bluuebunny/crossref_metadata_2025 huggingface dataset:
Late cyst formation following gamma knife surgery of arteriovenous malformations
Authors: Pan Hung-Chuan , Sheehan Jason , Stroila Matei , Steiner Melita , Steiner Ladislau
Published: May 2009

Object.The authors present data concerning the development of cysts following gamma knife surgery (GKS) in 1203 consecutive patients with arteriovenous malformations (AVMs) treated by the senior author (L.S.). The cyst was defined as a fluid-filled cavity at the site of a treated AVM. Cases involving regions corresponding to previous hematoma cavities were excluded. The incidence of cyst formation was assessed using magnetic resonance imaging studies performed in 196 cases with more than 10 years of follow up, in 332 cases with 5 to 10 years of follow up, and in 675 cases with less than 5 years of follow up. One hundred five cases were lost to follow-up study. The Cox regression method was used to analyze the factors related to cyst formation.

Methods.The incidence of cyst formation in the entire patient population was 1.6 and 3.6% in those undergoing follow-up examination for more than 5 years. Ten of 20 cysts developed between 10 to 23 years, nine between 5 to 10 years, and one in less than 5 years following the treatment. Cyst fluid aspiration, cystoperitoneal shunt placement, or craniotomy were used in three symptomatic cases. Analysis of age, sex, and treatment parameters yielded no significant relationship with cyst formation; however, radiation-induced tissue change following GKS (p = 0.027) and prior embolization (p = 0.011) were related to cyst formation.

Conclusions.Overall, the incidence of cyst formation in patients who underwent GKS for AVM was 1.6%. The development of the cyst was related to the duration of the follow-up period. When cysts are symptomatic, surgical intervention should be performed.
Power Doppler imaging in detection of surgically induced indirect neoangiogenesis in adult moyamoya disease
Authors: Perren Fabienne , Horn Peter , Vajkoczy Peter , Schmiedek Peter , Meairs Stephen
Published: May 2009

Object. Moyamoya is a rare, chronic disease that leads to the progressive narrowing and/or occlusion of the distal internal carotid and proximal cerebral arteries. Chronic cerebral ischemia ensues due to insufficient collateral blood supply. One potential treatment consists of the restoration of regional cerebral blood flow by direct or indirect revascularization surgery. The extent of neovascularization, especially in indirect procedures such as encephalomyosynangiosis (EMS), is currently evaluated with conventional angiography. Because this method is invasive and carries some risks, the authors investigated power Doppler imaging as an alternative noninvasive bedside procedure that can be used to assess surgically induced indirect revascularization in adult patients with moyamoya disease.

Methods. Twelve symptomatic patients with adult moyamoya disease (seven women and five men, mean age 38 ± 17 years) underwent combined (direct and indirect) revascularization. They were then examined using conventional angiography and power Doppler imaging to assess the extent of revascularization within 120 days postsurgery. According to the number of intracranial vessels demonstrating opacification on conventional angiography and power Doppler imaging studies, EMS was graded as follows: 1, absent (0 vessels); 2, moderate (one—four vessels); and 3, extensive (> four vessels) for both methods. Examiners were blinded to the classification results for the procedure that they did not grade.

All 24 hemispheres were examined. The visual grading of EMS revealed a highly significant agreement between conventional angiography and power Doppler imaging (Spearman rank coefficient, r = 0.92; p < 0.001) and there was 100% agreement of patency of the bypass between the direct and indirect methods.

Conclusions. The authors found excellent agreement between the two methods. Therefore, power Doppler imaging is a valid noninvasive alternative to carotid artery angiography in evaluating direct and indirect revascularization.
Flow changes caused by the sequential placement of stents across the neck of sidewall cerebral aneurysms
Authors: Cantón Gádor , Levy David I. , Lasheras Juan C. , Nelson Peter K.
Published: May 2009

Object. The goal of this study was to quantify the reduction in velocity, vorticity, and shear stresses resulting from the sequential placement of stents across the neck of sidewall cerebral aneurysms.

Methods. A digital particle image velocimetry (DPIV) system was used to measure the pulsatile velocity field within a flexible silicone sidewall intracranial aneurysm model and at the aneurysm neck–parent artery interface in this model. The DPIV system is capable of providing an instantaneous, quantitative two-dimensional measurement of the velocity vector field of “blood” flow inside the aneurysm pouch and the parent vessel, and its changes at varying stages of the cardiac cycle. The corresponding vorticity and shear stress fields are then computed from the velocity field data. Three Neuroform stents (Boston Scientific/Target), each with a strut thickness between 60 and 65 µm, were subsequently placed across the neck of the aneurysm model and measurements were obtained after each stent had been placed.

The authors measured a consistent decrease in the values of the maximal averaged velocity, vorticity, and shear stress after placing one, two, and three stents. Measurements of the circulation inside the sac demonstrated a systematic reduction in the strength of the vortex due to the stent placement. The decrease in the magnitude of the aforementioned quantities after the first stent was placed was remarkable. Placement of two or three stents led to a less significant reduction than placement of the first stent.

Conclusions. The use of multiple flexible intravascular stents effectively reduces the strength of the vortex forming in an aneurysm sac and results in a decrease in the magnitude of stresses acting on the aneurysm wall.
Nerve regeneration across a 2-cm gap in the rat median nerve using a resorbable nerve conduit filled with Schwann cells
Authors: Sinis Nektarios , Schaller Hans-Eberhard , Schulte-Eversum Caterina , Schlosshauer Burkhard , Doser Michael , Dietz Klaus , Rösner Harald , Müller Hans-Werner , Haerle Max
Published: May 2009

Object. In a rat model, nerve regeneration was evaluated across a 2-cm defect in the median nerve by using a resorbable artificial nerve conduit. The aim of this study was to develop an artificial, biocompatible nerve guide to induce regeneration in the peripheral nervous system.

Methods. The authors compared a nerve conduit of trimethylenecarbonate-co-epsilon-caprolactone (TMC/CL) filled with autologous Schwann cells with both an empty hollow conduit and an autologous nerve graft. Animals that did not undergo surgery served as the control group. Nerve regeneration was evaluated with the grasping test, histological analysis of the nerve, muscle weight analysis (flexor digitorum superficialis muscle), and electrophysiological examination.

After an observation period of 9 months, regeneration occurred only in animals that had received an autologous graft or a Schwann cell containing nerve conduit. No signs of regeneration were found in animals supplied with the empty conduit.

Conclusions. Results of this study reveal the important role of Schwann cells in the regeneration process across a 2-cm defect in the rat median nerve. Furthermore, Schwann cell—filled nerve conduits induced functional recovery, as demonstrated in the grasping test, that was comparable with that of the autologous graft 9 months after implantation.
Camptocormia in a patient with Parkinson disease: beneficial effects of pallidal deep brain stimulation
Authors: Micheli Federico , Cersósimo María G. , Piedimonte Fabian
Published: May 2009

✓ Camptocormia is a well-known feature in cases of Parkinson disease (PD), and is usually unresponsive to dopaminergic therapy. A 62-year old man with a long history of PD and severe progressive camptocormia underwent bilateral pallidal stimulation. During the next 6 months a sustained improvement in trunk flexion was observed. After 14 months of follow up, the patient's trunk flexion is almost normal.
Fat Intake Influences the Effect of the Hepatic Lipase C-514T Polymorphism on HDL-Cholesterol Levels in Children
Authors: Riestra Pía , López-Simón Laura , Ortega Henar , Gorgojo Lydia , Martin-Moreno José M. , Schoppen Stefanie , de Oya Manuel , Garcés Carmen
Published: May 2009

Polymorphisms in the hepatic lipase gene have been associated with variability in plasma HDL-C concentrations, but contradictory results have been reported regarding the effect of diet on this association in adults. In our study, we examined whether dietary fat intake modified the association between lipid levels and the C-514T polymorphism in the hepatic lipase gene (LIPC C-514T) in prepubescent children. The LIPC C-514T polymorphism was determined by PCR and restriction analysis in 1260 healthy school children, aged 6–8. Information on the children’s nutrient intake was obtained by means of a validated food frequency questionnaire. We found that regardless of gender, carriers of the minor allele had significantly higher apo A-I levels compared to noncarrier subjects. The effect of the polymorphism, however, was modified by dietary fat intake. In boys, the presence of the LIPC C-514T polymorphism was associated with significantly higher HDL-C among children within the highest tertiles of total, saturated, monounsaturated, or polyunsaturated fat intake. Apo A-I levels were significantly higher in carriers of the LIPC C-514T polymorphism, but only among boys who consumed high total as well as monounsaturated fat and among girls who consumed high total, saturated, monounsaturated, and polyunsaturated fat. Our data show that dietary fat intake modifies the effect of the LIPC C-514T polymorphism on plasma HDL-C and apo A-I levels in prepubescent children, being associated with higher levels of HDL-C and apo A-I only when fat intake is high. This significant gene-nutrient interaction could help to explain inter-individual variations in the plasma lipid response to fat intake.
Effects of Potassium Channel Blockers on Changes in Refractoriness of Atrial Cardiomyocytes Induced by Stretch
Authors: Qi Jie , Xiao Junjie , Zhang Yangyang , Li Jun , Liu Ying , Li Pengjuan , Liang Lei , Jiang Bing , Wen Wei , Zhao Cuimei , Liang Dandan , Liu Yi , Chen Yi-Han
Published: May 2009

Shortening of the effective refractory period (ERP) is regarded as one of the key mechanisms of atrial fibrillation (AF). Stretch is an important predisposing factor in the pathogenesis of AF. However, effective methods to counteract alteration of ERP induced by stretch still need to be explored. Although potassium channels play important roles in cardiac repolarization and refractoriness, the effects of potassium channel blockers on the alteration of repolarization and refractoriness induced by stretch are still unknown. Action potential duration (APD) and ERP were recorded using the standard intracellular microelectrode technique in the left atrial appendage cardiomyocytes of guinea pigs. Stretch accelerated repolarization of atrial cardiomyocytes and also shortened the ERP ( P < 0.05). Dofetilide, a rapid delayed rectifying potassium ion channel (IKr) blocker; 4-AP, a transient outward potassium ion channel (Ito) blocker; and BaCl2, an inward rectifying potassium ion channel (IK1) blocker could counteract the shortening of APD and ERP ( P < 0.01). Glibenclamide, an ATP-sensitive potassium ion channel (IKATP) blocker; 293-B, a slow delayed rectifying potassium channel (IKs) blocker; and DPO-1, an ultra-rapid delayed rectifying potassium ion channel (IKur) blocker all had no effect on APD and ERP ( P > 0.05). Stretch could accelerate repolarization of atrial cardiomyocytes and shorten their ERP, and the Ito, IKr, and IK1 blockers could counteract the effects of stretch.
Effects of positive reinforcement training techniques on the psychological welfare of zoo‐housed chimpanzees (Pan troglodytes)
Authors: Pomerantz Ori , Terkel Joseph
Published: May 2009

Captive environments encompass various factors that can elevate stress levels and jeopardize the wellbeing of the captive animals. The use of positive reinforcement training (PRT) techniques enables researchers and caretakers to reduce tension directly associated with potentially stressful procedures and states. The current study tested the general effect of PRT on the wellbeing of zoo‐housed chimpanzees (Pan troglodytes) by measuring behaviors that reflect poor and good welfare and that were not directly connected to the specific aim of the training session. The behavior of a group of twelve chimpanzees was measured throughout the day from the exhibition yard, at baseline (12 weeks) and during the PRT period (10 weeks). The results show a significant decrease in abnormal and stress‐related behaviors and a significant rise in prosocial affiliative behaviors following implementation of the training program. The training was shown to have a greater positive effect on low‐ranking individuals compared with high‐ranking ones. This research shows for the first time that PRT offers an enrichment effect whose general influence lasts throughout the day, irrespective of any direct link to a specific trained behavior. Consequently, it can be claimed that PRT presents an effective enrichment tool that can be implemented with captive animals. Because of the above‐noted differential effect between high‐ and low‐ranking chimpanzees, however, this should be taken into consideration when combining PRT with the non‐human primates' daily routine. Am. J. Primatol. 71:687–695, 2009. © 2009 Wiley‐Liss, Inc.
Spring committee events and doings
Authors: Bleemer Russ
Published: May 2009

A roundup report on eight CPR Institute committees; details on the Master Mediator online, for CLE credit; and the lowdown on next month's kickoff event for the CPR Institute's new YADR Group, which will bring attorneys 45 and younger together for ADR networking events.
A ‘sea change’ for collective bargaining as the U.S. Supreme Court permits unions to agree to arbitration for discrimination claims
Authors: Walsh Christopher
Published: May 2009

Last month's U.S. Supreme Court decision in 14 Penn Plaza LLC v. Pyett may signal a big change in the skills needed by labor arbitrators, according to Christopher Walsh, of Newark, N.J. He analyzes the case and tells readers what to expect as a result of Justice Clarence Thomas's majority opinion.
Ventricular dilation: Association with gait and cognition
Authors: Palm Walter M. , Saczynski Jane S. , van der Grond J. , Sigurdsson Sigurdur , Kjartansson Olafur , Jonsson Palmi V. , Eiriksdottir Gudny , Gudnason Vilmundur , Admiraal‐Behloul Faiza , Launer Lenore J. , van Buchem Mark A. ,   Age, Gene/Environment Susceptibility–Reykjavik Study
Published: May 2009

Objective

Normal pressure hydrocephalus is characterized by gait impairment, cognitive impairment, and urinary incontinence, and is associated with disproportionate ventricular dilation. Here we report the distribution of ventricular volume relative to sulcal cerebrospinal fluid (CSF) volume, and the association of increasing ventricular volume relative to sulcal CSF volume with a cluster of gait impairment, cognitive impairment, and urinary incontinence in a stroke‐free cohort of elderly persons from the general population.

Methods

Data are based on 858 persons (35.4% men; age range, 66–92 years) who participated in the Age, Gene/Environment Susceptibility–Reykjavik Study. Gait was evaluated with an assessment of gait speed. Composite scores representing speed of processing, memory, and executive function were constructed from a neuropsychological battery. Bladder function was assessed with a questionnaire. Magnetic resonance brain imaging was followed by semiautomated segmentation of intracranial CSF volume. White matter hyperintensity (WMH) volume was assessed with a semiquantitative scale. For the analysis of ventricular dilation relative to the sulcal spaces, ventricular volume was divided by sulcal CSF volume (VV/SV).

Results

Disproportion between ventricular and sulcal CSF volume, defined as the highest quartile of the VV/SV z score, was associated with gait impairment (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.1–3.3) and cognitive impairment (OR, 1.8; 95% CI, 1.1–3.0). We did not find an association between the VV/SV z score and bladder dysfunction.

Interpretation

The prevalence and severity of gait impairment and cognitive impairment increases with ventricular dilation in persons without stroke from the general population, independent of WMH volume. Ann Neurol 2009;66:485–493
Propagation of spreading depression inversely correlates with cortical myelin content
Authors: Merkler Doron , Klinker Florian , Jürgens Tanja , Glaser Raoul , Paulus Walter , Brinkmann Bastian G. , Sereda Michael W. , Stadelmann‐Nessler Christine , Guedes Rubem C. A. , Brück Wolfgang , Liebetanz David
Published: May 2009

Objective

Cortical myelin can be severely affected in patients with demyelinating disorders of the central nervous system. However, the functional implication of cortical demyelination remains elusive. In this study, we investigated whether cortical myelin influences cortical spreading depression (CSD).

Methods

CSD measurements were performed in rodent models of toxic and autoimmune induced cortical demyelination, in neuregulin‐1 type I transgenic mice displaying cortical hypermyelination, and in glial fibrillary acidic protein–transgenic mice exhibiting pronounced astrogliosis.

Results

Cortical demyelination, but not astrogliosis or inflammation per se, was associated with accelerated CSD. In contrast, hypermyelinated neuregulin‐1 type I transgenic mice displayed a decelerated CSD propagation.

Interpretation

Cortical myelin may be crucially involved in the stabilization and buffering of extracellular ion content that is decisive for CSD propagation velocity and cortical excitability, respectively. Our data thus indicate that cortical involvement in human demyelinating diseases may lead to relevant alterations of cortical function. Ann Neurol 2009;66:355–365
Zinc‐Mediated Formation of Trifluoromethyl Ethers from Alcohols and Hypervalent Iodine Trifluoromethylation Reagents
Authors: Koller Raffael , Stanek Kyrill , Stolz Daniel , Aardoom Raphael , Niedermann Katrin , Togni Antonio
Published: May 2009

Schieb mal rüber: Der Transfer einer intakten Trifluormethylgruppe von einem hypervalenten Iodreagens zu einem aliphatischen Alkohol verläuft glatt bei einer Aktivierung durch Zinkbis(triflimid). Dies ist eine einfache Methode zur Synthese von Trifluormethoxyalkyl‐Derivaten, die sonst nur schwer zugänglich sind.

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Stereodivergent Synthesis of 17‐α and 17‐β‐Aryl Steroids: Application and Biological Evaluation of D‐Ring Cortistatin Analogues
Authors: Shi Jun , Shigehisa Hiroki , Guerrero Carlos A. , Shenvi Ryan A. , Li Chuang‐Chuang , Baran Phil S.
Published: May 2009

Ein Stereozentrum macht den Unterschied: Eine Synthese von 17‐epi‐Cortistatin A geht von einem Biosyntheseintermediat von natürlichem Cortistatin A aus. Die Methode zeichnet sich durch eine stereokontrollierte Reduktion mit Raney‐Nickel aus, die Steroide mit sowohl α‐ als auch β‐konfiguriertem D‐Ring gezielt zugänglich macht. Erstmals wird über biologische Tests dieser „Cortaloge“ berichtet.

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Discovery of Heteroatom‐“Embedded” Te⊂{W18O54} Nanofunctional Polyoxometalates by Use of Cryospray Mass Spectrometry
Authors: Yan Jun , Long De‐Liang , Wilson Elizabeth F. , Cronin Leroy
Published: May 2009

The cryo game: Heteroatom‐embedded nanofunctional clusters are described that incorporate a [TeVIO6]6− species contained within a {W18O54} cage. Not only does the tellurium‐based species activate the {W18O54} cluster surface for assembly of larger nanoscale structures, such as [H10TeVI2W58O198]26−, it also undergoes a redox transformation inside the cluster from [TeVIO6]6− to [TeIVO3]2−.

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Cervical Carotid and Circle of Willis Arterial Anatomy of Macaque Monkeys: A Comparative Anatomy Study
Authors: Kumar Nishant , Lee John J. , Perlmutter Joel S. , Derdeyn Colin P.
Published: May 2009

Macaque monkeys are used in many research applications, including cerebrovascular investigations. However, detailed catalogs of the relevant vascular anatomy are scarce. We present our experience with macaque vessel patterns as determined by digital subtraction angiography of 34 different monkeys. We retrospectively analyzed digital subtraction angiograms obtained during experimental internal carotid artery (ICA) catheterization and subsequent injection of 1‐methyl 4‐phenyl 1,2,3,6‐tetrahydropyridine. Results were catalogued according to vascular distribution and variants observed. Macaque monkeys have a bovine aortic arch. The carotid vessels generally bifurcate, but are occasionally observed to divide into three vessels. The external carotid gives rise primarily to two trunks: an occipital branch and a common vessel that subsequently gives off the lingual, facial, and superior thyroid arteries. The internal maxillary artery may be present as a terminal branch of the external carotid or as a branch of the occipital artery. The ICA is similar in course to that of the human. The anterior circle of Willis was intact in all monkeys in our study. Its primary difference from that of the human is the union of the bilateral anterior cerebral arteries as a single (azygous) median vessel. Macaque cervical carotid and circle of Willis arterial anatomy differs from humans in a couple of specific patterns. Knowledge of these differences and similarities between human and macaque anatomy is important in developing endovascular macaque models of human diseases, such as ischemic stroke. Anat Rec, 2009. © 2009 Wiley‐Liss, Inc.
Anatomy education in a changing medical curriculum in India: Medical student feedback on duration and emphasis of gross anatomy teaching
Authors: Holla Sunil Jonathan , Ramachandran Kalpana , Isaac Bina , Koshy Shajan
Published: May 2009

Authors report here a survey of medical student feedback on the effectiveness of two different anatomy curricula at Christian Medical College, Vellore, India. Undergraduate medical students seeking the Bachelor in Medicine and Bachelor in Surgery (M.B.B.S.) degrees were divided into two groups by the duration of their respective anatomy curriculum. Group 1 students had completed a longer, 18‐month curriculum whereas Group 2 counterparts followed a shorter, 12‐month curriculum. Students' responses to a questionnaire were studied. Analysis of feedback from Groups 1 and 2 contrasted the effectiveness of the two anatomy curricula. The coverage of gross anatomy was rated adequate or more than adequate by 98% of Group 1 and 91% of Group 2. A desire for greater emphasis on gross anatomy teaching was expressed by 24% of Group 1 and 50% of Group 2 (P = 0.000). Two‐thirds of all students felt that the one‐year program was not adequate, and 90% of Group 1 and 74% of Group 2 felt that clinically oriented anatomy teaching required more emphasis. Dissection was helpful or very helpful for 94% of Group 1 and 88% of Group 2. This study suggests that a better understanding of gross anatomy was gained from a course of longer duration (18 months with 915 contact hr vs. 12 months with 671 contact hr). Students who completed the longer anatomy course had greater appreciation of the need for clinically oriented anatomy teaching and dissection. Anat Sci Educ 2:179–183, 2009. © 2009 American Association of Anatomists.
Training tomorrow's anatomists today: A partnership approach
Authors: Fraher John P. , Evans Darrell J.R.
Published: May 2009

Anatomy is recognized to play a central role in the education and training of clinicians, healthcare professionals, and scientists. However, in recent years, the perceived decline in popularity of anatomy has led to a deficiency in the numbers of new anatomy educators. The tide is now turning with anatomy once again taking its rightful place in a wide of variety of disciplines, and therefore it is imperative that a new generation of anatomists is in place to meet this need. In response, the Anatomical Society of Great Britain and Ireland has made the training of the next set of anatomists, one of its strategic priorities, and in collaboration with the American Association of Anatomists has developed a dedicated Training Program. The overall aim of the Program is to provide trainees with the necessary knowledge, understanding, aptitudes, and attitudes in appropriate detail, sufficient to enable them to teach and examine Anatomy with full competence at the undergraduate and postgraduate level. The Program offers opportunities to consolidate knowledge and deepen understanding of anatomy, improve skills in teaching and communication with students, and be competent in preparing teaching materials and assessment modalities. The Program uses a distance‐learning approach with an incorporated Residential School and is particularly aimed at those undertaking a career in the biosciences. Early indications suggest that initiatives such as the development of this Training Program will help deliver the next generation of anatomists and ensure that anatomy continues to play a fundamental role in the education of clinicians, healthcare professionals, and scientists. Anat Sci Ed 2:119‐125, 2009 © 2009 American Association of Anatomists.
Biospecific protein immobilization for rapid analysis of weak protein interactions using self‐interaction nanoparticle spectroscopy
Authors: Bengali Aditya N. , Tessier Peter M.
Published: May 2009

“Reversible” protein interactions govern diverse biological behavior ranging from intracellular transport and toxic protein aggregation to protein crystallization and inactivation of protein therapeutics. Much less is known about weak protein interactions than their stronger counterparts since they are difficult to characterize, especially in a parallel format (in contrast to a sequential format) necessary for high‐throughput screening. We have recently introduced a highly efficient approach of characterizing protein self‐association, namely self‐interaction nanoparticle spectroscopy (SINS; Tessier et al., 2008; J Am Chem Soc 130:3106–3112). This approach exploits the separation‐dependent optical properties of gold nanoparticles to detect weak self‐interactions between proteins immobilized on nanoparticles. A limitation of our previous work is that differences in the sequence and structure of proteins can lead to significant differences in their affinity to adsorb to nanoparticle surfaces, which complicates analysis of the corresponding protein self‐association behavior. In this work we demonstrate a highly specific approach for coating nanoparticles with proteins using biotin–avidin interactions to generate protein–nanoparticle conjugates that report protein self‐interactions through changes in their optical properties. Using lysozyme as a model protein that is refractory to characterization by conventional SINS, we demonstrate that surface Plasmon wavelengths for gold–avidin–lysozyme conjugates over a range of solution conditions (i.e., pH and ionic strength) are well correlated with lysozyme osmotic second virial coefficient measurements. Since SINS requires orders of magnitude less protein and time than conventional methods (e.g., static light scattering), we envision this approach will find application in large screens of protein self‐association aimed at either preventing (e.g., protein aggregation) or promoting (e.g., protein crystallization) these interactions. Biotechnol. Bioeng. 2009; 104: 240–250 © 2009 Wiley Periodicals, Inc.
Health-related quality of life assessment after breast reconstruction
Authors: Potter S , Thomson H J , Greenwood R J , Hopwood P , Winters Z E
Published: May 2009

Background

Health-related quality of life (HRQL) is an important outcome following breast reconstruction. This study evaluated current methods of HRQL assessment in patients undergoing latissimus dorsi breast reconstruction, hypothesizing that early surgical morbidity would be reflected by poorer HRQL scores.

Methods

Patients completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and breast module (QLQ-BR23), the Functional Assessment of Cancer Therapy (FACT) general measure, and breast module and arm subscale (FACT-B + 4), and the Body Image Scale and Hospital Anxiety and Depression Scale (HADS) 3 months after surgery. They also reported additional HRQL problems not included in the questionnaires. HRQL scores were compared between patients with and without early surgical morbidity.

Results

Sixty women completed the questionnaires, of whom 25 (42 per cent) experienced complications. All EORTC and FACT subscale and HADS scores were similar in patients with or without morbidity. Women with complications were twice as likely to report feeling less feminine and dissatisfied with the appearance of their scar than those without problems. Thirty-two women (53 per cent) complained of problems not covered by the questionnaires, most commonly donor-site morbidity.

Conclusion

Existing HRQL instruments are not sufficiently sensitive to detect clinically relevant problems following breast reconstruction.
Outcome of surgical treatment for fistula in ano in Crohn's disease
Authors: van Koperen P J , Safiruddin F , Bemelman W A , Slors J F M
Published: May 2009

Background

Recurrence rates and long-term functional outcome after surgical treatment of anal fistula in Crohn's disease were assessed.

Methods

A consecutive series of patients was treated for Crohn's fistula in ano; those without proctitis or active sepsis underwent surgery. Sex, seton usage, infliximab, previous fistula surgery, history of segmental resection and smoking were examined as risk factors for recurrence. Continence was assessed by Vaizey scale and a colorectal Functional outcome questionnaire. Results were compared with institutional data for cryptoglandular fistulas.

Results

Sixty-one patients were included, with a median follow-up of 79 (range 13–140) months. Twenty-four patients were treated with a seton, 28 by fistulotomy and nine by mucosal advancement. For low fistulas, fistulotomy was used more frequently than the seton, whereas seton drainage was used for most higher fistulas. Recurrence occurred in five of 28 and five of nine patients after fistulotomy and advancement respectively. Soiling was reported by half of the patients treated by seton versus two-thirds and three-quarters of those treated by fistulotomy and advancement respectively. Functional outcomes were worse for all patient groups than for cryptoglandular fistulas. No risk factor was significant.

Conclusion

Surgical outcome for high or complex Crohn's fistula in ano remains disappointing, and recurrence is unpredictable.
Colonic lymphoid follicles and NOD2/CARD15 mutational status in Crohn's disease
Authors: Nascimbeni R , Villanacci V , Bassotti G , Fisogni S , Gervasi M , Rossi E , Di Lorenzo D
Published: May 2009

Background

Interactions between the colonic lymphoid system and the genetic background in Crohn's disease are unexplored. This study analysed variations of colonic lymphoid follicles (CLFs) according to the nucleotide-binding oligomerization domain 2 (NOD2) and caspase recruitment domain-containing protein 15 (CARD15) gene in patients with Crohn's disease.

Methods

CLFs were characterized by histology and immunohistochemistry in the specimens of 41 patients undergoing colonic resection for Crohn's disease. Variants of the NOD2/CARD15 gene were assessed by denaturing high performance liquid chromatography and confirmed by DNA sequencing.

Results

Eleven patients had a heterozygous variant of the NOD2/CARD15 gene. The uninvolved colon of mutants had significantly lower CLF density (0·9 versus 2·7 follicles per cm2; P < 0·001) and proportion of those with a germinal centre (9 versus 22 per cent; P = 0·040) than in non-mutants. In active disease, CLF density increased similarly in patients with and without the mutation. The proportion of extramucosal CLFs was higher in mutants than in non-mutants (34 versus 22 per cent; P = 0·030). No significant difference between groups was recorded for cellular profile and proliferation.

Conclusion

Patients with Crohn's disease and the NOD2/CARD15 mutation show a remodelling of CLFs in both uninvolved and actively inflamed intestines. These subjects may have a defective immune response by organized lymphoid structures.
Randomized clinical trial of techniques for closure of the pancreatic remnant following distal pancreatectomy
Authors: Oláh A , Issekutz Á , Belágyi T , Hajdú N , Romics L
Published: May 2009

Background

Pancreatic fistula and intra-abdominal fluid collection are the commonest complications after distal pancreatectomy. Several techniques have been described to achieve perfect closure of the stump.

Methods

In this randomized clinical trial the stapler technique was compared with stapling combined with a seromuscular patch. Seventy patients who underwent distal pancreatectomy were randomized between January 2002 and December 2006 to either closure of the pancreatic stump by stapler (35 patients) or closure by stapler and covering with a seromuscular patch of jejunum (35). The primary endpoint was the rate of postoperative fistula and/or intra-abdominal fluid collections.

Results

The overall rate of these pancreas-related complications was higher in the stapling-alone group. However, rates of clinically relevant postoperative complications (grade B or C fistula and/or fluid collection requiring treatment) were comparable. The reintervention rate and median hospital stay were similar in both groups.

Conclusion

Covering the stapled pancreatic remnants with a seromuscular patch is a simple method that decreased overall pancreas-related complications such as fistula. This technique did not affect clinically relevant outcomes as severe complications requiring treatment were similar with both techniques.
Cell- and tissue-engineered organ replacements
Authors: Birchall M A
Published: May 2009

Results are encouraging
Interposition graft with polytetrafluoroethylene for mesenteric and portal vein reconstruction after pancreaticoduodenectomy (Br J Surg 2009; 96: 247–252)
Authors: Al-Ghnaniem R , Jah A , Huguet E L , Jamieson N V , Praseedom R K
Published: May 2009

The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length.
Analysis of the Porosity of Filter Cakes Obtained by Filtration of Colloidal Suspensions
Authors: Hieke M. , Ruland J. , Anlauf H. , Nirschl H.
Published: May 2009

The filtration of suspensions in the colloidal regime is part of many processes. It is necessary due to the widespread use of nano‐size particles in many applications. In nano‐scale particle systems, the huge specific surface of the particles is dominating the processes. The question is whether the well‐known filter theory is applicable for such type of products. The experiments in this study were conducted by gas‐driven filtration. The analysis of the filter cake was done globally according to the Darcy equation and locally by the use of magnetic resonance imaging (MRI) techniques. Due to the very high resistances during filtration for colloidal suspensions, comparatively thin filter cakes with an approximate height of 0.5–3  mm were investigated. The overall porosities determined by the different techniques are in good agreement. The MRI technique allows an in situ measurement of the porosity gradient within a filter cake formed by compressible material.
How to Achieve Confidence in Drug Discovery and Development: Managing Risk (from a Reductionist to a Holistic Approach)
Authors: Bakker Annette , Caricasole Andrea , Gaviraghi Giovanni , Pollio Giuseppe , Robertson Graeme , Terstappen Georg C. , Salerno Massimiliano , Tunici Patrizia
Published: May 2009

Confidence in mechanism: Creating a more holistic understanding of disease pathophysiology and an early confidence in the mechanism under investigation could help facilitate the selection of not only the most appropriate targets but also the best mechanisms for disease intervention and how to select and optimise the best compounds.

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Drug target and candidate selection are two of the key decision points within the drug discovery process for which all companies use certain selection criteria to make decisions on which targets to accept into their discovery pipelines and which compounds will pass into development. These steps not only help define the overall productivity of every company but they are also decisions taken without full predictive knowledge of the risks that lie ahead or how best to manage them. In particular, the process of selecting new targets does not normally involve full evaluation of the risk(s) in the mechanism under investigation (the modulation of the target), which may result in an inability to fully connect in vitro and animal model results to the disease (clinical) setting. The resulting poor progression statistics of many compounds in the clinic is at least partially the result of a lack of understanding of disease pathophysiology. Notably, the lack of efficacy is still a major reason for failure in the clinic.1 Creating a more holistic understanding of disease pathophysiology and an early confidence in the mechanism under investigation could help facilitate the selection of not only the most appropriate targets but also the best mechanisms for disease intervention and how to select and optimise the best compounds.
Finite element superplastic forming (FE‐SPF) of patient‐specific maxillofacial prostheses
Authors: Gil A. J. , Curtis R. V. , Bonet J. , Coward T.
Published: May 2009

This paper describes the application of superplastic forming (SPF) technology to the manufacturing of maxillofacial prostheses for human implants. A combined numerical/experimental methodology is explained in detail whereby initial patient‐specific data are collected in the form of computed tomography/magnetic resonance imaging scans and a final titanium alloy Ti‐6A1‐4V (suitably selected for bio‐compatibility and osseo‐integration) prosthesis is obtained for subsequent implantation into the damaged area of the patient. Various aspects ranging from the computational challenges (i.e. scanning technology, mesh generation, the finite element incremental flow formulation, pressure–time cycle) to the experimental/medical aspects (i.e. SPF laboratory conditions, patient data, SPF patient‐specific process, medical feedback) will be discussed. A cranioplasty prosthesis and an orbital floor prosthesis are presented in order to show the robustness and applicability of the methodology. Copyright © 2009 John Wiley & Sons, Ltd.
Nonlinear quasi‐static finite element formulations for viscoelastic Euler–Bernoulli and Timoshenko beams
Authors: Payette G. S. , Reddy J. N.
Published: May 2009

Weak form finite element models for the nonlinear quasi‐static bending and extension of initially straight viscoelastic Euler–Bernoulli and Timoshenko beams are developed using the principle of virtual work. The mechanical properties of the beams are considered to be linear viscoelastic. However, large transverse displacements, moderate rotations and small strains are allowed by retaining the von Kármán strain components of the Green–Lagrange strain tensor in the formulation. The fully discretized finite element equations are developed using the trapezoidal rule in conjunction with a two‐point recurrence relation. The resulting finite element equations, therefore, necessitate data storage from the previous time step only, and not the entire deformation history. Membrane locking is eliminated from the Euler–Bernoulli formulation through the use of selective reduced Gauss–Legendre quadrature. Membrane and shear locking are both circumvented in the Timoshenko beam finite element by employing a family of high‐order Lagrange polynomials. A Newton–Raphson iterative scheme is used to solve the nonlinear finite element equations. Copyright © 2009 John Wiley & Sons, Ltd.
Physical Properties of Elongated Magnetic Particles: Magnetization and Friction Coefficient Anisotropies
Authors: Vereda Fernando , de Vicente Juan , Hidalgo‐Álvarez Roque
Published: May 2009

Anisotropy counts: A brief review of the main physical properties of elongated magnetic particles (EMPs) is presented. The most important characteristic of an EMP is the additional contribution of shape anisotropy to the total anisotropy energy of the particle, when compared to spherical magnetic particles. The electron micrograph shows Ni‐ferrite microrods fabricated by the authors.

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We present an overview of the main physical properties of elongated magnetic particles (EMPs), including some of their more relevant properties in suspension. When compared to a spherical magnetic particle, the most important characteristic of an EMP is an additional contribution of shape anisotropy to the total anisotropy energy of the particle. Increasing aspect ratios also lead to an increase in both the critical single‐domain size of a magnetic particle and its resistance to thermally activated spontaneous reversal of the magnetization. For single‐domain EMPs, magnetization reversal occurs primarily by one of two modes, coherent rotation or curling, the latter being facilitated by larger aspect ratios. When EMPs are used to prepare colloidal suspensions, other physical properties come into play, such as their anisotropic friction coefficient and the consequent enhanced torque they experience in a shear flow, their tendency to align in the direction of an external field, to form less dense sediments and to entangle into more intricate aggregates. From a more practical point of view, EMPs are discussed in connection with two interesting types of magnetic colloids: magnetorheological fluids and suspensions for magnetic hyperthermia. Advances reported in the literature regarding the use of EMPs in these two systems are included. In the final section, we present a summary of the most relevant methods documented in the literature for the fabrication of EMPs, together with a list of the most common ferromagnetic materials that have been synthesized in the form of EMPs.
Altered striatal response to reward in bulimia nervosa after recovery
Authors: Wagner Angela , Aizenstein Howard , Venkatraman Vijay K. , Bischoff‐Grethe Amanda , Fudge Julie , May J. Christopher , Frank Guido K. , Bailer Ursula F. , Fischer Lorie , Putnam Karen , Kaye Walter H.
Published: May 2009

Objective:

It is possible that disturbances of systems modulating reward may contribute to a vulnerability to develop an eating disorder.

Method:

This hypothesis was tested by assessing functional magnetic resonance brain imaging response to a monetary reward task known to activate the anterior ventral striatum (AVS), a region implicated in motivational aspects toward stimuli. To avoid the confounding effects of malnutrition, 10 women who had recovered from bulimia nervosa (BN) were compared with 10 healthy comparison women (CW).

Results:

For the AVS, CW distinguished positive and negative feedback, whereas recovered BN women had similar responses to both conditions. In addition, these groups had similar patterns of findings for the dorsal caudate.

Discussion:

We have previously shown that individuals recovered from anorexia nervosa (AN) also had altered striatal responses and difficulties in differentiating positive and negative feedback. Thus BN and AN individuals may share a difficulty in discriminating the emotional significance of a stimulus. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010
13C NMR as a primary method for determining saturates, cis‐ and trans‐monounsaturates and polyunsaturates in fats and oils for nutritional labeling purposes
Authors: Gao Lei , Sedman Jaqueline , García‐González Diego L. , Ehsan Sadia , Sprules Tara , van de Voort Frederik R.
Published: May 2009

The suitability of 13C NMR as a primary method for the analysis of lipids to obtain nutritional labeling compositional data (NLCD), i.e. the percentages of saturated, cis‐monounsaturated, trans‐monounsaturated, and cis‐polyunsaturated fat, was assessed. The 13C NMR methodology was developed by using mixtures of pure triglycerides as model lipids to optimize and standardize scan conditions and spectral pre‐processing procedures, establish fixed integration limits for measurement of the 13C resonances used in the determination of NLCD, and evaluate the quantitative accuracy of the 13C NMR analysis. The standardized 13C NMR methodology allowed the NLCD of the model triacylglycerol mixtures to be determined within ˜±1%. To further evaluate the methodology, two sets of validation samples, consisting of ten unhydrogenated oils from the American Oil Chemists' Society Laboratory Proficiency Program (AOCS‐LPP) and two trans‐containing AOCS‐LPP samples combined with three samples from a hydrogenation process, were analyzed. Good overall agreement between the NMR‐determined NLCD (in units of mol‐%) and the mol‐% NLCD calculated for these samples from fatty acid compositional data obtained by gas chromatography was found, including good tracking of the trans content in the second validation set. Given that the NLCD must be expressed on a wt‐% basis to be of practical utility, a means of mol‐% to wt‐% conversion was developed assuming all unsaturates to be C18 and obtaining the weight‐average molecular weight of the saturated fatty acid contributions from the NMR data. This conversion was shown to be especially effective for oil blends, where errors become significant if unit conversion is not done. This work indicates that 13C NMR can provide excellent primary NLCD data, even in wt‐% terms, which can be used for calibrating simpler and automatable instrumental methods such as FTIR spectrometers to determine or screen for NLCD for fats and oils or lipids extracted from food on a routine basis.
Secondary Metabolites of Phomopsis sp. XZ‐26, an Endophytic Fungus from Camptothecaacuminate
Authors: Lin Ting , Lin Xiang , Lu Chunhua , Hu Zhiyu , Huang Wenyu , Huang Yaojian , Shen Yuemao
Published: May 2009

Eleven new metabolites, including nine lovastatin analogues [oblongolides N–V (1–2 and 5–11), which were defined as naphthalene‐type fungal polyketides], one linear furanopolyketide (13) and a monoterpene named dihydroxysabinane (14), together with four known compounds including oblongolides B (3) and C (4), one linear furanopolyketide (12) and the sesterterpene terpestacin (15), were isolated from the endophytic fungal strain Phomopsis sp. XZ‐26 of Camptotheca acuminate. Their structures were elucidated by spectroscopic analyses including HR‐ESI‐MS, 1H and 13C NMR, 2D NMR (HMQC, HMBC, 1H‐1H COSY and NOESY), and X‐ray single‐crystal analysis. The antimicrobial activities of 1–5, 8, 10 and 13–15 were evaluated, but none showed a substantial effect. Additionally, a hypothetical biosynthetic pathway for oblongolides was proposed.(© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009)
The Solvent‐Free Addition Reaction of Allylzinc Bromide and Carbonyl Compounds
Authors: Zhang Yumei , Jia Xuefeng , Wang Jin‐Xian
Published: May 2009

The reactivity of organozincs could be enhanced dramatically under solvent‐free conditions. Allylzinc bromide can react rapidly with aldehydes and ketones to give homoallylic alcohols in high yields in the absence of a catalyst under solvent‐free conditions in an open atmosphere at room temperature. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009)