bluuebunny/crossref_metadata_2025 huggingface dataset:
Article The free energies of metabolic reactions (ΔG) are not positive
Authors: Edwards Robert A.
Published: October 2008

Biochemistry textbooks often erroneously state that some metabolic reactions have positive free energies (ΔG), which suggests that they are spontaneous in the reverse direction. This incorrectly implies that reverse fluxes can occur through some steps in a metabolic pathway while the overall flux through the pathway is in the forward direction. In fact, at steady state all the reactions of a metabolic pathway proceed in the forward direction with the same flux. During periods of transition between steady states a positive free energy for any one reaction in a pathway means that the pathway is not actually proceeding from beginning to end. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Bringing the brain into the test tube: an experiment illustrating the effect of ethanol on nerve terminal viability
Authors: Cunha Rodrigo A.
Published: October 2008

Ethanol is primarily responsible for the behavioural effects of acute alcoholic beverage consumption, which involves central nervous system dysfunction. The mechanisms of ethanol action in the nervous system are poorly understood, particularly those related to the neurotoxicity of high acute ethanol consumption. We now describe a simple experiment showing that a concentration of ethanol, which is reached in the plasma after high acute ethanol intake, disrupts rat brain nerve terminals, as measured by the release of lactate dehydrogenase. This cytolytic action of ethanol was further enhanced upon depolarisation of the nerve terminals suggesting that the mechanism of action of ethanol might not be related to modification of lipid bilayer properties. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Conventional teaching remains effective in teaching medical biochemistry in BPKIHS, Nepal, although students enjoy supplementary computer teaching
Authors: Koner B. C. , Lamsal M. , Banerjee B. D. , Baralb N.
Published: October 2008

A computer program down loaded from the Internet was used as a tutorial to teach the structure‐function relationship of MHC molecule to MBBS students of BPKIHS, a medical college in Nepal. The computer‐aided teaching session, with a facilitator from the biochemistry faculty, was found to be more interesting to the students although learning outcomes were not enhanced by comparison to sessions using only conventional tools. A non‐subject expert presenting the computer tutorial failed to generate interest in the topic, and the achievement of learning objectives by the students was inferior. We conclude that the interaction with a biochemistry subject expert was crucial for success in our use of computer‐aided teaching sessions on the structure‐function relationship of proteins. The results are discussed with attention to the role of computer‐aided instruction in medical colleges in a developing country (Nepal). © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Metabolic pathways: does the actual Gibbs free‐energy change affect the flux rate?
Authors: Aledo J. Carlos
Published: October 2008

Energy dissipation fulfils an important function in metabolism driving the flux of matter through metabolic pathways. The flux rate is a multivariable function. One of such variables affecting the flux is the actual free energy change. A particular case of metabolic pathway is analysed to illustrate this fact, using only general enzymic and thermodynamic concepts. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Designer metabolic pathways in the teaching laboratory
Authors: Gillett Michael P. T.
Published: October 2008

Designer or artificial metabolic pathways are simple, cheap and readily available in the form of enzyme reagent kits for the determination of different biomolecules. Such kits can be easily adapted for use in the teaching laboratory and used to illustrate a variety of important concepts in metabolism and enzymology, including coupled reactions, pathway mapping, competition, anoxia, compartmentalization and effects of pH and temperature. Such experiments can be conducted in a fraction of the time that would be needed for procedures using sub‐cellular preparations from animals or plants. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Human rhinovirus 3C protease: a cysteine protease showing the trypsin(ogen)‐like fold
Authors: Bolognesi Martino , Spallarossa Andrea , Ascenzi Paolo
Published: October 2008

Viral‐encoded proteases cleave precursor polyprotein(s) leading to maturation of infectious virions. Strikingly, human rhinovirus 3C protease shows the trypsin(ogen)‐like serine protease fold based on two topologically equivalent six‐stranded β‐barrels, but displays residue Cys147 as the active site nucleophile. By contrast, papain, which is representative of most cysteine proteases, does not display the trypsin(ogen)‐like fold. Remarkably, in human rhinovirus 3C cysteine protease, the catalytic residues Cys147, His40 and Glu71 are positioned as Ser195, His57 and Asp102, respectively, building up the catalytic triad of serine proteases in the chymotrypsin‐trypsin‐elastase family. However, as compared to trypsin‐like serine proteases and their zymogens, residue His40 and the oxyanion hole of human rhinovirus 3C cysteine protease, both key structural components of the active site, are located closer to the protein core. Human rhinovirus 3C cysteine protease cleaves preferentially Gin — Gly peptide bonds or, less commonly, the Gin — Ser, Gin —Ala, Glu — Ser or Glu —Gly pairs. Finally, human rhinovirus 3C cysteine protease and the 3CD cysteine protease‐polymerase covalent complex bind the 5° non‐coding region of rhinovirus genomic RNA, an essential function for replication of the viral genome. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
A Biochemistry of Human Disease course for undergraduate and graduate students
Authors: Glew Robert H. , VanderJagt David L.
Published: October 2008

This paper describes the experience of members of a medical school faculty who have been offering for more than 10 years a two‐course series in the biochemistry of human disease to undergraduate students majoring in biochemistry, biology, or chemistry. Each of the iwo 3‐credit courses meets twice a week for 90min per session. The courses are divided into five three‐week blocs (total number of sessions per bloc, six), each of which is taught by a different instructor. The sixth and last class in each of the blocs is devoted to an exam; there is no cumulative final exam. The topics that are covered include the following: diabetes mellitus, alcoholism, Alzheimer's disease, trophoblastic diseases of pregnancy, molecular and cellular mechanisms of cancer (including chemical carcinogenesis), disorders of calcium metabolism, biochemical and nutritional causes of anemia, collagen diseases, and gene replacement therapy. The various teaching formats and kinds of reading assignments that are used are discussed, as are the reactions of selected faculty who have participated in these courses. The positive experience we have had with a bloc approach to topics‐based, multi‐instructor courses in human disease should encourage basic science faculty at other medical schools in the US and elsewhere to become involved in teaching specialized, advanced courses to undergraduate, pre‐professional students. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
The new biochemistry: in praise of alternate curricula
Authors: Feldberg Ross S.
Published: October 2008

The problem of what to include or exclude in designing a modern biochemistry course is becoming increasingly difficult to resolve. In this article, I suggest that the focus on which topics are to be covered is misplaced. Since factual information is rapidly forgotten, whereas skills can be retained, students would be better served if we designed our courses around those skill sets we desire our students to learn. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Dialogues as teaching tools in the biochemical sciences
Authors: Roberts‐Kirchhoff Elizabeth S. , Caspers Mary Lou
Published: October 2008

In their senior year, biochemistry majors take “Recent Advances in Biochemistry Related to Societal Issues” in which new advances in biochemical sciences are explored through the reading and presenting of recent articles from the literature. Emphasis is placed on the analysis and interpretation of experimental results and the ethical and societal implications of the work including the significance of the findings to the improvement of life. To fulfill the objectives of the course, a group project was implemented in which the goal was to write a dialogue that explores one area in which advances in biochemical research give rise to ethical and societal considerations. This assignment required the groups to research the topics and then creatively integrate the information into a dialogue format representing different views on the subject. The dialogue was presented to the rest of the class and invited guests in skit format and then a discussion followed. Based upon evaluations, the project was regarded highly by the students. The assignment, group and topic selection, examples of presentations and issues raised during discussions, and results from student and audience evaluations will be discussed. © 2001 Published by Elsevier Science Ltd. on behalf of IUBMB.
Use of the web to provide learning support for a large metabolism and nutrition class
Authors: Henly Debra C. , Reid Athol E.
Published: October 2008

To support student learning in a large Metabolism and Nutrition class, we have introduced a web‐based package, using a commercially available program, WebCT. The package was developed at a minimal cost and with limited resources. In addition to downloadable (PDF) versions of lecture Powerpoint presentations, tutorial outlines and a practical class exercise, web‐based self‐directed learning exercises were included to reinforce and extend lecture material in an active learning environment. The web‐site also contained a variety of formative and summative assessment tasks that examined both factual recall and higher order thinking. Detailed course information, timetables and a bulletin board were also readily accessible. Student usage of the site was generally high, but varied widely between individual students. Students who achieved a high overall score for the course completed on average three times as many formative assessment items and achieved a higher score for all tests than students who did poorly. Student feedback about the site was very positive with the majority of students reporting that the course material and assessment items that were available were useful to their learning. Administration of the course was also facilitated. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
A laboratory exercise designed to teach medical students about reverse‐transcription polymerase chain reaction
Authors: Faya Michael J. , Chandar Nalini , Viselli Susan M.
Published: October 2008

This report describes a laboratory exercise that was incorporated into an endocrinology elective course, with a class size between 5 and 20 students, taught to second year osteopathic medical school students. This exercise was designed to reinforce understanding of basic molecular biology techniques within the context of a clinically important aspect of endocrinology, that of hormone‐dependent cancers. Students used the technique of reverse transcription polymerase chain reaction to determine if two breast cancer cell lines were estrogen receptor‐α positive or negative. The experiment served as the basis for discussing the importance of estrogen in relation to breast cancer, and the use of antiestrogens for treating hormone‐dependent breast cancer. This laboratory exercise has been used successfully for both second year osteopathic medical school students and high school students. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Restriction enzyme mapping of bacterial urease genes: using degenerate primers to expand experimental outcomes
Authors: Reed Kelynne E.
Published: October 2008

Two degenerate primers are described that can be used to amplify a 340 bp fragment of the ureC gene from a variety of urease producing bacteria. A series of experiments are outlined that enable students to develop restriction maps of the urease gene clusters from different bacteria. Students learn a variety of molecular biology techniques including polymerase chain reaction, agarose gel electrophoresis, and Southern blotting. This project allows for multiple experimental outcomes using the same two PCR primers. © 2001 IUBMB. Published by Elsevier Science Ltd. All rights reserved.
Electrophoretic transfer technique to detect and identify amylases in polyacrylamide gels
Authors: Mulimani V. H. , Thippeswamy S.
Published: October 2008

A simple experiment to detect amylases of human saliva by electrophoretic transfer technique is described. © 2001 Published by Elsevier Science Ltd. on behalf of IUBMB.
Real‐Time Forecasting and Political Stock Market Anomalies: Evidence for the United States
Authors: Bohl Martin T. , Döpke Jörg , Pierdzioch Christian
Published: October 2008

Using monthly data from 1953 to 2003, we apply a real‐time modeling approach to investigate the implications of U.S. political stock market anomalies for forecasting excess stock returns in real‐time. Our empirical findings show that political variables, chosen on the basis of widely used model‐selection criteria, are often included in real‐time forecasting models. However, political variables do not contribute systematically to improving the performance of simple trading rules. For this reason, political stock market anomalies are not necessarily an indication of market inefficiency.
Political Views and Corporate Decision Making: The Case of Corporate Social Responsibility
Authors: Rubin Amir
Published: October 2008

This paper conducts an empirical analysis of the relationship between corporate social responsibility (CSR) and political beliefs in the United States. By analyzing the 2004 presidential election results of communities in which corporate headquarters are located, we establish a correlation between the political beliefs of corporate stakeholders and the CSR ratings of their firms. Companies with a high CSR rating tend to be located in Democratic, or “blue” states and counties, while companies with a low CSR rating tend to be located in Republican, or “red” states and counties.
Risk Shifts Following Sarbanes‐Oxley: Influences of Disclosure and Governance
Authors: Akhigbe Aigbe , Martin Anna D. , Newman Melinda
Published: October 2008

The Sarbanes‐Oxley Act of 2002 (SOX) aimed to improve financial reporting by enhancing corporate disclosure and governance. We find statistically significant increases, from before to after the passage of SOX, in total return variance, market risk and idiosyncratic risk. The risk increases are consistent with predictions that the legislation would cause firms to disclose more negative information, resulting in increased investment risk. However, in cross‐sectional tests, post‐SOX improvements in information certainty, board independence and monitoring are associated with smaller increases or greater decreases in risk. If SOX is responsible for these improvements, its effects are consistent with its purpose.
Lease Financing and Corporate Governance
Authors: Robicheaux Sara H. , Fu Xudong , Ligon James A.
Published: October 2008

Lease financing is a well‐recognized mechanism for reducing the agency costs of debt. This study examines whether firms that attempt to control the agency costs of equity through strong governance structures, including Chief Executive Officer compensation alignment and board structure, are more likely to use an agency cost reducing debt structure, such as leasing. For a sample of large firms, we find that firms who use more incentive compensation and have more outside directors also tend to use more lease financing, suggesting these agency cost reducing measures are complements.
A Theological Reflection on Torture and Democracy
Authors: Denton‐Borhaug Kelly
Published: October 2008

Abstract:  First, I summarize the major findings of a new comprehensive resource, Torture and Democracy, by Darius Rejali, as corrective for the current state of confusion and concealment in United States with regard to the persistence of torture. Second, I respond theologically to the insights from this scholarship through a) reflection on victims of torture as ‘nonpersons’ in light of theological anthropology, and through exploring the role of Christians in the public square, and b) addressing the problem of sacrificialism.
Torture and Theology of the Cross
Authors: Hoffmeyer John F.
Published: October 2008

Abstract:  A theology of the cross must (1) connect Christ's cross with the reality of torture, and (2) differentiate misuse of Christ's crucifixion from its power in the struggle against torture. To meet these tasks, a theology of the cross needs to (1) refuse to separate Christ's crucifixion from his life and resurrection, and (2) recognize that the crucified Christ can only be understood in relation to all Christ's suffering sisters and brothers.
A Bishop Saving ‘Singers’: Tales of Torture in Pinochet's Chile
Authors: Frenz Helmut
Published: October 2008

Abstract:  The article provides a brief biographical introduction of Lutheran Bishop Helmut Frenz, co‐founder of the Committee for Peace, credited with saving at least 6,000 lives of persecuted Chileans following the September 1973 military coup at the hands of the brutal general Agosto Pinochet. Excerpts from Frenz' book, Mi Vida Chilena, document Pinochet's acknowledgment that torture was the regime's official policy, and share the poignant story of one suspected leftist's brutal torture.
Re‐reading Bach as a Lutheran Theologian
Authors: Chia Roland
Published: October 2008

Abstract:  The presence of certain motifs associated with pietism in the music of J. S. Bach has led some scholars to conclude that the composer was profoundly influenced by the 17th century movement within the German Lutheran Church. This essay argues that Bach was a Lutheran theologian, whose works can be understood only in the closest relationship to Martin Luther. Bach's commitment to Lutheran orthodoxy is evidenced by his erudite grasp of the writings of Luther and his long friendship with Eerdmann Neumeister. But it is in his music that Bach shows himself to be the true heir of the Lutheran tradition. This essay examines Bach's commitment to Scripture, his Christology and his soteriology.
Prison Theology: A Theology of Liberation, Hope and Justice
Authors: Pounder Sadie
Published: October 2008

Abstract:  In our nation today, the number of prisons and prisoners continue to grow at rates that are out‐of‐control. One in 100 of our citizens is in jail or prison, the highest ratio in the world. Unlike the poor, homeless, critically ill, and elderly, those in prison are separated from us to the degree they are unseen. Unseen also, is the oppressiveness of the criminal justice system that oversees more than 6.5 million people either in confinement or on probation or parole. Liberation theology, which advocates and works toward freeing people from oppression, includes feminist, black, womanist and Latino/Hispanic movements. This article proposes prison theology as part of the liberation theology family and identifies a prison theology based on liberation, hope and justice. It encourages a prison theology movement led by the church to liberate those under the oppressiveness of the criminal justice system, especially those confined and to energize a passion for justice and compassion for the oppressed throughout the criminal justice system.
Evaluation of the Left Ventricular Function with Tissue Tracking and Tissue Doppler Echocardiography in Pediatric Malignancy Survivors after Anthracycline Therapy
Authors: Karakurt Cemşit , Koçak Gulendam , Özgen Unsal
Published: October 2008

Although the anthracyclines have gained widespread use in the treatment of childhood hematological malignancies and solid tumors, cardiotoxicity is the major limiting factor in the use of anthracyclines.

The aim of this study was to assess the mitral annular displacement by tissue tracking in pediatric malignancy survivors who had been treated with anthracycline groups chemotheraphy and compare with the tissue Doppler and conventional two dimensional measurements and Doppler indices.
In this study, 32 pediatric malignancy survivors and 22 healthy children were assessed with 2D, colour‐coded echocardiography. Left ventricular ejection fraction, fractional shortening, stroke volume, cardiac output, cardiac index and diastolic functions were measured. All subjects were assessed with tissue Doppler echocardiography, mitral annular displacements, and also with tissue tracking method.
We detected that peak velocity of the early rapid filling on tissue Doppler (E′) was lower (p < 0.05) and the ratio of early peak velocity of rapid filling on pulse Doppler to tissue Doppler (E/E′) values were statistically higher in patient group than control group (p < 0.05). Myocardial performance index values were also higher in patient group than the control group (p < 0.01). It appears that MPI is a useful echocardiograghic method than tissue tracking of mitral annular displacement in patients with pediatric cancer survivors who had subclinical diastolic dysfunction.
Normal Range of Mechanical Variables in Pulmonary Hypertension: A Tissue Doppler Imaging Study
Authors: López‐Candales Angel , Rajagopalan Navin , Dohi Kaoru , Edelman Kathy , Gulyasy Beth
Published: October 2008

Background: Tissue Doppler imaging (TDI) has been quite useful in determining the mechanical properties of right ventricular (RV) function in patients with pulmonary hypertension (PH). However, to what extent these mechanical properties are expected to identify RV dysfunction in PH patients is less clear. Methods: Our echocardiography database was queried for patients with PH of different etiologies (111 patients, age 55 ± 14 years, mean pulmonary artery pressure 63 ± 24 mmHg) who had undergone TDI analysis and compared to similarly collected data from a group of healthy individuals (35 patients, mean age 45 ± 15 years, mean pulmonary artery pressure 27 ± 5 mmHg). Results: ROC analysis demonstrated that a mechanical delay between the RVFw and IS > 25 ms detects PH while a delay > 37 ms detects abnormal RV performance. Peak RV strain < −20% identifies PH greater than 40 mmHg and a reduced RV systolic function. However, on a stepwise multiple regression analysis model RV dyssynchrony was the most significant predictor of PH (r = 0.515; P = 0.0003) over peak longitudinal RV strain (r = 0.553; P = 0.02) and RVFAC (r =−0.603; P = 0.01). Peak longitudinal strain was the most significant predictor (r =−0.722; P < 0.0001) of an abnormal RVFAC over PH (r =−0.603; P = 0.004) and RV dyssynchrony (r =−0.471; P = 0.01). Conclusion: A normal range of RV mechanical variables in PH patients are provided that can be applied in the assessment of RV performance.
Pseudopulmonary Artery Sling in a 22q11 Deletion Newborn with Tetralogy of Fallot and Isolated Left Subclavian Artery
Authors: Jan Sheng‐Ling , Tsai I.‐Chen , Ho Chi‐Ling , Lin Ming‐Chi , Fu Yun‐Ching
Published: October 2008

We report an interest and mystifying cardiovascular imaging in a 22q11 deletion neonate with rare congenital heart defects, including anomalous origin of the left pulmonary artery arising from the right pulmonary artery and in front of the trachea, called pseudo‐pulmonary artery sling, combined with isolated left subclavian artery confirmed by multidetector row computed tomography.
Echocardiographic Predictors of Change in Left Ventricular Diastolic Pressure in Heart Failure Patients Receiving Nesiritide
Authors: Weeks Sarah G. , Shapiro Mia , Foster Elyse , Michaels Andrew D.
Published: October 2008

Background: To evaluate the usefulness of currently accepted echocardiographic parameters of diastolic function to assess the acute change in left ventricular end‐diastolic pressure (LVEDP) following the administration of nesiritide in a heart failure population. Methods: In 25 heart failure patients (15 with systolic dysfunction, 10 with preserved ejection fraction [EF]), Doppler echocardiography, right and left heart catheterization, and invasive biventricular pressure hemodynamics were obtained at baseline and 30 minutes after nesiritide infusion. Results: Twenty‐four patients had sufficient echocardiographic images for analysis. The mean age was 60 ± 11 years, 48% were male, 56% had coronary artery disease, and 64% had hypertension. Right ventricular systolic pressure (RVSP) had the highest correlation with LV filling pressure: pulmonary capillary wedge pressure (PCWP), pre‐A wave LV, and LVEDP (r = 0.66, P = 0.0009; r = 0.63, P = 0.002; r = 0.72, P = 0.0002, respectively). Following nesiritide administration, the mean PCWP decreased from 17.1 ± 7.8 mmHg at baseline to 9.6 ± 6.2 mmHg (P < 0.001). Change in RVSP had the highest correlation with change in PCWP (r =−0.67, P = 0.10) and change in LVEDP (r =−0.71, P = 0.07). Conclusion: Echocardiographic parameters are frequently assessed in attempts to estimate left heart diastolic pressures. In heart failure patients, RVSP appears to be the best predictor of LVEDP, outperforming tissue Doppler E/E′. RVSP was found to be the best echocardiographic predictor of change in LV filling pressure with intravenous vasodilator therapy in heart failure patients. RVSP may provide a noninvasive means of assessing response to cardiac therapy.
An Unusual Cause of Stroke—the Importance of Saline Contrast Echocardiography
Authors: Tsang Wendy , Boulos Mark , Moody Alan R. , Sahlas Demetrios J. , Morgan Christopher D.
Published: October 2008

We report a case of a 38‐year‐old man who presented with a cryptogenic stroke in whom a persistent left superior vena cava (PLSVC) to the left atrium was established as an isolated anomaly by both echocardiography and magnetic resonance angiography. This rare cardiac abnormality creates a systemic right to left shunt and the potential for cerebral abscess or infarction. Echocardiographic diagnosis may be missed unless intravenous saline contrast is performed using a left upper extremity vein.
Echocardiographic Left Ventricular Mass in a Multiethnic Southeast Asian Population: Proposed New Gender and Age‐Specific Norms
Authors: Wong Raymond Ching‐Chiew , Yip James Wei‐Luen , Gupta Anuj , Yang Hong , Ling Lieng H.
Published: October 2008

Background: Left ventricular mass (LVM) is an independent risk factor for cardiovascular outcome. We aimed to define normal reference values of LVM/body surface area (BSA) in a multiethnic Southeast Asian population across ages, and define demographic parameters that predict LVM/BSA. Methods: 198 subjects (44% men, mean age 40 ± 14 years, 82% Chinese, 13% Malay and 5% Indian) with no cardiovascular comorbidity and had normal echo images for age were included in the analysis. Echo LVM was calculated as: 1.04 ×[(left ventricular internal diameter at end‐diastole {LVIDd}+ interventricular septal thickness at end‐diastole {IVSd}+ left ventricular posterior wall thickness at end‐diastole {LVPWd})3− LVIDd3× 0.8]+ 0.61, indexed by BSA (LVM/BSA)* and expressed as g/m2. Results: BSA and blood pressure (BP) were comparable between dichotomous age groups < or ≥ 50 years within the same gender. Women aged ≥ 50 years had larger IVSD, LVPWd, LVM and LVM/BSA compared to younger cohort. (p < 0.01 for all variables). The 95th percentile of LVM in men and women were 189 g and 148 g respectively; corresponding values for LVM/BSA were 106 and 96 g/m2. These values are consistently smaller than published values from the West. Age (r = 0.27, P < 0.001), gender (r =−0.30, P < 0.001), and systolic BP (r = 0.25, P = 0.003) were significant univariate predictors of LVM/BSA. Conclusion: We therefore propose a different cutoff value for the diagnosis of LV hypertrophy among Southeast Asians.
Live/Real Time Three‐Dimensional Transthoracic Echocardiographic Assessment of Pulmonary Regurgitation
Authors: Pothineni Koteswara R. , Wells Bryan J. , Hsiung Ming Chon , Nanda Navin C. , Yelamanchili Pridhvi , Suwanjutah Thouantosaporn , Prasad A.N. Ravi , Hansalia Sachin , Lin Chang‐Chyi , Yin Wei‐Hsian , Young Mason‐Shing
Published: October 2008

There is no gold standard for the measurement of pulmonary regurgitation (PR) severity. Two‐dimensional (2D) transthoracic echocardiography is most commonly used to quantify PR severity using color Doppler criteria for aortic regurgitation. However, this method is limited by visualization of only one or two dimensions of the proximal PR jet or vena contracta (VC) precluding accurate assessment of its shape or size. This limitation would be expected to be obviated by three‐dimensional (3D) transthoracic echocardiography, which could provide a more accurate quantitative assessment of PR severity. This study evaluated 82 adult patients with PR using 2D and 3D. PR VC area by 3D was obtained by planimetry by positioning the cropping plane exactly parallel to the VC, which was viewed en face by cropping of the 3D data set. Regurgitant volumes were calculated by 2D (assuming a circular VC) and by 3D as a product of the VC and velocity time integral obtained by color Doppler‐guided conventional Doppler interrogation of the PR jet.
The 3D VC area correlated with 2D jet width (JW)/right ventricular outflow tract (RVOT) width (r = 0.71) and 2D VC area (r = 0.79). 3D JW/RVOT width correlated with 2D JW/RVOT (r = 0.87). 3D regurgitant volumes also correlated with 2D regurgitant volumes (r = 0.76). The 3D VC values of <0.20, 0.20–0.45, 0.46–1.15, and >1.15 cm2 and regurgitant volumes of <15 ml, 15–50 ml, 51–115 ml, and >115 ml were effective as cutoffs for grades 1, 2, 3, and 4 PR, respectively. In conclusion, quantification of 3D VC area and regurgitant volumes correlate reasonably well with the current 2D methods for measurement of PR. Since 3D visualizes PR VC in three dimensions, it would be expected to provide a more accurate and more quantitative assessment of PR severity as compared to 2D.
A Heart Inside the Heart: Blood Cyst of Mitral Valve
Authors: López‐Pardo Francisco , López‐Haldón José , Granado‐Sánchez Carlos , Rodríguez‐Puras Maria Jose , Martínez‐Martínez Angel
Published: October 2008

We report a case of giant blood cyst originating from the anterior mitral valve leaflet, which was discovered during a two‐dimensional echocardiography examination performed for investigation of a systolic murmur in a 34‐year‐old healthy man. Three‐dimensional microbubble‐enhanced images showed a heart‐shape appearance that may be pathognomonic for blood cyst of the mitral valve.
Comparative Assessment of Left Atrial Appendage by Transesophageal and Combined Two‐ and Three‐Dimensional Transthoracic Echocardiography‡
Authors: Karakus Gultekin , Kodali Visali , Inamdar Vatsal , Nanda Navin C. , Suwanjutah Thouantosaporn , Pothineni Koteswara R.
Published: October 2008

Objective: Our objective was to compare the utility of combined two‐dimensional (2D) transthoracic echocardiography (TTE) and three‐dimensional (3D) TTE versus 2D transesophageal echocardiography (TEE) in evaluation of the left atrium (LA) and LA appendage (LAA) for clot. Background: 2DTEE, usually performed to visualize the LAA, is semi‐invasive and not without risks. With improved technology the LAA has been increasingly visualized by 2DTTE and 3DTTE in many patients. Methods: We compared combined 2DTTE and 3DTTE with 2DTEE in evaluating the LA/LAA for a thrombus. Ninety‐two patients underwent 2DTTE, 3DTTE, and 2DTEE. An additional 20 patients, in whom TEE could not be performed, underwent 2DTTE and 3DTTE. Results: LA and LAA could be visualized in all patients. Of 92 patients studied, 74 had no thrombus and 7 had thrombus in the LAA by all modalities. Eleven patients, 9 with atrial fibrillation (AF), had a suspected thrombus by 2DTEE, but 3DTTE cropping clearly showed these to be prominent pectinate muscles which were seen in short axis on 2DTEE as rounded echo dense masses and therefore mimicked thrombi. These 9 patients with AF underwent successful cardioversion without any complications. Of the 20 patients in whom TEE could not be performed, 19 had no thrombus in the LA/LAA and 1 had a clot in the LAA. These 19 patients underwent successful cardioversion without complications. Conclusions: Our preliminary study suggests that combined 2DTTE and 3DTTE has comparable accuracy to TEE in evaluating the LA and LAA for thrombus. In some patients TEE, but not 3DTTE, may misdiagnose pectinate musculature as thrombus.
Morphology and Small Subunit rDNA Gene Sequence of Pseudoamphisiella quadrinucleata n. sp. (Ciliophora, Urostylida) from the South China Sea
Authors: SHEN ZHUO , LIN XIAOFENG , LONG HONGAN , MIAO MIAO , LIU HONGBIN , AL‐RASHEID KHALED A. S. , SONG WEIBO
Published: October 2008

ABSTRACT. The urosylid genus Pseudoamphisiella was established by Song (1996) with hitherto only two known congeners. In the present work, the morphology and infraciliature of a new member, Pseudoamphisiella quadrinucleata n. sp., a form with conspicuous alveolar layer and four macronuclear nodules isolated from the coastal waters both near Hong Kong and near Guangzhou, South China were investigated using living observation and protargol silver impregnation methods. Pseudoamphisiella quadrinucleata differs from other two known forms mainly by the number of macronuclear nodules: constantly four vs. two in Pseudoamphisiella alveolata and 24–57 in Pseudoamphisiella lacazei. To support this, the sequence of the small subunit rDNA of P. quadrinucleata n. sp. showed 14 and 74 nucleotides in comparison with that of the two known congeners, respectively, which hence firmly supports the validity of the new species.
Mucocutaneous Splendore‐Hoeppli phenomenon
Authors: Hussein Mahmoud R.
Published: October 2008

Splendore‐Hoeppli phenomenon (asteroid bodies) is the in vivo formation of intensely eosinophilic material (radiate, star‐like, asteroid or club‐shaped configurations) around microorganisms (fungi, bacteria and parasites) or biologically inert substances. This study presents a literature review concerning Splendore‐Hoeppli reaction in the mucocutaneous diseases. It examines the histopathological features, nature and differential diagnosis of this reaction. It also discusses the mucocutaneous infections and the non‐infective diseases associated with it. Available studies indicate that several mucocutaneous infections can generate Splendore‐Hoeppli reaction. The fungal infections include sporotrichosis, pityrosporum folliculitis, zygomycosis, candidiasis, aspergillosis and blastomycosis. The bacterial infections include botryomycosis, nocardiosis and actinomycosis. The parasitic conditions include orbital pythiosis, strongyloidiasis, schistosomiasis and cutaneous larva migrans. In addition, Splendore‐Hoeppli reaction may be seen with non‐infective pathology such as hypereosinophilic syndrome and allergic conjunctival granulomas. The Splendore‐Hoeppli reaction material comprises antigen‐antibody complex, tissue debris and fibrin. Although the exact nature of this reaction is unknown, it is thought to be a localized immunological response to an antigen‐antibody precipitate related to fungi, parasites, bacteria or inert materials. The characteristic formation of the peribacterial or perifungal Splendore‐Hoeppli reaction probably prevents phagocytosis and intracellular killing of the insulting agent leading to chronicity of infection. To conclude, Splendore‐Hoeppli reaction is a tell tale of a spectrum of infections and reactive conditions. The molecular pathways involved in the development of this reaction are open for future investigations.
Urticaria associated with Norovirus infection: Report of two cases
Authors: Leiste Anke , Skaletz‐Rorowski Adriane , Venten Irene , Altmeyer Peter , Brockmeyer Norbert H.
Published: October 2008

Acute and chronic urticaria may be triggered by infection. Streptococci and Helicobacter pylori are the most frequent acute infectious causes. We present two cases in which we cultured Norovirus in the stool of patients with both acute and chronic urticaria. Noroviruses (genus Norovirus, family Caliciviridae) are a group of single stranded RNA, nonen‐veloped viruses which cause acute gastroenteritis in humans. Norovirus was recently approved as the official genus name for the group of viruses provisionally described as Norwalk‐like viruses (NLV). Therapy is symptomatic. Noroviruses should be regarded as possible infectious trigger for dermatologic diseases. In seeking a focus of viral or bacterial infection for skin diseases with unknown origin, stool cultures should be part of the routine evaluation.
Annular lichenoid dermatitis of youth – a further case in a 12‐year‐old girl
Authors: Kleikamp Stefanie , Kutzner Heinz , Frosch Peter J.
Published: October 2008

Annular lichenoid dermatitis of youth was first described by Annessi et al. in 2003. Clinical criteria are persistent erythematous macules and annular lesions with a red‐brown edge and a central hypopigmentation usually found on the flanks and groins of children and adolescents. Histologically, the disease is characterized by a lichenoid interface dermatitis with necrotic keratinocytes at the tip of the rete ridges. In our case a 12‐year old girl developed annular red‐brown macules with papules at the borders in an inframammary location. The histology of the lesion's border showed a lichenoid lymphocytic infiltrate with apoptotic keratinocytes at the tip of rete ridges. The lesions cleared with 0.03% tacrolimus ointment. Annular lichenoid dermatitis of youth is probably a new entity in the group of lichenoid dermatoses.
Dermatology – a surgical discipline – as exemplified by surgical procedures at the Hospital of Munich Thalkirchner Strasse
Authors: Kunte Christian , Pfützner Wolfgang , Kerschenlohr Karin , Konz Birger
Published: October 2008

Background: Despite the enormous progress in dermatosurgery during the last 35 years,this achievement is not always appropriately acknowledged by other surgical specialties.We outline the significance of dermatosurgery by looking at the development of dermatological operations at the Department of Dermatology,University of Munich/Hospital of Munich Thalkirchner Strasse. Patients and Methods: Data were collected and analyzed from surgery records, tables and from the SAP ISH‐Med.The survey covered the time frame from 1971 to 2006.

Results:There were 101,103 inpatient operations.The number of operations per year increased steadily,especially the number of medium‐sized and large operations.A special domain of dermatosurgery is the sentinel lymph node biopsy in patients with malignant melanoma. In the last years, there was a continuous increase of patients in whom more than one tumor had to be excised.The percentage of patients undergoing dermatosurgery was constant at 46% of all inpatients. Conclusions: The surgical therapy of skin tumors is the most important part of inpatient treatment of dermatology patients. The development of dermatosurgery shows that due to the increase of skin tumors and the opening of new fields of activity (for example the removal of sentinel lymph nodes) there is a growing demand for dermatological surgeons. Solid training and competent representation in dermatology and attention to our interactions with other surgical specialties will help guarantee optimal patient care in the future.
Proactive therapy of atopic eczema –an evidence‐based concept with a behavioral background
Authors: Wollenberg Andreas , Frank Reiner , Kroth Julia , Ruzicka Thomas
Published: October 2008

Atopic eczema is a highly pruritic, chronic inflammatory skin disease with a high socioeconomic burden. Different individually relevant exacerbating factors influence the clinical course of the disease. Current therapeutic paradigms call for maintaining or enhancing the epidermal barrier by continuous emollient therapy, which is combined with anti‐inflammatory topical treatment applied to all affected areas as they appear.

An alternative approach is proactive therapy, which involves long‐term, low‐dose intermittent topical anti‐inflammatory therapy for previously affected areas with subclinical inflammation. The immunodermatological background to this approach is the ongoing epidermal barrier dysfunction, the residual inflammatory skin infiltrate and the persistent immunological abnormalities which are all present but clinically invisible.

This manuscript summarizes the immunodermatological and behavioral background, the study data of controlled clinical trials and our personal experience in a special atopic dermatitis clinic. The clinical advantages of proactive therapy are fewer exacerbations, an improved quality of life and – in severe cases – lower treatment costs.
Seborrheic keratosis
Authors: Hafner Christian , Vogt Thomas
Published: October 2008

Seborrheic keratosis is one of the most common skin tumors. Because this tumor is benign, treatment is not mandatory. However, the lesions are often removed especially for cosmetic reasons. Despite its frequency, many aspects of seborrheic keratosis remain elusive. In the last years new molecular genetic insights into seborrheic keratoses have been gained. The current knowledge about seborrheic keratosis with respect to epidemiology, pathogenesis, diagnosis and therapy is summarized.
Sun protection by red wine?
Authors: Moehrle Matthias , Dietrich Helmut , Patz Claus Dieter , Häfner Hans‐Martin
Published: October 2008

Background: There is increasing evidence that polyphenols, antioxidants from plants such as green tea or grapes, may impair the UV‐induced erythema reaction as well as carcinogenesis and metastasis of melanoma and epithelial skin cancer. The UVB‐protective potential of wine polyphenols has not been studied so far in humans.

Patients and Methods: We tested the influence of local and systemic application of three red wines on the minimal erythema dose (MED) after UVB exposure in 15 healthy male physicians. Baseline MED were determined in all subjects. Irradiation was carried out prior to and immediately following 20 minutes of occlusive application of red wine as well as 12 % alcohol to the back. The systemic effect was tested by ultraviolet irradiation immediately prior to oral intake,

Results: There were no topical effects. Wine A also provided no protection sys‐temically. Drinking wine B has led to an almost significant rise of MED, while wine C, which had the highest polyphenol content, produced a statistically significant higher MED (p = 0.031).

Conclusions: “Wine baths” will not have sun protective properties. A significant rise of the MED following oral intake of the wine with the highest polyphenol content might be due to these substances. Further research is needed to clarify the role of polyphenol content, dose and duration of wine consumption.
Quality of psoriasis care in Germany – results of the national study PsoHealth 2007
Authors: Augustin Matthias , Reich Kristian , Reich Christine , Purwins Sandra , Jeff Rustenbach Stephan , Schäfer Ines , Radtke Marc
Published: October 2008

Background: Many different forms of treatment are available for psoriasis. The German standard is the national AWMF S3 guideline. A national survey on psoriasis care in 2005 indicated deficits in psoriasis care in Germany.

Aim: Assessment of the health care situation of patients with psoriasis in Germany.

Methods: Nation‐wide cross‐sectional study, in 142 dermatological practices and clinics. The following data were documented: a) Doctor Questionnaire: Treatment, illnesses, clinical characteristics and severity (PASI). b) Patient Questionnaire: Quality of life (QoL), patient relevant therapeutic benefits and satisfaction with the quality of the care. A panel of experts developed and analyzed 8 criteria as indicators of the quality of care.

Results: Of the 2009 evaluated patients, 11.6% suffered from severe psoriasis (PASI > 20) and 27.4% from moderate psoriasis (PASI 10–20). The average PASI value was 10.1, and the DLQI 7.5. 32.2% of patients had a serious reduction in their QoL (DLQI > 10). The share of patients with preceding systemic therapy was 47.3%, in severe psoriasis 62.1%, while 20.1% of the patients had received inpatient treatment. The average number of days absent from work was 3.4. Compared to 2005, all 8 indicators improved.

Conclusion: Significant numbers of psoriasis patients show serious quality of life reductions and high grades of clinical severity. In comparison to 2005, there has been a notable, nation‐wide improvement in psoriasis care.
Human polyomaviruses and cancer: expanding repertoire
Authors: Moens Ugo , Johannessen Mona
Published: October 2008

Polyomaviruses were originally isolated in mouse and in monkey (SV40) about 50 years ago. In 1971, the first human polyomaviruses BK and JC were isolated and subsequently demonstrated to be ubiquitous in the human population. Recent studies have shown that SV40 can spread between humans and led to the identification of three new human polyomaviruses (KIPyV, MCPyV, and WUPyV). BKV, JCV, and SV40 appear harmless in healthy individuals, but possess pathogenic properties in immunosuppressed patients. Moreover they may play an etiological role in human malignancies. Epidemiologic and pathogenic studies of KIPyV, MCPyC, and WUPyV are limited so far, but MCPyV may be associated with Merkel cell carcinoma, a rare but aggressive neuroendocrine skin cancer. We describe the biology of human polyomaviruses, review their non‐malignant and malignant potentials, and discuss the mechanisms by which these viruses may contribute to transformation.
Are obsessive‐compulsive disorders and personality disorders sufficiently considered in occupational dermatoses? A discussion based on three case reports
Authors: Shab Arna , Matterne Uwe , Diepgen Thomas L. , Weisshaar Elke
Published: October 2008

Hand dermatitis is relatively common in the general population. Among work‐related diseases, it is the most common form of occupational skin disease. Irritant hand dermatitis is the most frequent type. Besides wet work and direct contact to irritating occupational substances frequent hand washing can damage the barrier function of the skin facilitating the manifestation of hand dermatitis that frequently occurs chronically. According to own observations the role of obsessive‐compulsive washing as part of an anxiety disorder or personality disorders may not be considered sufficiently. A possible pathogenetic relation between hand dermatitis and psychogenic disorders is discussed in a 22‐year old physician's assistant, a 50‐year old male nurse working in intensive care, and a 54‐year old cleaner. All three patients complained about feelings of revulsion, fear of contamination and a high frequency of hand washing. These cases may encourage dermatologists to consider psychological aspects of hand dermatitis e.g. obsessive compulsive washing, overcome their inhibitions and consider these aspects in an integrated way when planning patient's therapy.
Fractional laser skin therapy
Authors: Bodendorf Marc Oliver , Grunewald Sonja , Wetzig Tino , Simon Jan C. , Paasch Uwe
Published: October 2008

Modern treatment of chronically photodamaged skin provides new, minimally invasive methods for laser intervention, using fractional, non‐ablative thermal energy for an induction of dermal remodeling. The clinical efficacy coupled with a minimum "down time" for the patient has directed the development of fractional ablative laser systems. Recently introduced systems are based on C02and heated Er:YAG laser systems. The clinical efficacy has been tested on one prototype each and verified their effects at a microscopic level. Initial reports suggest the results are comparable to those achieved with fractional ablative systems. We review the current possibilities incorporating our personal experience. Systematic investigations of clinical outcomes with various system settings are still needed. The possible combination of ablative and non‐ablative fractional technology may also lead to increased efficacy and safety of the procedure.