bluuebunny/crossref_metadata_2025 huggingface dataset:
Endocervical glandular cell abnormalities in conventional cervical smears: evaluation of the performance of cytomorphological criteria and HPV testing in predicting neoplasia
Authors: Rabelo‐Santos S. H. , Derchain S. F. M. , Do Amaral Westin M. C. , Angelo‐Andrade L. A. L. , Sarian L. O. Z. , Oliveira E. R. Z. M. , Morais S. S. , Zeferino L. C.
Published: September 2010

Objective:  To analyse the correlation between cytomorphological criteria in smears with atypical glandular cells (AGC) or adenocarcinoma in situ (AIS) and human papillomavirus (HPV) reflex test results with different neoplastic histological diagnoses, particularly to distinguish between glandular and squamous neoplasia.

Methods:  A series of 155 women with glandular abnormalities in their conventional cervical smears was included: 106 with AGC, 35 with AGC associated with high‐grade squamous intraepithelial lesion (HSIL) and 14 with AIS. Two reviewers evaluated 35 cytomorphological criteria and hybrid capture II (HCII) was performed in all cases. Colposcopy was carried out in all cases and biopsy in 126/155. For statistical purposes, predictive values and odds ratio (OR) were calculated, followed by chi‐square automatic interaction detection.

Results:  Histology detected 56 cases of squamous and 17 of glandular intraepithelial or invasive neoplasia. Predictive values of the papillary groups and feathering criteria for glandular neoplasia were, respectively, 80.0% and 73.3%. Feathering was the criterion with the highest OR for distinguishing glandular from squamous neoplasia and also for distinguishing between glandular and non‐neoplastic diagnosis. Rosettes and pseudostratified strips did not perform as well. Multivariant Classification and Regression Trees analysis identified feathering as the best criterion for distinguishing between glandular, squamous and non‐neoplastic diagnoses regardless of HPV status.

Conclusions:  Feathering was the best criterion for predicting glandular neoplasia.
The potential contribution of fluorescent in situ hybridization analysis to the cytopathological diagnosis of Merkel cell carcinoma
Authors: Suciu V. , Botan E. , Valent A. , Chami L. , Spatz A. , Vielh P.
Published: September 2010

We report the cases of two patients with head and neck Merkel cell carcinoma (MCC) who developed local recurrences confirmed by cytopathology. Interphase fluorescent in situ hybridization (FISH) analysis was performed for research purposes using centromeric probes of chromosomes 6 and 8, on cytological slides. Trisomy of chromosome 6 was found in 85% of tumour cells in the first case of MCC and case 2 exhibited trisomy 8 in 77% of tumour cells. In the absence of specific molecular markers, detection of trisomy 6 and/or trisomy 8 could help in identifying MCC. FISH analysis is easily and quickly performed on interphase nuclei obtained through fine needle aspiration and may be extended to the study of other relevant genetic abnormalities.
Interactions among intraspecific competition, emergence patterns, and host selection behaviour inIps pini(Coleoptera: Scolytinae)
Authors: SALLÉ AURÉLIEN , RAFFA KENNETH F.
Published: September 2010

Abstract1. Variations in developmental conditions of bark beetles, particularly intraspecific competition, can induce morphological and physiological modifications in the offspring. It is hypothesised that intraspecific competition could also affect host selection behaviour. Such behavioural changes might be manifested in response to host (alpha‐pinene) or beetle (verbenone) compounds.

2. Ips piniwere bred at different densities. The offspring were measured for size, weight, and lipid concentration, and then subjected to tunnelling bioassays in agar media amended with varying amounts of alpha‐pinene or verbenone.

3. High parental colonisation densities reduced emergence time of parents and offspring. Increasing colonisation density and emergence time had a negative influence on offspring vigour, resulting in a reduction of the distance tunnelled by the beetles.

4. Both alpha‐pinene and verbenone were repellent. Surprisingly, verbenone was also toxic at high concentrations, with its effect being greater on beetles arising from high densities. The repellent effect of these compounds did not vary according to colonisation density, but for both compounds, at a 1.5 mg g–1concentration, it increased with emergence time.

5. The consequences of varying vigour and behaviour in relation to developmental conditions and emergence patterns on population dynamics ofI. piniare discussed.
Intergenerational acclimation in aphid overwintering
Authors: POWELL S. J. , BALE J. S.
Published: September 2010

Abstract 1. When first instar nymphs and adults of the grain aphid Sitobion avenae (Fabricius) (Hemiptera: Aphidiae) were maintained in long‐term cultures (>6 months) at 20 °C and 10 °C, the LT50 decreased from −8 and −8.8 °C to −16.0 and −13.5 °C, respectively.

2. When aphids from the 20 °C culture were transferred to 10 °C, there was a progressive increase in cold tolerance through three successive generations. Transfer of newly moulted pre‐reproductive adults reared at 10 °C for three generations back to 20 °C resulted in a rapid loss of cold hardiness in their nymphal offspring.

3. In all generations reared at 10 °C, first born nymphs were more cold hardy than those born later in the birth sequence. The LT50 of nymphs produced on the first day of reproduction in the first, second and third generations maintained at 10 °C were −14.8, −17.0 and −16.6 °C, respectively. Thereafter, nymphal cold hardiness decreased over the subsequent 14 days of reproduction in each generation at 10 °C with mean LT50 values of −10.3, −12.6 and −14.8 °C, respectively. By contrast, the cold tolerance of first born nymphs of aphids reared continuously at 20 °C did not differ in comparison with later born siblings. The LT50 of adult aphids was also unaffected by ageing.

4. The ecological relevance of these findings is discussed in relation to the overwintering survival of aphids such as S. avenae.
Interception and Eradication of Colorado Beetle in England and Wales, 1958 ‐ 1977
Authors: Bartlett P.W.
Published: September 2010

For over a hundred years the policy of the British Government has been to maintain total freedom from Colorado beetle by preventing its introduction and eradicating any breeding colonies which may be found. Interceptions on imports during the years 1958 to 1977 are analysed by country of origin and also by the means of introduction. The numbers vary according to the time of year and also for each five‐year period of the twenty years. During the 20‐year period 563 live beetles of known origin were intercepted, 235 of them in 1973‐1977. The means used to intercept Colorado beetles are discussed. The statutory powers available in Great Britain for use in controlling Colorado beetle are summarised. The eradication of a breeding colony at Thanet, Kent in 1976‐1977 is described to illustrate the organisation and methods available. Estimates are presented which compare the cost of living with Colorado beetle as a pest (£0.7‐4.7 million) per year with the cost of statutory prevention (as low as £24,000 per year). The actual cost of the prevention and eradication campaigns during September 1976 to December 1977 are estimated to have been £105,000. The scope of research and development recently undertaken at Harpenden Laboratory is discussed briefly.
An evaluation of the potential side‐effects of α‐glucosidase inhibitors used for the management of diabetes mellitus
Authors: REUSER A. J. J. , WISSELAAR H. A.
Published: September 2010

Orally taken α‐glucosidase inhibitors are used for the management of diabetes mellitus. These drugs can prevent the postprandial rise of the blood glucose level by inhibiting the enzymatic digestion of carbohydrates in the intestinal lumen. Non‐absorbable inhibitors such as acarbose are expected to function exclusively in the intestine, but absorbable inhibitors such as miglitol may exert an inhibitory effect on non‐intestinal α‐glucosidases present in the various cell types of the body. The potential side‐effects of absorbable inhibitors are evaluated in this literature review. It is concluded that there is little risk of inducing unwanted side‐effects when miglitol is taken in an oral dose of approximately 1 mg kg−1 body weight. The use of absorbable inhibitors is, however, not advised in case of kidney dysfunction.
Acarbose and insulin therapy in type I diabetes mellitus
Authors: RIOS M. S.
Published: September 2010

In this paper relevant studies are summarized regarding the use of acarbose as an adjunct to insulin in the treatment of type I diabetes. It is concluded that this approach may contribute to a reduction of postprandial blood glucose excursions and a smoothening of daily blood glucose profiles, an improvement of metabolic control as expressed by glycosylate haemoglobin values and a reduction of insulin requirements. Long‐term studies are, however, necessary before one can conclude that addition of acarbose to the therapeutic regimen in type I diabetic subjects is of longstanding value.
Efficacy of α‐glucosidase inhibitors on lipids in NIDDM subjects with moderate hyperlipidaemia
Authors: LEONHARDT W. , HANEFELD M. , FISCHER S. , SCHULZE J.
Published: September 2010

This paper summarizes literature data concerning the action of acarbose, an α‐glucosidase inhibitor, on the concentrations of plasma lipids. Clinical trials in which acarbose has been used in the treatment of non‐insulin‐dependent diabetics have sometimes shown that it reduces serum triglycerides while it has little or no effect on serum cholesterol levels. The results of a randomized double‐blind placebo‐controlled study lasting 24 weeks are discussed in more detail. Under the controlled conditions, the effects of acarbose treatment on fasting concentrations of cholesterol, HDL‐cholesterol, and triglycerides did not reach statistical significance for the entire patient group. However, in the highest tertile of initial cholesterol concentrations acarbose treatment led to significant lowering of the cholesterol concentration and of the total‐to‐HDL‐cholesterol ratio. The most important benefits of acarbose were observed after a test meal given on day 0 and on week 24 of treatment. The triglyceride increment 1 h postprandial was significantly lowered. This was associated by a significant decrease of the insulin increment. Reduction of hyperinsulinaemia appears to be the mechanism by which acarbose treatment can improve plasma lipid concentrations.
Electronic nose analysis of bronchoalveolar lavage fluid
Authors: Humphreys Lee , Orme Robert M. L’E. , Moore Philippa , Charaklias Napoleon , Sahgal Natasha , Planas Pont Neus , Magan Naresh , Stone Nicholas , Kendall Catherine A.
Published: September 2010

Eur J Clin Invest 2010; 41 (1): 52–58

Background  Electronic nose (E‐nose) technology has been successfully used to diagnose a number of microbial infections. We have investigated the potential use of an E‐nose for the diagnosis of ventilator‐associated pneumonia (VAP) by detecting micro‐organisms in bronchoalveolar lavage (BAL) fluid in a prospective comparative study of E‐nose analysis and microbiology.

Materials and methods  BAL samples were collected using a blind technique from 44 patients following a minimum of 72 h mechanical ventilation. Control samples were collected from six patients mechanically ventilated on the intensive care unit (ICU) immediately following elective surgery. Quantitative microbiological culture and E‐nose headspace analysis of the BAL samples were undertaken. Multivariate analysis was applied to correlate E‐nose response with microbiological growth.

Results  E‐nose fingerprints correctly classified 77% of the BAL samples, with and without microbiological growth from patients not on antibiotics. Inclusion of patients on antibiotics resulted in 68% correct classification. Seventy per cent of isolates, cultured in the laboratory from the clinical samples, were accurately discriminated into four clinically significant groups.

Conclusions  E‐nose technology can accurately discriminate between different microbial species in BAL samples from ventilated patients on ICU at risk of developing VAP with accuracy comparable with accepted microbiological techniques.
A method for the analysis of theδ18O of inorganic phosphate extracted from soils with HCl
Authors: Tamburini F. , Bernasconi S. M. , Angert A. , Weiner T. , Frossard E.
Published: September 2010

The oxygen isotope composition of phosphate (δ18O‐PO4) has successfully been used to study the biological cycling of phosphorus (P) in seawater and marine sediments. However, only a few studies have used this approach in soils. In order to analyseδ18O‐PO4, phosphate must be extracted from the soil, purified and converted to silver phosphate (Ag3PO4). The published extraction methods, successfully applied to marine waters and sediments, lead to the precipitation of impure Ag3PO4when used with soils or organic‐rich samples. Here we present an improved purification protocol, designed for soils and other organic‐rich samples. After extraction with HCl, phosphate is purified with multiple mineral precipitations that do not require extreme pH adjustments of the solutions. We show that contaminant‐free Ag3PO4can be produced from fertilizers and various soils with different chemical and physical characteristics. Our first isotopic results confirm that differences in P status and availability in soils are expressed in theδ18O‐PO4signal, indicating the potential of this isotopic tracer to understand P dynamics in soil systems.
Inhibitors in haemophilia A: current management and open issues
Authors: HAYA S. , MORET A. , CID A. R. , CORTINA V. , CASAÑA P. , CABRERA N. , AZNAR J. A.
Published: September 2010

Summary.  The incidence of inhibitors in haemophilia A is 21–33%. The development of inhibitors to factor VIII (FVIII) is one of the most serious complications in haemophilia therapy and is an important challenge in haemophilia care. The main short‐term objective of the treatment of haemophilic patients with inhibitors is to control bleeding episodes, and the long‐term one is to eradicate the inhibitor by means of immune tolerance induction (ITI).The choice of treatment for bleeding in inhibitor patients is dictated by the current inhibitor titre, the severity of the bleed and the previous anamnesic response to FVIII. In low responder inhibitor patients the best treatment is large doses of concentrates of FVIII to attain haemostatic levels of the factor infused. The same approach can also be considered in high responders who have a temporarily low inhibitor level and major haemorrhage. High responders patients with high inhibitors titre or with minor haemorrhage must be treated with bypassing agents, such as FEIBA (factor VIII inhibitor bypassing activity) or recombinant activated FVII (rVIIa); there is no agreement which of both agents should be chosen in the different clinical situations. Only in patients waiting to start ITI treatment the rFVIIa use is clearly recommended, in order to avoide an anamnesic responce. In case of failure with this agents, extracorporeal immunoadsortion may be considered.

All haemophiliac children who develop an inhibitor should be considered for ITI. The start of ITI should be deferred until the inhibitor has declined below 10 Bethesda units/mL (BU ml−1) where possible. Starting the treatment when inhibitor titre is below 10 BU ml−1 is the strongest predictor of success. However, there are many other points to clarify: recommended FVIII doses in the ITI; if the results can be affected by concomitant infections during ITI; if there are any differences using plasma derived or recombinant concentrates, even more if the plasma‐derived concentrate contains large amounts von willebrand factor or not; age of starting the ITI and the delay in beginning it; if using immunosupresors can help in the treatment of patients with a bad prognosis; and when the treatment must be left in patients without a clear failure.
Utilizing disease surveillance to examine gene flow and dispersal in white‐tailed deer
Authors: Kelly Amy C. , Mateus‐Pinilla Nohra E. , Douglas Marlis , Douglas Michael , Brown William , Ruiz Marilyn O. , Killefer John , Shelton Paul , Beissel Tom , Novakofski Jan
Published: September 2010

1. The prevention and management of transmissible diseases hinges upon understanding host dispersal because it influences distribution of wildlife, affects the rate of disease transmission, and alters the spatial distribution of infection. The relationship between host dispersal and chronic wasting disease (CWD) in cervids is of interest because potential interspecies transmission of fatal prion diseases creates serious risks for wildlife, domestic species, and humans.

2. We used molecular techniques to examine dispersal in a population of Illinois white‐tailed deer Odocoileus virginianus. Sampled individuals inhabited areas with confirmed cases of CWD, a transmissible prion disease of cervids, with additional sampling in uninfected locations. We genotyped 1410 deer harvested through CWD surveillance using 10 microsatellites and measured gene flow, determined population structure and quantified gender‐specific differences in dispersal. Additionally we used spatial autocorrelation and parentage assignments to examine individual movements.

3. Female deer demonstrated philopatry as evidenced by higher levels of genetic structure, positive spatial autocorrelation and maternity assignments within one home range.

4. Male deer were less genetically structured and frequently exchanged genes across >100 km.

5. Synthesis and applications. Dispersal contributes to the spread of wildlife diseases. Therefore, knowledge of wildlife movement patterns can enhance the efficacy of disease control programmes. Our findings show that samples collected for disease surveillance are useful for measuring gene flow and inferring dispersal in white‐tailed deer. High genetic admixture indicates males disperse regardless of landscape features. In contrast, distinct clustering of females demonstrates localized dispersal and philopatry. Taken together, results suggest that CWD surveillance and culling of males should be broadly expanded after an outbreak. Furthermore, surveillance of hunter‐harvested deer can be used to identify locales in which CWD occurs, and this information should be used to focus culling efforts on females within genetically defined clusters (‘matriarchal groups’). Removal of matriarchal groups at those locations will reduce horizontal transmission more than widely distributed population reductions.
Assessment of dietary adequacy in a remote Inuvialuit population
Authors: Erber E. , Hopping B. N. , Beck L. , Sheehy T. , De Roose E. , Sharma S.
Published: September 2010

Background:  Traditional foods are rich sources of essential nutrients, but Inuvialuit in the Northwest Territories (NWT), Canada, have been undergoing a nutrition transition, characterised by an increased consumption of non‐nutrient‐dense foods. The present study aimed to characterise energy, nutrient and food intakes amongst adult Inuvialuit.

Methods:  The study collected up to three 24‐h dietary recalls on nonconsecutive days for each participant in spring/summer of 2008 in one remote community in the NWT. Recall data were analysed for energy and nutrient intake, dietary adequacy, most commonly reported foods, and food contributors to energy and nutrients.

Results:  Participants included 14 men and 50 women (response rate 79%). Median daily energy intake was 9.4 (interquartile range = 5.7) MJ for men and 8.3 (3.6) MJ for women. The majority of adult Inuvialuit did not meet the recommendation for vitamins A [median intake = 344.7 (246.3) μg‐RAE in men, 248.9 (213.8) μg‐RAE  in women], B6 [0.9 (0.8) mg in men, 1.0 (0.5) mg in women] and E [2.4 (2.1) mg in men, 1.8 (1.0) mg in women], dietary fibre [7.7 (5.7) g in men, 8.7 (4.4) g in women], calcium [779.6 (842.0) mg in men, 610.4 (431.5) mg in women] and total folate [222.6 (57.7) μg in men, 264.6 (127.5) μg in women]. Vitamin D intake was below the recommendation for most women [median intake = 100.0 (119.2) IU]. Traditional foods contributed substantially to protein and iron intake. Juices were the main contributors to energy, carbohydrate and calcium.

Conclusions:  The present study revealed an inadequate consumption of essential nutrients in an Inuvialuit population. If these nutrient deficiencies continue, this population will face an increased burden of chronic diseases and malnutrition.
Validation of a culturally appropriate quantitative food frequency questionnaire for Inuvialuit population in the Northwest Territories, Canada
Authors: Pakseresht M. , Sharma S.
Published: September 2010

Background:  The estimation of dietary intake in population‐based studies is often assessed by a food frequency questionnaire (FFQ). This present study aimed to establish the validity of a 142‐item quantitative FFQ (QFFQ) developed to assess dietary intake in a population living in the Northwest Territories, Canada, and undergoing rapid nutrition transition.

Methods:  Sixty‐four randomly selected Inuvialuit adults were recruited. The mean of one to three 24‐h recalls was used as the reference to measure the validity of the QFFQ. Spearman rank correlations (ρ), cross‐classification and weighted kappa were computed as measures of concordance, adjusting for the daily dietary intake variations in the recalls. Bland – Altman plots were used for additional assessment.

Results:  Four participants with daily energy intake of >25.1 MJ were not included in the analysis. For all nutrients, mean daily intake estimations were higher from the QFFQ than from the recalls. De‐attenuated ρ’s for macronutrients ranged from 0.33 (protein) to 0.45 (carbohydrate). The best de‐attenuated ρ amongst micronutrients was observed for vitamin C (0.53). Overall correlation between the two dietary tools improved after correction for within‐person variance (from 0.32 to 0.35). When nutrient intakes were categorised into quartiles, the QFFQ and 24‐h recalls indicated relative agreement (same or adjacent quartiles) for 77% for energy and macronutrients, 86% for total sugar and 72% for micronutrients. Bland–Altman plots showed a tendency for increased scatter of the differences at higher intakes.

Conclusions:  The QFFQ developed is valid and can be used to assess usual dietary intake and dietary adequacy, determine the contribution of foods to specific nutrient intakes, and identify dietary risk factors for chronic disease amongst Inuvialuit.
Evidence for late Pleistocene population expansion of the malarial mosquitoes, Anopheles arabiensis and Anopheles gambiae in Nigeria
Authors: MATTHEWS S. D. , MEEHAN L. J. , ONYABE D. Y. , VINEIS J. , NOCK I. , NDAMS I. , CONN J. E.
Published: September 2010

Abstract Anopheles gambiae Giles s.s. and Anopheles arabiensis Patton (Diptera: Culicidae) are major vectors of malaria in Nigeria. We used 1115 bp of the mitochondrial COI gene to assess their population genetic structures based on samples from across Nigeria (n = 199). The mtDNA neighbour‐joining tree, based on FST estimates, separated An. gambiae M and S forms, except that samples of An. gambiae M from Calabar clustered with all the An. gambiae S form. Anopheles arabiensis and An. gambiae could be combined into a single star‐shaped, parsimonious haplotype network, and shared three haplotypes. Haplotype diversity values were high in An. arabiensis and An. gambiae S, and intermediate in An. gambiae M; all nucleotide diversities were relatively low. Taken together, patterns of haplotype diversity, the star‐like genealogy of haplotypes, five of seven significant neutrality tests, and the violation of the isolation‐by‐distance model indicate population expansion in An. arabiensis and An. gambiae S, but the signal was weak in An. gambiae M. Selection is supported as an important factor shaping genetic structure in An. gambiae in Nigeria. There were two geographical subdivisions in An. arabiensis: one included all southern localities and all but two central localities; the other included all northern and two central localities. Re‐analysing an earlier microsatellite dataset of An. arabiensis using a Bayesian method determined that there were two distinctive clusters, northern and southern, that were fairly congruent with the mtDNA subdivisions. There was a trend towards decreasing genetic diversity in An. arabiensis from the northern savannah to the southern rainforest that corroborated previous data from microsatellites and polytene chromosomes.
Transplantation of adult‐sized kidneys in low‐weight pediatric recipients achieves short‐term outcomes comparable to size‐matched grafts
Authors: Goldsmith P. J. , Asthana S. , Fitzpatrick M. , Finlay E. , Attia M. S. , Menon K. V. , Pollard S. G. , Ridgway D. M. , Ahmad N.
Published: September 2010

Goldsmith PJ, Asthana S, Fitzpatrick M, Finlay E, Attia MS, Menon KV, Pollard SG, Ridgway DM, Ahmad N. Transplantation of adult‐sized kidneys in low‐weight pediatric recipients achieves short‐term outcomes comparable to size‐matched grafts. Pediatr Transplantation 2010: 14:919–924. © 2010 John Wiley & Sons A/S.

Abstract:  Low‐weight pediatric recipients are disadvantaged by scarcity of size‐matched donors. ASK have been successfully used for pediatric recipients. We report the results of renal transplantation using ASK in low‐weight pediatric recipients and compare outcomes in weight‐matched and unmatched donor–recipient pairs. The outcomes of renal transplants using ASK grafts in low‐weight (<20 kg) recipients from a single center over a 10‐yr period were reviewed. Two groups, comprising recipients of grafts from weight‐matched and mismatched donors, were compared. Primary outcome was one‐yr graft survival. Secondary outcomes were one‐ and two‐yr calculated eGFR, changes in recipient body weight, perioperative cardiovascular stability, rates of AR and DGF. Twenty‐three low‐weight recipients were transplanted. Eleven received ASK grafts from high‐weight donors and 12 grafts from low‐weight donors. One patient in each group had early graft loss. No significant difference was observed in rates of DGF, AR, one‐yr graft or patient survival and perioperative cardiovascular parameters. ASK with considerable donor:recipient weight discrepancies can be safely transplanted into small pediatric recipients with comparable outcomes to grafts with less weight discrepancy.
Donor‐transmitted adenovirus infection causing kidney allograft nephritis and graft loss
Authors: Kozlowski T. , Nickeleit V. , Andreoni K.
Published: September 2010

T. Kozlowski, V. Nickeleit, K. Andreoni. Donor‐transmitted adenovirus infection causing kidney allograft nephritis and graft loss. Transpl Infect Dis 2011: 13: 168–173. All rights reserved

Abstract: Adenovirus (AdV) infection can occur early after transplantation, especially with potent immunosuppression for induction or acute rejection treatment. We present the largest case series of adult renal recipients from a single institution with AdV infection, and the first apparent case of transferred AdV infection from 1 deceased donor to 2 kidney recipients. Three patients received kidneys from 2 deceased donors: 2 from a 23‐year‐old donor, and the third from a 4‐year‐old donor. The recipients with the same donor both displayed early rejection. One who eventually lost his graft to AdV nephritis required treatment with plasmapheresis, intravenous immunoglobulin, rituximab, and anti‐thymocyte globulin for severe antibody‐mediated rejection. The second required only steroids for acute cellular rejection and has good renal function at 7 years. The third recipient was discovered to have AdV and microabscesess on renal biopsy and required nephrectomy. In the 2 cases of graft loss, we observed sudden deterioration of graft function with rising creatinine and subsequent necrosis resulting in nephrectomy within 40 days after transplantation. AdV was detected by polymerase chain reaction in urine or serum and/or renal tissue. AdV activation after potent immunosuppression can lead to systemic infection and may trigger rejection and/or early graft loss.
Shaping the future of Scandinavian anaesthesiology: a position paper by the SSAI
Authors: SØREIDE E. , KALMAN S. , ÅNEMAN A. , NØRREGAARD O. , PERE P. , MELLIN‐OLSEN J. ,   on behalf of the Position Paper Task Force
Published: September 2010

Traditionally, Scandinavian anaesthesiologists have had a very broad scope of practice, involving intensive care, pain and emergency medicine. European changes in the different medical fields and the constant reorganising of health care may alter this. Therefore, the Board of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) decided to produce a Position Paper on the future of the speciality in Scandinavia. The training in the various Scandinavian countries is very similar and provides a stable foundation for the speciality. The Scandinavian practice in anaesthesia and intensive care is based on a team model where the anaesthesiologists work together with highly educated nurses and should remain like this. However, SSAI thinks that the role of the anaesthesiologists as perioperative physicians is not fully developed. There is an obvious need and desire for further training of specialists. The SSAI advanced educational programmes for specialists should be expanded and include formal assessment leading to a particular medical competency as defined by the European Union of Medical Specialists (UEMS). In this way, Scandinavian anaesthesiologists will remain leaders in perioperative, intensive care, pain and critical emergency medicine.
Effects of fibrinogen concentrate administration during severe hemorrhage
Authors: THORARINSDOTTIR H. R. , SIGURBJORNSSON F. TH. , HREINSSON K. , ONUNDARSON P. T. , GUDBJARTSSON T. , SIGURDSSON G. H.
Published: September 2010

Background: Fibrinogen concentrate has been shown to improve coagulation in dilutional coagulopathy in experimental studies, but clinical experience is still scarce. The aim of this study was to evaluate laboratory data and the clinical outcome of fibrinogen administration in patients suffering from severe hemorrhage.

Materials and methods: A retrospective study over a 3‐year observation period of consecutive patients who received a single dose of fibrinogen concentrate but not recombinant factor VIIa as part of their treatment of severe hemorrhage, defined as >6 U of packed red blood cells (PRBCs).

Results: Thirty‐seven patients were included, most of them suffering from severe hemorrhage following open heart surgery (68%). After a median fibrinogen dose of 2 g (range 1–6 g), an absolute increase in the plasma fibrinogen concentration of 0.6 g/l was observed (P<0.001). The activated partial thromboplastin time (APTT) decreased significantly (P<0.001), from 52 to 43 s and the prothrombin time (PT) decreased from 20 to 17 s, respectively. The transfusion requirement for PRBCs decreased from 6 to 3 U (P<0.01) in the 24 h after fibrinogen administration, but fresh‐frozen plasma and platelet concentrate transfusions did not change significantly. Eight patients (22%) died in intensive care unit and the pre‐operative fibrinogen concentration was not significantly different in these patients.

Conclusion: Administration of fibrinogen for severe hemorrhage was associated with an increased fibrinogen concentration and a significant decrease in APTT, PT and the requirement for PRBCs.
No effect of melatonin on oxidative stress after laparoscopic cholecystectomy: a randomized placebo‐controlled trial
Authors: KÜCÜKAKIN B. , KLEIN M. , LYKKESFELDT J. , REITER R. J. , ROSENBERG J. , GÖGENUR I.
Published: September 2010

Background: Melatonin, an endogenous circadian regulator, also has antioxidant and anti‐inflammatory properties. The aim of this study was to evaluate the antioxidative effect of melatonin in patients undergoing laparoscopic cholecystectomy.

Methods: Patients were randomized to receive 10 mg melatonin or placebo during surgery. Blood samples for analysis of malondialdehyde (MDA), ascorbic acid (AA), total ascorbic acid (TAA) dehydroascorbic acid (DHA) and C‐reactive protein (CRP) were collected pre‐operatively and at 5 min, 6 h and 24 h after operation.

Results: Twenty patients received melatonin and 21 patients received placebo during surgery. No significant differences were observed between the groups in the oxidative stress variables MDA, TAA, AA and DHA or in the inflammatory variable CRP (repeated‐measures ANOVA, P>0.05 for all variables).

Conclusions: Administration of 10 mg melatonin did not reduce variables of oxidative stress in patients undergoing elective laparoscopic cholecystectomy.
Fitness drivers in the threatened Dianthus guliae Janka (Caryophyllaceae): disentangling effects of growth context, maternal influence and inbreeding depression
Authors: Gargano D. , Gullo T. , Bernardo L.
Published: September 2010

We studied inbreeding depression, growth context and maternal influence as constraints to fitness in the self‐compatible, protandrous Dianthus guliae Janka, a threatened Italian endemic. We performed hand‐pollinations to verify outcomes of self‐ and cross‐fertilisation over two generations, and grew inbred and outbred D. guliae offspring under different conditions – in pots, a common garden and field conditions (with/without nutrient addition). The environment influenced juvenile growth and flowering likelihood/rate, but had little effect on inbreeding depression. Significant interactions among genetic and environmental factors influenced female fertility. Overall, genetic factors strongly affected both early (seed mass, seed germination, early survival) and late (seed/ovule ratio) life‐history traits. After the first pollination experiment, we detected higher mortality in the selfed progeny, which is possibly a consequence of inbreeding depression caused by over‐expression of early‐acting deleterious alleles. The second pollination induced a strong loss of reproductive fitness (seed production, seed mass) in inbred D. guliae offspring, regardless of the pollination treatment (selfing/crossing); hence, a strong (genetic) maternal influence constrained early life‐history traits of the second generation. Based on current knowledge, we conclude that self‐compatibility does not prevent the detrimental effects of inbreeding in D. guliae populations, and may increase the severe extinction risk if out‐crossing rates decrease.
Inbreeding in genome‐wide selection
Authors: Daetwyler H.D. , Villanueva B. , Bijma P. , Woolliams J.A.
Published: September 2010

Traditional selection methods, such as sib and best linear unbiased prediction (BLUP) selection, which increased genetic gain by increasing accuracy of evaluation have also led to an increased rate of inbreeding per generation (ΔFG). This is not necessarily the case with genome‐wide selection, which also increases genetic gain by increasing accuracy. This paper explains why genome‐wide selection reduces ΔFGwhen compared with sib and BLUP selection. Genome‐wide selection achieves high accuracies of estimated breeding values through better prediction of the Mendelian sampling term component of breeding values. This increases differentiation between sibs and reduces coselection of sibs and ΔFG. The high accuracy of genome‐wide selection is expected to reduce the between family variance and reweigh the emphasis of estimated breeding values of individuals towards the Mendelian sampling term. Moreover, estimation induced intraclass correlations of sibs are expected to be lower in genome‐wide selection leading to a further decrease of coselection of sibs when compared with BLUP. Genome‐wide prediction of breeding values, therefore, enables increased genetic gain while at the same time reducing ΔFGwhen compared with sib and BLUP selection.
D‐loop sequence mitochondrial DNA variability of Sarda goat and other goat breeds and populations reared in the Mediterranean area
Authors: Vacca G.M. , Daga C. , Pazzola M. , Carcangiu V. , Dettori M.L. , Cozzi M.C.
Published: September 2010

To provide useful knowledge on goat breed origin and history, we studied the mitochondrial DNA (mtDNA) of 69 goats from five different breeds, Camosciata delle Alpi, Maltese, Nubian, Saanen and Sarda, and one population, the Tunisian. All goats analysed displayed a moderate haplotype and nucleotide diversity. The highest was in the Sarda – the autochthonous breed reared in Sardinia. On the basis of mtDNA control region sequences, animals showed a high genetic haplotype diversity, 35 haplotypes were each represented by a single sequence and only a few haplotypes were shared among the animals. New haplotypes of goats reared in the Mediterranean area were identified and the majority of Italian goats belonged to haplogroup A. This result confirmed worldwide distribution and diversity of haplogroup A.
OPTICAL/DIGITAL CHROMOENDOSCOPY DURING COLONOSCOPY USING NARROW‐BAND IMAGING SYSTEM
Authors: Sano Yasushi , Muto Manabu , Tajiri Hisao , Ohtsu Atsushi , Yoshida Shigeaki
Published: September 2010

This review is regarding the narrow‐band imaging (NBI) system which has been developed at National Cancer Center Hospital East, Japan. The technology of the NBI system is based on modifying the spectral features by narrowing the bandwidth of spectral transmittance using various optical filters. The NBI system consists of three filters, 415–30 nm, 445–30 nm, and 500–30 nm, which are used as observing the fine capillaries in the superficial mucosa is essential to identify gastrointestinal neoplasms. The NBI system has been in development since 1999 and the first report of it's efficacy for gastrointestinal tract use was reported in 2001. In our pilot study, the NBI system may be sufficient to differentiate hyperplastic polyp from adenomatous polyp, and to visualize neoplasia with image processing in real‐time during colonoscopy without the need for dye spraying. Herein, we propose the term ‘optical/digital chromoendoscopy’ using the NBI system and hope that this instrument will become standard endoscopy for in the 21st century. To estimate the feasibility and efficacy of using the NBI system for surveillance or screening examination, randomized control trials should be conducted in the future.
A REVIEW OF CURRENT CLINICAL APPLICATIONS OF UPPER GASTROINTESTINAL ZOOM ENDOSCOPY
Authors: Yao Kenshi , Kida Mitsuhiro
Published: September 2010

Current clinical applications of upper gastrointestinal (GI) zoom endoscopy were reviewed. The objective of upper GI zoom endoscopy has been the diagnosis of neoplastic lesions as well as the diagnosis of minute inflammatory mucosal change. The target organ and pathology of the neoplastic lesions have been squamous cell carcinoma in the oro‐ and hypo‐pharynx and in the esophagus; intestinal metaplasia, dysplasia, and adenocarcinoma in Barrett's esophagus; and adenocarcinoma in the stomach. For analyzing the magnified endoscopic findings, there were two different basic principles (mucosal microstructural change and subepithelial microvascular changes). Overall diagnostic accuracy for diagnosing a neoplastic lesion was above 80% throughout the upper GI tract. Although the diagnostic accuracy of the zoom endoscopy technique seems to be superior to that of the ordinary endoscopy technique alone, the continuous efforts to establish standardized guidelines and procedures are mandatory in order to lead to the routine use of upper GI zoom endoscopy in clinical practice.
AN ENDOSCOPIC AND MAGNIFYING ENDOSCOPIC STUDY OF ESOPHAGEAL CARDIAC GLAND: WHAT ROLE DOES ESOPHAGEAL CARDIAC GLAND PLAY AT THE ESOPHAGO‐GASTRIC JUNCTION?
Authors: Yagi Kazuyoshi , Aruga Yukio , Nakamura Atsuo , Sekine Atsuo
Published: September 2010

The purpose of this study was to ascertain whether areas of yellow elevated change in the distal squamous epithelium represent esophageal cardiac gland and to further assess the features of the exposed esophageal cardiac gland in the magnified view. In addition, the relationship between the columnar‐lined esophagus, gastro‐esophageal reflux disease (GERD), reflux esophagitis, and H. pylori infection was also assessed. Fifty patients (28 men, 22 women; median age 61 years) underwent elective upper GI endoscopy. The distal margin of the squamo‐columnar junction was observed to ascertain whether a yellow elevated lesion was present. When such a lesion was observed, this area was studied using magnifying endoscopy with acetic acid and a biopsy specimen was taken. Furthermore, biopsy specimens of the cardia, antrum, and body were taken for biopsy specimen to check for the presence of carditis, gastritis, and H. pylori. Of 38 patients showing the yellow elevated change, all showed exposed columnar epithelium and 30 patients proved to have esophageal cardiac gland tissue in biopsy specimens. Of 31 patients with H. pylori infection, all had carditis and the yellow elevated lesion. Of 19 patients with a H. pylori‐negative normal stomach, none had carditis and seven patients had the yellow elevated change which was ascertained to be esophageal cardia by biopsy. The yellow elevated change at the distal squamo‐columnar junction was revealed to be esophageal cardiac gland and exposed esophageal cardiac gland was visible in all cases by magnifying endoscopy with acetic acid.
MINUTE FINDINGS DETECTED BY MAGNIFYING COLONOSCOPY IN ULCERATIVE COLITIS
Authors: Saitoh Yusuke , Fujiya Mikihiro , Watari Jiro , Maemoto Atsuo , Matsumoto Akinori , Ohta Tomoyuki , Kohgo Yutaka
Published: September 2010

In order to detect flat‐type dysplastic and cancerous lesions associated with longstanding ulcerative colitis, it is important to understand the minute findings detected by magnifying colonoscopy in active and quiescent stage of ulcerative colitis. The severity of mucosal findings by magnifying colonoscopy could be categorized as follows: polypoid mucosal tag which has severe ulceration and hemorrhage; coral‐reef‐like appearance which has coarse or nodular mucosa with ulcerations; minute defect of epithelia which has minute or shallow depressions surrounded by edematous mucosa; small yellowish spots which has minute whitish or yellowish coats; villi‐like appearance which has shaggy appearance like small intestinal villi; and regularly arranged crypt opening which has round shaped and regularly arranged crypt.
LIMITATIONS OF PERORAL CHOLANGIOSCOPY IN THE DIAGNOSIS OF BILIARY TUMORS
Authors: Mukai Hidekazu , Watanabe Akihiko , Fujiwara Hitoshi , Yasuda Kenjiro , Nakajima Masatsugu
Published: September 2010

In patients with carcinoma of the bile duct, a primary tumor with tumor spread along the bile duct is frequently shown as a stricture of the bile duct with ductal irregularity and rigidity on ERCP. In patients in whom histological diagnosis is necessary, larger caliber peroral cholangioscopes with a larger working channel should be chosen because they have the advantage of simultaneous biopsy diagnosis. However, peroral cholangioscopy (POCS) has limitations to inspect mucosal tumor spread along the upstream ducts due to the tight stricture, to obtain sufficient biopsy material for confirming the diagnosis, and to identify submucosal tumor spread. With further improvement of techniques, the combined use of POCS with biopsy under direct vision and intraductal ultrasonography (IDUS) is expected to be the best way in the diagnosis of biliary tumors.
THE ROLE OF PERORAL CHOLANGIOSCOPY FOR BILE DUCT LESIONS
Authors: Tsuyuguchi Toshio , Fukuda Yoshihiro , Tsuchiya Shin , Sakai Yuji , Saisho Hiromitsu
Published: September 2010

We reviewed the current status of peroral cholangioscopy under duodenoscopic assistance, which allows direct visualization of the bile duct. Direct visual assessment may be a useful adjunct to endoscopic retrograde cholangiopancreatography (ERCP) for distinguishing malignant from benign bile duct lesions. Several clinical studies suggest the efficacy of peroral cholangioscopy for various bile duct lesions. However, solely cholangioscopic examination may be insufficient to confirm accurate differential diagnosis between benign and malignant strictures or tumor extension of bile duct carcinoma. Directed tissue acquisition in biliary strictures by using peroral cholangioscopy is another application that has not been properly studied because of the limited maneuverability of the long babyscope. Further improvement of suitable instruments and cholangioscopes are needed.
ENDOSCOPIC MANAGEMENT OF PANCREATICO‐BILIARY STRICTURES: A MALAYSIAN EXPERIENCE
Authors: Goh Khean‐Lee , Murugan Periasamy , Anbarasu Renganathan , Tan Yan‐Mei , Ranjeev Prabhakeran
Published: September 2010

Three thousand one hundred and thirty‐seven endoscopic retrograde cholangiopancreatography procedures were carried out over a 10‐year period from 1993 to 2003. Two thousand three hundred and seventeen (73.9%) procedures were first attempt procedures, and 516 (22.2%) cases were performed for malignant biliary strictures. The majority of tumors were distally located (43.4%) followed by hilar or subhilar strictures (34.5%). Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 35 patients with non‐malignant biliary strictures: 12 were due to chronic pancreatitis and 13 due to postoperative damage one, tuberculous stricture four were benign strictures with no obvious cause, four cases of primary sclerosing cholangitis, and one case of Caroli's disease. Of 936 patients with biliary stone disease, 63 (6.7%) patients had strictures of varying degree and extent. ERCP was performed in only 12 cases of benign pancreatic strictures. Biliary stricture due to tuberculosis was distinctly uncommon and only one case was reported. Pre‐cutting with needle‐knife was used successfully in 27.0% of first attempts at common bile duct (CBD) cannulation. Overall, the use of needle knife precutting facilitated cannulation of the CBD in 159/435 (36.6%) (first and second attempts combined). The overwhelming majority of stents placed were polyethylene stents. Metallic self‐expandable stents were used only in a limited number of patients. Cytology brushings of biliary strictures were infrequently carried out. Multiple polyethylene stents were placed across benign strictures as a dilatation device for up to 12 months. Our experience with long‐term follow‐up (mean 7.7 years) of nine patients following for postoperative benign strictures has demonstrated excellent results with this management approach.
SURVEILLANCE FOR DYSPLASIA AND COLITIC CANCER BY MAGNIFYING COLONOSCOPY IN PATIENTS WITH ULCERATIVE COLITIS
Authors: Kobayashi Kiyonori , Igarashi Masahiro , Sada Miwa , Katsumata Tomoe , Saigenji Katsunori
Published: September 2010

The aim of this study was to evaluate the macroscopic appearance and pit pattern of colitic cancer and dysplasia associated with ulcerative colitis (UC) by conventional and magnifying colonoscopy. Twelve lesions of dysplasia in nine patients and five colitic cancers in four patients were observed by magnifying colonoscopy. On conventional colonoscopy, most colitic cancers and dysplasias were protruded lesions. However, flat lesions were observed only in dysplasia, not in colitic cancer. All colitic cancers and 83% (10/12 lesions) of dysplasias presented reddish surface. On magnifying colonoscopy, most lesions of colitic cancer and dysplasia showed IIIS to IIIL or IIIL to IV or IV type pit patterns. Tumorous pits associated with colitic cancers and dysplasias were similar to those seen in sporadic colorectal cancers and adenomas. Magnifying colonoscopy is expected to facilitate the qualitative diagnosis of colitic cancer and dysplasia associated with ulcerative colitis and to improve the efficiency of targeted biopsy.
MUCINOUS ADENOCARCINOMA ASSOCIATED WITH RADIATION COLITIS
Authors: Tamura Satoru , Ueta Hiroshi , Miyamoto Takako , Mizuta Hiroshi , Miyazaki Jun‐ichi , Onishi Saburo
Published: September 2010

A 57‐year‐old woman complained of anal bleeding. She had undergone radical hysterectomy followed by radiation total 60 gray for the treatment of uterus cancer 8 years prior. Colonoscopic examination was performed, and laterally spreading tumors were detected in the transverse, descending, and sigmoid colon. Histopathological findings of operated specimen were compatible with radiation colitis, and mucinous adenocarcinoma existed in this region and invaded to the subserosa with lymphonodi metastasis. She died of peritonitis carcinomatosa 8 months later.