bluuebunny/crossref_metadata_2025 huggingface dataset:
Nanoencapsulation in Lipid-Core Nanocapsules Controls Mometasone Furoate Skin Permeability Rate and Its Penetration to the Deeper Skin Layers
Authors: Melero Ana , Ferreira Ourique Aline , Stanisçuaski Guterres Silvia , Raffin Pohlmann Adriana , Lehr Claus-Michael , Ruver Beck Ruy Carlos , Schaefer Ulrich
Published: April 2014

Aims: The influence of nanoencapsulation of mometasone furoate (MF) in poly(ε-caprolactone) lipid-core nanocapsules (LNC) on its in vitro human skin permeation and penetration was evaluated. Methods: Semisolid formulations were prepared by increasing the viscosity of LNC using a carbomer (Carbopol® Ultrez at 0.5% w/v). Two complementary techniques (the static Franz diffusion cell model and the Saarbrücken penetration model) were used to evaluate skin permeation/penetration. Results: The drug release rate was decreased by nanoencapsulation. The skin permeability of MF was controlled by the nanoencapsulation as well as by increasing the viscosity. Furthermore, the formulation containing the nanoencapsulated MF controlled the amount of drug reaching the deeper skin layers without changing its accumulation in the stratum corneum. Conclusion: This formulation is suitable for prolonged treatment of skin disorders which should avoid systemic absorption.
Approaches to Understanding the Impact of Technologies for Aging in Place: A Mini-Review
Authors: Connelly Kay , ur Rehman Laghari Khalil , Mokhtari Mounir , Falk Tiago H.
Published: April 2014

Background: There are many approaches to evaluating aging-in-place technologies. While there are standard measures for outcomes such as health and caregiver burden, which lend themselves to statistical analysis, researchers have a harder time identifying why a particular information and communication technology (ICT) intervention worked (or not). Objective: The purpose of this paper is to review a variety of methods that can help answer these deeper questions of when people will utilize an ICT for aging in place, how they use it, and most importantly why. This review is sensitive to the special context of aging in place, which necessitates an evaluation that can explore the nuances of the experiences of older adults and their caregivers with the technology in order to fully understand the potential impact of ICTs to support aging in place. Methods: The authors searched both health (PubMed) and technology (ACM Digital Library) venues, reviewing 115 relevant papers that had an emphasis on understanding the use of aging-in-place technologies. This mini-review highlights a number of popular methods used in both the health and technology fields, including qualitative methods (e.g. interviews, focus groups, contextual observations, diaries, and cultural probes) and quantitative methods (e.g. surveys, the experience sampling method, and technology logs). Results: This review highlights that a single evaluation method often is not adequate for understanding why people adopt ICTs for aging in place. The review ends with two examples of multifaceted evaluations attempting to get at these deeper issues. Conclusion: There is no proscriptive formula for evaluating the intricate nuances of technology acceptance and use in the aging-in-place context. Researchers should carefully examine a wide range of evaluation techniques to select those that will provide the richest insights for their particular project.
The Usefulness of Preoperative 18FDG Positron-Emission Tomography and Computed Tomography for Predicting the Malignant Potential of Gastrointestinal Stromal Tumors
Authors: Tokumoto Noriaki , Tanabe Kazuaki , Misumi Toshihiro , Fujikuni Nobuaki , Suzuki Takahisa , Ohdan Hideki
Published: April 2014

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. The tumor size and mitotic count, typical risk category factors, are difficult to determine preoperatively. This study aimed to evaluate the usefulness of preoperative 18F-fluoro-2-deoxyglucose positron-emission tomography/computed tomography (18FDG-PET/CT) for predicting the malignant potential of GISTs by analyzing the correlation between the maximum standardized uptake value (SUVmax) and postoperative factors. Methods: Thirty consecutive patients underwent surgery after preoperative 18FDG-PET/CT and were diagnosed with pathologically confirmed GIST. The tumor size, mitotic count, MIB-1 index and National Institutes of Health (NIH) risk category were compared with SUVmax. Results: Significant correlations between SUVmax and tumor size and NIH risk category were determined. The sensitivity and specificity of SUVmax for predicting the risk of malignancy were 85.7 and 62.5%, respectively. The optimal cut-off value for SUVmax was 3.0 between patients classified into low-risk and high-risk malignancy groups. There was no significant correlation between SUVmax and mitotic count or MIB-1 index. Multivariate analysis indicated that SUVmax was the only predictive risk factor in the high-risk malignancy group. Conclusions: 18FDG-PET/CT is useful for assessing the malignant potential and bioactivity of GISTs. When SUVmax is >3.0, the tumor must be resected even if it measures <2 cm, because of its high malignant potential.
Physical and Mental Health and Social Functioning in Older Alcohol-Dependent Inpatients: The Role of Age of Onset
Authors: van den Berg Julia F. , Hermes Jolanda S.J. , van den Brink Wim , Blanken Peter , Kist Nicolien , Kok Rob M.
Published: April 2014

Aims: Age of onset is an important criterion to distinguish subgroups of alcohol-dependent patients. This study investigated physical and mental health and social functioning of older inpatients with early (age <25), late (25-44), and very late (≥45) onset of alcohol dependence. Methods: In a specialized detoxification ward for older patients in The Hague, the Netherlands, 157 older alcohol-dependent inpatients (38% women, mean age 62.7 ± 6.5) were interviewed with the European version of the Addiction Severity Index. Results: As a group, older alcohol-dependent patients had substantial physical, mental and social problems, which were largely independent of the age of onset of alcohol dependence. Patients with early-onset alcohol dependence had more chronic medical problems and more suicidal thoughts than patients with late-onset alcohol dependence. The very-late-onset group did not significantly differ from the other two groups in any of the variables under study. Conclusions: Despite previous studies showing more favourable outcomes for the (very) late-onset compared to the early-onset alcohol-dependent group, their comorbid (mental) health and social problems are in many respects similar, and require careful assessment and treatment. This may be crucial for successful treatment and improving quality of life in these patients.
Biobehavioral Pathways Underlying Spousal Health Dynamics: Its Nature, Correlates, and Consequences
Authors: Hoppmann Christiane A. , Gerstorf Denis
Published: April 2014

Marriage is a very special relationship that has a high potential to influence physical and mental health throughout the adult lifespan and into old age. In this viewpoint, we propose a model that outlines plausible biobehavioral pathways that may underlie previously established spousal interrelations in long-term health trajectories and discuss specific resources that may facilitate favorable outcomes for everyone involved. Specifically, we focus on spousal associations in physical activity as an important health behavior and in stress-related processes as a key daily-life mechanism, which both reveal effects that may accumulate over time to impact longer-term health outcomes. We also consider spousal resources such as collaborative problem solving and joint goals as psychological variables that characterize the dynamics within a given marriage. We conclude by discussing areas in theory and research that are ripe for further consideration and lay out target questions for future inquiry.
Effects of Motive-Oriented Therapeutic Relationship in a Ten-Session General Psychiatric Treatment of Borderline Personality Disorder: A Randomized Controlled Trial
Authors: Kramer Ueli , Kolly Stéphane , Berthoud Laurent , Keller Sabine , Preisig Martin , Caspar Franz , Berger Thomas , de Roten Yves , Marquet Pierre , Despland Jean-Nicolas
Published: April 2014

Background: Motive-oriented therapeutic relationship (MOTR) was postulated to be a particularly helpful therapeutic ingredient in the early treatment phase of patients with personality disorders, in particular with borderline personality disorder (BPD). The present randomized controlled study using an add-on design is the first study to test this assumption in a 10-session general psychiatric treatment with patients presenting with BPD on symptom reduction and therapeutic alliance. Methods: A total of 85 patients were randomized. They were either allocated to a manual-based short variant of the general psychiatric management (GPM) treatment (in 10 sessions) or to the same treatment where MOTR was deliberately added to the treatment. Treatment attrition and integrity analyses yielded satisfactory results. Results: The results of the intent-to-treat analyses suggested a global efficacy of MOTR, in the sense of an additional reduction of general problems, i.e. symptoms, interpersonal and social problems (F1, 73 = 7.25, p < 0.05). However, they also showed that MOTR did not yield an additional reduction of specific borderline symptoms. It was also shown that a stronger therapeutic alliance, as assessed by the therapist, developed in MOTR treatments compared to GPM (Z55 = 0.99, p < 0.04). Conclusions: These results suggest that adding MOTR to psychiatric and psychotherapeutic treatments of BPD is promising. Moreover, the findings shed additional light on the perspective of shortening treatments for patients presenting with BPD.
Clinical Presentation, Pathological Features and Natural Course of Metastatic Uveal Melanoma, an Orphan and Commonly Fatal Disease
Authors: Cerbone Linda , Van Ginderdeuren Rita , Van den Oord Joost , Fieuws Steffen , Spileers Werner , Van Eenoo Liza , Wozniak Agnieszka , Sternberg Cora N. , Schöffski Patrick
Published: April 2014

Background: Uveal melanoma (UM) is a rare disease characterized by an unpredictable course and a variable outcome. We assessed the natural course of patients with metastatic uveal melanoma (MUM). Methods: Data from 76 patients with MUM who were treated in Leuven between 1957 and 2008 were examined retrospectively. Statistical analysis involved the nonparametric, Kaplan-Meier and log rank tests. Results: The median age at diagnosis of UM was 58 years (range 30-94). Synchronous metastases were found in 9% of the cases; all other patients had metachronous disease after a median interval of 40 months (range 7-420). Statistical analysis failed to identify factors related to the time until metastatic spread with the exception of a significant negative correlation with age at UM diagnosis (Spearman: ρ = -0.4, p < 0.001). The most frequent metastatic site was the liver (in 96% of the patients). The median time from diagnosis of UM until death was 47 months (range 2-236) and only 5 months in patients with metastatic disease (range 1-128). Conclusions: MUM is an orphan disease. Advances in MUM can only be achieved by the networking of sites interested in this rare tumor type, with systematic collection of data and tumor tissue for improving our understanding of the molecular biology of this disease.
Colonic Anastomosis with a Doxycycline-Coated Stent: An Experimental Study in a Porcine Model
Authors: Wang YiFan , Cai XiaoYan , Mei JinHua , Liu Kun , Cai XiuJun
Published: April 2014

Background: Matrix metalloproteinases (MMPs) are supposed to be potential drug targets to prevent leakage after colonic anastomosis. A method of colonic anastomosis by using a stent coated with doxycycline, a MMP inhibitor, was developed and its safety and feasibility, as well as the effect of locally regulating MMPs, were evaluated by comparing with the conventional method or the method with a doxycycline-free stent. Methods: 48 pigs were assigned randomly to doxycycline-coated stent anastomosis group (DSA), doxycycline-free stent anastomosis group (SA), or conventional anastomosis group (CA). In each group, pigs were subdivided into four subgroups according to postoperative observation time (3, 7, 14, and 30 days). Healing of anastomosis and expressions of MMP-2/9 were evaluated. Results: No anastomotic leakage, stricture or necrosis was observed in the DSA group. No significant difference of bursting pressure was found between the DSA group and SA group. Relative expression of MMP-2 in the DSA group was significantly lower than in the SA group on postoperative days 3 and 7. No significant differences of hydroxyproline content, microvessel density and TGF-β1 level were found in these groups. Conclusion: These results suggested this method was feasible and safe for colonic anastomosis with the advantage of locally inhibiting MMPs.
Minimally Invasive Oesophagectomy: Preliminary Results after Introduction of an Intrathoracic Anastomosis
Authors: van Workum Frans , van den Wildenberg Frits J.H. , Polat Fatih , de Wilt Johannes H.W. , Rosman Camiel
Published: April 2014

Background: Intrathoracic anastomosis after oesophagectomy has recently been associated with reduced functional morbidity compared to a cervical anastomosis. Methods: From January 2011 until August 2012, all operable patients were scheduled to undergo minimally invasive oesophagectomy (MIE) with intrathoracic anastomosis. Patient characteristics, complications, morbidity and mortality were prospectively registered and analysed. Results: Forty-five patients underwent MIE with intrathoracic stapled end-to-side anastomosis. Major changes in operative technique were made 2 times due to non-satisfactory results, dividing the patients into 3 groups. One patient in group 1 died. The anastomotic leakage rate decreased from 44% in group 1 to 0% in groups 2 and 3 (p = 0.007). The pulmonary complication rate decreased from 67% in group 1 to 44% in group 2 (not significant, NS) and 22% in group 3 (p = 0.04). The median hospital stay decreased from 17 days in group 1 to 14 days in group 2 (NS) and 8 days in group 3 (p < 0.001). There were no stenoses, no dilatations and no patients with recurrent laryngeal nerve palsy. Conclusions: The introduction of the intrathoracic anastomosis led to favourable functional results but was initially associated with considerable morbidity. Results improved after changing operative techniques, but the learning curve may also be responsible.
Interferon-λ in the Context of Viral Infections: Production, Response and Therapeutic Implications
Authors: Hermant Pascale , Michiels Thomas
Published: April 2014

Interferon (IFN)-λ forms the type III IFN family. Although they signal through distinct receptors, type I (IFN-α/β) and type III IFNs elicit remarkably similar responses in cells. However, in vivo, type III and type I IFN responses are not fully redundant as their respective contribution to the antiviral defense highly depends on virus species. IFN-λ is much more potent than IFN-α/β at controlling rotavirus infection. In contrast, clearance of several other viruses, such as influenza virus, mostly depends on IFN-α/β. The IFN-λ receptor was reported to be preferentially expressed on epithelial cells. Cells responsible for IFN-λ production are still poorly characterized but seem to overlap only partly IFN-α/β-producing cells. Accumulating data suggest that epithelial cells are also important IFN-λ producers. Thus, IFN-λ may primarily act as a protection of mucosal entities, such as the lung, skin or digestive tract. Type I and type III IFN signal transduction pathways largely overlap, and cross talk between these IFN systems occurs. Finally, this review addresses the potential benefit of IFN-λ use for therapeutic purposes and summarizes recent results of genome-wide association studies that identified polymorphisms in the region of the IFN-λ3 gene impacting on the outcome of treatments against hepatitis C virus infection.
Lymphocyte-Based Model Systems for Allergy Research: A Historic Overview
Authors: Neunkirchner Alina , Schmetterer Klaus G. , Pickl Winfried F.
Published: April 2014

During the last decades, a multitude of studies applying distinct in vitro and in vivo model systems have contributed greatly to our better understanding of the initiation and regulation of inflammatory processes leading to allergic diseases. Over the years, it has become evident that among lymphocytes, not only IgE-producing B cells and allergy-orchestrating CD4+ helper cells but also cytotoxic CD8+ T cells, γδ-T cells and innate lymphoid cells, as well as regulatory lymphocytes, might critically shape the immune response towards usually innocuous allergens. In this review, we provide a historic overview of pioneering work leading to the establishment of important lymphocyte-based model systems for allergy research. Moreover, we contrast the original findings with our currently more refined knowledge to appreciate the actual validity of the respective models and to reassess the conclusions obtained from them. Conflicting studies and interpretations are identified and discussed. The tables are intended to provide an easy overview of the field not only for scientists newly entering the field but also for the broader readership interested in updating their knowledge. Along those lines, herein we discuss in vitro and in vivo approaches to the investigation of lymphocyte effector cell activation, polarization and regulation, and describe depletion and adoptive transfer models along with gene knockout and transgenic (tg) methodologies. In addition, novel attempts to establish humanized T cell antigen receptor tg mouse models for allergy research are described and discussed.
The Drosophila Deubiquitinating Enzyme dUSP36 Acts in the Hemocytes for Tolerance to Listeria monocytogenes Infections
Authors: Taillebourg Emmanuel , Schneider David S. , Fauvarque Marie-Odile
Published: April 2014

Listeria monocytogenes is a facultative intracellular pathogen which can infect Drosophila melanogaster. Upon infection, Drosophila mounts an immune response including antimicrobial peptide production and autophagy activation. A set of previously published results prompted us to study the role of the deubiquitinating enzyme dUSP36 in response to L. monocytogenes infections. We show in this report that flies with dUsp36-specific inactivation in hemocytes are susceptible to L. monocytogenes infections (as are flies with autophagy-deficient hemocytes) but are still able to control bacterial growth. Interestingly, flies with dUsp36-depleted hemocytes are not sensitized to infection by other pathogens. We conclude that dUsp36 plays a major role in hemocytes for tolerance to L. monocytogenes.
Clinical Outcomes and Complications Associated with TORS for OSAHS: A Benchmark for Evaluating an Emerging Surgical Technology in a Targeted Application for Benign Disease
Authors: Vicini Claudio , Montevecchi Filippo , Campanini Aldo , Dallan Iacopo , Hoff Paul T. , Spector Matthew E. , Thaler Erica , Ahn Jeffrey , Baptista Peter , Remacle Marc , Lawson George , Benazzo Marco , Canzi Pietro
Published: April 2014

Background: The aim of this study was to create benchmarks for evaluating clinical outcomes and complications of transoral robotic surgeries (TORS) in a multicenter setting. Methods: 243 TORS for obstructive sleep apnea/hypopnea syndrome (OSAHS) operations, carried out between 2008 and 2012, were analyzed at 7 different centers. The average hospitalization was 3.5 days. The mean patient age was 50 ± 12 years, the average BMI at the time of the procedure was 28.53 ± 3.87 and the majority of the patients were men (81%). Results: The mean preoperative and postoperative apnea/hypopnea index was 43.0 ± 22.6 and 17.9 ± 18.4, respectively (p < 0.001). The mean preoperative and postoperative Epworth Sleepiness Scale score was 12.34 ± 5.19 and 5.7 ± 3.49, respectively (p < 0.001). The mean pre- and postoperative lowest O2 saturation was 79.5 ± 8.77 and 83.9 ± 6.38%, respectively (p < 0.001). Conclusions: Patients undergoing TORS as part of a multilevel approach for the treatment of OSAHS have a reasonable expectation of success with minimal long-term morbidity.
Case Report on the Illness of Paul Klee (1879-1940)
Authors: Suter Hans
Published: April 2014

This article reports on the disease that afflicted Paul Klee, the famous artist. He died before the disease that killed him could be properly diagnosed. There was some conjecture afterwards that he may have suffered from scleroderma. The thorough and diligent research the author of this article has carried out over many years allows him to argue that Paul Klee was suffering from this autoimmune disease since 1935. With a degree of probability that borders on certainty, it seems that the artist suffered from ‘diffuse systemic sclerosis', and it is from this, the most severe form of the rare autoimmune disease, that he died in 1940.
The Utility of Chromosome Microdissection in Clinical Cytogenetics: A New Reciprocal Translocation in Sheep
Authors: Iannuzzi Alessandra , Perucatti Angela , Genualdo Viviana , Pauciullo Alfredo , Incarnato Domenico , Musilova Petra , Rubes Jiri , Iannuzzi Clara
Published: April 2014

Local sheep breeders and scientists in Italy cooperate and conduct research on the genetic improvement of autochthonous genetic types (AGTs) by various approaches, including a cytogenetic breeding selection since 2011. The Laticauda sheep (Ovis aries, 2n = 54) breed is one of the AGTs reared in the Campania region (southern Italy). Performing cytogenetic analyses, we have detected and described a novel reciprocal translocation in a Laticauda sheep identified as 54,XX t(18;23)(q14;q26). Our data support recurring appeals that suggest the regular performance of cytogenetic analyses for monitoring genetic health of livestock species. In total, 5 cases of reciprocal translocations in sheep are known, including the new case. None of them has any phenotypic effect on the living offspring. However, affected animals are characterized by sterility or have a low fertility which can have an effect on breeding success and on economical balance. Presence and kind of the described novel chromosomal aberration were detected by performing CBA-banding and FISH mapping with telomeric probes. RBA-banding allowed the karyotyping of sheep chromosomes and the identification of aberrant chromosomes and regions involved in the new reciprocal translocation. Whole chromosome painting (WCP) probes received from equivalent chromosomes in cattle and the derivative sheep chromosome 18 confirmed the cytogenetic data. This way, our study underlined both the importance of WCP probes by chromosome microdissection and a new way to use WCP probes directly generated from derivative chromosomes.
Polyploidy and Hybridization as Main Factors of Speciation: Complex Reticulate Evolution within the Grass Genus Helictochloa
Authors: Winterfeld G. , Schneider J. , Perner K. , Röser M.
Published: April 2014

To study the origin and evolution of naturally occurring polyploids, we performed phylogenetic analyses of nuclear ribosomal DNA spacers combined with molecular cytogenetics in 55 accessions of 27 taxa of the oat genus Helictochloa. A complex pattern of reticulate evolution was revealed with many diploid species and extensive polyploidy up to 20x. Altogether 11 groups of internal transcribed spacer (ITS) sequences can be distinguished. Sequences from 1-3 different ITS lineages were detected in polyploids. Cytogenetic data allow reconstruction of 8 basic monoploid chromosome sets. Six of these genomes occur in different combinations in the polyploid species. Two genomes are only found in diploids. Our sequence and karyological data highlight the occurrence of autopolyploidy and allopolyploidy, provide new information about the evolutionary history of taxa, and allow a more accurate systematic treatment of the concerned species. The geographical distribution of the 11 ITS lineages distinguished is highly structured and points to an origin of the genus in western Asia, presumably in grasslands like steppes or mountain steppes and meadows. The evolutionary basal lineages are of Asian, Minor Asian and east Mediterranean distribution and are present also in North America. The western and central parts of the Mediterranean and northern Europe harbor the modern lineages.
Safety and Efficacy of the StarClose Vascular Closure System following 8-Fr Sheath Placement for Intra-Aortic Balloon Pump: A Single-Center Analysis of 42 Consecutive Patients
Authors: Chu Guang , Yang Wenyi , Zhang Guobing , Zhang Zhi , Liu Shaowen , Sun Baogui , Wang Fang
Published: April 2014

Objective: To assess the safety and efficacy of the StarClose device following intra-aortic balloon pump (IABP) counterpulsation using 8-Fr femoral sheaths. Subjects and Methods: From June 2008 to August 2012, 42 consecutive patients who received IABP implantation via common femoral artery (CFA) punctures with an 8-Fr sheath (which were then sealed with the StarClose Vascular Closure System at the bedside) were included in this retrospective single-arm study. All the patients underwent duplex control of the puncture site 24 h after deployment of the device, in order to determine the presence or absence of vascular complications including hematoma, pseudoaneurysm, arteriovenous fistula and arterial/venous thrombosis or stenosis. The safety end points were the vascular complications during the hospital stay, and the efficacy end points included device and procedure success. Results: The procedure success rate was 92.9% (39/42) and the device success rate was 88.1% (37/42). Major vascular complications occurred in 3 (7.1%) patients; 1 developed a massive hematoma >10 cm which was managed by blood transfusion and surgical reconstruction, and the other 2 developed pseudoaneurysm which was cured by ultrasound-guided thrombin injection or manual compression. Minor vascular complications occurred in 5 (11.9%) patients, including blood oozing in 2, hematoma <5 cm in 2 and severe pain in the remaining patient. Conclusion: CFA closure with the StarClose device was safe, feasible and effective in patients undergoing IABP support using 8-Fr sheath sizes.
Food Insecurity, a Determinant of Obesity? - an Analysis from a Population-Based Survey in the Paris Metropolitan Area, 2010
Authors: Martin-Fernandez Judith , Caillavet France , Lhuissier Anne , Chauvin Pierre
Published: April 2014

Objective The relationship between food insecurity and obesity is discussed in the literature. The objective of this study was to determine whether food insecurity and obesity were associated in the Paris metropolitan area. Methods: We used data from third wave of the Health, Inequalities and Social Ruptures (SIRS) cohort study, a longitudinal population-based, representative health and socioepidemiological survey of the general population in the Paris metropolitan area. The participants' BMI (calculated using self-reported height and weight) was analyzed as a continuous variable, and a dichotomous variable (BMI < 30 kg/m2/BMI ≥ 30 kg/m2) was constructed. Food insecurity was estimated using the Household Food Security Scale Module (HFSSM) and was treated as a trichotomous variable (food security / low food security / very low food security). Multilevel models were estimated for men and women separately. Results: Obesity (BMI ≥ 30 kg/m2) prevalence was 10.2%. The determinant of obesity differs according to gender. After adjustment for age, income and the sociooccupational group, very low food security was associated with obesity in women (OR = 2.01, 95%CI 1.05-3.82), and women with very low food security had a higher BMI (Coef. = 1.78, 95% CI 0.24-3.31). This association, however, was not significant for men (OR = 1.84, 95%CI 0.64-5.30). Conclusion: In times of economic crisis, it is increasingly essential to explore and understand the pathway through which very low food security is linked to obesity.
Radiotherapy Is Effective for Desmoid Tumors (Aggressive Fibromatosis) - Long-Term Results of a German Multicenter Study
Authors: Kriz Jan , Eich Hans Theodor , Haverkamp Uwe , Seegenschmiedt M. Heinrich , Heide Jürgen , Bruns Frank , Micke Oliver
Published: April 2014

Background: Desmoids (aggressive fibromatosis) are defined as benign neoplasms of the connective tissue that arise from the deep muscle fascia, aponeurosis, tendons, and scar tissue. Recurrence rates between 40 and 80% were reported after surgery alone. We addressed the impact of radiation therapy (RT) in the management of aggressive fibromatosis. Patients and Methods: A large literature review was performed, and the data was compared with the results of a multicenter study of the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD). Results: This analysis included 52 patients treated with RT. 37 patients received postoperative RT (20 patients after R2 resection and 17 patients after R1 resection). 15 patients received RT alone (6 patients with inoperable primary tumor and 9 patients with inoperable recurrent tumor). In the case of postoperative RT, a median dose of 50 Gy (range 50-60 Gy) was used; for definitive RT, a median dose of 55 Gy (range 55-65 Gy) was used. The local control rate was 79% for the whole group. The median follow-up was 44 month (range 8-62 months). Conclusion: Given the large number of patients, these data show that RT is highly effective in the treatment of desmoid tumors. RT is an attractive alternative to mutilating surgery.
Single-Center Experience in the Treatment of Primary Testicular Lymphoma
Authors: Mihaljevic Biljana , Vukovic Vojin , Smiljanic Mihailo , Milic Natasa , Todorovic Milena , Bila Jelena , Andjelic Bosko , Djurasinovic Vladislava , Jelicic Jelena , Antic Darko
Published: April 2014

Background: Primary testicular lymphoma (PTL) is a rare and highly aggressive extranodal non-Hodgkin's lymphoma. Patients and Methods: We evaluated the clinical and histopathological features and outcomes of 10 PTL patients treated in the period of 2003-2013 with multimodal therapy (rituximab, CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), intrathecal prophylaxis, irradiation of the contralateral testis) following orchiectomy. Results: Complete remission was achieved in 8 patients after first-line therapy while 2 patients had disease progression. The median follow-up duration was 30 months (range 6-110 months). Relapse occurred in 3 patients. 1 patient relapsed in the contralateral testis, while the other 2 patients relapsed to the skin and the central nervous system (CNS), respectively. The time to relapse was 2, 8, and 9 months. Patients with disease progression and relapse received ESHAP (etoposide, methylprednisolone, cytarabine, and cisplatin) as salvage treatment, except for 1 patient who was treated with palliative radiotherapy. After second-line therapy, only 1 patient had a short partial remission of 2 months. The median overall survival was 48 months, and the mean progression-free survival was 36 months (the median was not reached). Conclusions: We evaluated 10 patients with PTL treated with rituximab plus CHOP, prophylactic intrathecal chemotherapy, and prophylactic irradiation of the contralateral testis, resulting in good outcome and low incidence of relapse in the contralateral testis; however, the benefit of intrathecal chemotherapy is not yet confirmed.
Dialysis and Quality of Dialysate in Southeast Asian Developing Countries
Authors: Naramura Tomotaka , Hyodo Toru , Kokubo Kenichi , Matsubara Hirokazu , Wakai Haruki , Nakajima Fumitaka , Shibahara Nobuhisa , Yoshida Kazunari , Komaru Yoshinori , Kawanishi Hideki , Kawamura Akio , Hidai Hideo , Takesawa Shingo
Published: April 2014

Background: The number of dialysis patients has been increasing in Southeast Asia, but statistical data about these patients and on the quality of dialysates in Southeast Asian dialysis facilities are still imprecise. For this study, dialysis-related statistical data were collected in Southeast Asia. Methods: A survey of the quality of dialysates was carried out at 4 dialysis facilities in Vietnam and Cambodia. The dialysis patient survey included the numbers of dialysis facilities and patients receiving dialysis, a ranking of underlying diseases causing the initiation of dialysis, the number of patients receiving hemodialysis (HD)/on-line hemodiafiltration/continuous ambulatory peritoneal dialysis, the number of HD monitoring devices installed, the cost of each session of dialysis (in USD), the percentage of out-of-pocket payments, and the 1-year survival rates of the dialysis patients (in percent). The dialysate survey covered the endotoxin (ET) level and bacterial count in tap water, in water filtered through a reverse osmosis system and in dialysate. Results: In each of the countries, the most frequent reason for the initiation of dialysis is diabetes mellitus. HD is usually carried out according to the ‘reuse' principle. The 1-year survival rates are 70% in Myanmar and about 90% in the Philippines and Malaysia. The ET levels in standard dialysates were satisfactory at 2 facilities. The bacterial counts in dialysates were not acceptable at any of the facilities investigated. Conclusion: There is an urgent need to teach medical workers involved in dialysis how to prepare sterile and ET-free dialysates.
Afatinib with Concurrent Radiotherapy in a Patient with Metastatic Non-Small Cell Lung Cancer
Authors: Atmaca Akin , Al-Batran Salah-Eddin , Allgäuer Michael , Jäger Elke
Published: April 2014

Background: The combination of radiotherapy and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) such as erlotinib and gefitinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) has not been widely investigated. For afatinib, a new second generation irreversible pan-EGFR TKI, no clinical trials in this setting have as yet been performed. Case Report: We report a patient with a pretreated metastatic NSCLC receiving afatinib in combination with concomitant palliative radiotherapy to the mediastinum and primary lung tumor. The treatment was feasible and well tolerated. The patient achieved a partial response in the irradiated tumor region and the metastatic sites. Conclusion: The combination of afatinib and radiotherapy is promising and should be investigated further. However, because of the limited experience and potential side effects known for other EGFR TKIs, a decision for treatment outside a clinical trial has to be made very carefully, balancing the risk and benefit on an individual patient basis.
Progressive Outer Retinal Necrosis and Immunosuppressive Therapy in Myasthenia Gravis
Authors: Coisy Solène , Ebran Jean-Marc , Milea Dan
Published: April 2014

Introduction: Progressive outer retinal necrosis (PORN) is a rare but devastating infectious retinitis associated with varicella zoster virus (VZV) and responsible for severe visual loss. Case Report: A 59-year-old man treated for generalized myasthenia with oral azathioprine and prednisone presented with severe unilateral necrotizing retinitis. Polymerase chain reaction of the aqueous and vitreous humors was diagnostic for VZV PORN. Conclusion: VZV PORN is a severe potential ocular complication of immunosuppression, prompting urgent diagnosis and appropriate treatment.
Relationship Between Time in Therapeutic Range and Comparative Treatment Effect of Rivaroxaban and Warfarin: Results From the ROCKET AF Trial
Authors: Piccini Jonathan P. , Hellkamp Anne S. , Lokhnygina Yuliya , Patel Manesh R. , Harrell Frank E. , Singer Daniel E. , Becker Richard C. , Breithardt Günter , Halperin Jonathan L. , Hankey Graeme J. , Berkowitz Scott D. , Nessel Christopher C. , Mahaffey Kenneth W. , Fox Keith A. A. , Califf Robert M. ,   ROCKET AF Investigators
Published: April 2014

Background

Time in therapeutic range (
TTR
) is a standard quality measure of the use of warfarin. We assessed the relative effects of rivaroxaban versus warfarin at the level of trial center
TTR
(c
TTR
) since such analysis preserves randomized comparisons.

Methods and Results

TTR
was calculated using the Rosendaal method, without exclusion of international normalized ratio (
INR
) values performed during warfarin initiation. Measurements during warfarin interruptions >7 days were excluded.
INR
s were performed via standardized finger‐stick point‐of‐care devices at least every 4 weeks. The primary efficacy endpoint (stroke or non‐central nervous system embolism) was examined by quartiles of c
TTR
and by c
TTR
as a continuous function. Centers with the highest c
TTR
s by quartile had lower‐risk patients as reflected by lower
CHADS
2
scores (
P
<0.0001) and a lower prevalence of prior stroke or transient ischemic attack (
P
<0.0001). Sites with higher c
TTR
were predominantly from North America and Western Europe. The treatment effect of rivaroxaban versus warfarin on the primary endpoint was consistent across a wide range of c
TTR
s (
P
value for interaction=0.71). The hazard of major and non‐major clinically relevant bleeding increased with c
TTR
(
P
for interaction=0.001), however, the estimated reduction by rivaroxaban compared with warfarin in the hazard of intracranial hemorrhage was preserved across a wide range of threshold c
TTR
values.

Conclusions

The treatment effect of rivaroxaban compared with warfarin for the prevention of stroke and systemic embolism is consistent regardless of c
TTR
.
Glutathionylation Mediates Angiotensin II–Induced eNOS Uncoupling, Amplifying NADPH Oxidase‐Dependent Endothelial Dysfunction
Authors: Galougahi Keyvan Karimi , Liu Chia‐Chi , Gentile Carmine , Kok Cindy , Nunez Andrea , Garcia Alvaro , Fry Natasha A. S. , Davies Michael J. , Hawkins Clare L. , Rasmussen Helge H. , Figtree Gemma A.
Published: April 2014

Background

Glutathionylation of endothelial nitric oxide synthase (
eNOS
) “uncouples” the enzyme, switching its function from nitric oxide (NO) to O
2
•−
generation. We examined whether this reversible redox modification plays a role in angiotensin II (Ang II)‐induced endothelial dysfunction.

Methods and Results

Ang II increased
eNOS
glutathionylation in cultured human umbilical vein endothelial cells (HUVECs), rabbit aorta, and human arteries in vitro. This was associated with decreased NO bioavailability and
eNOS
activity as well as increased O
2
•−
generation. Ang II‐induced decrease in
eNOS
activity was mediated by glutathionylation, as shown by restoration of function by glutaredoxin‐1. Moreover, Ang II‐induced increase in O
2
•−
and decrease in NO were abolished in HUVECs transiently transfected, with mutant
eNOS
rendered resistant to glutathionylation. Ang II effects were nicotinamide adenine dinucleotide phosphate (NADPH) oxidase dependent because preincubation with gp 91ds‐tat, an inhibitor of NADPH oxidase, abolished the increase in
eNOS
glutathionylation and loss of
eNOS
activity. Functional significance of glutathionylation in intact vessels was supported by Ang II‐induced impairment of endothelium‐dependent vasorelaxation that was abolished by the disulfide reducing agent, dithiothreitol. Furthermore, attenuation of Ang II signaling in vivo by administration of an angiotensin converting enzyme (ACE) inhibitor reduced
eNOS
glutathionylation, increased NO, diminished O
2
•−
, improved endothelium‐dependent vasorelaxation and reduced blood pressure.

Conclusions

Uncoupling of
eNOS
by glutathionylation is a key mediator of Ang II‐induced endothelial dysfunction, and its reversal is a mechanism for cardiovascular protection by ACE inhibition. We suggest that Ang II‐induced O
2
•−
generation in endothelial cells, although dependent on NADPH oxidase, is amplified by glutathionylation‐dependent
eNOS
uncoupling.
Narrowing Sex Differences in Lipoprotein Cholesterol Subclasses Following Mid‐Life: The Very Large Database of Lipids (VLDL‐10B)
Authors: Swiger Kristopher J. , Martin Seth S. , Blaha Michael J. , Toth Peter P. , Nasir Khurram , Michos Erin D. , Gerstenblith Gary , Blumenthal Roger S. , Jones Steven R.
Published: April 2014

Background

Women have less risk of atherosclerotic cardiovascular disease compared with men up until midlife (ages 50 to 60), after which the gap begins to narrow post menopause. We hypothesized that the average lipid profile of women undergoes unfavorable changes compared with men after midlife.

Methods and Results

We examined lipids by sex and age in the Very Large Database of Lipids 10B (
VLDL 10B
) study. The analysis included 1 350 908 unique consecutive patients clinically referred for lipoprotein testing by density gradient ultracentrifugation from 2009 to 2011. Ratio variables were created for density subclasses of
LDL
‐C,
HDL
‐C, and
VLDL
‐C (
LLDR
,
LHDR
,
LVDR
, respectively). Men showed higher median
LDL
‐C values than women for ages 20 to 59, with the greatest difference in their 30s: 146 mg/dL in men versus 130 mg/dL in women. In contrast, women consistently had higher values after midlife (age 60), for example ages 70 to 79: 129 mg/dL in women versus 112 mg/dL in men. After age 50, women had higher
LDL
‐C each decade, for example 14% higher from their 30s to 50s, while HDL‐C concentrations did not differ. Women had more buoyant LDL‐C and HDL‐C (lower LLDR and LHDR) than men at all ages but the gap closed in higher age groups. In contrast, women had a generally denser VLDL‐C (higher LVDR) leading into midlife, with the gap progressively closing in higher age groups, approximating that of men in their 60s and 70s.

Conclusion

The narrowing sex differential in cardiovascular disease risk after midlife is mirrored by a higher total atherogenic lipoprotein cholesterol burden in women and a closer approximation of the less favorable density phenotype characteristic of men.
Valve morphology of three species of Neidiomorpha (Bacillariophyceae) from Zoigê Wetland, China, including description of Neidiomorpha sichuaniana nov. sp.
Authors: LIU QI , KOCIOLEK J. P. , WANG QUANXI , FU CHENGXIN
Published: April 2014

A new diatom species, Neidiomorpha sichuaniana sp. nov., is described from Zoigê Wetland, China. The morphology of N. sichuaniana is documented by light and scanning electron microscope and discussed in detail, including a comparison with the two other species in the genus Neidiomorpha also found in Zoigê. Neidiomorpha sichuaniana has a smaller central area and smaller central constriction than N. binodiformis and less apiculate ends than N. binodis. We comment on the systematic position of Neidiomorpha based on the morphology of these three species.
Studies in Asian Nervilia (Nervilieae, Epidendroideae, Orchidaceae) IV: N. umphangensis, a new species from the Thai–Myanmar border
Authors: GALE STEPHAN W. , RUEANGRUEA SUKID , SUDDEE SOMRAN
Published: April 2014

The Old World terrestrial orchid genus Nervilia Commerson ex Gaudichaud-Beaupré in Freycinet (1829: 421, t. 35) remains poorly known, especially in Asia. It is diagnosed by its hysteranthous habit, in which a single, terminal, one–several-flowered inflorescence and a single ovate to cordate leaf emerge in succession from a single globose tuber. This temporal separation of flowers and leaves makes complete herbarium collections rare. Some species have been described only from flowers, others have been recorded only from leaves, and occasionally the two are mismatched on the same herbarium sheet. The situation is compounded by the ephemeral nature of the plants; the flowering phase is brief, fructification is rapid with fruit set usually occurring prior to leaf flush, and all above-ground parts die back at the end of the growing season, making plants difficult to locate in the field and under-represented in herbaria. Accordingly, species circumscriptions are often inadequate, vague and sometimes overlapping, and the loss or concealment of potentially useful characters (e.g. leaf coloration, lip indumentum) in dried herbarium (especially type) material challenges their critical re-evaluation.
Nomenclatural notes on Indian Calamus (Arecaceae)
Authors: V. B. SREEKUMAR , HENDERSON ANDREW
Published: April 2014

Several changes are proposed for Indian species of Calamus: C. basui is placed in synonymy under C. baratangensis; C. delessertianus is placed in synonymy under C. tenuis; C. dransfieldii, C. lacciferus, C. neelagiricus, C. prasinus, C. renukae, and C. shendurunii are considered members of a species complex and are placed in synonymy under C. gamblei; C. nicobaricus is placed in synonymy under C. pseudorivalis; C. pseudofeanus is shown to be based on a mixed collection and is placed in synonymy under C. vattayila; C. travancoricus is placed in synonymy under C. rheedei; and C. semierectus is placed in synonymy under C. andamanicus.
Habenaria osmastonii (Orchidaceae), a new terrestrial orchid from the Andaman Islands, India
Authors: KARTHIGEYAN K. , MAINA V. , SUMATHI R. , JAYANTHI J. , JALAL J.S.
Published: April 2014

Habenaria osmastonii, a new species of terrestrial orchid is described from Rutland Island of the Andaman Islands, India. This species differs from H. richardiana by having radical leaves, fewer and smaller flowers, shallowly denticulate, falcate lip side lobes and a lip midlobe slightly longer than the side lobes. A detailed description, illustrations and photographs are provided.
Ultrastructure of antennal sensilla in Hydrotaea armipes (Fallén) (Diptera: Muscidae): New evidence for taxonomy of the genus Hydrotaea
Authors: WANG QI-KE , LIU XIAN-HUI , LU PENG-FEI , ZHANG DONG
Published: April 2014

The morphology and ultrastructure of the antennal sensilla of male Hydrotaea (Hydrotaea) armipes (Fallén) are examined via scanning electron microscopy in order to highlight the importance of antennal sensilla as a source of morphological characters for taxonomy and phylogeny of Hydrotaea. Antennal scape and pedicel have only one type of sensilla, the sharp-tipped chaetic sensilla, whereas antennal funiculus possesses several types of sensilla, including trichoid sensilla, two subtypes of basiconic sensilla, coeloconic sensilla and clavate sensilla. These results are compared with previously published studies on other fly species, especially on H. (H.) irritans (Fallén) and H. (Ophyra) chalcogaster (Wiedemann), and there are possible uniquely derived characters or diagnostic characters examined on antennal pedicel and antennal funiculus, which suggests either affinities and divergence between species at subgenus level. Thus, new morphological evidence is provided, which might help to develop the much disputed taxonomy of genus Hydrotaea Robineau-Desvoidy in future.
A new Rhagovelia (Hemiptera: Heteroptera: Veliidae) from the Brazilian Amazon, with a key to species of the robusta group known from the country
Authors: MOREIRA FELIPE FERRAZ FIGUEIREDO , BARBOSA JULIANNA FREIRES
Published: April 2014

Rhagovelia zecai sp. nov., from the Brazilian Amazon, is described, illustrated, compared with similar species, and included in a key to species of the robusta group recorded from the country.