1, children with FAS showed more transfer‐related errors than controls after adjustment for confounding, and increased transfer‐related errors were associated with volume reductions in the isthmus and splenium of the CC. In Study 2, transfer‐related errors were associated with quantity of alcohol consumed per occasion during pregnancy. More errors were made if the mother reported binge drinking (≥5 standard drinks) during pregnancy than if she drank regularly (M ≥ 1 drink/day) without binge drinking.

Conclusions:  These findings confirm a previous report of impaired interhemispheric transfer of tactile information in children heavily exposed to alcohol in utero and extend these findings to show that these deficits are also seen in more moderately exposed individuals, particularly those exposed to binge‐like pregnancy drinking.
The in vitro effect of recombinant factor VIIa on coated platelet formation and clot dynamics of stored platelet concentrates
Authors: Svendsen Mette S. , Kristensen Annemarie T. , Bochsen Louise , Salado‐Jimena José A. , Johansson Pär I.
Published: June 2009

BACKGROUND: Storage can negatively impact the hemostatic potential of platelet concentrates (PCs) used for transfusion. At the site of vascular injury, normal platelets (PLTs) are hypothesized to change into highly procoagulant‐coated PLTs upon costimulation with collagen and thrombin. We investigated whether activated recombinant factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S) could improve the ability of stored PLTs to support coagulation under conditions that promote the formation of coated PLTs.

STUDY DESIGN AND METHODS: PCs stored for 1, 4, 6, and 8 days were costimulated with thrombin and with convulxin, a collagen glycoprotein VI receptor agonist, to create coated PLTs. The effect of rFVIIa on the ability of stored PCs to form coated PLTs, generate thrombin, and impact clot dynamics was evaluated by flow cytometry, a plasma‐based assay, and thrombelastography, respectively.

RESULTS: Coated PLT formation decreased significantly with increasing storage time (80% vs. 50%‐55%, p < 0.05), and this was not affected by the addition of rFVIIa. rFVIIa accelerated thrombin generation (p < 0.001) and clot formation (p < 0.001) and significantly increased thrombin generation throughout the storage period (p < 0.001). Resistance to fibrinolysis was impaired at the end of storage, and this was not affected by the addition of rFVIIa.

CONCLUSION: rFVIIa accelerated thrombin and clot formation throughout storage, with the most pronounced effect observed in the PCs that had been stored for the shortest length of time (Day 1). Resistance to fibrinolysis was gradually impaired throughout the storage period and was not affected by the addition of rFVIIa.
Prevalence and trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among blood donors in Iran, 2004 through 2007
Authors: Amini Kafi‐abad Sedigheh , Rezvan Houri , Abolghasemi Hassan , Talebian Ali
Published: June 2009

BACKGROUND:Evaluation and monitoring the prevalence of transfusion‐transmissible viral infections in blood donors is a valuable index of donor selection and blood safety. This study analyzed the trends of blood‐borne infections among Iranian blood donations during 4 years.

STUDY DESIGN AND METHODS:Viral screening results of 6,499,851 allogeneic donations from 2004 through 2007 were analyzed. All donations were screened for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis. The prevalence of HBV, HCV, and HIV infections per 100,000 donations and 95% confidence interval was calculated. The p value was estimated by chi‐square test.

RESULTS:The prevalences of HBV, HCV, and HIV decreased during the 4‐year study from 2004 through 2007. The overall prevalence was 0.56% for HBV, 0.004% for HIV, and 0.13% for HCV. There was a significant and impressive decrease in hepatitis B surface antigen prevalence from 0.73% in 2004 to 0.41% in 2007. The prevalence of HIV appeared to have decreased from 0.005% in 2004 to 0.004% in 2007 although the decrease was not significant. HCV prevalence showed a slight decline in blood donations from 0.14% in 2005 to 0.12% in 2007.

CONCLUSION:The trends of transfusion‐transmitted infection prevalence in Iranian blood donations suggest that most of the safety measures employed in recent years in Iran have been effective.
2008 Emily Cooley Memorial Lecture: lessons learned from pediatric transfusion medicine clinical trials . . . a little child shall lead them
Authors: Strauss Ronald G.
Published: June 2009

BACKGROUND: Many clinical practices in transfusion medicine are controversial and/or lack definitive guidelines established by sound clinical trials. Although recommendations based on results of clinical trials performed using infants and children may not always be applied directly to adults—and vice versa—lessons learned from pediatric trials can be useful when critically assessing the design/results/conclusions of adult trials.

STUDY DESIGN AND METHODS: Four randomized clinical trials (RCTs) studying pediatric patients were critically reviewed. They addressed two red blood cell (RBC) transfusion issues: 1) transfusion guidelines by which RBC transfusions are “triggered” by liberal (LIB; high pretransfusion patient hematocrit [Hct] levels) versus being “triggered” by restricted (RES; low pretransfusion Hct levels) and 2) transfusion of fresh RBCs (≤7 days' storage) versus RBCs (up to 42 days' storage).

RESULTS: Findings established by primary outcomes generally were firm (e.g., fewer RBC transfusions were given to infants/children managed by RES guidelines; transfusing small volumes of RBCs stored up to 42 days to preterm infants diminished allogeneic donor exposures and were equally efficacious and safe as fresh RBCs stored ≤7 days). Findings based on secondary outcomes, subset, and post hoc analyses were inconsistent (e.g., clinical outcomes were equivalent after LIB or RES transfusions in only two of three RCTs; in the third, more neurologic problems were found in neonates given RES transfusions).

CONCLUSIONS: Clinical practices should be based on data pertaining to the primary outcomes of RCTs, because trials are designed and statistically powered to address these issues. Clinical practices suggested by analysis of secondary outcomes, subsets of patients, and post hoc analyses should be applied cautiously until studied further—ideally, as primary outcomes in subsequent RCTs.
Verification, Performance, Validation, and Modifications to the SOVS Continuum Constitutive Model in a Nonlinear Large‐Deformation Finite Element Code
Authors: Argüello José Guadalupe , Reiterer Markus W. , Ewsuk Kevin G.
Published: June 2009

The continuum theory of sintering embodied in the constitutive description of Skorohod and Olevsky can be combined with results from mesostructure evolution simulations to model shrinkage and deformation of ceramics. An implementation (and variations) of this sintering model based on a finite element (FE) formulation that allows three dimensional (3D) components to be modeled using Sandia National Laboratories' nonlinear large‐deformation FE code, JAS3D, is presented. This tool provides a capability to model sintering of complex 3D components. Recent modifications to the model dictated that the suite of verification and validations problems, developed for the model, be exercised anew on the modified version. The verification, performance, and validation of the model within JAS3D is described and discussed herein. Modifications and improvements to the original implementation of the model are then also summarized and reviewed as the model's evolution is tracked to its current form.
Hot Isostatic Pressing of Transparent Nd:YAG Ceramics
Authors: Lee Sang‐Ho , Kupp Elizabeth R. , Stevenson Adam J. , Anderson Julie M. , Messing Gary L. , Li Xin , Dickey Elizabeth C. , Dumm John Q. , Simonaitis‐Castillo Vida K. , Quarles Gregory J.
Published: June 2009

This paper demonstrates that fine‐grained (2–3 μm), transparent Nd:YAG can be achieved at SiO2 doping levels as low as 0.02 wt% by the sinter plus hot isostatic pressing (HIP) approach. Fine grain size is assured by sintering to 98% density, in order to limit grain growth, followed by HIP. Unlike dry‐pressed samples, tape‐cast samples were free of large, agglomerate‐related pores after sintering, and thus high transparency (i.e., >80% transmission at 1064 nm) could be achieved by HIP at <1750°C along with lower silica levels, thereby avoiding conditions shown to cause exaggerated grain growth. Grain growth was substantially limited at lower SiO2 levels because silica is soluble in the YAG lattice up to ∼0.02–0.1 wt% at 1750°C, thus allowing sintering and grain growth to occur by solid‐state diffusional processes. In contrast, liquid phase enhanced densification and grain growth occur at ∼0.08–0.14 wt% SiO2, especially at higher temperatures, because the SiO2 solubility limit is exceeded.
The Anatomic Relationship Between the Common Femoral Artery and Common Femoral Vein in Frog Leg Position Versus Straight Leg Position in Pediatric Patients
Authors: Hopkins Jennifer W. , Warkentine Fred , Gracely Edward , Kim In K.
Published: June 2009

Background:  Overlap of the femoral artery (FA) on the femoral vein (FV) has been shown to occur in pediatric patients. This overlap may increase complications such as arterial puncture and failed insertions of central venous lines (CVLs). Knowledge of the anatomic relationship between the FV and FA may be important in avoiding these complications.

Objectives:  The objective was to evaluate the anatomic relationship of the FA and FV in straight leg position and frog leg position.

Methods:  This was a prospective, descriptive study of a convenience sample of 80 total subjects (16 subjects from each of five predetermined stratified age groups). Each subject underwent a standardized ultrasound examination in both the straight and the frog leg positions. The location of the FA in relation to the FV was measured at three locations: immediately distal, 1 cm distal, and 3 cm distal to the inguinal ligament. Overlap of the FA on the FV and the diameter of the FV was noted at each location. Measurements were repeated in both the straight leg and the frog leg positions.

Results:  For the left leg, immediately distal to the inguinal ligament, the FV was overlapped by the FA in 36% of patients in straight leg position and by 45% of patients in frog leg position. At 1 cm distal to the ligament, overlap was observed in 75% of patients in straight leg position and 88% of patients in the frog leg position. At 3 cm distal to the ligament, overlap was observed in 93% of patients in straight leg position and 86% of patients in the frog leg position. The percentage of vessels with overlap was similar in the right leg at each location for both the straight and the frog leg positions. Pooled mean (±SD) FV diameters for the left leg immediately distal to the inguinal ligament were 0.64 (±0.23) cm in the straight leg position and 0.76 (±0.28) cm in the frog leg position; at 1 cm distal to the ligament, 0.66 (±0.23) and 0.78 (±0.29) cm; and at 3 cm distal to the ligament, 0.65 (±0.27) and 0.69 (±0.29) cm. FV diameters for the right leg were similar to the left.

Conclusions:  A significant percentage of children have FAs that overlap their FVs. This overlap may be responsible for complications such as FA puncture with CVL placement. Ultrasound‐guided techniques may decrease these risks. Placing children in the frog leg position increases the diameter of the FV visualized on ultrasound.
Accuracy of a computerized tomography‐guided template‐assisted implant placement system: an in vitro study
Authors: Horwitz Jacob , Zuabi Otman , Machtei Eli E.
Published: June 2009

Objectives: To evaluate the accuracy of computer‐assisted 3D planning and implant insertion using computerized tomography (CT).

Materials and methods: Nine implants were planned on pre‐operative CTs of six resin models, which were acquired with radiographic templates, using a planning software (E implants). Each resin model contained three pre‐existing control implants (C implants). Radiographic templates were converted into operative guides containing 4.8‐mm‐diameter titanium sleeves. A single set of insertable sleeves was used for consecutively drilling the six models, followed by implant insertion through the guide sleeves. Models were further divided into group A (the first three models) and group B (the last three models). Post‐operative CTs were used to compare implant positions with pre‐operative planned positions. Statistical analysis included the Mann–Whitney U test for E and C implants and the Wilcoxon's signed ranks test for groups A and B.

Results: The mean apex depth deviations for E and C implants [0.49 mm±0.36 standard deviation (SD) and 0.32 mm±0.21 SD, respectively], and the mean apex radial deviations (0.63 mm±0.38 SD and 0.49 mm±0.17 SD, respectively) were similar (P>0.05). The mean angulation deviations for E and C implants were 2.17±1.06°SD and 1.33±0.69°SD, P<0.05. E implant deviations of all the parameters in group A were significantly smaller than E implant deviations in group B.

Conclusions: Computer‐assisted implant planning and insertion provides good accuracy. Deviations are mainly related to system and reproducibility errors. Multiple use of drills and titanium sleeves significantly reduces system accuracy.
Oral health behavior among  25‐year‐old‐Norwegian adults: factor structure, factorial invariance over time and trends
Authors: Åstrøm Anne Nordrehaug
Published: June 2009

Abstract –  Background:  Exploratory factor‐analytical studies suggest that health behaviors are multidimensional, leading to hypotheses that such behaviors are bi‐ or tri‐dimensional. This study applies confirmatory factor analysis (CFA), to semi‐longitudinal data and provides new information about the factor structure of oral health‐related behaviors among 25‐year‐old Norwegians. The purposes of the study were to (1) evaluate the factor structure of oral health behaviors and its invariance over time, (2) assess temporal changes in patterns of oral health behaviors and in their socioeconomic distribution between 1997 and 2007.

Methods:  Simple random samples of 1190 residents born in 1972 and 8000 residents born in 1982 were drawn from the populations of three counties in Western Norway in 1997 and 2007. Structured questionnaires were mailed to the eligible participants. After one reminder, 735 (58% women, response rate 62%) and 1509 (63.3% women, response rate 19%) replied.

Results:  A correlated three‐factor model with cross‐loadings showed a better fit than a two‐factor model to both the 1997 sample: χ2/df = 2.1, CFI = 0.95, RMSEA = 0.03 and the 2007 sample: χ2/df = 3.1, CFA = 0.95, RMSEA = 0.04. Multiple‐group CFA showed an acceptable fit for the unconstrained model, CFA = 0.95, RMSEA = 0.03, and no statistically significant difference in fit between the unconstrained and constrained models (P = 0.739). Multiple binary logistic regression with three sum scores based on the behavioral factors sugar intake, drug use and oral health‐enhancing behavior revealed that the odds ratios for frequent sugar intake (OR = 0.6, 95% CI: 0.5–0.8) and oral health‐enhancing behavior (OR = 0.6, 95% CI: 0.5–0.7) were less in 2007 than in 1997. Drug use remained stable over time (OR = 0.9, 95% CI: 0.7–1.1). Educational differences in sugar intake observed in 1997 had leveled off in 2007.

Conclusion:  A three‐factor structure fitted the data in 1997 and 2007 and the factor structure was invariant over time. This suggests that oral health behaviors should be addressed jointly in oral health promotion programs.
Fluoride ingestion from food items and dentifrice in 2–6‐year‐old Brazilian children living in a fluoridated area using a semiquantitative food frequency questionnaire
Authors: Miziara Ana Paula Borges , Philippi Sonia Tucunduva , Levy Flávia Mauad , Buzalaf Marília Afonso Rabelo
Published: June 2009

Abstract –  Objectives:  The aim of this study was to evaluate the fluoride intake of 2–6‐year‐old Brazilian children using a semiquantitative food frequency questionnaire (FFQ) which also estimated fluoride intake from dentifrice.

Methods:  The FFQ was previously validated through application to 78 2–6‐year‐old Brazilian children and then administered to 379 children residing in an optimally fluoridated community in Brazil (Bauru, State of São Paulo). The FFQ was applied to the parents and used to estimate the food intake of the children. The constituents of the diet were divided into solids, water and other beverages. The fluoride content of the diet items was analyzed with the fluoride electrode. The questionnaire also estimated fluoride intake from dentifrice.

Results:  The average (±SD) fluoride intake from solids, water, other beverages and dentifrice was 0.008 ± 0.005; 0.011 ± 0.004; 0.009 ± 0.014 and 0.036 ± 0.028 mg F/kg body weight/day, respectively, totalizing 0.064 ± 0.035 mg F/kg body weight/day. The dentifrice and the diet contributed with 56.3% and 43.7% of the daily fluoride intake, respectively. Among the children evaluated, 31.2% are estimated to have risk to develop dental fluorosis (intake>0.07 mg F/kg body weight/day).

Conclusions:  The dentifrice was the main source of fluoride intake by the children evaluated. However, the fluoride concentration in food items also significantly contributed to the daily ingestion by 2–6‐year‐old children. The questionnaire used seems to be a promising alternative to duplicate diet to estimate the fluoride intake at this age range and may have potential to be used in broad epidemiological surveys.
When fish meet fish as determined by physiological sensors
Authors: Slavík O. , Horký P.
Published: June 2009

Abstract – Electromyogram (EMG) biotelemetry allows a description of the spatial distribution of fish together with a simultaneous measurement of individual energy consumption. Using this technique, we observed behaviour of the largest European freshwater predator,Silurus glanis, in the Elbe River, Central Europe. In total, 52 diurnal cycles and 1248 individual fish positions were recorded with 12,480 EMG records during the period from March to May 2006; 1013 fish positions with 10,130 EMG records were further used for statistical analyses. Energy consumption increased with decreasing mutual distance between specimens, an effect that occurred predominantly when both of them were simultaneously in overlapping preferred areas [core areas (CAs)] appointed within their home ranges (HRs). Furthermore, with increasing energy consumption individual’s movement range in longitudinal and lateral profiles decreased; i.e., the fish were positioned within a small area. When the CAs of tested individuals did not overlap, no relationship between EMG signals and mutual distance of conspecifics was found. Our results indicate that movement activity and also social behaviour can be determined with physiological sensors.
Skin from various ethnic origins and aging: an in vivo cross‐sectional multimodality imaging study
Authors: Querleux Bernard , Baldeweck Thérèse , Diridollou Stéphane , De Rigal Jean , Huguet Etienne , Leroy Frédéric , Holloway Barbosa Victoria
Published: June 2009

Background: Ethnic differences in skin structural features have not been thoroughly investigated, and the few reported studies are contradictory. Thus, we have carried out a set of in vivo measurements on the skin of about 400 volunteers from various ethnic origins living in the same environment.

Methods: Female subjects were distributed into four ethnic groups: African Americans, Mexicans, Caucasians, and Chinese. Inter‐ and intra‐ethnic skin structural differences, according to age and anatomic site, were investigated using three non‐invasive skin‐imaging methods: ultrasound (US) at 25 and 150 MHz, and optical coherence tomography (OCT).

Results: The thickness of the skin is higher on the cheek compared with the dorsal and ventral forearm, with no ethnic or age‐related specificity. We confirm that the sub‐epidermal non‐echogenic band is a sensitive marker of skin aging, and reveal for the first time that it is less pronounced in African Americans. From OCT images, we bring out evidence that the thickness of the dermal–epidermal junction (DEJ) decreased with age, and was higher in African Americans than in Caucasians. Finally, by comparing US images at 150 MHz with OCT images, we show that papillary dermis thickness can be measured and appears to be quite constant irrespective of age or ethnic group.

Conclusion: Our study confirms that skin imaging is very attractive to further our knowledge of the morphology of skin from various ethnic origins. Regarding age effects, quantitative parameters have shown that they would be delayed in African Americans compared with all other ethnic populations.
ORIGINAL ARTICLE: HLA‐G Expression Is Up‐Regulated by Progesterone in Mesenchymal Stem Cells
Authors: Ivanova‐Todorova Ekaterina , Mourdjeva Milena , Kyurkchiev Dobroslav , Bochev Ivan , Stoyanova Elena , Dimitrov Rumen , Timeva Tanya , Yunakova Maria , Bukarev Dimitar , Shterev Atanas , Tivchev Petar , Kyurkchiev Stanimir
Published: June 2009

Problem  Maternal immune response to fetal tissues is modified in such way that it favors the development of pregnancy. Human leukocyte antigen (HLA)‐G, progesterone and mesenchymal stem cells (MSCs) have been identified as potent immunomodulatory agents in different experimental systems and the interactions between these three factors are studies in this paper.

Method of study  Human MSCs are isolated from human adipose tissue, bone marrow and decidua are cultured in the presence of progesterone and the expression of HLA‐G is followed‐up at protein and mRNA levels.

Results  The MSCs cultured in the presence of progesterone express increased levels of both cell surface and cytoplasmic HLA‐G when compared with the control MSCs.

Conclusion  Progesterone up‐regulates the expression by MSCs of HLA‐G which is a major player in maintenance of the immune balance between the mother and the fetus. MSCs are newly detected targets of progesterone with well documented immunomodulatory activity.