bluuebunny/crossref_metadata_2025 huggingface dataset:
All Primary Care Trainees Are Not the Same: The Role of Economic Factors and Career Choice
Authors: Freed Gary L. , Dunham Kelly M. ,   and the Research Advisory Committee of the American Board of Pediatrics
Published: February 2010

Historically, the specialties classified as “primary care” have been pediatrics, internal medicine, and family medicine. Often, primary care disciplines are aggregated in workforce or career-preference studies, and any differences among them are not assessed or reported. However, such aggregation is likely unwarranted and may actually lead to false or misguided policy direction in the name of “primary care disciplines” when, in fact, there may be substantive differences among these specialties. We examine here the data available to assess whether the physicians who make up 2 of the primary care specialties are necessarily the same with regard to their perspectives on the economic aspects of medicine in general, or their own personal economic preferences regarding career choice in particular. Recent research has demonstrated that there are substantive differences among internal medicine trainees and pediatric trainees. As such, we must be cautious when using data from 1 primary care specialty to suggest structural and/or policy changes regarding the economic structure of training for the others.
Kikuchi Disease in Association With Pasteurella multocida Infection
Authors: Wong Vanessa Kuan , Campion-Smith Joanna , Khan Marium , Smith Stephanie
Published: February 2010

Kikuchi disease is a rare condition characterized by fever and persistent lymphadenopathy. Its aetiology is unknown, but it has been associated with viral, bacterial, and protozoal agents. We report the case of a 15-year old boy who grew Pasteurella multocida from blood cultures with Kikuchi disease confirmed by histopathologic lymph node examination.
Physiology of intrauterine fetal activity
Authors: Jakobovits Ákos
Published: February 2010

A fogantatás után először a magzati szívműködés, majd a testmozgás indul meg. A mozgásokat ultrahanggal igen korán meg lehet figyelni. Kiváltó ok nem látható, ezért azt mondjuk, belső (intrinsit) indíttatásúak, autonóm módon következnek be. A spontán, nem kiváltott (stimulált), a központi idegrendszer által endogén módon létrejött mozgásképek az idegműködés (neuralis aktivitás) kifejezői. A méhen belüli mozgásaktivitást nagyrészt vagy teljesen belső tényezők váltják ki: belső motiváció. A korai mozgások többnyire a test minden izmát igénybe veszik. Eleinte aritmiások és szabálytalan időközökben jelentkeznek. A 9–12. héttől kezdve független végtagmozgások figyelhetők meg. A 24–28. héten a magzat jelentősen gyakrabban és rövidebb ideig mozog, mint a 30–39. hét között. Külső tényezők: érintés, lökés, hanghatás, hőmérséklet-változás a magzatból (válasz)reakciót válthat ki, ami testmozgásban nyilvánul meg. A magzatmozgások keletkezését, szervezettségét, egymással való kapcsolatát az etológusok, a gyakoriságát pedig a perinatológusok (szülészek) vizsgálják, tanulmányozzák. A két tudományos szakma közös vizsgálati alanya a magzat, de a cél kissé eltér, ezért határvonalat a kettő között nehéz húzni, mert határuk elmosódott, nemegyszer át is lépik azt, mert érdeklődési területük összefolyik. A magzat ténykedésének megfigyelésére a szülészeknek van módjuk, ezért a magzati etológia és perinatológia szerepköre összeolvad. A szülészek érdeklődési köréből adódik a magyarázat, hogy a közlemények mintegy négyötöde a terhesség második felében észlelt magzatmozgásokkal foglalkozik, sokkal kevesebb a gestatio első felében jelentkező magzatmozgásokkal foglalkozó közlemény.
Selective Estrogen-Receptor Modulators and Aromatase Inhibitors: Promising New Medical Therapies for Endometriosis?
Authors: Simsa Peter , Mihalyi Attila , Kyama Cleophas M , Mwenda Jason M , Fülöp Vilmos , D'Hooghe Thomas M
Published: February 2010

Endometriosis is an estrogen-dependent disease and estrogen-related pathways are imbalanced in women with endometriosis. One of the key enzymes in estrogen synthesis is aromatase. Inhibiting this pathway at several points is a promising idea for the treatment of endometriosis. The third generation of aromatase inhibitors is becoming more potent in efficacy, with fewer side effects than previous generations, but cotreatment with other hormones is needed to inhibit ovarian stimulation. Other components that promote estrogen synthesis such as COX-2 can also be potentially targeted. Selective estrogen-receptor modulators could also be interesting in view of their tissue-specific effect. However, all these new drugs are still in an early phase of development. At present, it is too early to conclude that aromatase inhibitors, COX-2 inhibitors or selective estrogen-receptor modulators really present any added value compared with the existing drugs that can be used to achieve hormonal suppression in the medical treatment of endometriosis.
Using 100- instead of 120-kVp computed tomography to diagnose pulmonary embolism almost halves the radiation dose with preserved diagnostic quality
Authors: Björkdahl Peter , Nyman Ulf
Published: February 2010

Background: Concern has been raised regarding the mounting collective radiation doses from computed tomography (CT), increasing the risk of radiation-induced cancers in exposed populations.

Purpose: To compare radiation dose and image quality in a chest phantom and in patients for the diagnosis of pulmonary embolism (PE) at 100 and 120 peak kilovoltage (kVp) using 16-multichannel detector computed tomography (MDCT).

Material and Methods: A 20-ml syringe containing 12 mg I/ml was scanned in a chest phantom at 100/120 kVp and 25 milliampere seconds (mAs). Consecutive patients underwent 100 kVp ( n = 50) and 120 kVp ( n = 50) 16-MDCT using a “quality reference” effective mAs of 100, 300 mg I/kg, and a 12-s injection duration. Attenuation (CT number), image noise (1 standard deviation), and contrast-to-noise ratio (CNR; fresh clot = 70 HU) of the contrast medium syringe and pulmonary arteries were evaluated on 3-mm-thick slices. Subjective image quality was assessed. Computed tomography dose index (CTDIvol) and dose–length product (DLP) were presented by the CT software, and effective dose was estimated.

Results: Mean values in the chest phantom and patients changed as follows when X-ray tube potential decreased from 120 to 100 kVp: attenuation +23% and +40%, noise +38% and +48%, CNR −6% and 0%, and CTDIvol −38% and −40%, respectively. Mean DLP and effective dose in the patients decreased by 42% and 45%, respectively. Subjective image quality was excellent or adequate in 49/48 patients at 100/120 kVp. No patient with a negative CT had any thromboembolism diagnosed during 3-month follow-up.

Conclusion: By reducing X-ray tube potential from 120 to 100 kVp, while keeping all other scanning parameters unchanged, the radiation dose to the patient may be almost halved without deterioration of diagnostic quality, which may be of particular benefit in young individuals.
Citizenship, craft and the making of Mode Two citizens?
Authors: Simpson Bob
Published: February 2010

What are the civic responsibilities of universities in a democratic society? Since the emergence of the modern university system in the nineteenth century, financial support and a degree of academic freedom have been bestowed on universities but what should society expect back from these places of specialised and, often, elite learning? These are perennial questions, yet answers have been very different under different political and economic circumstances. Originally, the emphasis was on the production of knowledge in settings that were ‘antifunctionalist as well as antiutilitarian’ (Sahlins 2009: 1000); subsequently the wider knowledgeability of students was incorporated as the way the debt to society would be repaid (Nowotny, Scott and Gibbons 2001: 80). In recent years, the making of citizens or, rather, the making of better citizens has come to the fore as an essential output in exchange for society’s input. As part of their ‘service’ to society at large, universities will, amongst other things, produce people who will take their place as members of society with a strong sense of rights that will be asserted and responsibilities that will be exercised.
Effective Population Size, Gene Flow, and Species Status in a Narrow Endemic Sunflower, Helianthus neglectus, Compared to Its Widespread Sister Species, H. petiolaris
Authors: Raduski Andrew  R. , Rieseberg Loren  H. , Strasburg Jared  L.
Published: February 2010

Species delimitation has long been a difficult and controversial process, and different operational criteria often lead to different results. In particular, investigators using phenotypic vs. molecular data to delineate species may recognize different boundaries, especially if morphologically or ecologically differentiated populations have only recently diverged. Here we examine the genetic relationship between the widespread sunflower species Helianthus petiolaris and its narrowly distributed sand dune endemic sister species H. neglectus using sequence data from nine nuclear loci. The two species were initially described as distinct based on a number of minor morphological differences, somewhat different ecological tolerances, and at least one chromosomal rearrangement distinguishing them; but detailed molecular data has not been available until now. We find that, consistent with previous work, H. petiolaris is exceptionally genetically diverse. Surprisingly, H. neglectus harbors very similar levels of genetic diversity (average diversity across loci is actually slightly higher in H. neglectus). It is extremely unlikely that such a geographically restricted species could maintain these levels of genetic variation in isolation. In addition, the two species show very little evidence of any genetic divergence, and estimates of interspecific gene flow are comparable to gene flow estimates among regions within H. petiolaris. These results indicate that H. petiolaris and H. neglectus likely do not represent two distinct, isolated gene pools; H. neglectus is probably more accurately thought of as a geographically restricted, morphologically and ecologically distinct subspecies of H. petiolaris rather than a separate species.
5-Methyl-4-oxo-4,6-dihydro-3H-pyridazino[4,5-b]carbazole-1-carbonitrile
Authors: Emich Miriam , Haider Norbert
Published: February 2010

The title compound was prepared in excellent yield from 5-methyl-4-oxo-4,6-dihydro-3H-pyridazino[4,5-b]carbazole-1-carbaldehyde by treatment with hydroxylamine hydrochloride in formic acid without isolation of the intermediate oxime.
Probing the Texture of the Calamitic Liquid Crystalline Dimer of 4-(4-Pentenyloxy)benzoic Acid
Authors: Qaddoura Maher A. , Belfield Kevin D.
Published: February 2010

The liquid crystalline dimer of 4-(4-pentenyloxy)benzoic acid, a member of the n-alkoxybenzoic acid homologous series, was synthesized using potassium carbonate supported on alumina as catalyst. The acid dimer complex exhibited three mesophases; identified as nematic, smectic X1 and smectic X2. Phase transition temperatures and the corresponding enthalpies were recorded using differential scanning calorimetry upon both heating and cooling. The mesophases were identified by detailed texture observations by variable temperature polarized light microscopy. The nematic phase was distinguished by a fluid Schlieren texture and defect points (four and two brushes) while the smectic phases were distinguished by rigid marble and mosaic textures, respectively.
Relative Dose Intensity Delivered to Patients with Early Breast Cancer: Canadian Experience
Authors: Raza S. , Welch S. , Younus J.
Published: February 2010

Adjuvant chemotherapy for early breast cancer improves disease-free and overall survival in pre- and postmenopausal women. The importance of maintaining relative dose intensity (rdi) is well-known; however, little information is available from routine clinical practice regarding how well dose intensity is maintained with modern chemotherapy regimens. In a retrospective review of patients undergoing chemotherapy for early breast cancer at a single institution in Canada from January 2006 to November 2007, a total of 263 patients received one of the following regimens: (1) ac-t [doxorubicin (Adriamycin: Pharmacia, Kalamazoo, MI, U.S.A.)–cyclophosphamide, paclitaxel (Taxol: Bristol–Myers Squibb, Princeton, NJ, U.S.A.)]; (2) fec-100 (5-fluorouracil–epirubicin–cyclophosphamide); (3) fec-d (5-fluorouracil–epirubicin–cyclophosphamide, docetaxel). Overall, only 14.4% of patients had a rdi less than 85%. Dose delay or reduction (or both) occurred in 46%, 37%, and 20% of patients receiving fec-100, ac-t, and fec-d respectively. Optimal rdi was delivered to 96%, 95%, and 70.7% of patients for ac-t, fec-d and fec-100 regimens respectively. Patients over 65 years of age accounted for 14% of the total cohort and were more likely to receive a suboptimal rdi than were patients younger than 65 years of age (35% vs. 6.6%). Optimal chemotherapy rdi (>85%) for early breast cancer can be achieved at an academic cancer centre. This goal is less often accomplished in elderly patients, and thus a proactive approach is required for managing toxicity in that population.
Predictors of Workplace Absenteeism in Cancer Care Workers
Authors: Carosi A. J. , Lightfoot N. E.
Published: February 2010

Workplace absenteeism occurs at an increased rate among employees in health care as compared with employees in other sectors [...]
Impact of Radiation Avoidance on Survival and Neurocognitive Outcome in Infant Medulloblastoma
Authors: Lafay–Cousin L. , Bouffet E. , Hawkins C. , Amid A. , Huang A. , Mabbott D. J.
Published: February 2010

Purpose: Concerns about radiotherapy-related neurocognitive sequelae in young children have led to deferral or avoidance of radiation in contemporary treatment for this fragile group of patients. We compared survival and neurocognitive outcome in two groups of infants with medulloblastoma who received adjuvant conventional craniospinal irradiation (csi) or reduced or no radiotherapy during an era of change in the philosophy of infant medulloblastoma treatment. Patients and Methods: From 1985 to 2007, 29 patients 3 years of age or younger were diagnosed and treated with curative intent in our institution. Children treated before 1994 received adjuvant radiation with chemotherapy; subsequently, radiation was prescribed essentially for disease progression or relapse. Results: Median age at diagnosis was 24 months (range: 1–36 months); 15 patients (52%) presented with metastatic disease at diagnosis. As part of initial treatment, 8 children received adjuvant radiotherapy with chemotherapy, and 21 children received postoperative chemotherapy only. Five children treated with chemotherapy alone are in prolonged remission. The 5-year event-free and overall survivals were 35.9% ± 9.8% and 50.2% ± 9.6% respectively. Extent of resection, metastatic status, and desmoplastic histology were not found to be significant prognostic factors. On serial neurocognitive evaluations, patients treated with chemotherapy with or without reduced radiotherapy demonstrated improvement of intellectual function over time. Patients treated with conventional csi exhibited significantly lower intelligence quotient scores and academic performance, with the exception of receptive vocabulary. Conclusions: Avoidance of conventional csi in treatment of very young children with medulloblastoma appears to be associated with a preserved neurocognitive profile. Neurocognitive evaluation should be integrated into the primary objectives of future infant protocols.
Under Pressure: Nursing Liability and Skin Breakdown in Older Patients
Authors: Plawecki Lawrence H. , Amrhein David W. , Zortman Todd
Published: February 2010

The geriatric patient presents many challenges to the professional nurse. As the body ages, its protective outer covering and largest organ, the skin, also changes. With an older adult's decreased mobility and amount of subcutaneous fat comes lessened protection from surfaces or bony prominences. As such, older adults' skin becomes weaker and more prone to breakdown and presents myriad challenges to the patient's well-being. One of the most hazardous challenges are pressure ulcers. Educating geriatric nurses in how to identify those at risk, accurately identify and categorize pressure ulcers, and limit or, ideally, eliminate their professional liability is essential to the effective care and treatment of this at-risk population.
Prevention and Clinical Outcomes in Older Inpatients with Suspected Venous Thromboembolism
Authors: Lee Jung-Ah , Zierler Brenda K.
Published: February 2010

Venous thromboembolism (VTE) is one of the most common preventable disorders among hospital inpatients. Advancing age is a major risk factor for VTE. The purpose of this study was to describe and compare prevention practices and clinical outcomes in older (age 65 and older) versus younger (ages 18 to 64) hospitalized patients at risk for or diagnosed with VTE. Medical charts of 210 older and 450 younger inpatients undergoing diagnostic tests to rule out VTE were reviewed at an academic medical center. Acute VTE was diagnosed in 17.1% of older and 22.7% of younger inpatients. Pharmacological prophylaxis was used in 70% of eligible older and 57% of eligible younger inpatients. Nearly one quarter of eligible older inpatients did not receive any VTE prevention measures. The 3-month mortality was higher in older inpatients (13.9%) compared with younger inpatients (9.8%) with VTE, despite the lower rate of VTE in older inpatients. Prevention measures for VTE were underused in both older and younger inpatients.
Iris Transillumination Defects Associated With Pallister–Killian Syndrome
Authors: Ticho Benjamin H.
Published: February 2010

This report describes a new finding of iris transillumination defects in Pallister–Killian syndrome, a rare multi-system disorder resulting from mosaic tetrasomy of the short arm of chromosome 12.
[J Pediatr Ophthalmol Strabismus 2010;47:58–59.]
Research with the doubly vulnerable Population of Individuals who Abuse Alcohol: An Ethical Dilemma
Authors: Gwyn Priscilla Gage , Colin Jessie M.
Published: February 2010

Individuals who have maladaptive patterns of drinking alcohol fall into the category of vulnerable research participants for many reasons, not the least of which includes the stigma often placed on individuals who abuse alcohol. Vulnerable subgroups within the population of people who abuse alcohol include women; older adults; incarcerated, socioeconomically disadvantaged, and mentally ill individuals; as well as people from racial minorities. Thus, as research participants, individuals who abuse alcohol can be labeled a
doubly vulnerable
population. Belonging to more than one population simultaneously can lead to a compromised ability to protect one's own interests or greater susceptibility to harm related to participating in research studies. Arguments against including people who abuse alcohol as research participants will be presented, followed by the argument for including these individuals, which is suggested as the more ethically sound of the two points of view.
Drinking Games and College Students: Part 1: Problem Description
Authors: Ahern Nancy R. , Sole Mary Lou
Published: February 2010

College students seek peer acceptance and opportunities for social interaction. For many, it may be the first time away from home, away from the supervision and watchful eyes of parents and other family members. Whether for fun, thrill, competition, or the need to socialize with others, approximately two thirds of U.S. college students participate in the risky binge drinking behavior called drinking games. Regardless of the game type, the goal of this behavior is to become intoxicated in a short period of time. Significant consequences and harm can result from this dangerous social behavior. This article, the first of two parts, will describe the problem; Part 2 will discuss the implications for community and mental health nurses.
Distribution of Angle Kappa Measurements with Orbscan II in a Population-Based Survey
Authors: Hashemi Hassan , KhabazKhoob Mehdi , Yazdani Kamran , Mehravaran Shiva , Jafarzadehpur Ebrahim , Fotouhi Akbar
Published: February 2010

Purpose:

To determine the mean angle kappa and its determinants in the population of Tehran, Iran.

Methods:

In a cross-sectional survey with random cluster sampling, a total of 442 participants aged >14 years were selected from 4 municipality districts of Tehran for Orbscan acquisitions. Exclusion criteria were history of eye surgery for refractive errors, cataract or glaucoma, and use of topical medication or any type of contact lens at the time of the study. Mean angle kappa in different age and gender groups and its association with other factors was assessed. Considering the high correlation between the right and left eyes, only results of the right eyes are presented.

Results:

After applying exclusion criteria, 800 eyes (399 right eyes and 401 left eyes) were examined. Mean participant age was 40.6±16.8 years (range: 14 to 81 years), and 38.8% of eyes were from men. Mean angle kappa was 5.46±1.33° in total; 5.41±1.32° in men and 5.49±1.34° in women (
P
=.558). It decreased significantly with age; 0.015°/year (
P
<.001). In individuals with myopia, emmetropia, and hypermetropia, the mean value was 5.13±1.50°, 5.72±1.10°, and 5.52±1.19°, respectively (
P
=.025); the post-hoc test indicated this was due to the difference between emmetropes and myopes.

Conclusions:

According to our results, angle kappa reduces with age, and the inter-gender difference is not significant. Largest angle kappas were seen among individuals with emmetropia. Angle kappas were larger in the hypermetropic population compared to the myopic population.
Planned Delayed Relaxing Retinotomy for Proliferative Vitreoretinopathy
Authors: Williamson Tom H. , Gupta Bhaskar
Published: February 2010

BACKGROUND AND OBJECTIVE:

A program involving three operations—the first to reattach most of the retina under silicone oil, the second to reattach the remaining retina by planned delayed relaxing retinectomy (PDRR), and the third to remove silicone oil—was tested.

PATIENTS AND METHODS:

Review of electronic records of patients receiving PDRR for proliferative vitreoretinopathy (PVR). The primary end point was reattached retina without silicone oil.

RESULTS:

Eighty-seven patients had PVR and 27 received PDRR (mean age: 66.6 years; mean follow-up: 2.3 years). Ten patients had grade B PVR, 8 had CP1 to CP6, and 7 had CA2 to CA6. Twenty- four (89%) patients achieved a reattached retina without silicone oil. Mean logarithm of the minimum angle of resolution visual acuities were 1.41 (standard deviation = 0.67) at presentation and 1.21 (standard deviation = 0.58) at final follow-up. Four patients had glaucoma and 1 had scleromalacia. The overall success rate for all patients with PVR was 85% reattached retina without oil tamponade.

CONCLUSION:

PDRR contributes to a high chance of reattached retina and oil removal in PVR.

[Ophthalmic Surg Lasers Imaging 2010;41:31–34.]
Different Patterns of Fundus Autofluorescence Related to ABCA4 Gene Mutations in Stargardt Disease
Authors: Sodi Andrea , Bini Alessandro , Passerini Ilaria , Forconi Simona , Menchini Ugo , Torricelli Francesca
Published: February 2010

BACKGROUND AND OBJECTIVE:

Stargardt disease is a type of juvenile-onset macular dystrophy. The clinical presentation is characterized by macular atrophy and the presence of lipofuscin storage. The aim of this study was to investigate a possible correlation between different ABCA4 gene mutations and the autofluorescence pattern.

PATIENTS AND METHODS:

Twenty patients with Stargardt disease were examined for ABCA4 gene mutations and were administered fundus autofluorescence examinations.

RESULTS:

Autofluorescence imaging demonstrated different patterns. ABCA4 gene analysis exhibited 16 missense mutations, 4 stop mutations, 4 splicing mutations, 3 deletions, and 1 insertion randomly distributed in the two alleles.

CONCLUSION:

The presence of two severe mutations in the two alleles was associated with a larger atrophy of the retinal pigment epithelium in the macular area.

[Ophthalmic Surg Lasers Imaging 2010;41:48–53.]
In Vivo Fluorescence Mode Confocal Microscopy of Subepithelial Tissues in Glaucoma Filtering Blebs
Authors: Wells Anthony P. , Wakely Laura , Birchall Wayne
Published: February 2010

BACKGROUND AND OBJECTIVE:

The miniaturization of confocal imaging technology has resulted in the development of a handheld confocal microscope probe capable of fluorescence mode imaging. Findings in the subepithelial tissues of glaucoma filtering blebs using this novel approach for proof of concept are described.

PATIENTS AND METHODS:

A fiberoptic confocal imaging probe using an illumination wavelength of 488 nm was applied to the bleb surface of 11 eyes after topical or subconjunctival administration of sodium fluorescein. The imaging plane was moved to the subepithelial region and multiple images from multiple bleb regions were captured at a resolution of 1,024 × 1,024 pixels per square inch.

RESULTS:

High-quality images of the bleb wall structure, vasculature, and superficial sclera were obtained and demonstrated subcellular detail. Lateral resolution was between 1 and 1.5 µm and axial resolution was approximately 30 µm. Identifiable structures in the failing blebs included vasculature (including individual erythrocytes, pericytes, and vascular endothelium); microcystic structures; and cells within the Tenon's tissue, some of which resembled fibroblasts.

CONCLUSION:

Fluorescence mode imaging of ocular subsurface detail is a viable and promising tool for assessment of wound healing and other processes in trabeculectomy blebs. The ability to image fluorophores creates the possibility of functional imaging.

[Ophthalmic Surg Lasers Imaging 2010;41:78–82.]
Comparison of the Outcomes of Limbal-Based Trabeculectomy With and Without Anchor Sutures
Authors: Miyawaki Takaya , Yaguchi Shigeo , Hanemoto Tsukasa , Ando Mikihiko , Kozawa Tadahiko
Published: February 2010

BACKGROUND AND OBJECTIVE:

To retrospectively evaluate the efficacy and safety of limbal-based trabeculectomy with anchor sutures compared to standard limbal-based trabeculectomy. Limbal-based trabeculectomy was performed with a new technique using anchor sutures, which involved tying the conjunctiva to the sclera at a deep fornix incision to prevent bleb localization induced by slippage of the conjunctival suture scar toward the scleral flap.

PATIENTS AND METHODS:

In this retrospective, comparative, interventional case series, 45 eyes that underwent limbal-based trabeculectomy with anchor sutures and 27 eyes that underwent standard limbal-based trabeculectomy were analyzed (primary surgery).

RESULTS:

At a target intraocular pressure of 15 mm Hg, the 3-year survival rate using Kaplan–Meier analysis was 76.2% in the limbal-based trabeculectomy with anchor sutures group and 55.6% in the standard limbal-based trabeculectomy group. Bleb morphology analysis using the Moorfields Bleb Grading System showed that blebs in the limbal-based trabeculectomy with anchor sutures group were more diffused than those in the standard limbal-based trabeculectomy group.

CONCLUSION:

Limbal-based trabeculectomy with anchor sutures appears to be an effective method for decreasing intraocular pressure and improving morphology of blebs.

[Ophthalmic Surg Lasers Imaging 2010;41:91–95.]
Retinal Nerve Fiber Layer Thickness After a Single Attack of Primary Acute Angle-Closure Glaucoma Measured With Optical Coherence Tomography
Authors: Wong Ian Y. H. , Yuen Nancy S. Y. , Chan Clement W. N.
Published: February 2010

BACKGROUND AND OBJECTIVE:

After a single unilateral acute primary angle-closure glaucoma attack, retinal nerve fiber layer (RNFL) may be thinned. The current study measured the RNFL thickness using optical coherence tomography in eyes with normal visual fields after recovery from a single attack of acute primary angle-closure glaucoma.

PATIENTS AND METHODS:

Twenty-one patients and age-matched control subjects underwent optical coherence tomography scanning after recovery from a single unilateral acute primary angle-closure glaucoma attack. Data from the affected eyes, normal fellow eyes, and control subjects were compared.

RESULTS:

Average RNFL thickness was 91.3 ± 16.4 µm in the affected eyes, 100.1 ± 16.4 µm in the fellow eyes, and 100.2 ± 16.7 µm in the control eyes. Significant thinning was present in the affected eyes compared to the fellow eyes (
P
= .001) and the control eyes (
P
= .04).

CONCLUSION:

RNFL thickness was found to be significantly thinner in the eyes with angle-closure glaucoma.

[Ophthalmic Surg Lasers Imaging 2010;41:96–99.]
Phacoemulsification With Intraocular Lens Implantation in Juvenile Idiopathic Arthritis
Authors: Ganesh Sudha K. , Sudharshan S.
Published: February 2010

BACKGROUND AND OBJECTIVE:

To evaluate outcomes of phacoemulsification cataract surgery with intraocular lens (IOL) implantation in children and adults with juvenile idiopathic arthritis-associated uveitis.

PATIENTS AND METHODS:

Charts of 7 patients (10 eyes) with juvenile idiopathic arthritis-associated uveitis who had phacoemulsification cataract surgery between December 2002 and March 2005 were analyzed.

RESULTS:

Ten eyes of 7 patients had phacoemulsification with IOL implantation done by a single surgeon. A heparin surface modified IOL was used in 7 eyes and a foldable acrylic IOL was used in 3 eyes. At final follow-up, 70% of eyes had a visual acuity of 20/40 or better and 30% had improved visual acuity to 20/60. Posterior capsular opacification was found in 2 eyes and anterior capsular fibrosis in 1 eye.

CONCLUSION:

Keys to success following cataract surgery in juvenile idiopathic arthritis are the age of the child, the absence of amblyopia, and strict preoperative and postoperative control of inflammation.

[Ophthalmic Surg Lasers Imaging 2010;41:104–108.]
Optical Coherence Tomography: A New Tool for Intraoperative Decision Making
Authors: Puliafito Carmen A.
Published: February 2010

Optical coherence tomography (OCT) has traditionally been used in the outpatient environment as an important diagnostic tool for retinal clinical decision making. Recent advances in OCT technology have made intraoperative use of OCT feasible.
[Ophthalmic Surg Lasers Imaging 2010;41:6.]
Tag4M in Predictive Maintenance and Machine Control
Authors: Ursutiu Doru , Ghercioiu M. , Oros Ramona , Samoila Cornel
Published: February 2010

This paper tray to introduce in the field of Predictive Maintenance and System Monitoring a new devices the Tag4M. This Wi-Fi tag has been built by Tag4M of Austin, TX, USA, with the purpose of connecting sensors to the Internet where data is displayed using Web Pages that are posted and can be accessed from anywhere in the world. The Tag4M Wi-Fi tag is tiny and low cost system working on battery power, and therefore it is very suitable for monitoring and reliability estimation of expensive systems.
Primary Leiomyosarcoma of the Kidney
Authors: Venkatesh Kusuma , Lamba Saini Monika , Niveditha S. R. , Krishnagiri Chaithra , Babu Sudarshan
Published: February 2010

Primary leiomyosarcoma of the kidney is a rare tumor with an aggressive behaviour. A 55-year-old woman presented with a left sided abdominal mass in our outpatient department. Radiologic investigations revealed the mass to be renal in origin with colonic adhesions for which radical nephrectomy and hemicolectomy were done. The tumor completely appeared to replace the left kidney and had a whorled character focally on cut section. Microscopically, spindle cells having malignant features with cigar shaped nuclei were seen. The smooth muscle origin of the cells was confirmed by immunohistochemical positivity for smooth muscle actin. Sarcomatoid variant of the renal cell carcinoma was ruled out as the tumor was negative for cytokeratin. Tumors with spindle cell morphology in the kidney should not always be taken for a sarcomatoid variant of renal cell carcinoma and should be investigated thoroughly.
Analysis of whole genome biomarker expression in blood and brain
Authors: Rollins Brandi , Martin Maureen V. , Morgan Ling , Vawter Marquis P.
Published: February 2010

The consistency of peripheral gene expression data and the overlap with brain expression has not been evaluated in biomarker discovery, nor has it been reported in multiple tissues from the same subjects on a genome wide transcript level. The effects of processing whole blood, transformation, and passaged cell lines on gene expression profiling was studied in healthy subjects using Affymetrix arrays. Ficoll extracted peripheral blood mononuclear cells (PBMCs), Epstein–Barr virus (EBV) transformed lymphocytes, passaged lymphoblastic cell lines (LCLs), and whole blood from Tempus tubes were compared. There were 6,813 transcripts differentially expressed between different methods of blood preparation. Principal component analysis resolved two partitions involving pre‐ and post‐transformation EBV effects. Combining results from Affymetrix arrays, postmortem subjects' brain and PBMC profiles showed co‐expression levels of summarized transcripts for 4,103 of 17,859 (22.9%) RefSeq transcripts. In a control experiment, rat hemi‐brain and blood showed similar expression levels for 19% of RefSeq transcripts. After filtering transcripts that were not significantly different in abundance between human cerebellum and PBMCs from the Affymetrix exon array the correlation in mean transcript abundance was high as expected (r = 0.98). Differences in the alternative splicing index in brain and blood were found for about 90% of all transcripts examined. This study demonstrates over 4,100 brain transcripts co‐expressed in blood samples can be further examined by in vitro and in vivo experimental studies of blood and cell lines from patients with psychiatric disorders. © 2010 Wiley‐Liss, Inc.
Theoretical evaluation of magnetoreception of power‐frequency fields
Authors: Vanderstraeten Jacques , Gillis Pierre
Published: February 2010

Several effects of power‐frequency (50/60 Hz) magnetic fields (PF‐MF) of weak intensity have been hypothesized in animals and humans. No valid mechanism, however, has been proposed for an interaction between PF‐MF and biological tissues and living beings at intensities relevant to animal and human exposure. Here we proposed to consider PF‐MF as disrupters of the natural magnetic signal. Under exposure to these fields, an oscillating field exists that results from the vectorial summation of both the PF‐MF and the geomagnetic field. At a PF‐MF intensity (rms) of 0.5 µT, the peak‐to‐peak amplitude of the axis and/or intensity variations of this resulting field exceeds the related discrimination threshold of magnetoreception (MR) in migrating animals. From our evaluation of the 50/60 Hz responsiveness of the putative mechanisms of MR, single domain particles (Kirschvink's model) appear unable to transduce that oscillating signal. On the contrary, radical pair reactions are able to, as well as interacting multidomain iron–mineral platelets and clusters of superparamagnetic particles (Fleissner/Solov'yov's model). It is, however, not yet known whether the reception of 50/60 Hz oscillations of the natural magnetic signal might be of consequence or not. Bioelectromagnetics 31:371–379, 2010. © 2010 Wiley‐Liss, Inc.
Identification of the Tirandamycin Biosynthetic Gene Cluster from Streptomyces sp. 307‐9
Authors: Carlson Jacob C. , Fortman J. L. , Anzai Yojiro , Li Shengying , Burr Douglas A. , Sherman David H.
Published: February 2010

The structurally intriguing bicyclic ketal moiety of tirandamycin is common to several acyl‐tetramic acid antibiotics, and is a key determinant of biological activity. We have identified the tirandamycin biosynthetic gene cluster from the environmental marine isolate Streptomyces sp. 307–9, thus providing the first genetic insight into the biosynthesis of this natural product scaffold. Sequence analysis revealed a hybrid polyketide synthase–nonribosomal peptide synthetase gene cluster with a colinear domain organization, which is entirely consistent with the core structure of the tirandamycins. We also identified genes within the cluster that encode candidate tailoring enzymes for elaboration and modification of the bicyclic ketal system. Disruption of tamI, which encodes a presumed cytochrome P450, led to a mutant strain deficient in production of late stage tirandamycins that instead accumulated tirandamycin C, an intermediate devoid of any post assembly‐line oxidative modifications.
Wärmeübergang und Druckverlust bei einer Gasströmung in Rohren mit Einbauten
Authors: Schinke L. , Seime D. , Meinert J.
Published: February 2010

Es wird eine einfache und kostengünstige Einbautenvariante für Rohre hinsichtlich ihrer Vergrößerung des Wärmeüberganges und des Druckverlustes bei einer Gasströmung experimentell untersucht. Als Messprinzip wird Luft bei der Durchströmung durch das Prüfrohr erwärmt und alle Parameter, die für eine Auswertung über die Energiebilanz benötigt werden, aufgenommen. Abschließend werden die Ergebnisse diskutiert und mit gängigen Theorien verglichen.
Left Ventricular Ejection Fraction Assessment by Tl‐201 Gated SPECT: A Comparison With Echocardiography
Authors: Harpaz David , Asman Arik , Kuperstein Rafael , Boaz Mona , Chouraqui Pierre
Published: February 2010

Background

Few studies including only a limited number of patients have compared left ventricular ejection fraction (LVEF) assessed by 2‐dimensional echocardiography (2‐DE) and electrocardiography‐gated Tl‐201 single‐photon emission computed tomography (SPECT).

Hypothesis

LVEF assessment by Tl‐201 gated spect is comparable with LVEF assessed by 2‐DE in two different echocardiographic laboratories.

Material and Methods

Patients (n = 402) underwent Tl‐201 gated SPECT in the same laboratory and 2‐DE in 2 different laboratories. Patients were divided into 2 groups according to the study laboratory: group 1, at the tertiary hospital and group 2, at a community laboratory.

Results

LVEF evaluations were similar (mean LVEF: 50.73% ± 11.67% by 2‐DE vs 50.11% ± 11.41% by SPECT in group 1 and 57.27% ± 7.44% by 2‐DE vs 57.41% ± 8.37% by SPECT in group 2). All LVEF measurements were highly correlated (r = 0.7, P<.001). Baseline characteristics differed between the groups, with a higher prevalence of past myocardial infarction in the in‐hospital vs the community echo group (46.7% vs 22.2%, P<.01), resulting in a higher LVEF in the latter, both by 2‐DE (mean 50.7% ± 11.7% vs 57.3% ± 7.4%, P<.01) and SPECT (50.1% ± 11.4% vs 57.4% ± 8.4%, P<.01).

Conclusions

The Tl‐201 gated SPECT is a reliable clinical tool for LVEF assessment, with good correlation when compared to 2‐DE. It may be routinely used as an alternative for patients with poor acoustic visualization and should be performed systematically in patients undergoing myocardial perfusion imaging with Tl‐201. Copyright © 2009 Wiley Periodicals, Inc.
Influence of Clinical Trial Participation on Subsequent Antithrombin Use
Authors: Shah Bimal R. , Peterson Eric D. , Chen Anita Y. , Mahaffey Kenneth W. , DeLong Elizabeth R. , Magnus Ohman E. , Pollack Charles V. , Brian Gibler W. , Roe Matthew T.
Published: February 2010

Background

Results from the Superior Yield of the New Strategy of Enoxaparin, Revascularization, and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial showed that the low‐molecular‐weight heparin (LMWH) enoxaparin was non‐inferior compared with unfractionated heparin (UFH) in patients with non‐ST‐elevation acute coronary syndromes (NSTE‐ACS) managed invasively.

Hypothesis

We explored the influence of SYNERGY trial site participation on subsequent patterns of heparin use for NSTE‐ACS patients treated in routine practice.

Methods

We examined temporal patterns of LMWH use compared with UFH use among 122 764 patients with NSTE‐ACS enrolled in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) quality improvement initiative between January 1, 2002 and June 30, 2006, to determine whether site participation in SYNERGY influenced the type of heparin used before and after publication of the SYNERGY results in July 2004.

Results

A total of 118 out of 388 (30%) U.S. hospitals participating in CRUSADE simultaneously participated in SYNERGY. SYNERGY sites in the CRUSADE registry were more likely to have a teaching affiliation and have more hospital beds than non‐SYNERGY centers in the registry. There was no difference in the proportion of patients treated with LMWH at SYNERGY and non‐SYNERGY sites prior to July 2004 compared with after July 2004. However, at SYNERGY sites, there was a slight decrease in the proportion of patients treated with both UFH and LMWH within 24 hours of presentation.

Conclusions

The results of the SYNERGY trial did not appear to influence temporal patterns of LMWH use at sites in the CRUSADE registry. Furthermore, site participation in the SYNERGY trial did not alter patterns of LMWH use for NSTE‐ACS after publication of the trial results in July 2004. Copyright © 2009 Wiley Periodicals, Inc.
Targeting FMS‐related tyrosine kinase receptor 3 with the human immunoglobulin G1 monoclonal antibody IMC‐EB10
Authors: Youssoufian Hagop , Rowinsky Eric K. , Tonra James , Li Yiwen
Published: February 2010

FMS‐related tyrosine kinase receptor 3 (FLT3) is a class III receptor tyrosine kinase that holds considerable promise as a therapeutic target in hematologic malignancies. Current efforts directed toward the development of small‐molecule tyrosine kinase inhibitors of FLT3 may be limited by off‐target toxicities and the development of drug resistance. Target‐specific antibodies could overcome these hurdles and provide additional mechanisms to enhance the antitumor efficacy of FLT3 inhibitors. IMC‐EB10 is a novel antibody directed against FLT3. The binding of IMC‐EB10 to FLT3 results in antiproliferative effects in vitro and in mouse models engrafted with human leukemia cells that harbor wild‐type or constitutively activated FLT3. Future clinical trials will test these notions formally and will identify the most appropriate opportunities for this member of a new generation of antileukemic therapies. Cancer 2010;116(4 suppl):1013–7. © 2010 American Cancer Society.
Rationale for the development of IMC‐3G3, a fully human immunoglobulin G subclass 1 monoclonal antibody targeting the platelet‐derived growth factor receptor α
Authors: Shah Gaurav D. , Loizos Nick , Youssoufian Hagop , Schwartz Jonathan D. , Rowinsky Eric K.
Published: February 2010

A large body of evidence suggests that the platelet‐derived growth factor (PDGF) family and associated receptors are potential targets in oncology therapeutic development because of their critical roles in the proliferation and survival of various cancers and in the regulation and growth of the tumor stroma and blood vessels. Several small molecules that nonspecifically target the PDGF signaling axis are in current use or development as anticancer therapies. However, for the majority of these agents, PDGF and its receptors are neither the primary targets nor the principal mediators of anticancer activity. IMC‐3G3, a fully human monoclonal antibody of the immunoglobulin G subclass 1, specifically binds to the human PDGF receptor α (PDGFRα) with high affinity and blocks PDGF ligand binding and PDGFRα activation. The results of preclinical studies and the frequent expression of PDGFRα in many types of cancer and in cancer‐associated stroma support a rationale for the clinical development of IMC‐3G3. Currently, IMC‐3G3 is being evaluated in early clinical development for patients with several types of solid malignancies. Cancer 2010;116(4 suppl):1018–26. © 2010 American Cancer Society.
Toxicity‐reducing potential of extracorporeal affinity adsorption treatment in combination with the auristatin‐conjugated monoclonal antibody BR96 in a syngeneic rat tumor model
Authors: Nilsson Rune , Mårtensson Linda , Eriksson Sophie E. , Sjögren Hans‐Olov , Tennvall Jan
Published: February 2010

BACKGROUND:

Antibody‐drug conjugates, comprising monoclonal antibodies (MoAbs) that bind to tumor‐associated antigens, display different toxicity profiles compared with radiolabeled MoAbs. Dose‐limiting toxicities may include damage to the liver and myelotoxicity. The drug component is the antimitotic agent auristatin, which is 100‐1000 times more potent than doxorubicin. Consequently, auristatin antibody‐drug conjugates require a high selectivity in tumor targeting to display pronounced activity at well‐tolerated doses. We have evaluated the possibility of increasing the therapeutic index of BR96‐auristatin by combining the administration of conjugates with subsequent extracorporeal affinity adsorption treatment.

METHODS:

Rats were injected with biotinylated, monomethyl auristatin F (MMAF)‐conjugated monoclonal antibody BR96. The conjugate was then removed from the circulation by extracorporeal affinity adsorption treatment, 24 hours postinjection using an avidin affinity column. By analyzing blood parameters for 100 days, myelotoxicity, hepatotoxicity, and nephrotoxicity were assessed. Body weight, general status, and tumor size were also recorded. The toxicity‐reducing effect of extracorporeal affinity adsorption treatment was evaluated.

RESULTS:

Extracorporeal affinity adsorption treatment removed 85%‐90% of BR96‐MMAF from the circulation. Early toxicity‐related death was seen in nontumor‐bearing animals that were given MMAF‐conjugated BR96, in contrast to animals that were given a higher amount of BR96‐MMAF with subsequent extracorporeal affinity adsorption treatment, in which all survived 100 days postinjection. Extracorporeal affinity adsorption treatment reduced the loss of body weight, myelotoxicity, and hepatotoxicity.

CONCLUSIONS:

Extracorporeal affinity adsorption treatment can be used to reduce the toxicity associated with administration of BR96‐MMAF conjugates, making it possible to increase the amount of conjugates administered. The combined treatment will be further optimized in future studies. Cancer 2010;116(4 suppl):1033–42. © 2010 American Cancer Society.
Improved efficacy of α‐particle–targeted radiation therapy
Authors: Milenic Diane E. , Brady Erik D. , Garmestani Kayhan , Albert Paul S. , Abdulla Alia , Brechbiel Martin W.
Published: February 2010

BACKGROUND:

Human epidermal growth factor receptor–2 (HER‐2) and tumor‐associated glycoprotein 72 (TAG‐72) have proven to be excellent molecular targets for cancer imaging and therapy. Trastuzumab, which binds to HER‐2, is effective in the treatment of disseminated intraperitoneal disease when labeled with 213Bi or 212Pb. 213Bi‐humanized CC49 monoclonal antibody (HuCC49ΔCH2), which binds to TAG‐72, inhibits the growth of subcutaneous xenografts. A next logical step to improve therapeutic benefit would be to target tumors with both molecules simultaneously.

METHODS:

Athymic mice bearing intraperitoneal human colon carcinoma xenografts were treated with a combination of trastuzumab and HuCC49ΔCH2 labeled with 213Bi administered through an intraperitoneal route. The sequence of administration also was examined.

RESULTS:

Before combining the 2 monoclonal antibodies, the effective doses of 213Bi‐CC49ΔCH2 and 213Bi‐trastuzumab for the treatment of peritoneal disease were determined to be 500 μCi for each labeled antibody. Treatment with 213Bi‐HuCC49ΔCH2 resulted in a median survival of 45 days and was comparable to the median survival achieved with 213Bi‐trastuzumab. Each combination provided greater therapeutic efficacy than either of the agents given alone. However, the greatest therapeutic benefit was achieved when 213Bi‐HuCC49ΔCH2 and 213Bi‐trastuzumab were coinjected, and a median survival of 147 days was obtained.

CONCLUSIONS:

Dual targeting of 2 distinct molecules in tumors such as TAG‐72 and HER‐2 with α‐particle radiation resulted in an enhanced, additive, therapeutic benefit. The authors also observed that this radioimmunotherapeutic strategy was well tolerated. Cancer 2010;116(4 suppl):1059–66. Published 2010 by the American Cancer Society.