bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics
Authors: SAADAWY I. , BOKER A. , ELSHAHAWY M. A. , ALMAZROOA A. , MELIBARY S. , ABDELLATIF A. A. , AFIFI W.
Published: January 2009

Background: Dexmedetomidine (DEX) is a highly selective α2‐adrenoceptor agonist that has been used increasingly in children. However, the effect of caudal DEX has not been evaluated before in children. This prospective randomized double‐blinded study was designed to evaluate the analgesic efficacy of caudal DEX with bupivacaine in providing pain relief over a 24‐h period.

Methods: Sixty children (ASA status I) aged 1–6 years undergoing unilateral inguinal hernia repair/orchidopexy were allocated randomly to two groups (n=30 each). Group B received a caudal injection of bupivacaine 2.5 mg/ml, 1 ml/kg; Group BD received the same dose of bupivacaine mixed with DEX 1 μg/kg during sevoflurane anesthesia. Processed electroencephalogram (bispectral index score), heart rate, blood pressure, pulse oximetry and end‐tidal sevoflurane were recorded every 5 min. The characteristics of emergence, objective pain score, sedation score and quality of sleep were recorded post‐operatively. Duration of analgesia and requirement for additional analgesics were noted.

Results: The end‐tidal sevoflurane concentration and the incidence of agitation were significantly lower in the BD group (P<0.05). The duration of analgesia was significantly longer (P<0.001) and the total consumption of rescue analgesic was significantly lower in Group BD compared with Group B (P<0.01). There was no statistically significant difference in hemodynamics between both groups. However, group BD had better quality of sleep and a prolonged duration of sedation (P<0.05).

Conclusion: Caudal DEX seems to be a promising adjunct to provide excellent analgesia without side effects over a 24‐h period. It has the advantage of keeping the patients calm for a prolonged time.

Implications statement: Caudally administered DEX (1 μg/kg), combined with bupivacaine, was associated with an extended duration of post‐operative pain relief.
Peribulbar blockade with a short needle for phacoemulsification surgery
Authors: RIAD W.
Published: January 2009

Background: Peribulbar blockade is still widely used for phacoemulsification surgery. The potential complications of this technique include central spread, globe perforation and retrobulbar hemorrhage. The 25 mm needle is the most common needle used to perform the block. The aim of this study was to demonstrate the efficacy of a 12.5 mm needle in performing peribulbar blockade for phacoemulsification surgery.

Methods: After obtaining the hospital research and the Human Ethics Committees' approval, 200 patients undergoing the phacoemulsification procedure under local anesthesia were enrolled in this descriptive study. Peribulbar blockade was performed with a 27 G, 12.5‐mm‐long needle. The needle was inserted transcutaneously through the lower eyelid into the inferotemporal quadrant. Digital pressure was applied by the thumb and index fingers around the needle hub during injection. After negative aspiration, a local anesthetic solution was injected until total drop of the upper eyelid was achieved. Ocular akinesia was assessed 10 min after the block using the simple akinesia score. A score of 3 or less was accepted to provide adequate analgesia for the surgical procedure to be performed. If the block was inadequate for surgery after 10 min, supplementary anesthesia was provided using the same needle.

Results: Adequate analgesia after the first injection was reported in 90.5% of the patients while 9.5% required supplementary anesthesia. There were no major sight or life‐threatening complications.

Conclusion: Using a 12.5‐mm‐long needle for peribulbar blockade produced satisfactory results. This technique is effective for phacoemulsification surgery.
Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial
Authors: MATHIESEN O. , RASMUSSEN M. L. , DIERKING G. , LECH K. , HILSTED K. L. , FOMSGAARD J. S. , LOSE G. , DAHL J. B.
Published: January 2009

Background: Multimodal analgesia may be important for optimal postoperative pain treatment and facilitation of early mobilization and recovery. We investigated the analgesic effect of pregabalin and dexamethasone in combination with paracetamol after abdominal hysterectomy.

Methods: One hundred and sixteen patients were randomly assigned to either group A (paracetamol+placebo × 2), group B (paracetamol+pregabalin+placebo) or group C (paracetamol+pregabalin+dexamethasone). According to randomization and preoperatively, patients received paracetamol 1000 mg, pregabalin 300 mg, dexamethasone 8 mg or placebo. General anaesthesia was performed. Postoperative pain treatment was paracetamol 1000 mg × 4 and patient‐controlled intravenous morphine, 2.5 mg bolus. Nausea was treated with ondansetron. Morphine consumption, pain score (visual analogue scale) at rest and during mobilization, nausea, sedation, dizziness, number of vomits and consumption of ondansetron were recorded 2, 4 and 24 h after the operation. P<0.05 was considered statistically significant.

Results: The 24‐h morphine consumption and pain score, both at rest and during mobilization, were not significantly different between treatment groups. The mean nausea score (P=0.002) was reduced in group C vs. A. The number of vomits was significantly reduced in both group B (P=0.041) and C (P=0.001) vs. A. Consumption of ondansetron was reduced in group C vs. A and B (P<0.001). Other side effects were not different between groups.

Conclusion: Combinations of paracetamol and pregabalin, or paracetamol, pregabalin and dexamethasone did not reduce morphine consumption and pain score compared with paracetamol alone for patients undergoing abdominal hysterectomy. Dexamethasone reduced nausea, vomiting and use of ondansetron.
Platelet concentrates transfusion in cardiac surgery and platelet function assessment by multiple electrode aggregometry
Authors: RAHE‐MEYER N. , WINTERHALTER M. , BODEN A. , FROEMKE C. , PIEPENBROCK S. , CALATZIS A. , SOLOMON C.
Published: January 2009

Background: Platelet dysfunction contributes to the pathophysiology of bleeding complications during and after cardiac surgery. In most surgical institutions, no peri‐operative point‐of‐care monitoring of platelet function is used. We evaluated the usefulness of the Multiplate® platelet function analyser based on impedance aggregometry for identifying groups of patients at a high risk of transfusion of platelet concentrates (PC).

Methods: Platelet function parameters were determined in 60 patients before and after routine cardiac surgery. Impedance aggregometry measurements were performed on Multiplate® using ADP (ADPtest), collagen (COLtest) and thrombin receptor activating peptide (TRAPtest) as platelet activators. The correlations between the aggregometry results and the transfusion of PC were calculated. The results of the aggregation tests were also divided into tertiles and the differences in PC transfusion between the low and the high tertile were assessed.

Results: Low aggregometry delimited groups of patients with significantly higher PC transfusion. In the receiver operating characteristic curve, low pre‐operative aggregation in the ADPtest identified patients with high total transfusion of PC (area under the curve 0.74, P=0.001), while the ADPtest performed at the end of the operation identified patients with high PC transfusion on the intensive care unit (ICU) (area under the curve 0.76, P=0.002).

Conclusions: Near‐patient platelet aggregation may allow the identification of patients with enhanced risk of PC transfusion, both pre‐operatively and upon arrival on the ICU.
Monitoring pulmonary perfusion by electrical impedance tomography: an evaluation in a pig model
Authors: FAGERBERG A. , STENQVIST O. , ÅNEMAN A.
Published: January 2009

Background: Electrical impedance tomography (EIT) is a non‐invasive technique that generates images of impedance distribution. Changes in the pulmonary content of air and blood are major determinants of thoracic impedance. This study was designed to evaluate EIT in monitoring pulmonary perfusion in a wide range of cardiac output.

Methods: Eight anaesthetised, mechanically ventilated pigs were fitted with a 16‐electrode belt at the mid‐thoracic level to generate EIT images that were analysed to determine pulse‐synchronous systolic changes in impedance (ΔZsys). Stroke volume (SV) was derived using a pulmonary artery catheter. Reductions in cardiac pre‐load, and thus pulmonary perfusion, were induced either by inflating the balloon of a Fogarty catheter positioned in the inferior caval vein or by increasing the positive end‐expiratory pressure (PEEP). All measurements were performed in a steady state during a short apnoea.

Results: Pulse‐synchronous changes in ΔZsys were easily discernable during apnoea. Balloon inflation reduced SV to 36% of the baseline, with a corresponding decrease in ΔZsys to 45% of baseline. PEEP reduced SV and ΔZsys to 52% and 44% of the baseline, respectively. Significant correlations between SV and ΔZsys were demonstrated during all measurements (ρ=0.62) as well as during balloon inflation (ρ=0.73) and increased PEEP (ρ=0.40). A Bland–Altman comparison of relative changes in SV and ΔZsys demonstrated a bias of −7%, with 95% limits of agreement at −51% and 36%.

Conclusions: EIT provided beat‐to‐beat approximations of pulmonary perfusion that significantly correlated to a wide range of SV values achieved during both extra and intrapulmonary interventions to change cardiac output.
INVOLVEMENT OF PROTEIN KINASE C IN THE REGULATION OF Na+/Ca2+EXCHANGER IN BOVINE ADRENAL CHROMAFFIN CELLS
Authors: Soma Shin , Kuwashima Haruhiro , Matsumura Chiaki , Kimura Tomohiko
Published: January 2009

The Na+/Ca2+exchanger (NCX) exchanges Na+ and Ca2+bidirectionally through the forward mode (Ca2+extrusion) or the reverse mode (Ca2+influx). The present study was undertaken to clarify the role of protein kinase C (PKC) in the regulation of NCX in bovine adrenal chromaffin cells. The Na+‐loaded cells were prepared by treatment with 100 µmol/L ouabain and 50 µmol/L veratridine. Incubation of Na+‐loaded cells with Na+‐free solution in the presence of the Ca2+channel blockers nicardipine (3 µmol/L) and ω‐conotoxin MVIIC (0.3 µmol/L) caused Ca2+uptake and catecholamine release.

The Na+‐dependent Ca2+uptake and catecholamine release were inhibited by 2‐[4‐[(2,5‐difluorophenyl)methoxy]phenoxy]‐5‐ethoxyaniline (SEA0400; 1 µmol/L) and 2‐[2‐[4‐(4‐nitrobenzyloxy)phenyl]isothiourea (KB‐R7943; 10 µmol/L), both NCX inhibitors. These results indicate that the Na+‐dependent responses are mostly due to activation of the NCX working in the reverse mode.

In addition, we examined the effects of PKC inhibitors and an activator on the NCX‐mediated Ca2+uptake and catecholamine release. Bisindolylmaleimide I (0.3–10 µmol/L) and chelerythrine (3–100 µmol/L), both PKC inhibitors, inhibited NCX‐mediated responses. In contrast, phorbol 12,13‐dibutyrate (0.1–10 µmol/L), a PKC activator, enhanced the responses. Bisindolylmaleimide I and chelerythrine, at effective concentrations for inhibition of Na+‐dependent catecholamine release, had a little or no effect on high K+‐induced catecholamine release in intact cells or on Ca2+‐induced catecholamine release in β‐escin‐permeabilized cells.

These results suggest that PKC is involved in the activation of NCX in bovine adrenal chromaffin cells.
EFFECTS OF COMBINATION THERAPY WITH PERINDOPRIL AND LOSARTAN ON LEFT VENTRICULAR REMODELLING IN PATIENTS WITH MYOCARDIAL INFARCTION
Authors: Li Ling , Liu Rui‐Yun , Zhao Xiao‐Yan , Zhang Jin‐Ying , Jia Min , Lu Pei‐Qi
Published: January 2009

Inhibiting the renin–angiotensin–aldosterone system prevents left ventricular (LV) remodelling after myocardial infarction (MI).

The present study was designed to assess the effects of a combination of perindopril and losartan on LV remodelling, cardiac function and serum procollagen type III amino terminal peptide (PIIINP) levels in patients with acute MI.

Patients with anterior MI were divided into three groups: (i) MI + perindopril; (ii) MI + losartan; and (iii) MI + perindopril + losartan. After successful intervention therapy, perindopril (2–4 mg daily), losartan potassium (25–50 mg daily) or their combination were administered. All patients received aspirin, clopidogrel and statins, and some patients were given beta‐blockers, nitrate and a platelet glycoprotein IIb/IIIa receptor antagonist. Three months later, LV dimensions and LV ejection fraction (LVEF) were measured by ultrasonography. Plasma B‐type natriuretic peptide (BNP), serum C‐reactive protein (CRP) and PIIINP levels were evaluated using enzyme‐linked immunosorbent assay or radioimmunoassay.

The baseline characteristics of the three groups were the same. Three months after the initiation of therapy, all patients showed decreased CRP, increased BNP and PIIINP levels and LV dilation and dysfunction. Compared with the two monotherapy groups, patients in the combination group showed significantly lower CRP, BNP and PIIINP levels, less LV dilation and higher LVEF. Serum PIIINP levels were positively correlated with CRP levels (r = 0.597; P < 0.01) and LV end‐diastolic volume index (r = 0.543; P < 0.01) and were negatively correlated with LVEF (r = –0.565; P < 0.01).

For patients with acute MI, combination treatment with perindopril and losartan significantly inhibited LV remodelling and improved LV function. Inhibition of myocardial interstitial fibrosis may be part of the underlying mechanism.
EFFECT OF EXERCISE ON GLUTAMINE SYNTHESIS AND TRANSPORT IN SKELETAL MUSCLE FROM RATS
Authors: Dos Santos Ronaldo VT , Caperuto Érico C , De Mello Marco T , Batista Jr Miguel L , Rosa Luis FBPC
Published: January 2009

Reductions in plasma glutamine are observed after prolonged exercise. Three hypotheses can explain such a decrease: (i) high demand by the liver and kidney; (ii) impaired release from muscles; and (iii) decreased synthesis in skeletal muscle. The present study investigated the effects of exercise on glutamine synthesis and transport in rat skeletal muscle.

Rats were divided into three groups: (i) sedentary (SED; n = 12); (ii) rats killed 1 h after the last exercise bout (EX‐1; n = 15); and (iii) rats killed 24 h after the last exercise bout (EX‐24; n = 15). Rats in the trained groups swam 1 h/day, 5 days/week for 6 weeks with a load equivalent to 5.5% of their bodyweight.

Plasma glutamine and insulin were lower and corticosterone was higher in EX‐1 compared with SED rats (P < 0.05 and P < 0.01, respectively). Twenty‐four hours after exercise (EX‐24), plasma glutamine was restored to levels seen in SED rats, whereas insulin levels were higher (P < 0.001) and costicosterone levels were lower (P < 0.01) than in EX‐1. In the soleus, ammonia levels were lower in EX‐1 than in SED rats (P < 0.001). After 24 h, glutamine, glutamate and ammonia levels were lower in EX‐24 than in SED and EX‐1 rats (P < 0.001). Soleus glutamine synthetase (GS) activity was increased in EX‐1 and was decreased in EX‐24 compared with SED rats (both P < 0.001).

The decrease in plasma glutamine concentration in EX‐1 is not mediated by GS or glutamine transport in skeletal muscle. However, 24 h after exercise, lower GS may contribute to the decrease in glutamine concentration in muscle.
Barrett's esophagus is characterized by the absence of Helicobacter pylori infection and high levels of serum pepsinogen I concentration in Japan
Authors: Abe Yasuhiko , Iijima Katsunori , Koike Tomoyuki , Asanuma Kiyotaka , Imatani Akira , Ohara Shuichi , Shimosegawa Tooru
Published: January 2009

Background and Aim:  It has been reported that patients with Barrett's esophagus (BE) may have gastric acid hypersecretion. Serological markers such as serum pepsinogen or gastrin have been used to estimate the gastric secretory function. The aim of this study was to compare the serum pepsinogen and gastrin concentrations in view of Helicobacter pylori infection status between BE patients and the controls.

Methods:  Thirty‐six patients with long‐segment BE were enrolled in this study. Three age‐ and sex‐matched controls were assigned to each patient. Serum pepsinogen and gastrin concentrations were measured by radioimmunoassay and H. pylori infection was determined by histology and serum IgG antibodies.

Results:  Helicobacter pylori infection was present in 4 of 36 patients (11%) with BE and in 80 of 108 controls (74%), being less prevalent in BE patients than in the controls (P < 0.0001). When examined in the H. pylori‐negative subjects, both the serum pepsinogen I and pepsinogen II concentrations in BE patients were significantly higher than those in the controls (mean pepsinogen I:BE 51.0 ± 14.0 ng/mL vs control 38.9 ± 13.5 ng/mL, P = 0.0012; mean pepsinogen II:BE 10.8 ± 4.0 ng/mL vs control 7.9 ± 2.0 ng/mL, P = 0.0097). There was no significant difference in the serum gastrin levels between BE patients and the controls irrespective of the H. pylori infection status.

Conclusions:  Most of the Japanese BE patients are characterized by the absence of H. pylori infection and high levels of serum pepsinogen. Determination of the serum pepsinogen level in combination with the H. pylori infection status could be a useful serological marker for BE screening.
Histopathological features and accuracy for diagnosing biliary atresia by prelaparotomy liver biopsy in developing countries
Authors: Rastogi Archana , Krishnani Narendra , Yachha Surender Kumar , Khanna Vikrant , Poddar Ujjal , Lal Richa
Published: January 2009

Background and Aim:  A major challenge in neonatal cholestasis (NC) is to differentiate biliary atresia (BA) from other non‐atretic causes. In developing countries there are considerable problems of late referral of NC cases and performing surgery without prelaparotomy liver biopsy that contributes to a high proportion of negative laparotomy and increased morbidity. We evaluated the hepatic histopathology for presence of features that correlate best with the diagnosis of BA and assessed the accuracy of percutaneous liver biopsy.

Methods:  Fifty‐five cases of NC that fulfilled the selection criteria and had liver biopsy available were analyzed. Among the 49 adequate liver biopsies, 28 cases were diagnosed as BA, 15 neonatal hepatitis (NH) and 6 were due to other causes. Validity of percutaneous liver biopsy diagnoses was compared with confirmed cases by laparotomy findings and 1‐year follow up. Twelve histological parameters of confirmed cases of BA and NH were evaluated by logistic regression analyses.

Results:  Ductular proliferation (P = 0.0002), bile duct and ductular bile plugs (P = 0.009), and portal fibrosis (P = 0.002) were the best indicators of BA and among them ductular proliferation was the most important in distinguishing BA from NH. Ductal plate malformation was observed in 17.9% cases of BA. Sensitivity and specificity of percutaneous liver biopsy for diagnosing BA was 88.2% each.

Conclusion:  Percutaneous liver biopsy is highly accurate (88.2%) in diagnosing BA. In developing countries. This investigation should be done to decrease the frequency of negative laparotomy and to achieve cost–benefit with reduced morbidity.
Adverse medical events associated with cataract surgery performed under topical anaesthesia
Authors: Sharwood Phillipa L , Thomas David , Roberts Timothy V
Published: January 2009

Abstract

Background:  Cataract surgery in Australia is increasingly performed in an elderly population with multiple medical comorbidities. The purpose of this study was to investigate the frequency and type of adverse medical events associated with cataract surgery performed under topical anaesthesia with light sedation.

Methods:  Retrospective analysis was undertaken for 631 consecutive cases of clear corneal phaco‐emulsification and implant surgery performed under assisted topical anaesthesia, by a single surgeon (TR) in a private ophthalmic day surgery unit. In the 238 patients who underwent bilateral surgery, data from the first procedure for each patient were analysed, unless the second procedure was associated with greater morbidity.

Results:  A total of 393 procedures were included in the study. The mean age was 73 ± 11 years with 75% of patients having at least one significant medical comorbidity. The most common comorbidities were hypertension (51%), gastro‐oesophageal reflux (19%), angina and myocardial infarction (14%), diabetes (13%) and asthma (9%). Significant intraoperative adverse medical events requiring intervention occurred in four cases (1%): bradycardia occurred in three cases and hypotension in one case. None of these adverse events resulted in death or hospitalization. There were no postoperative adverse events, hospitalizations or deaths within 7 days. Minor changes in heart rate, blood pressure and oximetry not requiring intervention were observed in 35 cases (9%).

Conclusion:  This retrospective analysis shows that cataract surgery performed under assisted topical anaesthesia is safe with a low rate of systemic complications despite being performed in an elderly population.
Determinants of assemblage structure in Neotropical dry forest lizards
Authors: De PINHO WERNECK FERNANDA , COLLI GUARINO RINALDI , VITT LAURIE JOSEPH
Published: January 2009

We investigated the structure of a lizard assemblage from Seasonally Dry Tropical Forest enclaves in the Brazilian Cerrado biome, by testing the roles of ecological and historical components. We analysed data from 469 individuals, belonging to 18 lizard species, sampled by a combination of pitfall, funnel and glue traps, as well as by haphazard sampling. Null model analyses and Canonical Phylogenetic Ordination analysis, coupled with Monte Carlo simulations, revealed lack of both ecological and phylogenetic structure in microhabitat use. Conversely, these analyses revealed a mean overlap in diet composition significantly smaller than expected by chance and significant historical structure. Structure in diet composition was due to phylogenetic effects corresponding to the most basal divergence of the squamate phylogeny (Iguania/Scleroglossa) and the clades Teiidae and Gymnophthalmidae. Among lizards, evolutionary constraints on microhabitat use appear less than on prey use, suggesting that the availability of historically preferred prey types moderates microhabitat selection. The lack of structure in microhabitat use suggests absence of competitive interactions on the spatial component. On the other hand, food preferences have a deep historical basis and do not reflect current competitive interactions.
Bilateral motor unit synchronization of leg muscles during a simple dynamic balance task
Authors: Boonstra Tjeerd W. , Daffertshofer Andreas , Roerdink Melvyn , Flipse Ivo , Groenewoud Karin , Beek Peter J.
Published: January 2009

To handle the rich repertoire of behavioural goals, the CNS has to control the many degrees of freedom of the musculoskeletal system in a flexible manner. This problem can be drastically simplified if muscle synergies serve as the to‐be‐controlled building blocks of motor performance, instead of the individual degrees of freedom. Muscle synergies have been identified as coherent activation patterns of a group of muscles in space or time, but the neural mechanisms underlying their formation remain largely unknown. Here we evaluated the hypothesis that synergies are reflected in common input to different contributing muscles, and investigated modulations in motor unit (MU) synchronization of homologous muscles during a rhythmic balance task. If common input is related to muscle synergies, the resultant MU synchronization should not be static but task dependent and, in the present context, vary in time. Coherence between surface electromyographic signals of bilateral leg muscles revealed MU synchronization in two distinct frequency bands. MU synchronization was not constant but modulated within a movement cycle, and its time course resembled the activation patterns of the muscles. These results are congruent with a linkage between MU synchronization and muscle synergies, and suggest that MU synchronization provides an expedient method for studying synergy‐related neural mechanisms.
Tectonigral projections in the primate: a pathway for pre‐attentive sensory input to midbrain dopaminergic neurons
Authors: May Paul J. , McHaffie John G. , Stanford Terrence R. , Jiang Huai , Costello M. Gabriela , Coizet Veronique , Hayes Lauren M. , Haber Suzanne N. , Redgrave Peter
Published: January 2009

Much of the evidence linking the short‐latency phasic signaling of midbrain dopaminergic neurons with reward‐prediction errors used in learning and habit formation comes from recording the visual responses of monkey dopaminergic neurons. However, the information encoded by dopaminergic neuron activity is constrained by the qualities of the afferent visual signals made available to these cells. Recent evidence from rats and cats indicates the primary source of this visual input originates subcortically, via a direct tectonigral projection. The present anatomical study sought to establish whether a direct tectonigral projection is a significant feature of the primate brain. Injections of anterograde tracers into the superior colliculus of macaque monkeys labelled terminal arbors throughout the substantia nigra, with the densest terminations in the dorsal tier. Labelled boutons were found in close association (possibly indicative of synaptic contact) with ventral midbrain neurons staining positively for the dopaminergic marker tyrosine hydroxylase. Injections of retrograde tracer confined to the macaque substantia nigra retrogradely labelled small‐ to medium‐sized neurons in the intermediate and deep layers of the superior colliculus. Together, these data indicate that a direct tectonigral projection is also a feature of the monkey brain, and therefore likely to have been conserved throughout mammalian evolution. Insofar as the superior colliculus is configured to detect unpredicted, biologically salient, sensory events, it may be safer to regard the phasic responses of midbrain dopaminergic neurons as ‘sensory prediction errors’ rather than ‘reward prediction errors’, in which case dopamine‐based theories of reinforcement learning will require revision.
Transplantation of human embryonic stem cell‐derived neural precursor cells and enriched environment after cortical stroke in rats: cell survival and functional recovery
Authors: Hicks Anna U. , Lappalainen Riikka S. , Narkilahti Susanna , Suuronen Riitta , Corbett Dale , Sivenius Juhani , Hovatta Outi , Jolkkonen Jukka
Published: January 2009

Cortical stem cell transplantation may help replace lost brain cells after stroke and improve the functional outcome. In this study, we transplanted human embryonic stem cell (hESC)‐derived neural precursor cells (hNPCs) or vehicle into the cortex of rats after permanent distal middle cerebral artery occlusion (dMCAO) or sham‐operation, and followed functional recovery in the cylinder and staircase tests. The hNPCs were examined prior to transplantation, and they expressed neuroectodermal markers but not markers for undifferentiated hESCs or non‐neural cells. The rats were housed in either enriched environment or standard cages to examine the effects of additive rehabilitative therapy. In the behavioral tests dMCAO groups showed significant impairments compared with sham group before transplantation. Vehicle groups remained significantly impaired in the cylinder test 1 and 2 months after vehicle injection, whereas hNPC transplanted groups did not differ from the sham group. Rehabilitation or hNPC transplantation had no effect on reaching ability measured in the staircase test, and no differences were found in the cortical infarct volumes. After 2 months we measured cell survival and differentiation in vivo using stereology and confocal microscopy. Housing had no effect on cell survival or differentiation. The majority of the transplanted hNPCs were positive for the neural precursor marker nestin. A portion of transplanted cells expressed neuronal markers 2 months after transplantation, whereas only a few cells co‐localized with astroglial or oligodendrocyte markers. In conclusion, hESC‐derived neural precursor transplants provided some improvement in sensorimotor function after dMCAO, but did not restore more complicated sensorimotor functions.
Genes, gene flow and adaptation ofDiabrotica virgifera virgifera
Authors: Miller Nicholas J. , Guillemaud Thomas , Giordano Rosanna , Siegfried Blair D. , Gray Michael E. , Meinke Lance J. , Sappington Thomas W.
Published: January 2009

1 Diabrotica virgifera virgiferahas emerged as a major pest of cultivated maize, due to a combination of its high capacity to inflict economic damage, adaptability to pest management techniques and invasiveness.

2 This review presents a survey of the current state of knowledge about the genetics ofD. v. virgifera. In addition, the tools and resources currently available toDiabroticageneticists are identified, as are areas where knowledge is lacking and research should be prioritized.

3 A substantial amount of information has been published concerning the molecular phylogenetic relationships ofD. v. virgiferato other chrysomelids.

4 There is a growing literature focused on the population genetics and evolution of the species. Several adaptations to anthropogenic selection pressure have been studied, with resistance to synthetic insecticides providing some particularly well‐characterized examples.

5 A notable deficiency is a lack of studies directed toward the formal genetics ofD. v. virgifera.
International cooperation on western corn rootworm ecology research: state‐of‐the‐art and future research
Authors: Moeser J. , Guillemaud T.
Published: January 2009

1 Invasive pest species are challenging partly because the invasion process may be highly dynamic and because of the lack of knowledge of many researchers, professionals and farmers in the newly‐invaded regions. The chrysomelid Diabrotica virgifera virgifera LeConte is such an invasive pest. It has been the main pest of continuous maize in the U.S.A. for more than 60 years and is currently spreading throughout Europe.

2 In the area with a long history of this pest (Central and North America), scientific knowledge concerning the ecology of this pest has accumulated over the last decades. This resource is of great importance to both America and Europe and has to be gathered, shared and adapted to new situations. We therefore examined, both qualitatively and quantitatively, the scientific literature relating to D. virgifera virgifera ecology.

3 The quantitative analysis suggests that research on D. virgifera virgifera ecology is still in its infancy in Europe and suffers from geographical barriers (between Europe and North America and between linguistic areas within Europe) and that scientific communication should be strengthened both between North America and Europe and within Europe.

4 As a first solution to this problem, we introduce three companion review articles that constitute a landmark for D. virgifera virgifera research, enabling European and American scientists and decision‐makers to orient themselves and discover new opportunities for research. We also stress that international research cooperation is the most important key to successfully manage invasive species.
Dynamics and functional relevance of ammonia‐oxidizing archaea in two agricultural soils
Authors: Schauss Kristina , Focks Andreas , Leininger Sven , Kotzerke Anja , Heuer Holger , Thiele‐Bruhn Sören , Sharma Shilpi , Wilke Berndt‐Michael , Matthies Michael , Smalla Kornelia , Munch Jean Charles , Amelung Wulf , Kaupenjohann Martin , Schloter Michael , Schleper Christa
Published: January 2009

Crucial steps in geochemical cycles are in many cases performed by more than one group of microorganisms, but the significance of this functional redundancy with respect to ecosystem functioning is poorly understood. Ammonia‐oxidizing archaea (AOA) and their bacterial counterparts (AOB) are a perfect system to address this question: although performing the same transformation step, they belong to well‐separated phylogenetic groups. Using pig manure amended with different concentrations of sulfadiazine (SDZ), an antibiotic that is frequently used in veterinary medicine, it was possible to affect AOB and AOA to different degrees. Addition of manure stimulated growth of AOB in both soils and, interestingly, also growth of AOA was considerably stimulated in one of the soils. The antibiotic treatments decreased the manure effect notably on AOB, whereas AOA were affected to a lower extent. Model calculations concerning the respective proportions of AOA and AOB in ammonia oxidation indicate a substantial contribution of AOA in one of the soils that further increased under the influence of SDZ, hence indicating functional redundancy between AOA and AOB.
Viral biogeography revealed by signatures in Sulfolobus islandicus genomes
Authors: Held Nicole L. , Whitaker Rachel J.
Published: January 2009

Viruses are a driving force of microbial evolution. Despite their importance, the evolutionary dynamics that shape diversity in viral populations are not well understood. One of the primary factors that define viral population structure is coevolution with microbial hosts. Experimental models predict that the trajectory of coevolution will be determined by the relative migration rates of viruses and their hosts; however, there are no natural microbial systems in which both have been examined. The biogeographic distribution of viruses that infect Sulfolobus islandicus is investigated using genome comparisons among four newly identified, integrated, Sulfolobus spindle‐shaped viruses and previously sequenced viral strains. Core gene sequences show a biogeographic distribution where viral genomes are specifically associated with each local population. In addition, signatures of host–virus interactions recorded in the sequence‐specific CRISPR (clustered regularly interspaced short palindromic repeats) system show that hosts have interacted with viral communities that are more closely related to local viral strains than to foreign ones. Together, both proviral and CRISPR sequences show a clear biogeographic structure for Sulfolobus viral populations. Our findings demonstrate that virus–microbe coevolution must be examined in a spatially explicit framework. The combination of host and virus biogeography suggests a model for viral diversification driven by host immunity and local adaptation.
Development of a bacterial challenge test for gnotobiotic sea bass (Dicentrarchus labrax) larvae
Authors: Dierckens K. , Rekecki A. , Laureau S. , Sorgeloos P. , Boon N. , Van den Broeck W. , Bossier P.
Published: January 2009

The use of probiotic microorganisms in aquaculture is gaining a lot of interest. Gnotobiotic model systems are required in order to fully understand the effects and modes‐of‐action of these microorganisms, as the native microbial communities present in non‐sterile animals can lead to false conclusions. In this study, a gnotobiotic sea bass larvae (Dicentrarchus labrax) test system was developed. In order to obtain bacteria‐free animals, the eggs were disinfected with glutaraldehyde and subsequently incubated in a solution of rifampicin and ampicillin. Axenity was confirmed using culture‐dependent and ‐independent techniques. The gnotobiotic larvae were fed axenic Artemia sp. from 7 days after hatching onwards. In the challenge test, one of the three opportunistic pathogens, Aeromonas hydrophila, Listonella anguillarum serovar O1 and O2a, was added to the model system via the water and encapsulated in Artemia sp. Only serovar O2a led to increased mortality in the sea bass larvae. The presented gnotobiotic model can be used for research on, among others, reciprocal metabolic effects between microorganisms and the host (e.g. as measured by gene expression), immunostimulants, pharmacological research and the histological development of the gastrointestinal tract and growth of larvae.
Sequestered organelles sustain aerobic microbial life in anoxic environments
Authors: Esteban Genoveva F. , Finlay Bland J. , Clarke Ken J.
Published: January 2009

We report aerobic eukaryotic microbial life in the dimly lit anoxic water layer of a small freshwater lake. The microbial eukaryote is the ciliated protozoonHistiobalantium natans. Electron microscopy of thin sections shows that the cytoplasm of the ciliate harbours sequestered chloroplasts and sequestered mitochondria. The sequestered chloroplasts are attached or in very close proximity to the ciliate's own mitochondria. The sequestered mitochondria also seem to be associated with host‐ciliate mitochondria. We suggest that the oxygenic photosynthetic activity of sequestered chloroplasts, perhaps enhanced by respiration in sequestered mitochondria, contributes to servicing the respiratory oxygen requirements of the ciliate host in its anoxic habitat. Our observations are novel, with the discovery of an aerobic microbial eukaryote capable of thriving and completing its life cycle in an anoxic environment, fuelled by oxygen generated by sequestered chloroplasts. The acknowledged flexibility and functional diversity within eukaryotic microbial communities still have many secrets to release.
Draping and associated equipment for indwelling catheter manipulation by hospital staff: an assessment of attitudes and adequacy
Authors: Weerakoon Mahesha , Lawrentschuk Nathan
Published: January 2009

OBJECTIVE

To address the usability and safety aspects of current equipment for indwelling urinary catheter (IDC) manipulation, by assessing the attitudes of doctors and nurses to infection control, occupational health and environmental waste, and the perceived adequacy of available catheter packs, particularly drapes, when performing such manipulations.

SUBJECTS AND METHODS

A self‐administered survey instrument was created using an online database and completed by doctors and nurses. The survey covered basic demographics and experience with IDC, attitudes to infection control, occupational health and safety, and the environment, as well as adequacy of current equipment in containing spillage of urine and/or blood.

RESULTS

In all, 87 doctors and 228 nurses completed 315 of 350 (90%) surveys. Doctors and nurses were concerned about infection control, occupational health and safety issues, and environmental waste. Incidents involving spillage of urine and/or blood often go unreported. There were no differences between nurses and doctors having specialist training in urology or experience (P > 0.05). The second major finding is that available catheter packs, particularly drapes, when manipulating IDCs, are inadequate and spillage is likely. These findings were more pronounced in doctors and those with urology training (P < 0.05).

CONCLUSION

The attitudes of health professionals involved with IDC manipulations are consistent with other fields, as is the under‐reporting of episodes of contamination by bodily fluids. The current equipment, particularly drapes, are inadequate for containing urine and blood, leading to infection control, occupational health, environmental and cost implications.
Gleason score 7 screen‐detected prostate cancers initially managed expectantly: outcomes in 50 men
Authors: Van Den Bergh Roderick C.N. , Roemeling Stijn , Roobol Monique J. , Aus Gunnar , Hugosson Jonas , Rannikko Antti S. , Tammela Teuvo L. , Bangma Chris H. , Schröder Fritz H.
Published: January 2009

OBJECTIVE

To assess whether men newly diagnosed with Gleason 7 prostate cancer are eligible for active surveillance (AS) instead of radical treatment. AS is an appropriate initial strategy in selected men who are presently diagnosed with prostate cancer, as many tumours will not progress during a patient’s lifetime.

PATIENTS AND METHODS

Cancer‐specific‐, overall and treatment‐free survival were analysed retrospectively in men with Gleason score 7 cancer who were initially managed expectantly. All were screen‐detected in four centres of the European Randomized Study of Screening for Prostate Cancer.

RESULTS

In 50 men active therapy was initially withheld if they had Gleason 7 disease; 29 of 50 (58%) would otherwise have been suitable for AS, as they had a prostate‐specific antigen (PSA) level of ≤10.0 ng/mL, a PSA density of <0.2 ng/mL/mL, stage T1c/T2, and two or fewer positive biopsy‐cores; 44 of 50 (88%) had a Gleason score 3 + 4 = 7. The mean (range) age of the men was 69.5 (59.6–76.2) years and the median (interquartile range) follow‐up was 2.6 (0.8–5.0) years; the mean American Society of Anesthesiologists score was 1.8. The 6‐year cancer‐specific survival (nine patients at risk) was 100%, which sharply contrasted with the 68% overall survival. Men alive at the time of analysis had a favourable PSA level and PSA‐doubling time. The 6‐year treatment‐free survival was only 59%, with most patients switching to active therapy, justified on the basis of their PSA level. However, men with otherwise favourable tumour characteristics and a Gleason score of 3 + 4 = 7 remained treatment‐free significantly longer than their counterparts with unfavourable other tumour features and a Gleason score of 4 + 3 = 7.

CONCLUSION

In selected patients with screen‐detected Gleason 3 + 4 = 7 prostate cancer, AS might be an option, especially in those with comorbidity and/or a short life‐expectancy.
Lower urinary tract symptoms increase the risk of falls in older men
Authors: Parsons J. Kellogg , Mougey Jolee , Lambert Lori , Wilt Timothy J. , Fink Howard A. , Garzotto Mark , Barrett‐Connor Elizabeth , Marshall Lynn M.
Published: January 2009

OBJECTIVE

To evaluate the association of lower urinary tract symptoms (LUTS) with the risk of falls in elderly community‐dwelling men.

SUBJECTS AND METHODS

We evaluated 5872 participants in the Osteoporotic Fractures in Men, a prospective cohort study of risk factors for falls and osteoporotic fractures among community‐dwelling men aged ≥65 years. The primary outcome was the 1‐year cumulative incidence of falls in men with moderate or severe, vs mild LUTS at baseline, as measured by the American Urological Association Symptom Index. We used Poisson regression models and considered multiple variables as potential confounders.

RESULTS

At baseline, 3188 (54%) reported mild, 2301 (39%) moderate, and 383 (7%) severe LUTS. Compared with men who had mild symptoms, the adjusted 1‐year cumulative incidence of falls was significantly higher among men with moderate or severe LUTS. The risk of at least one fall was increased by 11% among those with moderate (relative risk 1.11, 95% confidence interval, CI, 1.01–1.22; P = 0.02) and by 33% among those with severe LUTS (1.33, 1.15–1.53; P < 0.001). Further, those with moderate LUTS had a 21% (1.21, 1.05–1.40; P = 0.01) and those with severe LUTS a 63% (1.63, 1.31–2.02; P < 0.001) greater risk of at least two falls. LUTS most strongly associated with falls were urinary urgency, difficulty initiating urination, and nocturia.

CONCLUSIONS

Moderate and severe LUTS independently increase the 1‐year risk of falls, particularly recurrent falls, in community‐dwelling older men. Because of the serious consequences of falls, these results might justify the routine assessment of LUTS with a validated questionnaire in the primary care of this population.
Final analysis of a phase II trial using sorafenib for metastatic castration‐resistant prostate cancer
Authors: Aragon‐Ching Jeanny B. , Jain Lokesh , Gulley James L. , Arlen Philip M. , Wright John J. , Steinberg Seth M. , Draper David , Venitz Jürgen , Jones Elizabeth , Chen Clara C. , Figg William D. , Dahut William L.
Published: January 2009

OBJECTIVE

To determine if sorafenib is associated with an improved 4‐month probability of progression‐free survival, using radiographic and clinical criteria alone, in patients with metastatic castration‐resistant prostate cancer. Secondary endpoints included pharmacokinetics, toxicity analysis and overall survival.

PATIENTS AND METHODS

The study was an open‐label, phase II, two‐stage design, focusing on the results from the second stage, as criteria for progression were modified after completing the first stage. Sorafenib was given at a dose of 400 mg orally twice daily in 28‐day cycles. Clinical and laboratory assessments were done every 4 weeks, and radiographic scans were obtained every 8 weeks.

RESULTS

Twenty‐four patients were accrued in the second stage; the median (range) age was 66 (49–85) years, the on‐study prostate‐specific antigen level was 68.45 (5.8–995) ng/mL, the Gleason score 8 (6–9) and Eastern Cooperative Oncology Group status 1 (in 17 patients). Of the 24 patients, 21 had previous chemotherapy with docetaxel. All patients had bony metastases, either alone (in 11) or with soft‐tissue disease (in 13). One patient had a partial response; 10 patients had stable disease (median duration 18 weeks, range 15–48). At a median potential follow‐up of 27.2 months, the median progression‐free survival was 3.7 months and the median overall survival was 18.0 months. For the whole trial of 46 patients the median survival was 18.3 months. Most frequent toxicities included hand‐foot skin reaction (grade 2 in nine patients, grade 3 in three), rash, abnormalities in liver function tests, and fatigue.

CONCLUSIONS

Sorafenib has moderate activity as a second‐line treatment for metastatic castration‐resistant prostate cancer.
Reliability and validity of the King’s Health Questionnaire for lower urinary tract symptoms in both genders
Authors: Okamura Kikuo , Nojiri Yoshikatsu , Osuga Yoko
Published: January 2009

OBJECTIVE

To investigate the reliability and validity of the King’s Health Questionnaire (KHQ) in both genders, which was originally developed as a health‐related quality of life (HRQoL) questionnaire for female urinary incontinence for general lower urinary tract symptoms (LUTS).

SUBJECTS AND METHODS

Data from the International Prostate Symptom Score (IPSS) and KHQ obtained from 179 men and 75 women consulting urologists (Sample A) were analysed. Cronbach’s α coefficient and inter‐domain correlation were calculated for reliability and validity assessment, respectively. Factor analysis was used to explore the underlying factor structure of the KHQ. KHQ scores of sample A were compared with those of 330 men and 418 women consulting general practitioners (Sample B).

RESULTS

Internal consistency of KHQ was acceptable with a Crohnbach’s α of 0.721–0.915 in the total population of sample A. Correlation analysis showed convergent validity among ‘Physical Limitations’, ‘Role Limitation’ and ‘Social Limitations’ and discriminant validity among ‘Personal Relationship’, ‘Emotion’s and ‘Sleep/Energy’. Factor analysis showed three underlying components to explain convergent and discriminant validity. In both sample A and sample B, HRQoL was impaired in the eight domains according to IPSS severity. KHQ scores of domains other than ‘General Health Perception’ in sample B were lower than those in sample A.

CONCLUSION

The KHQ can be used as a HRQoL questionnaire for LUTS in both genders. In the future, it is expected that the KHQ could be used in clinical studies for benign prostate hyperplasia and other conditions.