bluuebunny/crossref_metadata_2025 huggingface dataset:
Reported Alcohol Consumption and Cognitive Decline: The Northern Manhattan Study
Authors: Wright Clinton B. , Elkind Mitchell S.V. , Luo Xiaodong , Paik Myunghee C. , Sacco Ralph L.
Published: October 2006

Background: Moderate alcohol intake may slow cognitive decline, and both vascular and neurodegenerative mechanisms have been implicated. Methods: We examined reported alcohol intake and cognitive decline in a community-based cohort of Hispanic, black and white individuals (n = 1,428). The role of the apolipoprotein E Ε4 (APOE4) allele as a modifier was also studied. Results and Conclusions: Reported drinking was as follows: 300 participants (21%) were ‘never’ drinkers, 622 (44%) ‘past’ drinkers, 145 (10%) reported taking less than 1 drink weekly, 330 (23%) 1 drink weekly up to 2 daily and 31 (2%) more than 2 drinks daily. A positive relationship was seen between reported alcohol intake and cognition. Drinking less than 1 drink a week (p = 0.09), between 1 drink weekly up to 2 drinks daily (p = 0.001) and more than 2 drinks daily (p = 0.003) were associated with less cognitive decline on the modified Telephone Interview for Cognitive Status compared to never drinkers. This dose-response relationship was not modified by the presence of an APOE4 allele in a subsample.
Improvement of Episodic Memory in Persons with Mild Cognitive Impairment and Healthy Older Adults: Evidence from a Cognitive Intervention Program
Authors: Belleville Sylvie , Gilbert Brigitte , Fontaine Francine , Gagnon Lise , Ménard Édith , Gauthier Serge
Published: October 2006

The efficacy of cognitive training was assessed in persons with mild cognitive impairment (MCI) and persons with normal cognitive aging. Forty-seven participants were included in this study: 28 with MCI and 17 controls. Twenty-one participants received intervention (20 MCI and 9 controls) and 16 participants (8 MCI and 8 controls) received no intervention (waiting-list group). The intervention focused on teaching episodic memory strategies. Three tasks of episodic memory (list recall, face-name association, text memory) were used as primary outcome measures. Results were analyzed using analyses of variance. The intervention effect (pre- and post-intervention difference) was significant on two of the primary outcome measures (delayed list recall and face-name association). A significant pre-post-effect was also found on measures of subjective memory and well-being. There was no improvement in the performance of groups of individuals with MCI and normal elderly persons who did not receive the intervention. These results suggest that persons with MCI can improve their performance on episodic memory when provided with cognitive training.
A Theory of Cultural Value Orientations: Explication and Applications
Authors: Schwartz Shalom
Published: October 2006

This article presents a theory of seven cultural value orientations that form three cultural value dimensions. This theory permits more finely tuned characterization of cultures than other theories. It is distinctive in deriving the cultural orientations from a priori theorizing. It also specifies a coherent, integrated system of relations among the orientations, postulating that they are interdependent rather than orthogonal. Analyses of data from 73 countries, using two different instruments, validate the 7 cultural orientations and the structure of interrelations among them. Conceptual and empirical comparisons of these orientations with Inglehart's two dimensions clarify similarities and differences. Using the cultural orientations, I generate a worldwide empirical mapping of 76 national cultures that identifies 7 transnational cultural groupings: West European, English-speaking, Latin American, East European, South Asian, Confucian influenced, and African and Middle Eastern. I briefly discuss distinctive cultural characteristics of these groupings. I then examine examples of socioeconomic, political, and demographic factors that give rise to national differences on the cultural value dimensions, factors that are themselves reciprocally influenced by culture. Finally, I examine consequences of prevailing cultural value orientations for attitudes and behavior (e.g., conventional morality, opposition to immigration, political activism) and argue that culture mediates the effects of major social structural variables on them.
Globalization, "McDonaldization" and Values: Quo Vadis?
Authors: Esmer Yilmaz
Published: October 2006

It is frequently asserted that the ongoing process that is commonly referred to as globalization should bring about wide-spread changes in values. Furthermore, it is hypothesized that the unparalleled increases in the flow of capital, goods, services and information coupled with the revolutionary developments in information and communication technologies should result in a convergence of values.This paper is attempt to assess the direction and the magnitude of value change between 1981, when the first WVS/EVS surveys were conducted, and 2001, the last year for which data are available. Data from some 20 countries are analyzed to follow possible changes in values. Furthermore, the paper offers a test of the convergence hypothesis by examining the standard deviations and the coefficients of variation of a wide-ranging list of values.The conclusion is that cultural value change has been rather limited during this period at least for this sample of countries. Among the dimensions studied, marriage, family and gender relations seem to be the area of most significant change. On the other hand, we have found almost no evidence for even a slow convergence of values.
From Text to Talisman: Al-Būsīrī's Qasīdat al-Burdah (Mantle Ode) and the Supplicatory Ode
Authors: Stetkevych Suzanne Pinckney
Published: October 2006

According to popular and literary tradition, when the Mamlūk period poet al-Būsīrī (d. 694-6/1294-7) was stricken with semi-paralysis that confounded his physicians, he turned in despair to compose a poem of praise to the Prophet Muhammad (madīh nabawī). He then saw the Prophet in a dream and recited the poem to him, upon which the Prophet bestowed his mantle (burdah) upon him, and the poet awoke miraculously cured. The present study argues that the story of the miraculous cure, the talismanic uses of various verses of the Burdah, and the extraordinary power of the poem to generate a vast body of imitations, expansions, translations and commentaries, cannot be understood except through a literary analysis of the text of the poem itself. After analyzing the structural and generic differences between the Burdah and the Sufi ghazal of Ibn al-Fārid of which it is technically a contrafaction (mu'āradah), this study argues that the overall ritual-poetic structure of the Burdah, as contained in Parts 1-3 and 9-10 of the poem, is that of the supplicatory panegyric ode as practiced by such poets as the pre-Islamic al-Nābighah al-Dhubyānī or the poet of the Prophet, Ka'b ibn Zuhayr. It then proceeds to demonstrate that the Burdah exhibits the same structural elements as the supplicatory qasīdat al-madh: 1) Lyric-Elegiac Prelude (nasīb); 2) Self-Abasement; 3) Praise of the One Supplicated (mamdūh); and 4) Supplication (including benediction). It notes that in post-classical madīh nabawī the mamdūh is no longer of this world, and therefore the ritual exchange between poet and patron is essentially a spiritual one: what the supplicant is asking for is shafā'ah, the intercession of the Prophet on the Day of Judgment. The myth of the miraculous cure then serves, above all, as a symbol, a physical sign of a spiritual transformation or cure, that is, of the poem's ritual and spiritual efficacy. Taking these stories literally, believers engaged the poem, as text and talisman, to procure a wide range of physical and spiritual boons.
Cultural Representation in Literary Translation: Translators as Mediators/Creators
Authors: Ettobi Mustapha
Published: October 2006

This article examines the French and English translations of Mohamed Choukri's Al-Khubz al-Hāfī (For Bread Alone), by Tahar Ben Jelloun and Paul Bowles respectively, and the impact on the representation of Moroccan (Arab) culture. It explores the roles of these translators in the emergence and promotion of Choukri's controversial book. It also shows how they used this text to convey different views on various issues and, therefore, change the representation of cultural aspects. Giving specific examples of these shifts and the probable motivations for making them, the article proves that nuanced readings of these translations cannot ignore the presence of these mediators/creators.
The International Covenant on Civil and Political Rights: One Covenant, Two Chinese Texts?
Authors: Shiyan Sun
Published: October 2006

This article discloses the fact that there have coexisted two Chinese texts of the International Covenant on Civil and Political Rights. One of the texts has been widely used by the United Nations and in China for more than three decades. However, it is not the authentic Chinese text of ICCPR. The authentic Chinese text of the Covenant, as published in the United Nations Treaty Series, has been rarely referred to in Chinese literature on human rights. The article compares the two texts and points out a number of mistakes in the widely used text in the light of the object and purpose of the Covenant. The article also analyses the legal and practical consequences of the situation, and proposes both a legally justifiable and practically acceptable solution to the problem.
The Use of Coastal Brownfields as Nature Preserves
Authors: Levi Daniel , Kocher Sara
Published: October 2006

Brownfields have the potential to be reused as nature preserves or recreation areas. This reuse depends on the public’s perceptions of risk and their willingness to support the new uses of the sites. This study examines attitudes about the reuse of large coastal brownfields from local and nonlocal students and the public. The sites include the buffer area surrounding a nuclear power plant, an area contaminated by a chemical spill, and a ranch (which was used as a control site). The results show that all the samples are more supportive of the establishment of nature preserves with human access than either nature preserves without access or developed recreation areas. Limits on human access to the sites are more acceptable for the contaminated sites and more acceptable to the nonlocal samples.
Investigation of the Effects of Herbal Medicines on Warfarin Response in Healthy Subjects: A Population Pharmacokinetic‐Pharmacodynamic Modeling Approach
Authors: Jiang Xuemin , Blair Elaine Y. L. , McLachlan Andrew J.
Published: October 2006

Systematic evidence regarding herb‐drug interactions is lacking. This study investigated herb‐drug interactions with warfarin. S‐warfarin concentration and response (prothrombin complex activity) data from healthy subjects (n = 24) who received a single warfarin dose (25 mg) and either St John's wort, Asian ginseng, Ginkgo biloba, or ginger were analyzed using a population pharmacokinetic‐pharmacodynamic modeling approach. The ratio of S‐warfarin apparent clearance (CL/F) compared to control was 1.39 ± 0.06 and 1.14 ± 0.04 after St John's wort and Asian ginseng pretreatment, respectively. Other pharmacokinetic and pharmacodynamic parameters were unaffected. Coadministration of St John's wort significantly increased S‐warfarin CL/F, whereas treatment with Asian ginseng produced only a moderate increase in CL/F. Ginkgo and ginger did not affect the pharmacokinetics of warfarin in healthy subjects. None of the herbs studied had a direct effect on warfarin pharmacodynamics. Studies in anticoagulated patients are warranted to assess the clinical significance of these herb‐drug interactions.
Effects of Ginkgo Biloba Extract on Pharmacokinetics and Pharmacodynamics of Tolbutamide and Midazolam in Healthy Volunteers
Authors: Uchida Shinya , Yamada Hiroshi , Li Xiao Dong , Maruyama Shuji , Ohmori Yuki , Oki Tomomi , Watanabe Hiroshi , Umegaki Keizo , Ohashi Kyoichi , Yamada Shizuo
Published: October 2006

This study was undertaken to clarify the influence of repeated oral administration of Ginkgo biloba extract (GBE) on CYP2C9 and CYP3A4. CYP2C9 probe (tolbutamide, 125 mg) and CYP3A4 probe (midazolam, 8 mg) were orally administered to 10 male healthy volunteers before and after GBE intake (360 mg/d) for 28 days, and they received 75 g glucose after the dosing of tolbutamide. Plasma drug concentrations and blood glucose levels were measured. The area under concentration versus time curve (AUC0–∞) for tolbutamide after GBE intake was slightly but significantly (16%) lower than that before GBE intake. Concomitantly, GBE tended to attenuate AUC0–2 of blood glucose—lowering effect of tolbutamide. AUC0–∞ for midazolam was significantly (25%) increased by GBE intake and oral clearance was significantly (26%) decreased. Thus, it is suggested that the combination of GBE and drugs should be cautious in terms of the potential interactions, especially in elderly patients or patients treated with drugs exerting relatively narrow therapeutic windows.
Pharmacodynamics, Chiral Pharmacokinetics, and Pharmacokinetic‐Pharmacodynamic Modeling of Fenoprofen in Patients With Diabetes Mellitus
Authors: Poggi Josiane Cristófani , Barissa Giuliano Rodrigo , Donadi Eduardo Antônio , Foss Milton Cesar , de Queiróz Cunha Fernando , Lanchote Vera Lucia , dos Reis Marina Lemos
Published: October 2006

The objective of the present study was to assess the influence of type 1 and type 2 diabetes mellitus on the enantioselective pharmacodynamics and pharmacokinetics of fenoprofen. Patients with diabetes mellitus type 1 (n = 7) or type 2 (n = 7) and healthy volunteers (n = 13) received orally a single 600‐mg dose of racemic fenoprofen. Monocompartmental analysis of (+)‐(S)‐fenoprofen showed a significant difference (P < .05, Kruskal‐Wallis test) in area under the curve (AUC) values (153.68 vs 243.50 μg·h/mL) and oral clearance (1.95 vs 1.23 L/h) only between patients with diabetes mellitus type 2 and healthy volunteers. The inhibitory activity of cyclooxygenases was evaluated indirectly by the determination of prostaglandin E2 (COX‐2) and thromboxane B2 (COX‐1) using the sigmoidal inhibitory Emaxmodel. The patients with type 2 diabetes mellitus presented lower IC50(3.29 vs 6.0 μg/mL) and γ (0.73 vs 2.01) values for COX‐1 activity compared to healthy volunteers (P < .05, Kruskal‐Wallis test). These results show that diabetes mellitus type 2, but not type 1, influences the pharmacokinetics and pharmacodynamics of (+)‐(S)‐fenoprofen.
Population‐Based Assessments of Clinical Drug‐Drug Interactions: Qualitative Indices or Quantitative Measures?
Authors: Zhou Honghui
Published: October 2006

Population‐based assessments of drug‐drug interactions have become more common since the introduction and acceptance of the population pharmacokinetic approach. Unlike traditional methods, population‐based studies provide clinically relevant results that can be applied directly to a target patient population. Furthermore, population‐based studies do not demand the traditional requirements of intensive pharmacokinetic sampling, rigorous inpatient stays, or stringent assessment schedules. As such, the population‐based approach can effectively be used to confirm known drug‐drug interactions and further characterize anticipated interactions. A prospectively designed analysis can also reveal drug‐drug interactions that might otherwise have gone undetected with traditional methods. Ultimately, these results could help to alleviate clinicians' concerns about using widely marketed drugs in combination therapies and also reduce patients' risk of experiencing unacceptable side effects. This article intends to provide a balanced overview of the population‐based approach and its merits, drawbacks, and potential utility in the assessment of drug‐drug interactions during clinical drug development.
Transition to Parenthood and Conjugal Life
Authors: Bouchard Geneviève , Boudreau Jolène , Hébert Renée
Published: October 2006

One of the variables that could explain the considerable variety of ways that adult couples handle the transition to parenthood is whether the pregnancy was planned or not. However, very little is known about the impact of pregnancy intendedness on the conjugal life of couples during this transition. The aim of this study was to address this gap in the literature by comparing the trajectory of 21 couples facing an unplanned pregnancy to the one of 99 couples facing a planned pregnancy. Each partner completed measures of dyadic adjustment and conjugal conflicts during the third trimester of pregnancy and at 6 months postpartum. Results indicate that pregnancy intendedness influences the way couples experienced the transition to parenthood. Results suggest that couples with unplanned pregnancies experience higher levels of relationship functioning following than before the birth, whereas couples facing planned pregnancies experience lower levels of functioning following than before the birth.
Microenterprise Development in the United States: Current Challenges and New Directions
Authors: Servon Lisa J.
Published: October 2006

U.S. microenterprise programs provide business training, small amounts of credit ($35,000 or less), or both to businesses with five or fewer employees. As the microenterprise field nears the end of its second decade in the United States, experts and practitioners agree that the field is in a difficult place; there appears to be relatively widespread agreement on the nature of the problems, which include a lack of standardized data, decreasing funding from some key sectors, increased competition, and difficulty in reaching the target market. The author argues that if the microenterprise field does not make some significant changes, it will neither sustain itself nor approach its potential. Strategies to address these challenges fall into three broad categories: restructuring, innovation, and accreditation and standardization.
A New Universal Mean Girl: Examining the Discursive Construction and Social Regulation of a New Feminine Pathology
Authors: Ringrose Jessica
Published: October 2006

This article examines recent sensationalist media attention to mean girls. Popular constructions of the mean girl are argued to be rooted in a developmental psychology debate on girls as indirectly and relationally aggressive. The developmental psychology model of feminine aggression is analyzed as a postfeminist discourse, illustrated to pathologize girls through universalizing, essentializing and context-devoid models of girlhood, which contribute to a shift from notions of girls as vulnerable to girls as mean in popular culture. Constructions of the mean girl are also linked to postfeminist gender anxieties over middle-class girl power and girl success. Regulatory strategies emerging to manage mean girls are examined as oriented toward maintaining appropriate modes of repressive, white, middle-class femininity. When ‘other’ girls do figure in the mean girl story, it is through sensational incidences of isolated girl violence, held up as a dangerous risk of uncontained feminine aggression. Girlhood is argued to remain carefully regulated, through class and race-specific categories of femininity, which continue to produce normative (mean) and deviant (violent) girls.
An Evaluation of a Court-Mandated Batterer Intervention Program: Investigating Differential Program Effect for African American and White Women
Authors: Carney Michelle Mohr , Buttell Frederick P.
Published: October 2006

Objective: The purpose of this study is to (a) evaluate a 16-week batterer intervention program by investigating changes in psychological variables related to abuse between pretreatment and posttreatment assessments in a sample of women involuntarily placed in treatment and (b) to investigate the differential effectiveness of this same batterer intervention program for African American and White batterers. Method: The study employed a secondary analysis of 59 treatment completers. Results: The findings of this study suggest that the court-ordered batterers constituting this sample demonstrate significant changes, in the desired direction, on psychological variables related to domestic violence, as a result of participation in a court-mandated treatment program, and there was no significant difference in terms of magnitude of change on these same psychological variables between African American and White batterers, indicating that the treatment program was reaching both groups equally well. Conclusion: Implications of the findings for social workers were explored and discussed.
Effects on WAIS-III Performance IQ (PIQ) and Full Scale IQ (FSIQ) When Object Assembly Is Substituted for Each Standard Performance Scale Subtest
Authors: Ryan Joseph J. , Morris Jeri , Brown Kristina I. , Glass Laura A.
Published: October 2006

According to the WAIS-III Administration and Scoring Manual, Object Assembly (OA) may be substituted for any spoiled Performance subtest. This assertion has not been evaluated in a clinical sample. The present investigation reports differences that resulted in Performance IQ (PIQ) and Full Scale IQ (FSIQ) when OA replaced each of the Performance subtests. Participants were 47 referrals for neuropsychological assessment (age M = 45.98 years, SD = 9.82; education M = 13.82 years, SD = 2.78). Results indicated that OA may replace any Performance subtest without seriously altering the summary scores. Differences between the standard IQs and OA-based composites were < 2 points for PIQ and < 1 point for FSIQ. More than 90% of the OA-based composites fell within the 90% confidence limits of the corresponding IQ.
Public Choice of Tax and Regulatory Instruments—The Role of Heterogeneity
Authors: Lee Dong (Dan) , Borcherding Thomas E.
Published: October 2006

In the authors' political equilibrium model, regulation is considered an implicit and regressive tax-equivalent alternative to the common and less regressive fiscal alternatives: income, property, and sales taxes. The authors hypothesize that in more heterogeneous jurisdictions the state relies more on regulation and less on budgetary spending than in more homogeneous units. Using data drawn from U.S. state-level environmental policy from 1980 to 1994, the authors confirm this hypothesis.
Modeling Customer Lifetime Value
Authors: Gupta Sunil , Hanssens Dominique , Hardie Bruce , Kahn Wiliam , Kumar V. , Lin Nathaniel , Ravishanker Nalini , Sriram S.
Published: October 2006

As modern economies become predominantly service-based, companies increasingly derive revenue from the creation and sustenance of long-term relationships with their customers. In such an environment, marketing serves the purpose of maximizing customer lifetime value (CLV) and customer equity, which is the sum of the lifetime values of the company’s customers. This article reviews a number of implementable CLV models that are useful for market segmentation and the allocation of marketing resources for acquisition, retention, and cross-selling. The authors review several empirical insights that were obtained from these models and conclude with an agenda of areas that are in need of further research.
Situating restorative justice within criminal justice
Authors: Shapland Joanna , Atkinson Anne , Atkinson Helen , Colledge Emily , Dignan James , Howes Marie , Johnstone Jennifer , Robinson Gwen , Sorsby Angela
Published: October 2006

Drawing from the evaluation of three major restorative justice schemes in England and Wales, the article considers the theoretical implications for process and outcomes of situating restorative justice for adults within criminal justice, including the allocation of roles, the balance of power, the importance of procedural justice, and the tasks of restorative justice (such as apology, rehabilitation, reparation, healing, restoration, and reintegration and its relation with social capital). Given that restorative justice events are by definition unique, because of their participative nature, the ability to make generalizations across cultures is problematic, stemming from whether participants bring normative assumptions about justice to the event.
Whither survey research?
Authors: Gerrish Kate , Guillaume Louise
Published: October 2006

In April 2004 new requirements for research governance were introduced in England. In order to safeguard the interests of research participants, research involving NHS patients, their tissues or NHS staff has to be registered with each organisation from where data will be collected and authorisation obtained before the study can commence. NHS Trusts/Primary Care Trusts (PCTs) have set up individual mechanisms for research governance approval with the result that there are no standardised procedures or documentation.

Drawing upon data derived from making research governance applications for a postal survey involving nurses in 90 NHS Trusts/PCTs in seven strategic health authorities in England, this paper examines the implications of introducing research governance for this research method. An analysis of the application process, and the time and resources required suggests that undertaking survey research is increasingly problematic. Moreover, implications arising from the Data Protection Act and the need to complete commissioned research within contractual arrangements led to methodological compromises being made. Recommendations for changes in research governance policy are proposed, most notably the need to standardise procedures, provide greater clarification for R&D managers on the interpretation of research governance procedures and apportion the level of scrutiny according to risk.
Continuous delivery of human type I interferons (α/β) has significant activity against acute myeloid leukemia cells in vitro and in a xenograft model
Authors: Benjamin Reuben , Khwaja Asim , Singh Nalini , McIntosh Jenny , Meager Anthony , Wadhwa Meenu , Streck Christian , Ng Catherine , Davidoff Andrew M. , Nathwani Amit C.
Published: October 2006

In this study, we focused primarily on the antileukemic activity of interferon-β (IFN-β) in a murine xenograft model of acute myeloid leukemia (AML). Bolus administration of recombinant IFN-β via the subcutaneous or intravenous route failed to show efficacy in mice injected with AML cells despite achieving peak plasma IFN-β levels of more than 200 IU/mL. In contrast, stable expression of IFN-β following adeno-associated virus (AAV) vector–mediated gene transfer resulted in significant antileukemic activity against primary AML cells derived from patients with poor prognostic markers. An almost linear relationship was observed with stable plasma levels of IFN-β and antileukemic activity in mice. Even levels below 10 IU/mL were able to reduce tumor load by 50-fold when compared with control animals. These levels of IFN-β are likely to be nontoxic in humans. Therefore, approaches capable of maintaining stable plasma levels of IFN-β merit further clinical evaluation in patients with AML.
Prolonged exposure to FLT3 inhibitors leads to resistance via activation of parallel signaling pathways
Authors: Piloto Obdulio , Wright Melissa , Brown Patrick , Kim Kyu-Tae , Levis Mark , Small Donald
Published: October 2006

Continuous treatment of malignancies with tyrosine kinase inhibitors (TKIs) may select for resistant clones (ie, imatinib mesylate). To study resistance to TKIs targeting FLT3, a receptor tyrosine kinase that is frequently mutated in acute myelogenous leukemia (AML), we developed resistant human cell lines through prolonged coculture with FLT3 TKIs. FLT3 TKI-resistant cell lines and primary samples still exhibit inhibition of FLT3 phosphorylation on FLT3 TKI treatment. However, FLT3 TKI-resistant cell lines and primary samples often show continued activation of downstream PI3K/Akt and/or Ras/MEK/MAPK signaling pathways as well as continued expression of genes involved in FLT3-mediated cellular transformation. Inhibition of these signaling pathways restores partial sensitivity to FLT3 TKIs. Mutational screening of FLT3 TKI-resistant cell lines revealed activating N-Ras mutations in 2 cell lines that were not present in the parental FLT3 TKI-sensitive cell line. Taken together, these data indicate that FLT3 TKI-resistant cells most frequently become FLT3 independent because of activation of parallel signaling pathways that provide compensatory survival/proliferation signals when FLT3 is inhibited. Anti-FLT3 mAb treatment was still cytotoxic to FLT3 TKI-resistant clones. An approach combining FLT3 TKIs with anti-FLT3 antibodies and/or inhibitors of important pathways downstream of FLT3 may reduce the chances of developing resistance.
Clinical implications for Vascular Endothelial Growth Factor in the lung: friend or foe?
Authors: Papaioannou Andriana I , Kostikas Konstantinos , Kollia Panagoula , Gourgoulianis Konstantinos I
Published: October 2006

Vascular endothelial growth factor (VEGF) is a potent mediator of angiogenesis which has multiple effects in lung development and physiology. VEGF is expressed in several parts of the lung and the pleura while it has been shown that changes in its expression play a significant role in the pathophysiology of some of the most common respiratory disorders, such as acute lung injury, asthma, chronic obstructive pulmonary disease, obstructive sleep apnea, idiopathic pulmonary fibrosis, pulmonary hypertension, pleural disease, and lung cancer. However, the exact role of VEGF in the lung is not clear yet, as there is contradictory evidence that suggests either a protective or a harmful role. VEGF seems to interfere in a different manner, depending on its amount, the location, and the underlying pathologic process in lung tissue. The lack of VEGF in some disease entities may provide implications for its substitution, whereas its overexpression in other lung disorders has led to interventions for the attenuation of its action. Many efforts have been made in order to regulate the expression of VEGF and anti-VEGF antibodies are already in use for the management of lung cancer. Further research is still needed for the complete understanding of the exact role of VEGF in health and disease, in order to take advantage of its benefits and avoid its adverse effects. The scope of the present review is to summarize from a clinical point of view the changes in VEGF expression in several disorders of the respiratory system and focus on its diagnostic and therapeutic implications.
High prevalence of ACE DD genotype among north Indian end stage renal disease patients
Authors: Tripathi Gaurav , Dharmani Poonam , Khan Faisal , Sharma RK , Pandirikkal Baburajan Vinod , Agrawal Suraksha
Published: October 2006

Background

The Renin-Angiotensin system (RAS) is a key regulator of both blood pressure and kidney functions and their interaction. In such a situation, genetic variability in the genes of different components of RAS is likely to contribute for its heterogeneous association in the renal disease patients. Angiotensin converting enzyme-1 (ACE-1) is an important component of RAS which determines the vasoactive peptide Angiotensin-II.

Methods

In the present study, we have investigated 127 ESRD patients and 150 normal healthy controls from north India to deduce the association between ACE gene polymorphism and ESRD. The inclusion criteria for patients included a constantly elevated serum creatinine level above normal range (ranging from 3.4 to 15.8) and further the patients were recommended for renal transplantation. A total of 150 normal healthy controls were also genotyped for ACE I/D polymorphism. The criterion of defining control sample as normal was totally based on the absence of any kidney disease determined from the serum creatinin level. Genotyping of ACE I/D were assayed by polymerase chain reaction (PCR) based DNA amplification using specific flanking primers Based on the method described elsewhere.

Results

The difference of DD and II genotypes was found highly significant among the two groups (p = 0.025; OR = 3.524; 95%CI = 1.54-8.07). The combined genotype DD v/s ID+II comparison validated that DD genotype is a high risk genotype for ESRD (p = 0.001; OR = 5.74; 95%CI limit = 3.4-8.5). However, no correlation was obtained for different biochemical parameters of lipid profile and renal function among DD and non DD genotype. Interestingly, ~87% of the DD ESRD patients were found hypertensive in comparison to the 65% patients of non DD genotype

Conclusion

Based on these observations we conclude that ACE DD genotype implicate a strong possible role in the hypertensive state and in renal damage among north Indians. The study will help in predetermining the timing, type and doses of anti-hypertensive therapy for ESRD patients.
Generalizability in two clinical trials of Lyme disease
Authors: Cameron Daniel J
Published: October 2006

Objective

To examine the generalizability of two National Institutes of Health (NIH)-funded double-blind randomized placebo-controlled clinical trials in patients with chronic Lyme disease and to determine whether selection factors resulted in the unfavorable outcomes.

Design

Epidemiologic review of the generalizability of two trials conducted by Klempner et al. This paper considers whether the study group was representative of the general chronic Lyme disease population.

Results

In their article in The New England Journal of Medicine, Klempner et al. failed to discuss the limitations of their clinical trials. This epidemiologic review argues that their results are not generalizable to the overall Lyme disease population. The treatment failure reported by the authors may be the result of enrolling patients who remained ill after an average of 4.7 years and an average of 3 previous courses of treatment. The poor outcome cited in these trials may be explained by having selected patients who had undergone delayed treatment or multiple treatments unsuccessfully. These selection factors were not addressed by the studies' authors, nor have they been discussed by reviewers. The trials have been over-interpreted by the NIH and widely publicized in a press release. The results have been extrapolated to other groups of Lyme disease patients by commentators, by a case discussant in an influential medical journal, and by health insurance companies to deny antibiotic treatment.

Conclusion

The Klempner et al. trials are assumed to be internally valid based on a Randomized Control Trial (RCT) design. However, this review argues that the trials have limited generalizability beyond the select group of patients with characteristics like those in the trial. Applying the findings to target populations with characteristics that differ from those included in these trials is inappropriate and may limit options for chronic Lyme disease patients who might benefit from antibiotic treatment.
The organisation of the stress response, and its relevance to chiropractors: a commentary
Authors: Hardy Katie , Pollard Henry
Published: October 2006

The stress response is a natural reaction by the body, against potentially harmful stimuli to enhance the chance for survival. Persistent activation of the stress response can cause changes to homeostatic mechanisms. The study of stress neurophysiology, in the evaluation of the manifestation of disease in the body, suggests that these chronic changes have detrimental effects on sub cortical structures. Furthermore, there is much scientific support for the notion that chronic activation of supraspinal systems will lead to maladaptation of homeostatic mechanisms, causing the impairment of processes within the body, and ultimately leading to visceral disorders. The chiropractic profession for many years has alluded to chronic change of neurophysiological pathways as a potential explanation of visceral disorders, but the profession has typically described these in terms of somatovisceral or viscerosomatic reflex activity. Change in supraspinal neurophysiological efferent activity is increasingly being used to explain "stress" related disease. The chiropractic profession should consider investigating such stress responses by conducting spinal manipulative therapy trials that evaluate supraspinal effects of manipulation. Such research may help elucidate key mechanisms associated with the change of visceral disorders noted by some chiropractors following manipulative therapy.
Different prion disease phenotypes result from inoculation of cattle with two temporally separated sources of sheep scrapie from Great Britain
Authors: Konold Timm , Lee Yoon Hee , Stack Michael J , Horrocks Claire , Green Robert B , Chaplin Melanie , Simmons Marion M , Hawkins Steve AC , Lockey Richard , Spiropoulos John , Wilesmith John W , Wells Gerald AH
Published: October 2006

Background

Given the theoretical proposal that bovine spongiform encephalopathy (BSE) could have originated from sheep scrapie, this study investigated the pathogenicity for cattle, by intracerebral (i.c.) inoculation, of two pools of scrapie agents sourced in Great Britain before and during the BSE epidemic.

Two groups of ten cattle were each inoculated with pools of brain material from sheep scrapie cases collected prior to 1975 and after 1990. Control groups comprised five cattle inoculated with sheep brain free from scrapie, five cattle inoculated with saline, and for comparison with BSE, naturally infected cattle and cattle i.c. inoculated with BSE brainstem homogenate from a parallel study. Phenotypic characterisation of the disease forms transmitted to cattle was conducted by morphological, immunohistochemical, biochemical and biological methods.

Results

Disease occurred in 16 cattle, nine inoculated with the pre-1975 inoculum and seven inoculated with the post-1990 inoculum, with four cattle still alive at 83 months post challenge (as at June 2006). The different inocula produced predominantly two different disease phenotypes as determined by histopathological, immunohistochemical and Western immunoblotting methods and biological characterisation on transmission to mice, neither of which was identical to BSE. Whilst the disease presentation was uniform in all scrapie-affected cattle of the pre-1975 group, the post-1990 inoculum produced a more variable disease, with two animals sharing immunohistochemical and molecular profile characteristics with animals in the pre-1975 group.

Conclusion

The study has demonstrated that cattle inoculated with different pooled scrapie sources can develop different prion disease phenotypes, which were not consistent with the phenotype of BSE of cattle and whose isolates did not have the strain typing characteristics of the BSE agent on transmission to mice.
Postmastectomy Radiation and Survival in Older Women With Breast Cancer
Authors: Smith Benjamin D. , Haffty Bruce G. , Hurria Arti , Galusha Deron H. , Gross Cary P.
Published: October 2006

Purpose

Clinical trials indicate that postmastectomy radiation therapy (PMRT) improves survival for women age younger than 70 years with high-risk breast cancer. However, for women age 70 years or older, the benefits of PMRT are unknown. As recent evidence suggests that certain adjuvant treatments appropriate for younger women may only be marginally beneficial for older women, we sought to determine whether PMRT improves survival for older women with breast cancer.

Methods

Using the Surveillance, Epidemiology and End Results Medicare data spanning 1992 to 1999, we identified 11,594 women age 70 years or older treated with mastectomy for invasive breast cancer. A proportional hazards model adjusted for clinical-pathologic covariates tested whether PMRT was associated with improved overall survival for low-risk (T1/2 N0), intermediate-risk (T1/2 N1), and high-risk (T3/4 and/or N2/3) patients.

Results

A total of 502 (7%) of 7,416 low-risk, 242 (11%) of 2,145 intermediate-risk, and 785 (38%) of 2,053 high-risk patients received PMRT. Median follow-up was 6.2 years. For low- and intermediate-risk patients, PMRT was not associated with survival. For high-risk patients, PMRT was associated with a significant improvement in survival (hazard ratio, 0.85; 95% CI, 0.75 to 0.97; P = .02). Five-year adjusted survival was 50% for patients not treated with PMRT or chemotherapy, 56% for patients treated with PMRT only, 57% for patients treated with chemotherapy only, and 59% for patients treated with both PMRT and chemotherapy.

Conclusion

PMRT is associated with improved survival for older women with high-risk breast cancer. Randomized clinical trials are urgently needed to confirm this finding and define optimal treatment strategies for this patient group.
Surgical Pitfalls of an Ultrasonic Bone Curette (Sonopet) in Spinal Surgery
Authors: Kim Kyongsong , Isu Toyohiko , Matsumoto Ryoji , Isobe Masanori , Kogure Kazunari
Published: October 2006

OBJECTIVE:

We report our experience with the SONOPET ultrasonic bone curette.

METHODS:

Between September 2001 and July 2005, 546 patients underwent microscopic spinal surgeries using a high-speed drill and the SONOPET instrument.

RESULTS:

We encountered operative complications thought to be attributable to the use of the SONOPET in six patients (1.1%). There were five instances of dural puncture and one spinal cord injury. All dural tears occurred when the dura mater was aspirated into the tip of the SONOPET. None of the affected patients developed postoperative clinical complications because cerebrospinal fluid leakage was avoided by appropriate closure. We think that the transient spinal cord injury occurred because the vibration emanating from the SONOPET was transmitted directly to the spinal cord. Some patients experienced damage to the epidural venous plexus for reasons similar to those described above.

CONCLUSION:

SONOPET facilitates the removal of bone in a narrow field, such as that encountered during keyhole surgery. It aids in the removal of the lateral edge of bone and is especially useful for expanding the foramen intervertebrale or opening the lateral recess. However, its use is not without risk. To prevent dural tears and venous plexus injury, we recommend that cotton be placed between the SONOPET and important structures. To avoid spinal cord injury, we suggest that the SONOPET be inserted horizontal with the dura mater to avoid the direct transmission of vibrations emanating from the instrument to the spinal cord. SONOPET is suitable for decompression on the lateral side, but not for decompression above the spinal cord.
Gray Matter Overlying Anterior Basal Temporal Sulci as an Intraoperative Landmark for Locating the Temporal Horn in Amygdalohippocampectomies
Authors: Wen Hung T. , Rhoton Albert L. , Marino Raul
Published: October 2006

OBJECTIVE:

Use of the gray matter overlying the anterior portions of the occipitotemporal and rhinal sulci as an intraoperative landmark for locating the temporal horn during amygdalohip-pocampectomies approached by the superior or lateral surface of the temporal lobe.

METHODS:

The presence of occipitotemporal and rhinal sulci was analyzed in the magnetic resonance imaging scans of 165 patients who subsequently underwent mesial temporal resections, focusing on coronal slices up to 4 cm from the temporal pole. These sulci were used during surgery to locate the temporal horn in 150 surgeries. Five adult cadaveric heads whose vessels were perfused with colored silicone were used for photography.

RESULTS:

These sulci are the principal sulci of the anterior basal temporal lobe. They were present in 154 out of 165 and 165 out of 165 patients, respectively. When approaching mesial temporal structures from the superior or lateral surface of the temporal lobe, dissection is initially performed through the white matter toward the floor of the middle fossa until the gray matter overlying an anterior basal sulcus is encountered. Dissection continues medially and superiorly from the top of the gray matter until the temporal horn is entered.

CONCLUSION:

Gray matter overlying these sulci leads toward the anterior portion of the floor of the temporal horn and constitutes a landmark for locating the temporal horn. However, only the rhinal sulcus was always present. When both are present, the gray matter overlying the occipitotemporal sulcus is a reliable landmark. These landmarks are most suitable for mesial temporal resections without significant displacement of the temporal horn.
Microsurgical Approaches to the Medial Temporal Region: An Anatomical Study
Authors: Campero Alvaro , Tro´ccoli Gustavo , Martins Carolina , Fernandez-Miranda Juan C. , Yasuda Alexandre , Rhoton Albert L.
Published: October 2006

OBJECTIVE:

To describe the surgical anatomy of the anterior, middle, and posterior portions of the medial temporal region and to present an anatomic-based classification of the approaches to this area.

METHODS:

Twenty formalin-fixed, adult cadaveric specimens were studied. Ten brains provided measurements to compare different surgical strategies. Approaches were demonstrated using 10 silicon-injected cadaveric heads. Surgical cases were used to illustrate the results by the different approaches. Transverse lines at the level of the inferior choroidal point and quadrigeminal plate were used to divide the medial temporal region into anterior, middle, and posterior portions. Surgical approaches to the medial temporal region were classified into four groups: superior, lateral, basal, and medial, based on the surface of the lobe through which the approach was directed. The approaches through the medial group were subdivided further into an anterior approach, the transsylvian transcisternal approach, and two posterior approaches, the occipital interhemispheric and supracerebellar transtentorial approaches. @@RESULTS:@@ The anterior portion of the medial temporal region can be reached through the superior, lateral, and basal surfaces of the lobe and the anterior variant of the approach through the medial surface. The posterior group of approaches directed through the medial surface are useful for lesions located in the posterior portion. The middle part of the medial temporal region is the most challenging area to expose, where the approach must be tailored according to the nature of the lesion and its extension to other medial temporal areas.

CONCLUSION:

Each approach to medial temporal lesions has technical or functional drawbacks that should be considered when selecting a surgical treatment for a given patient. Dividing the medial temporal region into smaller areas allows for a more precise analysis, not only of the expected anatomic relationships, but also of the possible choices for the safe resection of the lesion. The systematization used here also provides the basis for selection of a combination of approaches.
An Oblique Paraspinal Approach for Intracanalicular Disc Herniations of the Upper Lumbar Spine: Technical Case Report
Authors: Moon Ki-Hyoung , Lee Sang-Ho , Joon Kong Byoung , Shin Song-Woo , Bhanot Arun , Kim Dong-Yun , Lee Ho Yeon
Published: October 2006

OBJECTIVE:

To present our experience of treating the central or paramedian disc herniations of the upper lumbar levels through a paraspinal approach.

CLINICAL PRESENTATION:

We present four patients with intracanalicular disc herniations at the L1–L2 or L2–L3 level. All patients had unilateral or bilateral radicular leg pain and motor weakness.

TECHNIQUE:

Considering the unique characteristics of the upper lumbar spine, we performed the oblique paraspinal approach to expose the central portion of disc and removed the herniated disc effectively. Postoperatively, their symptoms were improved. There was no instability during the follow-up period. @@CONCLUSION:@@ The oblique paraspinal approach for the treatment of central disc herniations at the upper lumbar levels is an effective nonfusion technique that preserves most of the facet joint and provides a wide surgical field.