bluuebunny/crossref_metadata_2025 huggingface dataset:
Carvedilol reduces myocardial no-reflow by decreasing endothelin-1 via activation of the ATP-sensitive K+ channel
Authors: Zhao JL , Yang YJ , Pei WD , Sun YH , Zhai M , Liu YX , Gao RL
Published: September 2008

It has been verified that carvedilol can attenuate myocardial no-reflow. However, the effects of carvedilol on adenosine triphosphate-sensitive K+ (KATP) channel and endothelin-1 (ET-1) are unknown. Forty mini-swines were randomized into 5 study groups: 8 control, 8 carvedilol pretreatment, 8 glibenclamide (KATP channel blocker)-treated, 8 carvedilol and glibenclamide-pre-treated and 8 sham-operated. An acute myocardial infarction(AMI) and reperfusion model was created with a three-hour occlusion of the left anterior descending coronary artery followed by one-hour reperfusion. Compared with the control group, carvedilol significantly decreased the area of no-reflow (myocardial contrast echocardiography: from 78.5±4.5% to 24.9±4.1%, pathological means: from 82.3±1.9% to 25.8±4.3% of ligation area, respectively; all p < 0.01) and reduced necrosis size from 98.5±1.3% to 74.4±4.7% of ligation area, p < 0.05). It also decreased plasma ET-1 and myocardial tissue ET-1. However, glibenclamide abrogated the protective effect of carvedilol. The beneficial effect of carvedilol on myocardial no-reflow could be due to its effect on ET-1 via the activation of the KATP channel.
Whole blood hypercoagulability despite anticoagulation during mechanical cardiac assist
Authors: Niemi TT , Kukkonen SI , Hämmäinen PT , Suojaranta-Ylinen RT , Sipponen JT
Published: September 2008

We report hypercoagulability despite activated partial thromboplastin time (APTT)-guided heparin treatment during Berlin Heart®-supported circulation in a 38-year-old man with heart failure for 19 days. The patient was anticoagulated using unfractionated heparin, acetylsalicylic acid and dipyridamole. Contact and tissue factor-activated thromboelastometry revealed increased clot firmness, although anticoagulation assessed by APTT was in accordance with the treatment protocol. Strength of polymerized fibrin was also increased. We saw no clinical signs of thrombosis. Thromboelastometry normalized after heart transplantation. Our results suggest that hypercoagulability is due to excess fibrin formation. Monitoring anticoagulation using APTT may, therefore, be misleading during mechanical cardiac assist.
Use of warm priming solution in open heart surgery: its effects on hemodynamics and acute inflammation
Authors: Buyukates M , Acikgoz S , Kandemir O , Aktunc E , Ceylan E , Can M
Published: September 2008

Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20°C and 36°C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15th and 60th minutes of aortic cross-clamping and the 24th hour following surgery. Serum pre-albumin, α-1 antitrypsin, and tumor necrosis factor-α levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.
ICU outcomes in adult cardiac surgery patients in relation to ultrafiltration type
Authors: Pérez-Vela JL , Ruiz-Alonso E , Guillén-Ramírez F , García-Maellas MT , Renes-Carreño E , Cerro-García M , Cortina-Romero J , Hernández-Rodríguez I
Published: September 2008

Ultrafiltration (UF) is used to ameliorate the deleterious effects of cardiopulmonary bypass (CPB) in cardiac surgery patients. There are two different methods; conventional ultrafiltration (CUF), performed during CPB, and modified ultrafiltration (MUF), performed after CPB is finished. It has not been established which is better, and controversy remains regarding the optimal UF strategy. The objective of this study was to evaluate if MUF alone, or combined with CUF, could achieve greater fluid removal and contribute to better postoperative clinical outcomes. Also, the potential technique complications were studied. This was a prospective study which enrolled 125 consecutive adult patients receiving elective cardiac surgery with CPB. We analysed three treatment groups: MUF, CUF and both. Ultrafiltration was performed using a non-pulsatile CPB with a non-occlusive roller pump, Sarns 9000®, and a polysulfone ultrafilter, Minntech®. We studied pre- and intraoperative data and immediate postoperative clinical outcomes: total amount of drainage, transfusion needs, respiratory outcome, cardiac, renal and neurologic complications. Statistical analysis was performed using SPSS 11.0. All three groups were homogeneous and did not have differences in terms of demographic factors, previous history, risk scores, intervention and operative data. Volume of filtrate removal in the group which applied both techniques was larger than in the CUF or MUF groups alone (2569±823 vs 1679±651 vs 1398±353 ml, respectively, p=0.0001); however, despite this difference, there was no difference in the immediate postoperative fluid balances between the groups (596±1244 vs 880±1054 vs 986±1190 ml, p=0.30). Respiratory parameters and postoperative morbidity data analysed (total amount of drainage, transfusion needs, haemoglobin, acute lung injury, time with inotropes, ventricular failure, cardiogenic shock, neurologic complications and renal failure) were similar in all three groups, without statistical differences. Extubation time (10±7 vs 8.9±3 vs 9.4±7.9 hours, p=0.72) and ICU stay (56.6±72 vs 66.5±109 vs 44.2±25 hours, p=0.43) also were similar between the groups. We did not find any technique complication associated with any patient. In the present study, with adult patients receiving elective cardiac surgery, the combined ultrafiltration group had a larger fluid removal. However, neither type of ultrafiltration nor amount of filtered volume was accompanied by different postoperative ICU clinical outcomes. Ultrafiltration was considered a safe and reliable technique, with no related complications.
Bloodless cardiac surgery and the pediatric patient: a case study
Authors: Ging AL , St. Onge JR , Fitzgerald DC , Collazo LR , Bower LS , Shen I
Published: September 2008

Peri-operative transfusion of blood or blood products is associated with increased morbidity and mortality after cardiac surgery. However, excessive hemodilution as a result of avoiding the use of homologous blood products can also lead to decreased oxygen delivery to vital end organs and dilutional coagulopathy. This is particularly challenging in pediatric cardiac surgery where there is a large discrepancy between the patient circulating blood volume and the priming volume of the cardiopulmonary bypass (CPB) circuit. Strategies to avoid the use of homologous blood products during pediatric cardiac surgery must also incorporate miniaturization of the CPB circuit and other bypass techniques in order to avoid problems with excessive hemodilution. We report a 5.9 kg male infant who underwent successful surgical correction of a ventricular septal defect without the use of homologous blood transfusion. Our strategies included the pre-operative administration of erythropoietin and iron to increase red blood cell mass, acute normovolemic hemodilution (ANH) before the institution of CPB, retrograde autologous priming (RAP), cell salvage, continuous ultrafiltration, vacuum-assisted venous drainage to minimize the circuit size and priming volume, and the use of near infrared spectroscopy (NIRS) to monitor the patient during the entire procedure. The utilization of these strategies is now standard for our entire pediatric cardiac surgical population.
Transportation of critically ill patients on extracorporeal membrane oxygenation
Authors: Wagner K , Sangolt GK , Risnes I , Karlsen HM , Nilsen JE , Strand T , Stenseth LB , Svennevig JL
Published: September 2008

Serious pulmonary and cardiac failure may be treated with extracorporeal membrane oxygenation (ECMO) when conventional treatment fails. In some severely ill patients, it may be necessary to initiate ECMO at the local hospital and, thereafter, transport the patient back to the ECMO center. The aim of this study was to evaluate our experiences with transportation of patients on ECMO. From Oct 1992 to Jan 2008 23, patients were transported on ECMO from local hospitals to Rikshospitalet. The study included seventeen patients with pulmonary failure and four patients with cardiac failure. All age groups were represented. Aircraft were used in 17 cases, ground vehicles in six. The times from decision until ECMO was established, the time from ECMO to departure from the local hospital and the transportation time were registered. All transportations were uneventful. After 10.3 ±6.7 days, six patients died on ECMO and another patient died within 30 days. Mean ECMO time for those who died was 13.3 ± 9.6 vs. 8.5 ± 4.7 days for survivors, p=0.34. Seventeen patients were able to be successfully weaned from ECMO. Thirty day survival was 67%. The mean age for survivors was 15.3±18.3 (range 0-54.6) vs. 23.6 ± 20.3 years (range 0-55.9) in fatal cases, p=0.41. The time from referral to initiating ECMO was a mean of 7.32 ± 2.3 (3.0-12.0) hours for survivors vs. 7.88 ± 3.0 (3.50-13.40) hours for non- survivors, p=0.76. The time from initiating ECMO to departure was 5.1 ± 6.5 (0.58-23.75) hours in survivors vs. 9.1 ± 6.8 (0.55-18.45) hours in non-survivors, p=0.18. Time from departure to arrival at Rikshospitalet was a mean of 3.2 (0.50-5.10) hours for survivors versus 2.5 (0.5-4.40) for non-survivors, p=0.41. This study shows that ECMO can be successfully established at local hospitals, using an experienced team, and that transportation of patients on ECMO can be performed safely and without technical difficulties. Survival for this group of patients did not differ from patients treated at the ECMO center.
Young People's Perspectives on `Information' — Revisited
Authors: Shenton Andrew K. , Johnson Andrew
Published: September 2008

Little research has investigated the ways in which young people understand the word, `information', despite the fact that what is learnt from such studies can have clear implications for practice. In order to extend the meagre knowledge base, the authors conducted a quantitative research project that collected, via an electronic questionnaire, data from 348 teenagers in an English high school. Respondents were asked to use a Likert scale to indicate their reactions to thirteen statements pertaining to the nature of `information'. There was much uncertainty or indifference among the pupils in relation to the issues and considerable variation in the balance of opinion between boys and girls. The relative prevalence of a particular response to a certain question also often varied appreciably from one year group to another. The uncertainty and lack of consensus on many matters highlights the problems of using the word, `information', with young people.
The European Library — gateway to the resources of Europe's national libraries
Authors: Stigter Fleur , Chambers Sally , Edwards Louise
Published: September 2008

The European Library aggregates the collections of 48 European national libraries into one single portal. Users will discover and access a wealth of materials and the service aims to promote the outstanding collections of these libraries to a global audience.
Consultant and Critics on the Couch
Authors: Goldman Alan
Published: September 2008

The process of situating the “client on the couch” also entails the seating of “consultant and critics on the couch” as they participate in a self-reflective and dialectical process. The author argues the importance of strategic use of the “toxicity” metaphor and the central role of an initially qualitative lens via corporate cases and narrative investigations into dark side, destructive behavior in companies. Central to the study of toxicity is the blending of micro and macro, as individual psychology and systemic company-wide perspectives are fused into consulting and coaching hybrids. The patience of an anthropologist is required for the consultant facing thick, textured cases of organizational and leadership toxicity, and similar emotional intelligence is depicted as essential for a bridging of both qualitative and metric-driven streams of consultation and research.
Customer Expectation and Warranty Cost — Nominal-the-Best Case
Authors: Naresh Kumar Sharma  , Drain David , Cudney Elizabeth A. , Ragsdell Kenneth M.
Published: September 2008

A fixed target, be it at zero or infinity, is assumed in Taguchi's method for formulating the quality loss function (QLF). The QLF only accounts for immediate issues within manufacturing facilities whereas warranty cost occurs during customer use. Variable customer expectation has not been considered in the Taguchi methodology. This article presents a methodology to predict warranty probability, the probability of customer complaint, on the basis of two independent variables; product performance and consumer expectation. It is expected that the formulation presented will serve as a basic model for predicting warranty loss using warranty probability due to a single characteristic under certain assumptions. The nominal-the-best case is considered in this article and warranty cost is estimated for an automotive example to demonstrate the methodology.
Design for Product Adaptability
Authors: Yi Li  , Deyi Xue  , Peihua Gu
Published: September 2008

Adaptable design is a new design paradigm to create designs and products that can be easily changed to satisfy different requirements. Adaptable design aims at identifying the designs and products considering functionality, manufacturing efforts, customization, and environment friendliness. This research focuses on adaptable design considering product adaptability. In this work, product adaptability is evaluated by three measures including extendibility of functions, upgradeability of modules, and customizability of components. Various design candidates created in adaptable design are evaluated by different life-cycle evaluation measures including product adaptability of design, part and assembly costs of manufacturing, and operationability of customers. Since different evaluation measures are modeled in different units, the grey relational analysis method is employed to integrate these measures for prioritizing different design candidates. A case study is given to demonstrate the effectiveness of the introduced adaptable design approach.
Determining the Value of Sequential and Concurrent NPD Processes
Authors: Linghua Kong  , Bhuiyan Nadia , Thomson Vincent
Published: September 2008

The value of using sequential (SE) and concurrent engineering (CE) processes for new product development (NPD) is quantitatively determined by means of the maximum expected payoff method. This method models a process into a sequence of intervals and calculates the value of the maximum benefit as a result of optimum decisions during each interval. SE and CE processes are evaluated in terms of the parameters: simultaneity and intensity of interaction. The maximum expected payoff method shows under what conditions SE or CE is best, and the effect of incomplete information and resultant rework. Results are compared to actual NPD processes with good agreement.
The Contribution of Forensic Archaeology to Homicide Investigations
Authors: Schultz John J. , Dupras Tosha L.
Published: September 2008

Collecting and processing forensic evidence during a death investigation has become an endeavor that may incorporate numerous personnel from many disciplines. During death investigations, specialized forensic experts regularly consult with law enforcement agencies at city, state, and federal levels, and with medical examiner and coroner offices. These forensic experts can also provide training, specialized laboratory analyses of forensic evidence, and services for which law enforcement may have very little or no training. Forensic archaeology is one such discipline that can provide specialized expertise at the crime scene. In addition to discussing the differences between forensic anthropology and forensic archaeology, this article presents a summary of the contributions that forensic archaeology can make during the search for and processing of crime scenes involving human remains.
Conceptualizing personal media
Authors: Lüders Marika
Published: September 2008

The digitalization and personal use of media technologies have destabilized the traditional dichotomization between mass communication and interpersonal communication, and therefore between mass media and personal media (e.g. mobile phones, email, instant messenger, blogs and photo-sharing services). As private individuals use media technologies to create and share personal expressions through digital networks, previous characteristics of mass media as providers of generally accessible information are no longer accurate. This article may be situated within a medium-theoretical tradition, as it elucidates technical and social dimensions of personal media and revises the distinction between mass media and personal media. A two-dimensional model suggests locating personal media and mass media according to an interactional axis and an institutional/professional axis: personal media are de-institutionalized/de-professionalized and facilitate mediated interaction. The implementation of digital media technologies has important consequences for social networks and fits well within a theoretical discussion of the post-traditional self.
Manipulating interactivity with thematically hyperlinked news texts: a media learning experiment
Authors: Tremayne Mark
Published: September 2008

This article concerns the influence of news presentation on the web. The study had two primary goals. The first was to test the effects of interactivity on learning, and the second was to explore the role of motivation in learning from interactive media. Hypotheses were tested using an experimental design. Study participants were assigned one of four web news stories with structures that encouraged varying degrees of interactivity. The results of hypothesis testing were heavily dependent on which measure of learning was employed. A traditional multiple-choice test of recognition verified an effect of motivation but not of interactive behaviour. A comprehension measure of learning, supported by the cognitive constructivism theory of learning employed in this study, supported an effect of interactive behaviour but not of motivation. Explanations for the findings are proposed and implications for mass communicators discussed.
Untangling the technology cluster: mobile telephony, internet use and the location of social ties
Authors: Sooryamoorthy Radhamany , Miller B. Paige , Shrum Wesley
Published: September 2008

Among the communication technologies introduced in the developing world during the past century, none has grown more rapidly than mobile telephony.Yet the impact of mobile phone use on social relationships has received limited systematic study. This article examines the factors associated with mobile phone usage in the south Indian state of Kerala and the social structural consequences of such usage, particularly the composition and location of the social ties maintained through mobile technologies. Bivariate analysis of mobile phone usage and network composition shows that frequent users have fewer local ties and more external ties than non-frequent users. However, these effects are due largely to the association of email and mobile phone use. The article shows that internet use increases, while mobile phone use decreases the geographical diversity of social ties. The implication is that mobile telephony and internet technologies may have different consequences for the globalization process.
Anisotropy of elastic wave velocities in deformed shales: Part 1 — Experimental results
Authors: Sarout Joël , Guéguen Yves
Published: September 2008

Elastic wave velocity measurements in the laboratory are used to assess the evolution of the microstructure of shales under triaxial stresses, which are representative of in situ conditions. Microstructural parameters such as crack aperture are of primary importance when permeability is a concern. The purpose of these experiments is to understand the micromechanical behavior of the Callovo-Oxfordian shale in response to external perturbations. The available experimental setup allows for the continuous, simultaneous measurement of five independent elastic wave velocities and two directions of strain (axial and circumferential), performed on the same cylindrical rock sample during deformation in an axisymmetric triaxial cell. The main results are (1) identification of the complete tensor of elastic moduli of the transversely isotropic shales using elastic wave velocity measurements, (2) assessment of the evolution of these moduli under triaxial loading, and (3) assessment of the evolution of the elastic anisotropy under loading in terms of Thomsen’s parameters. This last outcome allows us to use the anisotropy of the elastic properties of this rock as an indicator of the evolution of its microstructure. In particular, [Formula: see text] in the dry case decreases from 0.5 (ambient pressure) toward 0.37 [Formula: see text], while [Formula: see text] and [Formula: see text] are almost insensitive to pressure. In the wet case, [Formula: see text] decreases from 0.3 (ambient pressure) toward 0.2 [Formula: see text]. Deviatoric stresses have a strong effect on [Formula: see text], [Formula: see text], and [Formula: see text] variations. In this case, [Formula: see text] drops (both for the dry and wet conditions) when failure is approached.
Discontinuous Galerkin methods for wave propagation in poroelastic media
Authors: de la Puente Josep , Dumbser Michael , Käser Martin , Igel Heiner
Published: September 2008

We have developed a new numerical method to solve the heterogeneous poroelastic wave equations in bounded three-dimensional domains. This method is a discontinuous Galerkin method that achieves arbitrary high-order accuracy on unstructured tetrahedral meshes for the low-frequency range and the inviscid case. By using Biot’s equations and Darcy’s dynamic laws, we have built a scheme that can successfully model wave propagation in fluid-saturated porous media when anisotropy of the pore structure is allowed. Zero-inflow fluxes are used as absorbing boundary conditions. A continuous arbitrary high-order derivatives time integration is used for the high-frequency inviscid case, whereas a space-time discontinuous scheme is applied for the low-frequency case. We conducted a numerical convergence test of the proposed methods. We used a series of examples to quantify the quality of our numerical results, comparing them to analytic solutions as well as numerical solutions obtained by other methodologies. In particular, a large scale 3D reservoir model showed the method’s suitability to solve poroelastic wave-propagation problems for complex geometries using unstructured tetrahedral meshes. The resulting method is proved to be high-order accurate in space and time, stable for the low-frequency case, and asymptotically consistent with the diffusion limit.
Psychosocial Factors and Survival of Young Women With Breast Cancer: A Population-Based Prospective Cohort Study
Authors: Phillips Kelly-Anne , Osborne Richard H. , Giles Graham G. , Dite Gillian S. , Apicella Carmel , Hopper John L. , Milne Roger L.
Published: September 2008

Purpose

Most women with early-stage breast cancer believe that psychosocial factors are an important influence over whether their cancer will recur. Studies of the issue have produced conflicting results.

Patients and Methods

A population-based sample of 708 Australian women diagnosed before age 60 years with nonmetastatic breast cancer was observed for a median of 8.2 years. Depression and anxiety, coping style, and social support were assessed at a median of 11 months after diagnosis. Hazard ratios for distant disease-free survival (DDFS) and overall survival (OS) associated with psychosocial factors were estimated separately using Cox proportional hazards survival models, with and without adjustment for known prognostic factors.

Results

Distant recurrence occurred in 209 (33%) of 638 assessable patients, and 170 (24%) of 708 patients died during the follow-up period. There were no statistically significant associations between any of the measured psychosocial factors and DDFS or OS from the adjusted analyses. From unadjusted analyses, associations between greater anxious preoccupation and poorer DDFS and OS were observed (P = .02). These associations were no longer evident after adjustment for established prognostic factors; greater anxious preoccupation was associated with younger age at diagnosis (P = .03), higher tumor grade (P = .02), and greater number of involved axillary nodes (P = .008).

Conclusion

The findings do not support the measured psychosocial factors being an important influence on breast cancer outcomes. Interventions for adverse psychosocial factors are warranted to improve quality of life but should not be expected to improve survival.
Dynamic Contrast-Enhanced Magnetic Resonance Imaging Pharmacodynamic Biomarker Study of Sorafenib in Metastatic Renal Carcinoma
Authors: Hahn Olwen M. , Yang Cheng , Medved Milica , Karczmar Gregory , Kistner Emily , Karrison Theodore , Manchen Elizabeth , Mitchell Myrosia , Ratain Mark J. , Stadler Walter M.
Published: September 2008

Purpose

Sorafenib is an antiangiogenic agent with activity in renal cancer. We conducted a randomized trial to investigate dynamic contrast magnetic resonance imaging (DCE-MRI) as a pharmacodynamic biomarker.

Patients and Methods

Patients were randomly assigned to placebo or 200 or 400 mg twice per day of sorafenib. DCE-MRI was performed at baseline and 4 weeks. DCE-MRI parameters, area under the contrast concentration versus time curve 90 seconds after contrast injection (IAUC90), and volume transfer constant of contrast agent (Ktrans) were calculated for a metastatic site selected in a blinded manner. Primary end point was change in Ktrans.

Results

Of the 56 assessable patients, 48 underwent two MRIs; 44 MRIs were assessable for study end points. Mean Ktrans log ratios were 0.131 (standard deviation [SD], 0.315), −0.148 (SD, 0.382), −0.271 (SD, 0.499) in placebo, 200- and 400-mg cohorts, respectively (P = .0077 for trend) corresponding to changes of +14%, −14%, and −24%. IAUC90 log ratios were 0.041 (SD, 0.197), −0.040 (SD, 0.132), −0.356 (SD, 0.411), respectively (P = .0003 for trend), corresponding to changes of +4%, −4%, and −30%. Using a log-rank test, IAUC90 and Ktrans changes were not associated with progression-free survival (PFS). Patients with high baseline Ktrans had a better PFS (P = .027).

Conclusion

IAUC90 and Ktrans are pharmacodynamic biomarkers for sorafenib, but variability is high and magnitude of effect is less than previously reported. Changes in DCE-MRI parameters after 4 weeks of sorafenib are not predictive of PFS, suggesting that these biomarkers are not surrogate end points. The value of baseline Ktrans as a prognostic or predictive biomarker requires additional study.
Phase II Study of Imatinib in Patients With Recurrent Gliomas of Various Histologies: A European Organisation for Research and Treatment of Cancer Brain Tumor Group Study
Authors: Raymond Eric , Brandes Alba A. , Dittrich Christian , Fumoleau Pierre , Coudert Bruno , Clement Paul M.J. , Frenay Marc , Rampling Roy , Stupp Roger , Kros Johan M. , Heinrich Michael C. , Gorlia Thierry , Lacombe Denis , van den Bent Martin J.
Published: September 2008

Purpose

To evaluate the safety and the efficacy of imatinib in recurrent malignant gliomas.

Patients and Methods

This was a single-arm, phase II study. Eligible patients had recurrent glioma after prior radiotherapy with an enhancing lesion on magnetic resonance imaging. Three different histologic groups were studied: glioblastomas (GBM), pure/mixed (anaplastic) oligodendrogliomas (OD), and low-grade or anaplastic astrocytomas (A). Imatinib was started at a dose of 600 mg/d with dose escalation to 800 mg in case of no toxicity; during the trial this dose was increased to 800 mg/d with escalation to 1,000 mg/d. Trial design was one-stage Fleming; both an objective response and 6 months of progression-free survival (PFS) were considered a successful outcome to treatment.

Results

A total of 112 patients (51 patients with GBM, 25 patients with A, and 36 patients with OD) were enrolled. Imatinib was in general well tolerated. The median number of cycles was 2.0 (range, 1 to 43 cycles). Five patients had an objective partial response, including three patients with GBM; all had 6 months of PFS. The 6-month PFS rate was 16% (95% CI, 8.0% to 34.0%) in GBM, 4.0% (95% CI, 0.3% to 15.0%) in OD, and 9% (95% CI, 2.0% to 25.0%) in A. The exposure to imatinib was significantly lower in patients using enzyme-inducing antiepileptic drugs. The presence of ABCG2 point mutations were not correlated with pharmacokinetic findings. No somatic activating mutations of KIT or platelet-derived growth factor receptor–A or –B were found.

Conclusion

In the dose range of 600 to 1,000 mg/d, single-agent imatinib is well tolerated but has limited antitumor activity in patients with recurrent gliomas.
13C CP/MAS NMR Study of Cross-linked Poly(vinylpyrrolidone) on Surface of Cerium Oxide Nanoparticles
Authors: Itoh Toshio , Izu Noriya , Matsubara Ichiro , Shin Woosuck , Nishibori Maiko
Published: September 2008

The highly dispersed property of poly(vinylpyrrolidone) (PVP)-coated cerium oxide nanoparticles can be retained for a long time in polar solvents. In this 13C CP/MAS NMR study, it is revealed that the surface PVP forms cross-linked structures during the synthesis of the nanoparticles.
Integrated community-based sexual health services for young people in urban areas: are we meeting the needs of the local community?
Authors: Forbes K M , Rahman N , Mccrae S , Reeves I
Published: September 2008

Community-based sexual health services (SHS) are intended to improve access for people who may have difficulty attending traditional genitourinary medicine clinics. The objective of this study was to review uptake of sexually transmitted infection (STI) testing in an outreach clinic for those under 25 in an area where Black and minority ethnic groups comprise the majority of the local population. A retrospective case-notes review was undertaken of those attending. Standards were that Fraser guidelines should be completed in all under 16-year-old and all clients should be offered STI testing, HIV testing and contraception (if applicable) in accordance with local standards. One hundred and seventeen clients attended. Ten percent self-reported ethnicity was Asian. Thirty-six (31%) clients tested for chlamydia. Thirty (26%) had an HIV test. Five (14% of those tested) had a positive nucleic acid amplification test for chlamydia. Five (13%) of those requesting long term contraception had STI testing. This service has successfully improved access to STI screening. However, there may have been missed opportunities to offer tests in those requesting contraception. Under-representation of those of non-white ethnicity suggests access to SHS may be a particular problem and further work is required to improve the sexual health of the local community.
Gay men who engage in substance use and sexual risk behaviour: a dual-risk group with unique characteristics
Authors: Mor Z , Davidovich U , Mcfarlane M , Feldshtein G , Chemtob D
Published: September 2008

‘Recreational’ substances used among men having sex with men, and their association with risky unprotected anal intercourse (RUAI) were examined – for the first time in Israel – in an internet-based questionnaire assessing knowledge, practices and motivation. Between March and May 2005, 2873 participants completed the entire questionnaire. Of the total, 669 (23%) reported RUAI during the last six months, and 1319 (46%) used substances during sex. Use of substance was significantly higher among those performing RUAI than those who did not (31.5% versus 26.4%, P = 0.03). Involvement in both substance use and RUAI was reported by 366 participants (13%). HIV rates were higher in this dual-risk group ( P < 0.01), and individuals reported more partners in the last six months than those not part of this dual risk (11.6 versus 8.2, P = 0.02). In multivariate analyses, Tel-Aviv residency, lower education, performing receptive RUAI, misperception of HIV transmission and limited negotiation skills were positively associated with this dual-risk behaviour.
Topical cidofovir for severe warts in a patient affected by AIDS and Hodgkin's lymphoma
Authors: De Socio G V L , Simonetti S , Rosignoli D , Minga P , Tomassini G M , Baldelli F
Published: September 2008

We describe a 42-year-old man with AIDS and Hodgkin's lymphoma whose severe and recalcitrant cutaneous warts resolved following treatment with local 1% cidofovir. Clinically significant improvements were observed in a two-week period of therapy. In advanced HIV disease complicated by additional haematological malignancy, cutaneous warts may be difficult to treat and present a challenge for the attending physicians. In similar clinical condition topical anti-human papillomavirus therapy may prove to be safe and curative.
Commercial sex and HIV transmission in mature epidemics: a study of five African countries
Authors: Leclerc P M , Garenne M
Published: September 2008

The study compares the association between using the services of commercial sex workers and male HIV seroprevalence in five African countries: Ghana, Kenya, Lesotho, Malawi and Rwanda. The HIV seroprevalence among men who ‘ever paid for sex’ was compared with controls who ‘never paid for sex’. Results were based on 12,929 eligible men, aged 15–59 years, interviewed in Demographic and Health Surveys. The odds ratio of HIV seroprevalence associated with ever paying for sex was 1.89 (95% confidence interval = 1.57–2.28), with only minor differences by country. The results were stable in multivariate analysis after controlling for available potential cofactors (data on non-sexual routes of transmission were not available). Given the relatively small proportion of men involved, the risk attributable to ‘ever paying for sex’ remained low: 7.1% in univariate analysis and 4.4% after adjustment, and it varied among countries (range 1.3–9.4%). These results match previous observations that commercial sex seems to play a minor role in the spread of HIV in mature epidemics.
Syphilis causing hearing loss
Authors: Chan S Y , Medhi M , Ekbote A , Moses S , Sibtain N , Andrews T , O'connor A F , Kulasegaram R
Published: September 2008

An HIV-positive man with hepatitis B co-infection, naïve to highly active antiretroviral therapy, with a CD4 of 594 copies/mL and HIV-1 viral load of 140,070 copies, presented with right-sided facial weakness and hearing loss. He had been treated for secondary syphilis three months earlier when his rapid plasma reagin (RPR) result was 1:16, this had fallen to neat. At presentation, his RPR had risen to 1:16 again. A magnetic resonance imaging scan showed enhancement of the internal auditory canal and right cochlea. His cerebrospinal fluid examination was normal. He was treated with acyclovir and prednisolone before the syphilis serology was known. He was then treated for syphilis with doxycycline. He made an excellent recovery.
Sexually transmitted infections among brothel-based sex workers in Tel-Aviv area, Israel: high prevalence of pharyngeal gonorrhoea
Authors: Linhart Y , Shohat T , Amitai Z , Gefen D , Srugo I , Blumstein G , Dan M
Published: September 2008

Sex workers play a major role in spreading sexually transmitted infections (STIs). We studied the prevalence rates and risk factors for STIs among 300 brothel-based sex workers in Tel-Aviv. Throat swabs were cultured for Neisseria gonorrhoeae, urine samples were tested by polymerase chain reaction (PCR) for Chlamydia trachomatis and N. gonorrhoeae, and sera were tested for syphilis, human immunodeficiency virus (HIV) and type 2 herpes simplex virus (HSV) antibodies. N. gonorrhoeae was cultured from throat samples of 9.0% of participants; PCR testing of urine was positive for C. trachomatis in 6.3% and for N. gonorrhoeae in 5.0%. Syphilis serology was positive (Venereal Disease Research Laboratory [VDRL] titres >1:8) in 1.3% of women, HSV-2-specific immunoglobulin G was detected in 60% and HIV serology was positive in a single case (0.3%). Having STI was significantly associated with age, number of years in Israel, number of clients a week and condom use for vaginal sex. In a multivariate analysis, having STI was significantly associated with number of clients per week and condom use for vaginal sex. The high prevalence of pharyngeal gonorrhoea reflects most probably the expanding demand of clients for oral sex and the insufficient condom use in this form of sex.
Denialism undermines AIDS prevention in sub-Saharan Africa
Authors: Gisselquist D
Published: September 2008

Some denialists, widely reviled, contend that HIV does not cause AIDS. Other denialists, widely respected, contend that HIV transmits so poorly through trace blood exposures that iatrogenic infections are rare. This second group of denialists has had a corrosive effect on public health and HIV programmes in sub-Saharan Africa. Guided by this second group of denialists, no African government has investigated unexplained HIV infections. Denialists have withheld and ignored research findings showing that non-sexual risks account for substantial proportions of HIV infections in Africa. Denialists have promoted invasive procedures for HIV prevention in Africa – injections for sexually transmitted infections, and adult male circumcision – without addressing unreliable sterilization of reused instruments. By denying that health care causes more than rare infections, denialists blame (stigmatize) HIV-positive African adults for causing their own infections through sexual behaviour. Denialism must be overcome to ensure safe health care and to combat HIV-related stigma in Africa.
Chocks away? Time for a surgical checklist
Authors: Worrall Matthew
Published: September 2008

Battery voltage? Check. Avionics off? Check. Flaps down? Check. Oil level? Check. Ready for first incision? We are all familiar with the disaster movie cliché of the pilot and co-pilot of a doomed airliner earnestly running through the pre-flight checklist only to succumb to food poisoning by both having the fish. But the reality is that the humble checklist has been the mainstay strategy for reducing human error factors in aviation safety since the 1930s.
Robotic surgery: the future is now
Authors: Towell Elaine
Published: September 2008

Once the stuff of science fiction films, the era of robotic surgery is finally upon us and experts predict it is set to revolutionise treatment for patients having surgery. Enthusiastic doctors and engineers have been collaborating since the mid-80s but only now are we seeing the fruit of their labour as cost-effective, safe, minimally invasive robotic surgery finally arrives in our operating theatres.
Surgeons in the operating theatre: preparing to lead by example
Authors: Woo K
Published: September 2008

Surgeons, anaesthetists and theatre staff have always worked to ensure that no harm comes to their patients, particularly within the operating theatre environment. Patient safety and the prevention of adverse events underlie many of our traditional practices such as the use of identity bracelets, consent forms and marking of the operative site. Perhaps even more so today than ever, unnecessary or avoidable mistakes in the operating theatre cannot be afforded, with the current climate of increasing standards of health care and rising expectations.
The not-so-silly season
Authors: Black John
Published: September 2008

Journalists call the end of July and August the silly season as they scrabble around for serious stories to fill the vacuum left by the parliamentary recess. For the College these are crucial months for behind-the-scenes political lobbying in the run-up to the party conferences and the new parliamentary session. The seeds of future health policy are often sown in these quiet months and the College was involved in a number of important discussions.
Spatial and Temporal Variability in Size at Maturity of Walleye Pollock in the Eastern Bering Sea
Authors: Stahl Jennifer P. , Kruse Gordon H.
Published: September 2008

Size at maturity is incorporated into stock assessments of walleye pollockTheragra chalcogramma. For eastern Bering Sea walleye pollock, however, this important biological variable has not been examined since 1976 and possible interannual and geographic variations have never been evaluated. Maturity condition and fish length data were collected from 10,197 walleye pollock aboard factory trawlers during winter 2002 and 2003. We also analyzed a smaller, previously unanalyzed data set on maturity collected annually by National Marine Fisheries Service scientists during eight echo integration‐trawl surveys over 1989‐2002. Length at 50% maturity (L50) was estimated by year and area by logistic regression using maximum likelihood methods. Spatial (within subareas) and temporal (interannual) variability were found. For instance, fish matured at the smallest lengths north of the Pribilof Islands and in the years 1989, 1991, and 1995 and at the largest lengths in the southeastern Bering Sea and in the years 2001 and 2002. We found evidence that the variability in size at maturity was related to biological mechanisms. Length at 50% maturity appeared to be directly related to growth as measured by length at age. Moreover, an inverse relationship between walleye pollock biomass andL50suggests that growth is density dependent. This spatiotemporal variability in size at maturity has implications for estimates of spawning stock biomass and should be incorporated into the annual stock assessments for setting annual catch specifications.
Identification of the antimicrobial substances produced by Solanum palinacanthum (Solanaceae)
Authors: Pereira Aline C. , Oliveira Denilson F. , Silva Geraldo H. , Figueiredo Henrique C.P. , Cavalheiro Albero J. , Carvalho Douglas A. , Souza Luciana P. , Chalfoun Sára M.
Published: September 2008

To find out natural antimicrobial agents as alternative in therapeutics and to preserve food, the methanol extract of Solanum palinacanthum aerial parts was submitted to purification steps guided by antibacterial and antifungal assays. As a consequence, the flavonoid rutin and 3,5-dicaffeoylquinic acid were isolated by column chromatographyand high performance liquid chromatography, and identified by mass and nuclear magnetic resonance spectrometry. Minimal inhibitory concentrations (MIC) of the quinic acid derivative against Aeromonas hydrophila, Bacillus subtilis, Staphylococcus aureus and the fungus Aspergillus ochraceus were 250, 1000, 1000 and > 568µg/mL, respectively. Against the same microorganisms, MIC for rutin were 1000, > 1000, > 1000 and 35µg/mL, respectively. Rutinwas very promising for A. ochraceus control, since its MIC against such fungus was close to the one observed for benzalkonium chloride, which is used as a fungicide in Brazil.
Evidences of delayed size recovery in Araucaria angustifolia populations after post-glacial colonization of highlands in Southeastern Brazil
Authors: Stefenon Valdir M. , Behling Hermann , Gailing Oliver , Finkeldey Reiner
Published: September 2008

Up to date, little is known about the relationship between historical demography and the current genetic structure of A. Angus As a first effort towards overcoming this lack, microsatellite data scored in six populations and isozyme allele frequencies published for 11 natural stands of this species were analysed in order to assess molecular signatures of populations' demographic history. Signatures of genetic bottlenecks were captured in all analysed populations of southeastern Brazil. Among southern populations, signatures of small effective population size were observed in only three out of 13 populations. Southern populations likely experienced faster recovery of population size after migration onto highlands. Accordingly, current genetic diversity of the southern populations gives evidence of fast population size recovery. In general, demographic history of A. Angusmatches climatic dynamics of southern and southeastern Brazil during the Pleistocene and Holocene. Palynological records and reconstruction of the past climatic dynamics of southeastern and southern Brazil support the hypothesis of different population size recovery dynamics for populations from these regions.
The importance of feeding in the larval development of the ghost shrimp Callichirus major (Decapoda: Callianassidae)
Authors: Abrunhosa Fernando A. , Arruda Danielle C.B. , Simith Darlan J.B. , Palmeira Carlos A.M.
Published: September 2008

The present study investigated whether the callianassid Callichirus major shows a lecithotrophic behaviour during larval development. Two experiments were carried out. In the first experiment, larvae were subjected to an initial period of feeding, while in the second they were subjected to an initial period of starvation. In Experiment 1, 80% of C. major larvae succeeded moulting to juvenile stage in treatment with larvae fed every day. In the treatments with larvae fed for 1, 2 and 3 days there was total mortality before they reached the megalopal stage. In Experiment 2, zoea larvae showed more resistance when subjected to an initial period of starvation in which larvae starved for 1, 2 and 3 days and had survival rates of 100, 60 and 80%, respectively. But, a delay in the development duration of the zoeal stages was observed. Total mortality was observed for larvae reared in the treatment with entire starvation. The results suggest that zoeal stages of C. major are not lecithotrophic.
Record of the genus Lycopodites in the Lower Permian of Paraná Basin, Brazil
Authors: Salvi Juliana , Jasper André , Ricardi-Branco Fresia , Bernardes-de-Oliveira Mary Elizabeth C. , Guerra-Sommer Margot
Published: September 2008

The genus Lycopodites, which encompasses the herbaceous forms of the lycopsids, presents broad time and spacial distribution during the Paleozoic in the Northern Hemisphere, with its initial records dating from the European Devonian. As to Gondwanan Paleozoic, to this moment, only Lycopodites amazonica Dolianiti had been reported for the Amazonian Middle Devonian (Curuá Group). Thus, the specimens reported in this study such as Lycopodites sp., coming from sedimentary rocks of the Itararé Subgroup, São Paulo State, and Lycopodites riograndensis sp. nov., collected in Rio Bonito Formation, Rio Grande do Sul, represent the oldest fertile forms recorded for Gondwana and the first ones to be described for the Paraná Basin. Its presence in layers, deposited after the end of the Neopaleozoic Glaciation, shows the appearance of new taxa in high latitudes, as well as the diversity of the lycopsids present in the Basin, previously indicated through the abundance of spores associated to the Class Lycopsida present in the palinomorphous assemblages.