bluuebunny/crossref_metadata_2025 huggingface dataset:
A General Asymmetric Aldol Reaction of Silyl Ketene Acetals Derived from Simple Esters to Aryl α‐Keto Esters
Authors: Le Engers Julie , Pagenkopf Brian L.
Published: October 2009

A general method for the enantioselective addition of O,O‐ketene silyl acetals made from simple esters to α‐keto esters catalyzed by a CuCl2·bis(oxazoline) complex is reported that overcomes the limitations of the classic aldol reaction, such as steric intolerance and the need for expensive thio esters. This method excels with aryl α‐keto esters and provides products in good yield and high ee that are not readily available by alternative strategies. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2009)
Enantioselective analysis of propranolol and 4‐hydroxypropranolol by CE with application to biotransformation studies employing endophytic fungi
Authors: Borges Keyller Bastos , Pupo Mônica Tallarico , Bonato Pierina Sueli
Published: October 2009

A CE method is described for the enantioselective analysis of propranolol (Prop) and 4‐hydroxypropranolol (4‐OH‐Prop) in liquid Czapek medium with application in the study of the enantioselective biotransformation of Prop by endophytic fungi. The electrophoretic conditions previously optimized were as follows: an uncoated fused‐silica capillary, 4% w/v carboxymethyl‐β‐CD in 25 mmol/L triethylamine/phosphoric acid (H3PO4) buffer at pH 9 as running electrolyte and 17 kV of voltage. UV detection was carried out at 208 nm. Liquid–liquid extraction using diethyl ether: ethyl acetate (1:1 v/v) as extractor solvent was employed for sample preparation. The calibration curves were linear over the concentration range of 0.25–10.0 μg/mL for each 4‐OH‐Prop enantiomer and 0.10–10.0 μg/mL for each Prop enantiomer (r≥0.995). Within‐day and between‐day relative standard deviations and relative errors for precision and accuracy were lower than 15% for all the enantiomers. Finally, the validated method was used to evaluate Prop biotransformation in its mammalian metabolite 4‐OH‐Prop by some selected endophytic fungi. The screening of five strains of endophytic fungi was performed and all of them could biotransform Prop to some extent. Specifically,Glomerella cingulata(VA1) biotransformed 47.8% of (−)‐(S)‐Prop to (−)‐(S)‐4‐OH‐Prop with no formation of (+)‐(R)‐4‐OH‐Prop in 72 h of incubation.
On‐line combination of CE and microscopy: An insight into the migration of microorganisms
Authors: Petr Jan , Ryparová Olga , Znaleziona Joanna , Maier Vítězslav , Ševčík Juraj
Published: October 2009

Identification of microbial contamination by CE has interested many researchers mainly because of the high speed of CE analysis. However, the CE separation of such big structures brings a lot of questions mainly about the behavior of microorganisms and about the mechanism of separation. In this work, we constructed a simple apparatus where a microscope was used as one detector and a UV detector was used as the second one and we made the comparison of three typical setups for CE of microorganisms. Saccharomyces cerevisiae was chosen as a model microorganism and was analyzed in bare fused‐silica capillaries, covalently modified capillaries and dynamically modified capillaries by poly(ethylene oxide) or CTAB. Results showed that the use of CE instrument directly connected with a microscope could be advantageous for the study of separation mechanisms and/or migration behavior.
Estimation and testing of portfolio Value‐at‐Risk based on L‐comoment matrices
Authors: Liu Wei‐Han
Published: October 2009

This study employs L‐comoments introduced by Serfling and Xiao (2007) into portfolio Value‐at‐Risk estimation through two models: the Cornish–Fisher expansion (Draper, N. R. & Tierney, D. E., 1973) and modified VaR (Zangari, P., 1996). Backtesting outcomes indicate that modified VaR outperforms and L‐comoments give better estimates of portfolio skewness and excess kurtosis than do classical central moments in modeling heavy‐tailed distributions. © 2009 Wiley Periodicals, Inc. Jrl Fut Mark 30:897–908, 2010
A new synthesis of alkane and polyfluoroalkanesulfonyl chlorides
Authors: Benfodda Zohra , Guillen Franck , Arnion Hélène , Dahmani Abdelkader , Blancou Hubert
Published: October 2009

This study describes a new and advantageous procedure for the synthesis of alkanesulfonyl chlorides (2) by the reaction of alkyl thiocyanates (1) with sulfuryl chloride in a mixture of acetic acid and water. The alkanesulfonyl chlorides were obtained in good yields. © 2009 Wiley Periodicals, Inc. Heteroatom Chem 20:355–361, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hc.20559
Allelic loss of chromosomes 8 and 19 in MENX‐associated rat pheochromocytoma
Authors: Shyla Alena , Hölzlwimmer Gabriele , Calzada‐Wack Julia , Bink Karin , Tischenko Oleg , Guilly Marie‐Noëlle , Chevillard Sylvie , Samson Elenore , Graw Jochen , Atkinson Michael J. , Pellegata Natalia S.
Published: October 2009

Pheochromocytomas are neoplasias of neural crest origin that arise from the chromaffin cells of the adrenal medulla. Pheochromocytomas arise with complete penetrance in rats homozygous for a germ‐line frameshift mutation of Cdkn1b, encoding the cell cycle inhibitor p27KIP1 (MENX syndrome). We performed a genome‐wide scan for allelic imbalance comparing 20 rat pheochromocytoma DNAs with normal rat DNA to better understand the pathobiology of the tumors and to correlate the findings with human pheochromocytoma. We identified allelic imbalance (AI) at candidate regions on rat chromosomes 8 and 19. Interestingly, the regions often lost in rat tumors are syntenic to regions involved in human pheochromocytomas. Fluorescence in situ hybridization analysis further validated the AI data. Sdhd and Rassf1a were analyzed in detail as they map to regions of AI on chromosome 8 and their homologues are implicated in human pheochromocytoma: we found no genetic mutations nor decreased expression. We also analyzed additional candidate genes, that is, rat homologues of genes predisposing to human pheochromocytoma and known tumor‐suppressor genes, but we found no AI. In contrast, we observed frequent overexpression of Cdkn2a and Cdkn2c, encoding the cell cycle inhibitors p16INK4a and p18INK4c, respectively. The relative small number of allelic changes we found in rat pheochromocytoma might be related to their nonmalignant status and losses at chromosomes 8 and 19 are events that precede malignancy. Because of the high concordance of affected loci between rat and human tumors, studies of the MENX‐associated pheochromocytomas should facilitate the identification of novel candidate genes implicated in their human counterpart.
Phosphatidylinositol 4,5‐bisphosphate‐specific AKT1 is oncogenic
Authors: Dannemann Nadine , Hart Jonathan Ross , Ueno Lynn , Vogt Peter K.
Published: October 2009

The protein kinase AKT1 (v‐akt murine thymoma viral oncogene homolog 1), also referred to as protein kinase B (PKB), is an essential mediator of the phosphatidylinositol 3‐kinase signaling pathway. Elevated activity of AKT1 is common in human cancer. Localization at the plasma membrane, leading to enhanced phosphorylation and activation of AKT1, is an important factor determining the oncogenicity of this kinase. Although the phosphatidylinositol 3‐kinase signaling pathway is frequently upregulated in cancer, cancer‐specific mutations in AKT1 are not common. Recently, such a mutation has been identified in breast, colon and ovarian cancers. The mutation is located in the pleckstrin homology (PH) domain of AKT1 and results in a glutamic acid to lysine substitution at residue 17. The resultant change in the conformation of the PH domain facilitates membrane binding of the mutant protein. Here we show that exchange of the PH domain leading to preferential binding of phosphatidylinositol 4,5‐bisphosphate (PIP2) over phosphatidylinositol 3,4,5‐trisphosphate (PIP3) constitutively activates AKT1. AKT1 with this altered PIP affinity induces oncogenic transformation in cultures of chicken embryo fibroblasts and causes neoplastic growth and angiogenesis in the chorioallantoic membrane of the chicken embryo. Gain‐of‐function mutants of AKT1 may not be affected by PI3K inhibitors that are currently in development. Therefore, AKT1 remains a distinct and important cancer target.
Dietary patterns and gastric cancer in a Portuguese urban population
Authors: Bastos Joana , Lunet Nuno , Peleteiro Bárbara , Lopes Carla , Barros Henrique
Published: October 2009

Dietary patterns analysis is a powerful technique to study the relations between diet and cancer. We aimed to quantify the association between dietary patterns and gastric cancer, by location and histological type, according to Helicobacter pylori infection status. We analyzed 591 incident cases of gastric adenocarcinoma and 1,463 community controls. Dietary intake was assessed using a validated food frequency questionnaire. Principal components and cluster analyses were used to define dietary patterns. Anti‐H. pylori IgG was assessed by ELISA. Age‐, gender‐, education‐ and total energy intake‐adjusted odds ratios (OR) were computed. Three dietary patterns were identified, with the following main characteristics: (I) high consumption of fruits and dairy products, and low consumption of alcoholic beverages; (II) low consumption of fruit, salads, vegetables, dairy products, fish and meat; (III) high consumptions of most food groups and low vegetable soup intake. Compared to pattern I, the risk of gastric cancer was higher for pattern II (OR = 1.68, 95% CI: 1.31–2.14) but not for pattern III (OR = 0.80, 95% CI: 0.57–1.14), with no effect modification by H. pylori infection. The association was similar for cardia and non‐cardia gastric cancer, but for tumors of the diffuse Laurén histological type, the association was weaker for pattern II vs. I (OR = 1.32, 95% CI: 0.83–2.08) and a protective effect was observed for pattern III vs. I (OR = 0.43, 95% CI: 0.22–0.87). Our results confirm the protective effect of high fruit and vegetables intake, and show a differential association according to histological type. No effect modification by H. pylori infection was observed.
miRNA control of tumor cell invasion and metastasis
Authors: Baranwal Somesh , Alahari Suresh K.
Published: October 2009

MicroRNAs have emerged as a novel class of noncoding RNAs that regulate gene expression at the post‐translational level in almost every biological event. A large body of evidence indicates that microRNAs regulate the expression of different genes that play an important role in cancer cell invasion, migration and metastasis. In this review, we briefly describe the role of various miRNAs in invasion, migration and metastasis which are essential steps during cancer progression.
Thrombotic microangiopathy during peripheral blood stem cell mobilization
Authors: Naina Harris V.K. , Gertz Morie A. , Elliott Michelle A.
Published: October 2009

Granulocyte colony‐stimulating factor (GCSF) is currently the most widely used cytokine for stem cell mobilization. There are few studies suggesting GCSF administration may induce activation of both coagulation and endothelial cells that could favor the developing of thrombotic events. We report a 58‐year‐old female with vasculitis and renal impairment. She was found to have an underlying monoclonal gammopathy of unknown significance (MGUS). The monoclonal protein was felt to play a role in her underlying renal disease and peripheral neuropathy. She was considered a candidate for peripheral blood stem cell transplantation to manage the monoclonal protein. During stem cell mobilization with GCSF, she developed worsening of anemia; thrombocytopenia and worsening of renal function. She was diagnosed with thrombotic microangiopathy (TMA) which was successfully treated with therapeutic plasma exchange and rituximab. It is possible that GCSF may have directly (activating endothelial cells) or indirectly (activation of underlying autoimmune disorder) contributed to TMA in this patient. J. Clin. Apheresis 2009. © 2009 Wiley‐Liss, Inc.
Genome modification in human embryonic stem cells
Authors: Tenzen Toyoaki , Zembowicz Filip , Cowan Chad A.
Published: October 2009

Induced pluripotent stem cell (iPSC) technology has emerged as the most promising method for generating patient‐specific human embryonic stem (ES) cells and adult stem cells (Takahashi et al., 2007, Cell 131:861–872; Wernig et al., 2007, Nature 448:318–324; Park et al., 2008, Nature 451:141–146). So far, most studies of direct reprogramming have been done by using lentiviruses/retroviruses encoding the reprogramming factors. This represents a major limitation to therapeutic applications since viral integration in the host genome increases the risk of tumorigenicity, and low‐level residual expression of reprogramming factors may alter the differentiation potential of the human iPSCs (hiPSCs). As a result, more attention has been paid to developing new techniques to manipulate the human genome, with the goal of making safer hiPSCs that have fewer or no lesions or alterations in the genome. Additionally, the efficiency of reprogramming and of homologous recombination in gene therapy must be improved, if iPSC technology is to be a viable tool in regenerative medicine. Here, we summarize the recent developments in human genome manipulation for generating hiPSCs and advances in homologous recombination for gene targeting. J. Cell. Physiol. 222: 278–281, 2010. © 2009 Wiley‐Liss, Inc.
Quick and efficient method for genetic transformation of biopolymer‐producing bacteria
Authors: Wang Qin , Mueller Alexander P. , Leong Chean Ring , Matsumoto Ken'ichiro , Taguchi Seiichi , Nomura Christopher T.
Published: October 2009

In order to genetically modify microorganisms capable of producing polyhydroxyalkanoate (PHA) biopolymers, a simple and rapid method to prepare freshly plated Pseudomonas cells for transformation via electroporation was developed. This method can be used to transfer both replicative plasmids and linear DNA to knock out genes into the cells. The transformation efficiencies were in the range of ≥107 transformants µg−1 DNA for replicative plasmids and ≥106 transformants µg−1 DNA for linear DNA, which are comparable with commercially available competent cells. Furthermore, this transformation procedure can be performed in less than 10 min, saving a great deal of time compared with traditional methods. Knockout mutants of several Pseudomonas species were generated by transformation of linear DNA and these mutations were verified by PCR and analysis of PHA content. Copyright © 2009 Society of Chemical Industry
Long‐term survivors of esophageal cancer: Disease‐specific quality of life, general health and complications
Authors: Gockel I. , Gönner U. , Domeyer M. , Lang H. , Junginger Th.
Published: October 2009

Introduction

The aim of our study was to assess the quality of life as well as secondary cancers/diseases and esophagectomy‐related or unrelated interventions in the long‐term course of surgery.

Patients and Methods

Out of 417 patients who underwent esophageal resection for cancer between September 1985 and November 2003, 85 were defined as long‐term survivors (≥5 years). Fifty patients still alive in November 2008 complied with our inclusion criteria. The general (QLQ‐C 30, version 3.0) as well as the esophagus specific quality of life (QLQ‐OES 18) were analyzed with the help of the EORTC QLQ‐questionnaires.

Results

The median observation interval since the operation was 100.1 (range 60–238) months. A median Global Health Status of quality of life (EORTC QLQ‐C 30) of 66.7 was found (range 16.7–100). Among the functioning scores, emotional (83.3 (range 16.7–100)) and cognitive functioning (83.3 (range 0–100)) were highest. The esophagus‐specific quality of life (EORTC QLQ‐OES 18) revealed a median value (scale 0–100) of 0 each for dysphagia and difficulties with swallowing saliva, whilst reflux was a major problem with a score of 50.0 (range 0–100).

Conclusion

Our results show that long‐term survival with a good quality of life is possible after curative esophagectomy for carcinoma. J. Surg. Oncol. 2010;102:516–522. © 2009 Wiley‐Liss, Inc.
Multivariant optimization, validation, and application of capillary electrophoresis for simultaneous determination of polyphenols and phenolic acids in Brazilian wines
Authors: Peres Renato G. , Micke Gustavo A. , Tavares Marina F. M. , Rodriguez‐Amaya Delia B.
Published: October 2009

A method for the simultaneous determination of the stilbene resveratrol, four phenolic acids (syringic, coumaric, caffeic, and gallic acids), and five flavonoids (catechin, rutin, kaempferol, myricetin, and quercetin) in wine by CE was developed and validated. The CE electrolyte composition and instrumental conditions were optimized using 27‐3 factorial design and response surface analysis, showing sodium tetraborate, MeOH, and their interaction as the most influential variables. The optimal electrophoretic conditions, minimizing the chromatographic resolution statistic values, consisted of 17 mmol/L sodium tetraborate with 20% methanol as electrolyte, constant voltage of 25 kV, hydrodynamic injection at 50 mbar for 3 s, and temperature of 25°C. The R2 values for linearity varied from 0.994 to 0.999; LOD and LOQ were 0.1 to 0.3 mg/L and 0.4 to 0.8 mg/L, respectively. The RSDs for migration time and peak area obtained from ten consecutive injections were less than 2% and recoveries varied from 97 to 102%. The method was applied to 23 samples of inexpensive Brazilian wines, showing wide compositional variation.
Characterization of the polyphenolic fraction of Morus alba leaves extracts by HPLC coupled to a hybrid IT‐TOF MS system
Authors: Dugo Paola , Donato Paola , Cacciola Francesco , Paola Germanò Maria , Rapisarda Antonio , Mondello Luigi
Published: October 2009

Infusions or dried leaves from Morus alba (L., Moraceae) have long been used in folk medicine for the prevention or treatment of several diseases. Despite the great interest in determining the role of phytonutrients as potential therapeutic agents, and the rising demand of natural sources with nutraceutic benefits, the antioxidant content of many foodstuffs is unknown, making accurate estimation for human dietary consumption and the correlation to human diseases difficult. The high content in polyphenols mainly accounts for in vitro and in vivo antioxidant activity of extracts obtained from this plant, and it is responsible for their preventive and therapeutic roles in a number of human diseases. In this study, we achieved full characterization and quantitation of flavonoids and other phenolic components extracted from lyophilized mulberry leaves, by maceration with ethanol. To tackle such a task, an RPLC‐diode array detector‐MS system was optimized, employing a partially porous octadecylsilica column as stationary phase. Identification of mulberry leaves constituents was carried out on the basis of the complementary information obtained from their migration times, diode array spectra, MS ions, and MS/MS fragments. The employment of the hybrid (IT‐TOF) mass spectrometer further allowed the structural assignment of a series of structural isomers. To the best of our knowledge, 11 out of 22 identified compounds are being reported in mulberry leaves for the first time, and the relative amounts determined, in the two cultivars analyzed.
Chemometric extraction of analyte‐specific chromatograms in on‐line gradient LC‐infrared spectrometry
Authors: Kuligowski Julia , Quintás Guillermo , Garrigues Salvador , de la Guardia Miguel
Published: October 2009

This work exploits the possibilities offered by the recently developed multivariate method named Science‐Based Calibration (SBC), for the extraction of ‘analyte‐specific’ chromatograms in on‐line gradient reversed phase LC‐infrared spectrometry (IR) in the presence of a high spectral and chromatographic overlapping between the analyte of interest, co‐eluting sample matrix constituents and the mobile phase components. The SBC method uses an experimentally measured single response spectrum of the analyte of interest and representative noise to calculate an optimum regression vector (bopt(1)). Then, the bopt(1) vector is used to predict the concentration of the analyte of interest in the spectra of the LC‐IR sample chromatograms. To evaluate the advantages and pitfalls of the proposed approach, two different situations were analysed on real LC‐IR data sets obtained from the injection of a series of standard solutions of four nitrophenols (p‐nitrophenol, 3‐methyl‐4‐nitrophenol, 2,4‐dinitrophenol and 4‐nitrophenol) in a reversed phase system under gradient conditions. In the first situation, the extraction of the ‘analyte‐specific’ chromatogram was carried out without previous knowledge of the spectral features of other interferents present in the sample matrix. In a second situation evaluated, data obtained from the LC injection of a sample blank is available. Results show the potential applicability of this technique in a variety of situations and evidenced that the proposed chemometric approach improves the selectivity and sensitivity of the LC‐IR hyphenation.
Application of dispersive liquid–liquid microextraction for the determination of phenylurea herbicides in water samples by HPLC‐diode array detection
Authors: Saraji Mohammad , Tansazan Neda
Published: October 2009

A simple dispersive liquid–liquid microextraction method combined with HPLC‐photodiode array detection has been developed for the determination of phenylurea herbicides in water samples. The herbicides studied included tebuthiuron, diuron, propanil, fluometuron, siduron, linuron, thidiazuron, and diflubenzuron. Several factors influencing the extraction efficiency of the studied compounds, such as extraction and disperser solvent type and their volumes, co‐solvent type and its fraction, and ionic strength were investigated and optimized. Under the optimum extraction conditions, the calibration graphs were linear in the range of 0.2–200 μg/L for target analytes. The enrichment factors were between 11 and 118. The LOD were in the range of 0.01–0.5 μg/L (S/N=3). The relative standard deviations obtained ranged from 3.0 to 7.8% (n=5).
Good for workers, good for companies: How knowledge sharing benefits individual employees
Authors: Reychav Iris , Weisberg Jacob
Published: October 2009

The paper aims to identify the ways in which explicit and tacit knowledge sharing occur in organizations and to investigate the impact of sharing these two knowledge types on the employee's rewards, performance, and intention to leave.

This paper focuses on two hi‐tech companies working in the telecommunications field producing cellular networks. The final sample consisted of 278 completed questionnaires from business departments including finance, R&D, marketing, IT, engineering, and manufacturing.

Explicit knowledge sharing is perceived by the employees as having: (1) a direct positive effect on the receipt of monetary rewards; (2) a positive indirect effect on the employee's performance; and it has a (3) positive direct and negative indirect effects on employee's intention to leave. Tacit knowledge sharing is perceived by employees as having: (1) a positive direct effect on the receipt of non‐monetary rewards; (2) a positive direct effect on performance; and (3) it has a positive indirect effect on employee's intention to leave.

Although the findings show that increased knowledge sharing results in positive outcomes at the individual level, the research model would benefit from an examination of larger samples for reasons of statistical complexity analysis and in order to allow for generalizability of the results to other companies that operate in similar environments. It would also be worthwhile to conduct a comparative analysis of companies from different industries.

Understanding knowledge‐sharing behaviors may prove helpful to managers in developing strategies to encourage organizational knowledge sharing and in the development of an organizational knowledge base. The knowledge sharing outcomes outlined here can give employees a way to predict potential positive outcomes and benefits that are likely to arise as a result of engaging in knowledge sharing activities.

The model enables for the first time to substantiate, in a valid way, to hypothesize that knowledge sharing within an organization is perceived by employees to be a rewarding behavior, improving employees' performance, and decrease the intention to leave. Copyright © 2009 John Wiley & Sons, Ltd.
Vocal process granuloma and glottal insufficiency: An overlooked etiology?
Authors: Carroll Thomas L. , Gartner‐Schmidt Jackie , Statham Melissa M. , Rosen Clark A.
Published: October 2009

Objectives/Hypothesis:

Vocal process granuloma has been attributed to intubation, laryngopharyngeal reflux, and phonotraumatic/hyperfunctional vocal behaviors. Vocal process granuloma has recurrence rates following surgical excision approaching 92%. We hypothesize that a portion of persistent or idiopathic cases of vocal process granuloma result from underlying glottal insufficiency (GI) caused by paresis, scar, or atrophy. Our goal was to examine our vocal process granuloma population and determine the incidence of GI, treatment interventions, and outcomes.

Study Design:

Retrospective chart review.

Methods:

Thirty‐four patients with vocal process granuloma were divided into surgically or conservatively managed groups. Patients were identified if they carried a diagnosis of GI. The time to resolution and number of recurrences within the overall treatment period was recorded and compared between subgroups. Pre‐ and post‐treatment Voice Handicap Index‐10 (VHI‐10) and Reflux Symptom Index (RSI) scores were compared.

Results:

Eighteen of 34 patients (53%) carried an underlying diagnosis of GI, 13/34 (38%) were treated surgically, and 8/13 (62%) surgical patients had underlying GI. VHI‐10 and RSI scores significantly improved after disease resolution (P < .05).

Conclusions:

The incidence of GI among patients with vocal process granuloma was 53%. Conservative therapies including treatment of laryngopharyngeal reflux and voice therapy may lead to resolution despite underlying glottal incompetence. If conservative measures fail, recognizing and treating glottal incompetence with true vocal fold augmentation may lead to a shorter surgical treatment course. Laryngoscope, 2010
Patient reported voice outcome in recurrent respiratory papillomatosis
Authors: van Nieuwenhuizen Annette J. , Rinkel Rico N. P. M. , de Bree Remco , Leemans C. René , Verdonck‐de Leeuw Irma M.
Published: October 2009

Objectives/Hypothesis:

To assess the impact of patient reported voice outcome on quality of life and emotional functioning in patients treated for recurrent respiratory papillomatosis (RRP).

Study Design:

Cross‐sectional.

Methods:

All adult patients treated for RRP between 1984 and 2008 were asked to participate. Outcome measures were obtained from questionnaires including VHI (Voice Handicap Index), HADS (Hospital Anxiety and Depression Scale), 36‐Item Short Form Health Survey (SF‐36), and Utrechtse Coping List.

Results:

Out of 45 included patients, 34 (22 males,12 females) participated (76%). Mean age was 52 years (range, 25–85 years). RRP was located only in the larynx in 90% of the cases. Adult onset RRP was diagnosed in 29 cases, juvenile onset RRP in 5. Median number of surgical procedures was five (range, 1–17). In this study cohort, 68% scored above the VHI cutoff point, and 18% had an increased risk for depression or anxiety disorders (HADS). VHI scores were related to age, time between consecutive surgeries, time since last surgery, and passive coping. They were not related to gender, onset of RRP, or location. VHI scores were related to the SF‐36 subscales social functioning (r = −0.43) and mental health (r = −0.43).

Conclusions:

Patients with RRP often report voice problems in daily life, and this is related to (a passive) coping style, social functioning, and mental health. Psychosocial intervention targeting an adaptive coping style may be beneficial in selected cases. Laryngoscope, 2010
Decoy NF‐κB fortified immature dendritic cells maintain laryngeal allograft integrity and provide enhancement of regulatory T cells
Authors: Lott David G. , Dan Olivia , Lu Lina , Strome Marshall
Published: October 2009

Objectives/Hypothesis:

The increased risk of malignancy associated with post‐transplant immunosuppression limits the potential of laryngeal transplantation as a reconstructive option. This risk may be mitigated by utilizing decoy nuclear factor kappa B (NF‐κB) immature dendritic cells (iDC) to provide donor‐specific tolerance. The purpose of this study was to explore whether tolerogenic properties of iDC can be applied to composite tissue transplantation.

Study Design:

Animal study.

Methods:

Five iDC‐injected mice were euthanized at 15, 30, and 60 days post‐laryngeal transplant. Control groups included five transplanted mice without immunosuppression, one iDC‐injected mouse euthanized prior to transplantation, one mouse without injection or transplantation, and one mouse administered mature DC to serve as an accelerated rejection control. Larynges were graded for rejection severity according to a grading scale. Draining lymph nodes and spleens were evaluated by flow cytometry to determine immunogenic activity of iDC and T cells locally and peripherally.

Results:

Each time group demonstrated moderate allograft rejection (rejection severity scores: 4.38, 5.10, 5.29). NF‐κB iDC‐treated mice had significantly less rejection at all time points compared to nonimmunosuppressed mice. Flow cytometry showed inhibition of cytotoxic T cell infiltration and expansion of regulatory T cells at the allograft site.

Conclusions:

iDC immunosuppression maintains laryngeal allograft integrity up to 60 days post‐transplantation. Regulatory T cells are enhanced at the allograft site, which serves to suppress immune cell activation and induce self‐antigen tolerance. iDC injection may lessen post‐transplant comorbidities by decreasing the systemic immune response and favorably affecting concurrent immunosuppressive dose sequencing for laryngeal allograft preservation. Laryngoscope, 2010
Clarithromycin inhibits rhinovirus‐induced bacterial adhesions to nasal epithelial cells
Authors: Wang Jong Hwan , Lee Si Hyeong , Kwon Hyun Ja , Jang Yong Ju
Published: October 2009

Objectives/Hypothesis:

We investigated the inhibitory effects of clarithromycin (CM) on the rhinovirus (RV)‐induced expression of fibronectin (Fn) and carcinoembryonic antigen‐related cell adhesion molecules (CEACAMs), which act as major receptors for Staphylococcus aureus and Haemophilus influenzae, respectively. We further investigated the effects of CM on secondary S. aureus and H. influenzae adhesions to RV‐infected primary human nasal epithelial cells (HNECs).

Methods:

Cells were pretreated with 10 μM CM 24 hours before RV‐16 infection and for 48 hours thereafter. The expression levels of Fn and CEACAMs were assayed by reverse transcriptase‐polymerase chain reaction and Western blotting. Bacterial adhesion to cells was assessed by confocal microscopy and the fluorescence intensity of adherent bacteria was analyzed using Image‐Pro Plus 5.1 (Media Cybernetics, Bethesda, MD).

Results:

Clarithromycin significantly inhibited the RV‐induced gene and protein expression of Fn and CEACAMs in HNECs. Compared with RV‐infected cells, CM treatment significantly reduced the adhesion levels of S. aureus and H. influenzae in RV‐infected HNECs to the levels seen in noninfected control cells.

Conclusions:

These findings indicate that CM has the potential to prevent secondary bacterial infections in RV‐infected HNECs by inhibiting the expression of Fn and CEACAM, thereby interfering with bacterial adhesion. Laryngoscope, 2010
Transoral approach for plunging ranula—10‐Year experience
Authors: Huang Shiang‐Fu , Liao Chun‐Ta , Chin Shy‐Chyi , Chen I‐How
Published: October 2009

Objective/Hypothesis:

Plunging ranulas (PRs) are infrequently encountered. The origin of PRs is mostly from the sublingual gland (SLG). Different routes to manage PRs include marsupialization, simple SLG excision, and combined SLG and submandibular gland (SMG) excision either transcervically or transorally. In this study, we demonstrated our experience managing PRs via transoral excision of the SLG with marsupialization.

Study Design:

Retrospective study.

Methods:

We retrospectively reviewed 20 patients at Chang Gung Memorial Hospital, Linkou, between January 1999 and April 2009. All patients received preoperative computed tomography or magnetic resonance imaging and were clinically diagnosed with PR. At surgery, the SLG was excised transorally with preservation of Wharton's duct and lingual nerve. The mucus contents of the PRs were drained through the posterior edge of the mylohyoid muscle.

Results:

Two patients were found to have final diagnosis of lymphangioma. Eighteen patients were eligible for analysis. The age distribution ranged from 6 to 48 years old. Sexual distribution was equally distributed. The successful rate was 17/18 (94.4%) with a lingual nerve paresthesia rate of 2/18 (11.1%). The paresthesia persisted for 3 and 6 months, respectively. One recurrent patient was salvaged by excision of the SMG and ranula. The other two recurrent patients received excision of the SMG and cyst and had a final diagnosis of lymphangioma.

Conclusions:

Transoral approach with excision of the SLG alone provides a high success rate (94.4%) with minor complications and could be the first choice in managing PRs. The results of this study confirm PRs mostly originate from the SLG. Laryngoscope, 2010
Patterns of recurrence and survival of head and neck adenoid cystic carcinoma after definitive resection
Authors: Oplatek Agnes , Ozer Enver , Agrawal Amit , Bapna Sumit , Schuller David E.
Published: October 2009

Objectives/Hypothesis:

To determine factors impacting recurrence and long‐term survival of adenoid cystic carcinoma (ACC) of the head and neck after definitive resection.

Study Design:

Retrospective cohort study at an academic tertiary care hospital.

Methods:

Patients with ACC of the head and neck treated at our institution were reviewed. Those not receiving surgery, or with metastatic disease were excluded. Clinicopathological data on each patient was collected.

Results:

Of 113 patients identified with ACC, 99 were studied. The overall median survival for the cohort was 71 months (mean ± standard deviation, 94 ± 79 months). American Joint Committee on Cancer (AJCC) tumor stage and N stage were independent predictors of survival on multivariate analysis. Mean overall survival (P = .001) and time to recurrence (P = .006) were lower for patients with cervical lymph node positive disease (N+). Tumors in major salivary glands were associated with longer survival (P = .027). The overall recurrence rate was 53%, with a mean time to recurrence of 63 ± 64 months. The presence of lymphovascular invasion predicted recurrence on multivariate analysis (P = .002), with advanced tumor stage predicting early (≤36 months) recurrence (P = .013). Among the 57 patients who received adjuvant radiation therapy, there was no difference in survival, rate of recurrence, or time to recurrence, when compared to patients treated with surgery alone.

Conclusions:

Clinicopathological variables including AJCC tumor stage, tumor site, presence of N+ disease, and lymphovascular invasion may be used as prognostic factors in predicting survival and recurrence after a definitive resection of ACC of the head and neck. Laryngoscope, 2010
Improvement of respiratory compromise through abductor reinnervation and pacing in a patient with bilateral vocal fold impairment
Authors: Broniatowski Michael , Grundfest‐Broniatowski Sharon , Hadley Aaron J. , Shah Nemath S. , Barbu Anca M. , Phillipbar Sue Ann , Strohl Kingman P. , Tucker Harvey M. , Tyler Dustin J.
Published: October 2009

Objectives/Hypothesis.

To determine whether respiratory compromise from bilateral vocal fold impairment (paralysis) can be objectively alleviated by reinnervation and pacing.

Methods.

A patient with paramedian vocal folds and synkinesis had a tracheotomy for stridor after bilateral laryngeal nerve injury and Miller Fisher syndrome. One posterior cricoarytenoideus (PCA) received a nerve‐muscle pedicle fitted with a perineural electrode for pacemaker stimulation. The airway was evaluated endoscopically and by spirometry for up to 1 year.

Results.

Bilateral vocal fold patency during quiet breathing was reversed to active vocal fold adduction during tracheal occlusion. Peak inspiratory flows (PIFs) were significantly higher (P < .001) after reinnervation. PIFs and glottic apertures increased further under stimulation (42 Hz, 1–4 mA, 42–400 μsec). although the differences were not significant.

Conclusions.

Based on our preliminary data, PCA reinnervation and pacing offer promise for amelioration of respiratory compromise after paradoxical adduction in bilateral vocal fold impairment. Laryngoscope, 2010
Quantitative estimation of the degree of hepatic macrovesicular steatosis in a disease-free population: A single-center experience in mainland China1
Authors: Liu Zuo-Jin , Gong Jian-Ping , Yan Lv-Nan
Published: October 2009

The aim of this study was to derive a simple equation to enable the extent of hepatic macrovesicular steatosis (HMS) to be predicted quantitatively from data obtained noninvasively and hence avoid unnecessary liver biopsies. One hundred sixty-seven potential living liver donors and 45 subjects suspected of having nonalcoholic fatty liver disease (NAFLD) underwent percutaneous liver biopsy to evaluate HMS quantitatively. Their hepatic unenhanced computed tomography (CT) attenuation, body mass index (BMI), and indices of serum lipids were reviewed. Logistic regression analysis was undertaken to screen for independent predictors of HMS. Linear regression analysis was then used to plot the relationship between the severity of histologically confirmed HMS and identified independent predictors of HMS. For potential donors with HMS of severity ≥ 5% by histological assessment, the following equation was derived:

HMS = 47.7 + 1.48BMI - 1.14CT (R
2 = 0.74)

The calculated HMS for potential donors with histologically confirmed HMS of severity < 5% seemed to be unreliable (R
2 = = 0.230, P < 0.3). In addition, in subjects suspected of having NAFLD, there was a close agreement between values for histologically confirmed HMS and calculated values for HMS derived from the equation (intraclass correlation coefficient = 0.88). Hepatic CT imaging in conjunction with other noninvasive clinical data may enable the extent of HMS to be accurately predicted with the equation derived from potential donors with appreciable degrees of histologically confirmed HMS. Liver Transpl 15:1605–1612, 2009. © 2009 AASLD.
Treatment with immunoglobulin improves outcome for pediatric liver transplant recipients1
Authors: Bucuvalas John C. , Anand Ravinder
Published: October 2009

Immunoglobulin mitigates autoimmune disease and facilitates acceptance of ABO-incompatible transplanted organs. To test the hypothesis that treatment with immunoglobulin is associated with improved graft survival and a decreased rate of allograft rejection, a cohort study of primary liver transplant recipients in the Studies of Pediatric Liver Transplantation registry was performed. The outcomes of 336 pediatric liver transplant recipients who received immunoglobulin within 7 days of liver transplantation were compared with the outcomes of 1612 recipients who did not receive immunoglobulin. The outcome measures were patient survival, death-free graft survival, and allograft rejection. The Kaplan-Meier probability of patient survival was not different between patients treated with immunoglobulin and patients who did not receive immunoglobulin. Death-free graft survival was increased in patients treated with immunoglobulin (hazard ratio of death-free survival = 0.57, P = 0.014). The probability of allograft rejection at 3 months was 31% for patients treated with immunoglobulin versus 40% for patients who did not receive immunoglobulin (hazard ratio = 0.81, P = 0.02). The proportion of patients with 2 or more episodes of allograft rejection was lower in patients treated with immunoglobulin (13.1% with immunoglobulin versus 19.2% with no immunoglobulin, P = 0.009). Treatment with immunoglobulin was associated with a decreased risk for allograft rejection, whereas use of cyclosporine as the initial immunosuppression and transplantation before 2002 were independently associated with an increased risk of allograft rejection in pediatric liver transplantation recipients. A trend toward a decreased rate of retransplantation was detected in the population that received treatment with immunoglobulin. Liver Transpl 15: 1564–1569, 2009. © 2009 AASLD.
Donor and recipient selection leads to good patient and graft outcomes for right lobe split transplantation versus whole graft liver transplantation in adult recipients
Authors: Sandroussi Charbel , Crawford Michael , Lockwood David S. , Tang Patrick , Gallagher James P. , Pleass Henry , Strasser Simone I. , Shackel Nicholas A. , McCaughan Geoffrey W. , Verran Deborah J.
Published: October 2009

The outcomes of right lobe split (RLS) liver transplantation are variable in adult recipients. This report is an analysis of outcomes of our initial 5-year experience with the right lobe trisegment split graft. A retrospective analysis was performed of the recipient and graft outcomes from July 2002 to March 2007 of all adult recipients of RLS grafts versus recipients of whole grafts (WGs). All data were analyzed with Stata version 8 (Stata Corp., Texas). There were 43 (19.1%) RLS recipients and 182 (80.9%) WG recipients. The median Model for End-Stage Liver Disease score was 13 (7-23) in the RLS group and 18 (6-50) in the WG group (P < 0.001). Hepatocellular carcinoma and primary sclerosing cholangitis were more common in the RLS group (P < 0.05), whereas alcoholic cirrhosis and chronic hepatitis C were more common in the WG group. The median donor age was lower in the RLS group at 39 (13-61) years versus the WG group at 47 (12-79) years (P < 0.001). Primary nonfunction occurred in 1.6% of the WG patients only. Biliary complications occurred in 28% of the RLS patients versus 28% of the WG patients. Vascular complications occurred in 18% of the RLS patients versus 14% of the WG patients. The retransplantation rate was similar at 2.3% in the RLS group versus 4.9% in the WG group (P = not significant). Overall 3-year recipient survival was 92.7% in the RLS group versus 82.7% in the WG group (P = 0.284). Graft survival was 88.4% in the RLS group at 3 years versus 78.5% in the WG group (P = 0.304). In conclusion, good outcomes can be achieved with RLS liver transplantation in adult recipients without a detrimental effect on recipient or graft survival. Liver Transpl 15:1586–1593, 2009. © 2009 AASLD.
A prospective randomized open study in liver transplant recipients: Daclizumab, mycophenolate mofetil, and tacrolimus versus tacrolimus and steroids
Authors: Otero Alejandra , Varo Evaristo , de Urbina Jorge Ortiz , Martín-Vivaldi Rafael , Cuervas-Mons Valentin , González-Pinto Ignacio , Rimola Antoni , Bernardos Angel , Otero Santiago , Maldonado Jorge , Herrero Jose I. , Barrao Elena , Domínguez-Granados Rosa
Published: October 2009

This open-label, randomized study compared the efficacy of a regimen of corticosteroids and tacrolimus (standard therapy group, n = 79) with a regimen of daclizumab induction therapy in combination with mycophenolate mofetil and tacrolimus (modified therapy group, n = 78) in primary liver transplant recipients. The primary endpoint was biopsy-proven acute rejection (BPAR) at 24 weeks. Secondary endpoints included time to rejection and patient and graft survival. The incidence of BPAR was significantly reduced in the modified therapy group compared to the standard therapy group (11.5% versus 26.6%, respectively, P = 0.017). The time to rejection was significantly shorter in the standard therapy group compared with the modified therapy group (P = 0.044). There was no significant difference between groups in patient or graft survival. Hepatitis C virus–positive patients exhibited no differences from hepatitis C virus–negative patients with respect to the incidence of BPAR. A steroid-sparing regimen of daclizumab, mycophenolate mofetil, and tacrolimus was effective and well tolerated in the prevention of BPAR in adult liver transplant recipients in comparison with a standard regimen of tacrolimus and steroids. Liver Transpl 15:1542–1552, 2009. © 2009 AASLD.
Survival of Clostridium perfringens sepsis in a liver transplant recipient
Authors: Diaz Geraldine C. , Boyer Thomas , Renz John F.
Published: October 2009

Clostridium perfringens sepsis following orthotopic liver transplantation (OLT) is a rare but reported complication that historically results in mortality or emergent retransplantation (ReTx).1–7 Complications from C. perfringens emphysematous gastritis have contributed to the death of a healthy live liver donor as well.8 Herein, we describe the first documented survivor of C. perfringens sepsis following OLT managed without laparotomy or emergent ReTx. Liver Transpl 15:1469–1472, 2009. © 2009 AASLD.
Adenosine restores the hepatic artery buffer response and improves survival in a porcine model of small-for-size syndrome1
Authors: Kelly Dympna M. , Zhu Xiaocheng , Shiba Hiroaki , Irefin Samuel , Trenti Loris , Cocieru Andrei , Diago Teresa , Wang Lian Fu , Quintini Cristiano , Chen Zhong , Alster Joan , Nakagawa Shunichi , Miller Charles , Demetris Anthony , Fung John J.
Published: October 2009

The aim of the study is to define the role of the HABR in the pathophysiology of the SFS liver graft and to demonstrate that restoration of hepatic artery flow (HAF) has a significant impact on outcome and improves survival. Nine pigs received partial liver allografts of 60% liver volume, Group 1; 8 animals received 20% LV grafts, Group 2; 9 animals received 20% LV grafts with adenosine infusion, Group 3. HAF and portal vein flow (PVF) were recorded at 10 min, 60 min and 90 min post reperfusion, on POD 3 and POD 7 in Group 1, and daily in Group 2 and 3 up to POD 14. Baseline HAF and PVF (ml/100g/min) were 29 ± 12 (mean ± SD) and 74 ± 8 respectively, with 28% of total liver blood flow (TLBF) from the HA and 72% from the PV. PVF peaked at 10 mins in all groups, increasing by a factor of 3.8 in the 20% group compared to an increase of 1.9 in the 60% group. By POD 7-14 PVF rates approached baseline values in all groups. The HABR was intact immediately following reperfusion in all groups with a reciprocal decrease in HAF corresponding to the peak PVF at 10 min. However in the 20% group HAF decreased to 12 ± 8 ml/100 g/min at 90 min and remained low out to POD 7-14 despite restoration of normal PVF rates. Histopathology confirmed evidence of HA vasospasm and its consequences, cholestasis, centrilobular necrosis and biliary ischemia in Group 2. HA infusion of adenosine significantly improved HAF (p < .0001), reversed pathological changes and significantly improved survival (p = .05). An impaired HABR is important in the pathophysiology of the SFSS. Reversal of the vasospasm significantly improves outcome. Liver Transpl 15:1448–1457, 2009. © 2009 AASLD.