bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV-Testing Practices and a History of Substance Use among Women Living in Public Housing in Puerto Rico
Authors: Norman Lisa R. , Dévieux Jessy G. , Rosenberg Rhonda , Malow Robert M.
Published: April 2011

The objective of this study was to examine the relationship between HIV testing practices and history of substance use among a large sample of women living in public housing in Puerto Rico and the relationships among HIV testing and history of substance abuse. A total of 1138 women were surveyed between April and August 2006 using a self-administered survey instrument. A total of 82% of the women in the sample group reported a history of HIV testing. Logistic regression analysis revealed that those with a history of alcohol use, marijuana use, and other illicit drug use were more likely to report a history of HIV testing ( P < .05). These findings suggest the possibility that women who engage in riskier behaviors may be aware of these risks and therefore make more of an effort to determine their status. Future studies should, however, further examine the risks among women from subpopulations who may be at high risk for HIV.
The Role of the Home Environment and Routinization in ART Adherence
Authors: Vaughan Christine , Wagner Glenn , Miyashiro Lisa , Ryan Gery , Scott James D.
Published: April 2011

Previous research suggests that routinization of medication-taking behavior promotes antiretroviral therapy (ART) adherence. The current study explored the nature of medication-taking routines in the home environment, where medication is most often taken, to identify home-based cues for taking ART. Qualitative interviews were conducted in the homes of 31 HIV-positive adult males in the United States with varying levels of adherence problems. Interviews were audiotaped and transcribed. Content analysis was performed to elicit themes from the text and further categorize responses. Patients with more routinized medication-taking behavior reported fewer adherence problems. Home-based medication-taking triggers that were especially common among patients who reported fewer adherence problems included meals, pillboxes, time of day, and visual cues. Findings characterize the nature of home-based medication-taking routines and suggest the potential utility of the home environment as a setting for adherence interventions.
Epidemiology of HIV among Asians and Pacific Islanders in the United States, 2001-2008
Authors: Adih William K. , Campsmith Michael , Williams Cheryl L. , Hardnett Felicia P. , Hughes Denise
Published: April 2011

Background: Recent analyses have shown increases in combined annual HIV diagnosis rates for Asians and Pacific Islanders (API). Methods: Using surveillance data from 33 states and 4 dependent areas we investigated the epidemiology of HIV among API during 2001—2008. Results: HIV diagnoses for API during 2001—2008 were predominantly among persons age 30-39 years (40%) and males (78%). The primary risk factor for males was sexual contact with males (78%) and for females, heterosexual contact (86%). API were the only racial/ethnic groups with a statistically significant estimated annual percentage increase (4.4%) in HIV diagnoses over the time period. Thirty-seven percent of HIV diagnoses among API progressed to AIDS in <12 months, with significantly greater likelihood among those 30 years and older. Survival was lower among API with AIDS diagnosis after 49 years of age, and was higher among persons with AIDS whose primary risk factor for infection was heterosexual contact. Conclusions: In contrast to other racial/ethnic groups, API were the only groups to show a significant increase in HIV diagnoses. A clearer understanding of the reasons for this trend is needed, so that appropriate interventions can be selected and adapted to prevent increased HIV prevalence among API in the U.S.
The Clinical Significance of CD4 Counts in Asian and Caucasian HIV-Infected Populations: Results from TAHOD and AHOD
Authors: Achhra Amit C. , Zhou Jialun , Choi Jun Yong , Hoy Jennifer , Zhang Fujie , Templeton David J. , Merati Tuti , Woolley Ian , Petoumenos Kathy , Amin Janaki ,   TAHOD and AHOD
Published: April 2011

The significance of interethnic variation in CD4 counts between Asian and Caucasian populations is not known. Patients on combination antiretroviral therapy from Treat Asia and Australian HIV Observational Databases (TAHOD, predominantly Asian, n = 3356; and AHOD, predominantly Caucasian, n = 2312, respectively) were followed for 23 144 person-years for AIDS/death and all-cause mortality endpoints. We calculated incidence-rates and used adjusted Cox regression to test for the interaction between cohort (TAHOD/AHOD) and time-updated CD4 count category (lagged by 3 months) for each of the endpoints. There were 382 AIDS/death events in TAHOD (rate: 4.06, 95%CI: 3.68-4.50) and 305 in AHOD (rate: 2.39, 95%CI: 2.13-2.67), per 100 person-years. At any given CD4 count category, the incidence-rates of endpoints were found to be similar between TAHOD and AHOD (in the adjusted models, P > .05 for the interaction term between cohort type and latest CD4 counts). At any given CD4 count, risk of AIDS or death was not found to vary by ethnicity, suggesting that the CD4 count thresholds for predicting outcomes defined in Caucasian populations may be equally valid in Asian populations.
Leader Deception Influences on Leader–Member Exchange and Subordinate Organizational Commitment
Authors: Griffith Jennifer A. , Connelly Shane , Thiel Chase E.
Published: April 2011

Deception is a common and daily occurrence in organizations. Despite this, little is known about how leader deception influences follower perceptions and commitment to the leader and the broader organization. This laboratory experiment uses a low-fidelity simulation task to investigate the effects of leader deception on follower perceptions of leader–member exchange (LMX) and follower commitment to the organization. Moderating effects of financial outcomes that resulted from deception, or who gained from deception, were also tested. Results showed negative effects of leader deception on follower LMX perceptions and affective commitment. Leader financial gain worsened the effects of leader deception on LMX compared with organizational financial gain. Implications of these findings are discussed.
Quantitative evaluation of single-arm versus randomized phase II cancer clinical trials
Authors: Pond Gregory R , Abbasi Saqib
Published: April 2011

Background There is a debate among cancer researchers about the use of single-arm or randomized phase II clinical trial designs; however, there is limited published objective evaluation of this issue.

Purpose To objectively quantify the impact on phase III clinical trials of a policy of all single-arm versus all randomized phase II trials.

Methods A simulation study was performed comparing optimal single-arm and randomized phase II trial designs with a variety of commonly used α and β error rates. Parameters modeled included: between-institution variability in the standard of care response rate, between-institution variability in the treatment effect, between-institution variability in the estimate of historical control rate (for selecting H0), presence of historical bias, and proportion of phase II trials conducted using active agents.

Results Using single-arm phase II trials resulted in a higher percentage of phase III trials conducted using active agents when there was minimal standard of care activity, or in the presence of a positive historical bias (H0 estimated to be greater than truth). Randomized phase II trials performed better in the presence of a negative historical bias, in the presence of high variability, and were more consistent across variation of historical bias. The proportion of phase III trials conducted using active agents was increased by reducing the α error. Presence of historical bias and the proportion of active agents studied in phase II had the greatest influence on results.

Limitations It was estimated that between 5% and 20% of agents studied in phase II trials are active; however, the conclusions could change if this estimate is incorrect. This study did not account for the possibility of a new drug application submission immediately following phase II. The primary outcome looked at was response rate, although some investigators have suggested that time-to-event outcomes should be used in phase II, particularly for randomized phase II trials.

Conclusions Both single-arm and randomized phase II trials appear warranted in certain situations. Investigators should increase consideration of the potential impact on phase III trials to optimally select the proper trial design prior to phase II study implementation.
Bollyculture: Ethnography of identity, media and performance
Authors: Kavoori Anandam , Joseph Christina A
Published: April 2011

This article offers the concept of ‘Bollyculture’ as a paradigmatic frame for understanding the media/dance cultures and life-space of young South-Asian Americans. Drawing on an extended ethnographic study of India Nite1 (a performance of Bollywood inspired dances), the essay argues that concepts like Bollyculture capture the hybrid and contested nature of diasporic subcultures, while offering concrete ways of observing the longitudinal and discursive impact of Bollywood on issues of identity, gender and culture.
The Rush of Regret
Authors: Summerville Amy
Published: April 2011

The current research examines immediate regrets occurring at the time of a meaningful life outcome to better understand influences on real-life regrets. This research used a longitudinal approach to examine both initial severity and the rate of change in immediate regrets. Initial severity was associated with greater past control over the outcome and lower levels of future ability to attain goals relevant to the regret and correct the regretted situation. Regret decreased over time, but less so if it concerned attainable ongoing goals. These contrasting effects of future opportunity on initial severity and change over time support a Dynamic Opportunity Principle of regret. Furthermore, the effects of past opportunity and of actions versus inactions on immediate regrets diverged from past findings about retrospective regrets. Immediate regrets may fundamentally differ from retrospective regrets, and implications for our understanding of regret are discussed.
Activated protein C cofactor function of protein S: a novel role for a γ-carboxyglutamic acid residue
Authors: Ahnström Josefin , Andersson Helena M. , Canis Kevin , Norstrøm Eva , Yu Yao , Dahlbäck Björn , Panico Maria , Morris Howard R. , Crawley James T. B. , Lane David A.
Published: April 2011

Protein S has an important anticoagulant function by acting as a cofactor for activated protein C (APC). We recently reported that the EGF1 domain residue Asp95 is critical for APC cofactor function. In the present study, we examined whether additional interaction sites within the Gla domain of protein S might contribute to its APC cofactor function. We examined 4 residues, composing the previously reported “Face1” (N33S/P35T/E36A/Y39V) variant, as single point substitutions. Of these protein S variants, protein S E36A was found to be almost completely inactive using calibrated automated thrombography. In factor Va inactivation assays, protein S E36A had 89% reduced cofactor activity compared with wild-type protein S and was almost completely inactive in factor VIIIa inactivation; phospholipid binding was, however, normal. Glu36 lies outside the ω-loop that mediates Ca2+-dependent phospholipid binding. Using mass spectrometry, it was nevertheless confirmed that Glu36 is γ-carboxylated. Our finding that Gla36 is important for APC cofactor function, but not for phospholipid binding, defines a novel function (other than Ca2+ coordination/phospholipid binding) for a Gla residue in vitamin K–dependent proteins. It also suggests that residues within the Gla and EGF1 domains of protein S act cooperatively for its APC cofactor function.
Identification of CCR9− murine plasmacytoid DC precursors with plasticity to differentiate into conventional DCs
Authors: Schlitzer Andreas , Loschko Jakob , Mair Katrin , Vogelmann Roger , Henkel Lynette , Einwächter Henrik , Schiemann Matthias , Niess Jan-Hendrik , Reindl Wolfgang , Krug Anne
Published: April 2011

Whereas the final differentiation of conventional dendritic cells (CDCs) from committed precursors occurs locally in secondary lymphoid or peripheral tissues, plasmacytoid dendritic cells (PDCs) are thought to fully develop in the bone marrow from common DC progenitors before migrating to the periphery. In our study, we define, for the first time, a subpopulation of CCR9− major histocompatibility complex class IIlow PDCs in murine bone marrow, which express E2-2 and are immediate precursors of CCR9+ fully differentiated PDCs. However, CCR9− PDCs have the plasticity to acquire the phenotype and function of CD11b+ CD8α− major histocompatibility complex class IIhigh CDC-like cells under the influence of soluble factors produced by intestinal epithelial cells or recombinant GM-CSF. This deviation from the PDC lineage commitment is regulated on the level of transcription factors reflected by down-regulation of E2-2 and up-regulation of ID2, PU.1, and BATF3. Thus, CCR9− PDCs are immediate PDC precursors that can be reprogrammed to differentiate into CDC-like cells with higher antigen-presenting and cytokine-producing capacity under the influence of the local tissue microenvironment.
A multi gene sequence-based phylogeny of the Musaceae (banana) family
Authors: Christelová Pavla , Valárik Miroslav , Hřibová Eva , De Langhe Edmond , Doležel Jaroslav
Published: April 2011

Background

The classification of the Musaceae (banana) family species and their phylogenetic inter-relationships remain controversial, in part due to limited nucleotide information to complement the morphological and physiological characters. In this work the evolutionary relationships within the Musaceae family were studied using 13 species and DNA sequences obtained from a set of 19 unlinked nuclear genes.

Results

The 19 gene sequences represented a sample of ~16 kb of genome sequence (~73% intronic). The sequence data were also used to obtain estimates for the divergence times of the Musaceae genera andMusasections. Nucleotide variation within the sample confirmed the close relationship ofAustralimusaandCallimusasections and showed thatEumusaandRhodochlamyssections are not reciprocally monophyletic, which supports the previous claims for the merger between the two latter sections. Divergence time analysis supported the previous dating of the Musaceae crown age to the Cretaceous/Tertiary boundary (~ 69 Mya), and the evolution ofMusato ~50 Mya. The first estimates for the divergence times of the fourMusasections were also obtained.

Conclusions

The gene sequence-based phylogeny presented here provides a substantial insight into the course of speciation within the Musaceae. An understanding of the main phylogenetic relationships between banana species will help to fine-tune the taxonomy of Musaceae.
Differences in TCDD-elicited gene expression profiles in human HepG2, mouse Hepa1c1c7 and rat H4IIE hepatoma cells
Authors: Dere Edward , Lee Andrea W , Burgoon Lyle D , Zacharewski Timothy R
Published: April 2011

Background

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is an environmental contaminant that elicits a broad spectrum of toxic effects in a species-specific manner. Current risk assessment practices routinely extrapolate results from in vivo and in vitro rodent models to assess human risk. In order to further investigate the species-specific responses elicited by TCDD, temporal gene expression responses in human HepG2, mouse Hepa1c1c7 and rat H4IIE cells were compared.

Results

Microarray analysis identified a core set of conserved gene expression responses across species consistent with the role of AhR in mediating adaptive metabolic responses. However, significant species-specific as well as species-divergent responses were identified. Computational analysis of the regulatory regions of species-specific and -divergent responses suggests that dioxin response elements (DREs) are involved. These results are consistent with in vivo rat vs. mouse species-specific differential gene expression, and more comprehensive comparative DRE searches.

Conclusions

Comparative analysis of human HepG2, mouse Hepa1c1c7 and rat H4IIE TCDD-elicited gene expression responses is consistent with in vivo rat-mouse comparative gene expression studies, and more comprehensive comparative DRE searches, suggesting that AhR-mediated gene expression is species-specific.
Mycobacterium tuberculosis complex drug resistance pattern and identification of species causing tuberculosis in the West and Centre regions of Cameroon
Authors: Assam-Assam Jean-Paul , Penlap Veronique B , Cho-Ngwa Fidelis , Tedom Jean-Claude , Ane-Anyangwe Irene , Titanji Vincent P
Published: April 2011

Background

Data on the levels of resistance of Mycobacterium tuberculosis complex (MTBC) strains to first line anti-tuberculosis drugs in Cameroon, and on the species of MTBC circulating in the country are obsolete. The picture about 10 years after the last studies, and 6 years after the re-organisation of the National Tuberculosis (TB) Control Programme (NTBCP) is not known.

Methods

The study was conducted from February to July 2009 in the West and Centre regions of Cameroon. A total of 756 suspected patients were studied. MTBC species were detected by the standard Ziehl-Neelsen staining method. Bacterial susceptibility to the first line drugs [isoniazid (INH), rifampicin (RIF), ethambutol (EMB) and streptomycin (SM)] were performed on cultures using the indirect proportion method. MTBC species were identified by standard biochemical and culture methods.

Results

Of the 756 suspected patients, 154 (20.37%) were positive by smear microscopy. Of these, 20.77% were HIV patients. The growth of Mycobacterium was observed with the sputa from 149 (96.75%) subjects. All the isolates were identified as either M. tuberculosis or M. africanum. Among these, 16 (10.73%) were resistant to at least one drug (13.3% for the West region and 8.1% for the Centre). The initial resistance rates were 7.35% for the Centre region and 11.29% for the West region, while the acquired resistance rates were 16.66% (1/6) for the Centre region and 23.07% (3/13) for the West. Within the two regions, the highest total resistance to one drug was obtained with INH and SM (2.68% each). Multidrug-resistance (MDR) was observed only in the West region at a rate of 6.67%. No resistance was recorded for EMB.

Conclusions

M. tuberculosis and M. africanum remain the MTBC species causing pulmonary TB in the West and Centre regions of Cameroon. Following the re-organisation of the NTBCP, resistance to all first line anti-TB drugs has declined significantly (p < 0.05 for West; and p < 0.01 for Centre) in comparison to previous studies. However, the general rates of anti-TB drug resistance remain high in the country, underscoring the need for greater enforcement of control strategies.
Piper sarmentosum inhibits ICAM-1 and Nox4 gene expression in oxidative stress-induced human umbilical vein endothelial cells
Authors: Ugusman Azizah , Zakaria Zaiton , Hui Chua Kien , Megat Mohd Nordin Nor Anita
Published: April 2011

Background

Aqueous extract of Piper sarmentosum (AEPS) is known to possess antioxidant and anti-atherosclerotic activities but the mechanism responsible for it remains unclear. In early part of atherosclerosis, nuclear factor-kappa B (NF-κB) induces the expression of cellular adhesion molecules such as vascular cell adhesion molecule-1 (VCAM-1), intracellular adhesion molecule-1 (ICAM-1) and E-selectin. NADPH oxidase 4 (Nox4) is the predominant source of superoxide in the endothelial cells whereas superoxide dismutase 1 (SOD1), catalase (CAT) and glutathione peroxidase (GPx) are the antioxidant enzymes responsible for inactivating reactive oxygen species. The present study aimed to investigate the effects of AEPS on the gene expression of NF-κB, VCAM-1, ICAM-1, E-selectin, Nox4, SOD1, CAT and GPx in cultured human umbilical vein endothelial cells (HUVECs).

Methods

HUVECs were divided into four groups:- control; treatment with 180 μM hydrogen peroxide (H2O2); treatment with 150 μg/mL AEPS and concomitant treatment with AEPS and H2O2 for 24 hours. Total RNA was extracted from all the groups of HUVEC using TRI reagent. Subsequently, qPCR was carried out to determine the mRNA expression of NF-κB, VCAM-1, ICAM-1, E-selectin, Nox4, SOD1, CAT and GPx. The specificity of the reactions was verified using melting curve analysis and agarose gel electrophoresis.

Results

When stimulated with H2O2, HUVECs expressed higher level of ICAM-1 (1.3-fold) and Nox4 (1.2-fold) mRNA expression. However, AEPS treatment led to a reduction in the mRNA expression of ICAM-1 (p < 0.01) and Nox4 (p < 0.05) in the H2O2-induced HUVECs. AEPS also upregulated the mRNA expression of SOD1 (p < 0.05), CAT (p < 0.01) and GPx (p < 0.05) in oxidative stress-induced HUVECs. There was no significant change in the mRNA expression of VCAM-1 and E-selectin.

Conclusion

The expressional suppression of ICAM-1 and Nox4 and induction of antioxidant enzymes might be an important component of the vascular protective effect of AEPS.
Malignant mesenchymal tumor with leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, and osteosarcoma differentiation: case report and literature review
Authors: Li Yao-Feng , Yu Cheng-Ping , Wu Seng-Tang , Dai Ming-Shen , Lee Herng-Sheng
Published: April 2011

A case of malignant mesenchymoma of the bladder containing leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, osteosarcoma, and myxomatous components is described. The primary pedunculated tumor measuring 14 × 13 × 7 cm and weighing 343 g arose from the left trigone of the bladder and was treated by total cystectomy. The histogenesis of malignant mesenchymomas and their optimal management strategy and prognosis remain uncertain. Herein, we present the fifth case of malignant mesenchymoma of the urinary bladder to be reported in the literature, which presented five unrelated differentiated tissues more than did previously reported cases.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1964291058509642.
Mannan Binding Lectin (MBL) genotypes coding for high MBL serum levels are associated with rheumatoid factor negative rheumatoid arthritis in never smokers
Authors: Saevarsdottir Saedis , Ding Bo , Steinsson Kristjan , Grondal Gerdur , Valdimarsson Helgi , Alfredsson Lars , Klareskog Lars , Padyukov Leonid
Published: April 2011

Introduction

Previous studies have provided inconsistent results on whether variants in the MBL2 gene, coding for the complement-activating mannan-binding lectin (MBL) protein, associate with rheumatoid arthritis (RA). We re-evaluated this in context of the main environmental and genetic risk factors (smoking, HLA-DRB1 'shared epitope' (SE), PTPN22*620W), which predispose to rheumatoid factor (RF) and/or anti-citrullinated-protein antibody (ACPA)-positive RA.

Methods

In this population-based EIRA study, rheumatoid factor (RF), ACPA, smoking, SE and PTPN22*620W status was determined in incident RA cases and matched controls. MBL-high (n = 1330) and MBL-low (n = 1257) genotypes predicting MBL levels were constructed from four promoter and exon-1 polymorphisms in the MBL2 gene. Odds ratios with 95% confidence interval (OR, 95% CI) were calculated by logistic regression. In extended families (n = 316), previously reported data were re-analyzed, considering RF and smoking.

Results

MBL-high genotypes tended to be associated with RF-negative (OR = 1.20, 95% CI 0.96-1.51) but not RF-positive (OR = 1.00, 95% CI 0.83-1.20) RA. Results divided by ACPA status did not differ. When stratified for smoking, MBL-high genotype was strongly associated with RF-negative RA in never smokers (OR = 1.82, 95% CI 1.24-2.69) but not in ever smokers (OR = 0.96, 95% CI 0.73-1.30). In never smokers, the association was observed in both the RF-negative/ACPA-negative (OR = 1.67, 95% CI 1.10-2.55) and RF-negative/ACPA-positive subgroups (OR = 3.07, 95% CI 1.37-6.89), and remained on an SE/PTPN22*620W negative background. In the extended families, the reported association between high MBL and RA was in fact confined to never smokers.

Conclusions

High MBL may predispose to RF-negative RA but only in individuals who have never smoked. This illustrates the importance of phenotypic subgrouping in genetic studies.
Childhood sexual abuse and psychosis: data from a
cross-sectional national psychiatric survey in England
Authors: Bebbington Paul , Jonas Sarah , Kuipers Elizabeth , King Michael , Cooper Claudia , Brugha Traolach , Meltzer Howard , McManus Sally , Jenkins Rachel
Published: April 2011

Background

A number of studies in a range of samples attest a link between childhood
sexual abuse and psychosis.

Aims

To use data from a large representative general population sample (Adult
Psychiatric Morbidity Survey 2007) to test hypotheses that childhood
sexual abuse is linked to psychosis, and that the relationship is
consistent with mediation by revictimisation experiences, heavy cannabis
use, anxiety and depression.

Method

The prevalence of psychosis was established operationally in a
representative cross-sectional survey of the adult household population
of England (n = 7353). Using computer-assisted
self-interview, a history of various forms of sexual abuse was
established, along with the date of first abuse.

Results

Sexual abuse before the age of 16 was strongly associated with psychosis,
particularly if it involved non-consensual sexual intercourse (odds ratio
(OR) = 10.14, 95% CI 4.8–21.3, population attributable risk fraction
14%). There was evidence of partial mediation by anxiety and depression,
but not by heavy cannabis use nor revictimisation in adulthood.

Conclusions

The association between childhood sexual abuse and psychosis was large,
and may be causal. These results have important implications for the
nature and aetiology of psychosis, for its treatment and for primary
prevention.
Body Fluid Expansion in Acromegaly Is Related to Enhanced Epithelial Sodium Channel (ENaC) Activity
Authors: Kamenicky Peter , Blanchard Anne , Frank Michael , Salenave Sylvie , Letierce Alexia , Azizi Michel , Lombès Marc , Chanson Philippe
Published: April 2011

Background:

Soft-tissue swelling and increased extracellular volume, two features of acromegaly, are related to the antinatriuretic effects of excess GH/IGF-I, but the precise pathophysiological mechanism is unclear.

Objective:

Our objective was to determine the effect of the GH excess on renal and extrarenal epithelial sodium channel (ENaC) activity.

Design and Setting:

We conducted a prospective randomized open-label blinded-endpoint (PROBE) crossover study (www.ClinicalTrials.gov Identifier: NCT00531908) at a tertiary referral medical center and clinical investigation center.

Intervention:

Sixteen patients (five females, 11 males) with acromegaly were randomly assigned to receive 20 mg amiloride (an ENaC blocker) and 25 mg furosemide (a Na-K-2Cl cotransporter blocker) under a high-sodium diet to suppress endogenous renin and aldosterone.

Measurements:

Diuretic-induced changes in the urinary Na/K ratio (reflecting coupling between ENaC-mediated Na reabsorption and distal K secretion) and the intranasal amiloride-sensitive potential (reflecting extrarenal ENaC activity) were measured before and 6 months after (range, 1–12 months) treatment of acromegaly.

Results:

Serum IGF-I concentrations normalized in all the patients after treatment of acromegaly. Baseline plasma renin and aldosterone concentrations remained unchanged after treatment. Active acromegaly, compared with controlled disease, was associated with an enhanced response [median (interquartile range)] to amiloride [urinary Na/K, 13.9 (9.8–19.5) vs. 6.3 (4.3–8.4) mmol/mmol, P = 0.0003], a reduced response to furosemide [urinary Na/K, 5.2 (4.6–7.2) vs. 7.1 (5.4–8.8) mmol/mmol, P =0.0151], and an increased intranasal amiloride-sensitive potential [5.8 (11.9–3.8) vs. 4.2 (6.4–2.1) mV, P = 0.031], respectively.

Conclusion:

GH/IGF-I excess in humans is associated with enhanced renal and extrarenal ENaC activity that may contribute to soft-tissue swelling and volume expansion in acromegaly.
Oxidative C–H/C–H Coupling of Azine and Indole/Pyrrole Nuclei: Palladium Catalysis and Synthesis of Eudistomin U
Authors: Yamaguchi Atsushi D , Mandal Debashis , Yamaguchi Junichiro , Itami Kenichiro
Published: April 2011

We have developed a palladium-catalyzed C–H/C–H coupling reaction of indoles or pyrroles with azine N-oxides. The reaction proceeds selectively at the C3 position of indoles/pyrroles and the C2 position of azine N-oxides. Furthermore, we have accomplished the synthesis of marine indole alkaloid eudistomin U by utilizing this newly developed C–H/C–H coupling reaction.
CT urography in the urinary bladder: To compare excretory phase images using a low noise index and a high noise index with adaptive noise reduction filter
Authors: Takeyama Nobuyuki , Ohgiya Yoshimitsu , Hayashi Takaki , Takahashi Toshiyuki , Yoshiaki Suzuki , Takasu Daisuke , Nakashima Junya , Kato Kyoichi , Kinebuchi Yuko , Hashimoto Toshi , Gokan Takehiko
Published: April 2011

Background

Although CT urography (CTU) is widely used for the evaluation of the entire urinary tract, the most important drawback is the radiation exposure.

Purpose

To evaluate the effect of a noise reduction filter (NRF) using a phantom and to quantitatively and qualitatively compare excretory phase (EP) images using a low noise index (NI) with those using a high NI and postprocessing NRF (pNRF).

Material and Methods

Each NI value was defined for a slice thickness of 5 mm, and reconstructed images with a slice thickness of 1.25 mm were assessed. Sixty patients who were at high risk of developing bladder tumors (BT) were divided into two groups according to whether their EP images were obtained using an NI of 9.88 (29 patients; group A) or an NI of 20 and pNRF (31 patients; group B). The CT dose index volume (CTDIvol) and the contrast-to-noise ratio (CNR) of the bladder with respect to the anterior pelvic fat were compared in both groups. Qualitative assessment of the urinary bladder for image noise, sharpness, streak artifacts, homogeneity, and the conspicuity of polypoid or sessile-shaped BTs with a short-axis diameter greater than 10 mm was performed using a 3-point scale.

Results

The phantom study showed noise reduction of approximately 40% and 76% dose reduction between group A and group B. CTDIvol demonstrated a 73% reduction in group B (4.6 ± 1.1 mGy) compared with group A (16.9 ± 3.4 mGy). The CNR value was not significantly different ( P = 0.60) between group A (16.1 ± 5.1) and group B (16.6 ± 7.6). Although group A was superior ( P < 0.01) to group B with regard to image noise, other qualitative analyses did not show significant differences.

Conclusion

EP images using a high NI and pNRF were quantitatively and qualitatively comparable to those using a low NI, except with regard to image noise.
Reproducibility of phantom-based quality assurance parameters in real-time ultrasound imaging
Authors: Sipilä Outi , Blomqvist Päivi , Jauhiainen Mervi , Kilpeläinen Tiina , Malaska Paula , Mannila Vilma , Vinnurva-Jussila Tuula , Virsula Sari
Published: April 2011

Background

In a large radiological center, the ultrasound (US) quality assurance (QA) program involves several professionals. Although the operator and the parameters utilized can contribute to the results, the selected QA parameters should still reflect the quality of the US scanner, not the measuring process.

Purpose

To evaluate the reproducibility of recommended phantom-based US QA parameters in a realistic environment.

Material and Methods

Six sonographers measured six high-end US scanners with 20 transducers using a general purpose phantom. Every transducer was measured altogether seven times, using one frequency per transducer. The QA parameters studied were homogeneity, visualization depth, vertical and horizontal distance measurements, axial and lateral resolution, and the correct visibility of anechoic and high-contrast masses. The evaluation of the homogeneity was based on visual observations. Inter-observer interquartile ranges were computed for the grading of the masses. For the other QA parameters, the mean inter- and intra-observer coefficients of variation (CoV) were calculated. In addition, the symmetry of the reverberations when imaging air with a clean transducer was checked.

Results

The mean inter-observer CoVs were: visualization depth 11 ± 4%, vertical distance 1.7 ± 0.4%, horizontal distance 1.4 ± 0.6%, axial resolution 22 ± 7%, and lateral resolution 16 ± 8%. The mean intra-observer values were about half of these values with similar standard deviations. The visual evaluation of the homogeneity and the symmetry of the reverberations produced false-positive findings in 5% of the cases, but were found useful in detecting a defective transducer. The grading of the masses had mean interquartile ranges of 20–30% of the grading scale.

Conclusion

The inter-observer variability in measuring phantom-based QA parameters can be relatively high. This should be considered when implementing a phantom-based QA protocol and evaluating the results.
Normal values for renal parenchymal volume and kidney length as measured by non-enhanced multidetector spiral computed tomography
Authors: Gao Fei , Yang Mei , Luo Chun Li , Pang Hua , Wu Xiao Hou
Published: April 2011

Background

Renal parenchymal volume (RPV) is considered an important index for clinical decisions. However, normal values have not been established, which hinders the clinical application of RPV.

Purpose

To test the accuracy and reproducibility of RPV and to investigate the normal values of RPV and kidney length as measured by non-enhanced multidetector computed tomography (CT).

Material and Methods

An animal model study was performed to test the accuracy and repeatability of RPV measured by CT. RPV of porcine kidneys was measured by water displacement (actual values) and non-enhanced multidetector CT. Individual RPV and kidney length were measured by non-enhanced CT in patients with no clinical history of renal disease ( n = 722). Patient height, age, weight, body surface area (BSA), and body mass index (BMI) were assessed before each patient's CT examination was performed.

Results

RPV obtained by the CT method was within 2% of the RPV determined by the water displacement method. The normal values of RPV (M ± 1.96 standard deviation [SD]) were 145.72 ± 54.37 mL for men and 132.46 ± 41.94 mL for women. The normal values of kidney length (M ± 1.96 SD) were 10.27 ± 1.98 cm for men and 9.93 ± 1.58 cm for women. RPV did not significantly correlate with BSA or weight in women, but correlated significantly with height and age in both men and women. Of the assessed factors age, weight, height, BSA, and BMI, age, and height were the independent factors that best reflected RPV, in both men and women.

Conclusion

The present animal study results showed that non-enhanced multidetector CT findings accurately reflect the RPV. The subsequent study performed in humans showed that the RPV of the presently sampled Chinese population was lower than the commonly quoted reference values obtained from Western populations.
Measurement of tumor volume by PET to evaluate prognosis in patients with advanced non-small cell lung cancer treated by non-surgical therapy
Authors: Yan Hongjiang , Wang Renben , Zhao Fen , Zhu Kunli , Jiang Shumei , Zhao Wei , Feng Rui
Published: April 2011

Background

Patients with advanced non-small cell lung cancer (NSCLC) seem to have disparity in prognosis. Accurate prediction of prognosis could be useful in the future to predict individual risk and to develop more aggressive or alternative treatment strategies.

Purpose

To evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with NSCLC.

Material and Methods

We retrospectively reviewed 120 patients with pathologically proven NSCLC (61 squamous cell carcinomas and 59 adenocarcinomas) who underwent pretreatment 18F-FDG PET. MTV and maximum standardized uptake value (SUVmax) for the primary tumors were measured by 18F-FDG PET. Pretreatment variables (age, sex, American Joint Committee on Cancer [AJCC] stage, histological type, SUVmax, and MTV) were analyzed to identify their correlation with two-year survival. To further evaluate and compare the predictive value of PET parameters, MTV, and SUVmax, time-dependent receiver-operating characteristic curve (ROC) analysis was used.

Results

In the univariate analysis, AJCC stage, histological type, MTV, and SUVmax of primary tumor were significant predictors of survival. On multivariate analysis, independent prognostic factors associated with decreased two-year survival were AJCC stage (hazard ratio [HR] 2.236, P = 0.003), histological type (HR 2.038, P = 0. 004), and MTV (HR 1.016, P = 0.001). SUVmax was not a significant factor (HR 0.96, P = 0.490). On time-dependent ROC analysis, MTV showed good predictive performance for two-year survival consistently better than SUVmax.

Conclusion

MTV, a volumetric parameter of 18F-FDG PET, is an important independent prognostic factor for survival and a better predictor of survival than SUVmax for the primary tumor in patients with advanced NSCLC.
The role of the renin–angiotensin system in liver fibrosis
Authors: Munshi M Kamruzzman , Uddin Mohammad N , Glaser Shannon S
Published: April 2011

Hepatic fibrosis, which is characterized by progressive inflammation and deposition of extracellular matrix components, is a common response to chronic liver disease. Hepatic fibrogenesis is a dynamic process that involves several liver cell types including hepatic stellate cells and Kupffer cells. In addition, recent evidence indicates that bile duct epithelial cells (i.e. cholangiocytes) also participate in the progression of biliary fibrosis that is observed during chronic cholestatic liver diseases, such as primary sclerosing cholangitis. To date, there are no effective treatments for hepatic fibrosis. Several recent studies have demonstrated that the renin–angiotensin system (RAS) plays a key role in hepatic fibrosis. Therapies targeting the RAS may represent a promising paradigm for the prevention and treatment of hepatic fibrosis in the setting of chronic liver disease. In this review, we provide a comprehensive update on the role of RAS in the pathogenesis of hepatic fibrosis in both animal models and human studies. We will discuss the profibrotic mechanisms activated by the RAS and the cell types involved. Studies that have utilized angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors to modulate the RAS in order to ameliorate hepatic fibrosis will also be discussed. Although the cumulative evidence supports the potential for the use of ARBs and ACE inhibitors as treatment for hepatic fibrosis, extensive studies of the effectiveness of RAS therapeutics are necessary in patients with chronic liver disease.
Neuromonitoring in a porcine model of acute hepatic failure
Authors: Frühauf N R , Radunz S , Grabellus F , Laube T , Uerschels A K , Kaiser G M
Published: April 2011

Cerebral oedema has been noted to occur frequently in patients dying of fulminant hepatic failure. Therefore, in the present study, multimodal neuromonitoring was evaluated in an animal model of hepatectomy. Acute liver failure was surgically induced in swine by complete hepatectomy ( n = 8). Intracranial pressure monitoring via a ventricular drainage system, electroencephalogram and recording of visually evoked potentials were used to establish a continuous neuromonitoring system. Measurements of liquor and serum ammonia (NH3) levels were taken at later stages of the trial in an approach to widen monitoring. Serial monitoring of the electroencephalogram revealed progressive slowing of the frequency with decreasing amplitude. Monitoring of the intracranial pressure with a subdural pressure transducer demonstrated a progressive and reproducible elevation. Increase in blood NH3 was observed. Anaesthesia was terminal. In all cases death was caused by cardiocirculatory insufficiency, confirmed by autopsy. At autopsy, brain tissue of the animals was found to be swollen showing flattened cortical gyri. In conclusion, the technique of extended neuromonitoring offers an advanced option for monitoring animal models of fulminant hepatic failure for further developments and investigations.
Trochanteric osteotomy in total hip replacement for congenital hip disease
Authors: Hartofilakidis G. , Babis G. C. , Georgiades G. , Kourlaba G.
Published: April 2011

We studied the effect of trochanteric osteotomy in 192 total hip replacements in 140 patients with congenital hip disease. There was bony union in 158 hips (82%), fibrous union in 29 (15%) and nonunion in five (3%). The rate of union had a statistically significant relationship with the position of reattachment of the trochanter, which depended greatly on the pre-operative diagnosis. The pre-operative Trendelenburg gait substantially improved in all three disease types (dysplasia, low and high dislocation) and all four categories of reattachment position. A persistent Trendelenburg gait post-operatively was noticed mostly in patients with defective union (fibrous or nonunion). Acetabular and femoral loosening had a statistically significant relationship with defective union and the position of reattachment of the trochanter.

These results suggest that the complications of trochanteric osteotomy in total hip replacement for patients with congenital hip disease are less important than the benefits of this surgical approach.
The effect of percutaneous pin fixation in the treatment of distal femoral physeal fractures
Authors: Garrett B. R. , Hoffman E. B. , Carrara H.
Published: April 2011

Distal femoral physeal fractures in children have a high incidence of physeal arrest, occurring in a mean of 40% of cases. The underlying nature of the distal femoral physis may be the primary cause, but other factors have been postulated to contribute to the formation of a physeal bar. The purpose of this study was to assess the significance of contributing factors to physeal bar formation, in particular the use of percutaneous pins across the physis.

We reviewed 55 patients with a median age of ten years (3 to 13), who had sustained displaced distal femoral physeal fractures. Most (40 of 55) were treated with percutaneous pinning after reduction, four were treated with screws and 11 with plaster. A total of 40 patients were assessed clinically and radiologically after skeletal maturity or at the time of formation of a bar. The remaining 15 were followed up for a minimum of two years.

Formation of a physeal bar occurred in 12 (21.8%) patients, with the rate rising to 30.6% in patients with high-energy injuries compared with 5.3% in those with low-energy injuries. There was a significant trend for physeal arrest according to increasing severity using the Salter-Harris classification. Percutaneous smooth pins across the physis were not statistically associated with growth arrest.
Osteoconductivity of thermal-sprayed silver-containing hydroxyapatite coating in the rat tibia
Authors: Yonekura Y. , Miyamoto H. , Shimazaki T. , Ando Y. , Noda I. , Mawatari M. , Hotokebuchi T.
Published: April 2011

A silver-containing hydroxyapatite (Ag-HA) coating has been developed using thermal spraying technology. We evaluated the osteoconductivity of this coating on titanium (Ti) implants in rat tibiae in relation to bacterial infection in joint replacement.

At 12 weeks, the mean affinity indices of bone formation of a Ti, an HA, a 3%Ag-HA and a 50%Ag-HA coating were 97.3%, 84.9%, 81.0% and 40.5%, respectively. The mean affinity indices of bone contact of these four coatings were 18.8%, 83.7%, 77.2% and 40.5%, respectively. The indices of bone formation and bone contact around the implant of the 3%Ag-HA coating were similar to those of the HA coating, and no significant differences were found between them (bone formation, p = 0.99; bone contact, p = 0.957). However, inhibition of bone formation was observed with the 50%Ag-HA coating.

These results indicate that the 3%Ag-HA coating has low toxicity and good osteoconductivity, and that the effect of silver toxicity on osteoconductivity depends on the dose.
The position and orientation of total knee replacement components
Authors: Hirschmann M. T. , Konala P. , Amsler F. , Iranpour F. , Friederich N. F. , Cobb J. P.
Published: April 2011

We studied the intra- and interobserver reliability of measurements of the position of the components after total knee replacement (TKR) using a combination of radiographs and axial two-dimensional (2D) and three-dimensional (3D) reconstructed CT images to identify which method is best for this purpose.

A total of 30 knees after primary TKR were assessed by two independent observers (an orthopaedic surgeon and a radiologist) using radiographs and CT scans. Plain radiographs were highly reliable at measuring the tibial slope, but showed wide variability for all other measurements; 2D-CT also showed wide variability. 3D-CT was highly reliable, even when measuring rotation of the femoral components, and significantly better than 2D-CT. Interobserver variability in the measurements on radiographs were good (intraclass correlation coefficient (ICC) 0.65 to 0.82), but rotational measurements on 2D-CT were poor (ICC 0.29). On 3D-CT they were near perfect (ICC 0.89 to 0.99), and significantly more reliable than 2D-CT (p < 0.001).

3D-reconstructed images are sufficiently reliable to enable reporting of the position and orientation of the components. Rotational measurements in particular should be performed on 3D-reconstructed CT images. When faced with a poorly functioning TKR with concerns over component positioning, we recommend 3D-CT as the investigation of choice.
Cross-linkedversusconventional polyethylene for total hip replacement
Authors: Kuzyk P. R. T. , Saccone M. , Sprague S. , Simunovic N. , Bhandari M. , Schemitsch E. H.
Published: April 2011

We conducted a systematic review and meta-analysis of randomised controlled trials comparing cross-linked with conventional polyethylene liners for total hip replacement in order to determine whether these liners reduce rates of wear, radiological evidence of osteolysis and the need for revision. The MEDLINE, EMBASE and COCHRANE databases were searched from their inception to May 2010 for all trials involving the use of cross-linked polyethylene in total hip replacement. Eligibility for inclusion in the review included the random allocation of treatments, the use of cross-linked and conventional polyethylene, and radiological wear as an outcome measure. The pooled mean differences were calculated for bedding-in, linear wear rate, three-dimensional linear wear rate, volumetric wear rate and total linear wear. Pooled risk ratios were calculated for radiological osteolysis and revision hip replacement. A search of the literature identified 194 potential studies, of which 12 met the inclusion criteria. All reported a significant reduction in radiological wear for cross-linked polyethylene.

The pooled mean differences for linear rate of wear, three-dimensional linear rate of wear, volumetric wear rate and total linear wear were all significantly reduced for cross-linked polyethylene. The risk ratio for radiological osteolysis was 0.40 (95% confidence interval 0.27 to 0.58; I2= 0%), favouring cross-linked polyethylene. The follow-up was not long enough to show a difference in the need for revision surgery.