bluuebunny/crossref_metadata_2025 huggingface dataset:
TV talk show therapy as a distinct genre of discourse
Authors: Xiaoping Yan
Published: July 2008

Using therapeutic conversations from a televised talk show as the source data, this article investigates how people solve emotional problems in an institutional setting within a specific social cultural context. In light of the genre framework and the Systemic Functional Linguistics, the investigation considers the TV talk show therapy under examination a distinct genre. The claim is based on the linguistic evidence drawn from the analytical work. As a valid genre the talk show therapy has been characterized with the communicative intentionality to resolve emotional problems and to promote mental health to the public. These components in turn have shaped the generic structures, which become the crucial criteria that constitute a text as a genre. The article proposes that a broader conception of genre framework is an effective research method to describe the textual typologies and interpret the semantic structures of the social interaction in postmodern society.
The pragmatics of Akan greetings
Authors: Agyekum Kofi
Published: July 2008

This article addresses greetings as one of the most frequent linguistic interactional routines among the Akan of Ghana. The article will look at the functions, situations, and the major forms of Akan greetings. The article will highlight the major functions of greetings such as the creation of social relationship, commitment to one another in social encounters and manifestation of an individual's communicative competence. It discusses the taxonomy of Akan greetings in terms of formality, periods, events and activities. The article further looks at the changes in greetings in the Akan modern society. The article treats greetings within the frameworks of ethnography of communication, politeness and speech act theory within anthropological linguistics.
Highlighted moves within an action: segmented talk in Japanese conversation
Authors: Morita Emi
Published: July 2008

Japanese conversational data reveal that Japanese speakers produce, and recipients orient to, smaller units of talk than what the conventional notion of a `turn constructional unit' (TCU) represents. Unlike TCUs, such units may be grammatically, prosodically and pragmatically incomplete and may happen on the sub-phrasal level of discourse, as Japanese conversationalists prosodically break up even a single semantic constituent with the insertion of an interactional particle. In this article, I give numerous examples of how such practices of separating a segment of talk are not random but are precisely embedded in the sequential organization of talk that participants co-create. I argue that such segmentation contributes to the interactional co-construction of a turn so as to highlight specifically a `move' Within the larger action that is implemented by the TCU. Doing so thereby provides opportunities for the participants to deal with local contingency problems without changing the global level of the pragmatic work of the turn.
Membership categorization and professional insanity ascription
Authors: Roca-Cuberes Carles
Published: July 2008

This study, based on three years of research and over 40 hours of videotaped interaction in psychiatry, investigates the issue of insanity ascription/exoneration in psychiatric interviews. Following Sacks's model of membership categorization analysis (MCA), this article analyzes the discursive resources that psychiatrists may draw on to achieve some conclusion regarding their patients' psychopathological status. As it turns out, psychiatrists' invocation of patients' putative membership categories plays a crucial role in the achievement of such a conclusion. I examine some fragments of psychiatric intake interviews (PIIs) and subsequent psychiatric interviews (SPIs). The analysis shows that the process that may lead to insanity ascription/exoneration in psychiatric interviews basically involves the use of mundane, commonsense reasoning.
Endovascular Repair of a Ruptured Internal Iliac Arterial Aneurysm With a Novel Application of the Aorto-uni-iliac Converter Device
Authors: Kim Jason K. , Noll Robert E. , Sternbergh W. Charles , Tonnessen Britt H.
Published: July 2008

Internal iliac artery aneurysms are rarely discovered by examination and may consequently present with rupture in a patient without an established diagnosis. Ruptured internal iliac aneurysms harbor a high risk of morbidity and mortality. Although open repair is possible, endovascular repair may be an option in some patients. We present a case of a ruptured internal iliac artery aneurysm with an adjoining ipsilateral common iliac artery aneurysm repaired with a novel use of an aorto-uni-iliac device.
A Novel Hybrid Device for Avoiding Redo Surgery in Synchronous Iliac and Femoral Peri-anastomotic Pseudo-aneurysms
Authors: Varcoe Ramon L. , Jayamanne Dasantha , Tiwari Alok , Swinnen John
Published: July 2008

Synchronous peri-anastomotic pseudo-aneurysms were discovered in a 65-year-old man 26 years after an aorto-bi-iliac bypass and 11 years after an ileo-femoral bypass. He was a poor surgical candidate owing to his obesity, hostile abdomen, and multiple medical comorbidities. Therefore, a novel hybrid device was designed that was part stent graft with the addition of two 6-mm Dacron limbs for anastomosis onto the superficial femoral and profunda femoris arteries. An unexpected type 2 endoleak developed through the internal iliac artery, which was thought to be occluded. This was successfully treated with a direct injection of bovine thrombin. This was an excellent outcome, and the patient made an uneventful recovery.
Emergency communication: the discursive challenges facing emergency clinicians and patients in hospital emergency departments
Authors: Slade Diana , Scheeres Hermine , Manidis Marie , Iedema Rick , Dunston Roger , Stein-Parbury Jane , Matthiessen Christian , Herke Maria , McGregor Jeannette
Published: July 2008

Effective communication and interpersonal skills have long been recognized as fundamental to the delivery of quality health care. However, there is mounting evidence that the pressures of communication in high stress work areas such as hospital emergency departments (EDs) present particular challenges to the delivery of quality care. A recent report on incident management in the Australian health care system (NSW Health, 2005a) cites the main cause of critical incidents (that is, adverse events such as an incorrect procedure leading to patient harm), as being poor and inadequate communication between clinicians and patients. This article presents research that describes and analyses spoken interactions between health care practitioners and patients in one ED of a large, public teaching hospital in Sydney, Australia. The research aimed to address the challenges and critical incidents caused by breakdowns in communication that occur between health practitioners and patients and by refining and extending knowledge of discourse structures, to identify ways in which health care practitioners can enhance their communicative practices thereby improving the quality of the patient journey through the ED. The research used a qualitative ethnographic approach combined with discourse analysis of audio-recorded interactions. Some key findings from the analysis of data are outlined including how the absence of information about processes, the pressure of time within the ED, divergent goals of clinicians and patients, the delivery of diagnoses and professional roles impact on patient experiences. Finally, the article presents an in-depth linguistic analysis on interpersonal and experiential patterns in the discursive practices of patients, nurses and doctors.
Outcome of Conservative Management of Spiral/Long Oblique Fractures of the Metacarpal Shaft of the Fingers Using a Palmar Wrist Splint and Immediate Mobilisation of the Fingers
Authors: AL-QATTAN M. M.
Published: July 2008

Conservative management of spiral/long oblique fractures of the shaft of the metacarpal almost always results in shortening and hence these fractures have the reputation of ending up with an extension lag and reduced grip strength. In a prospective study, 42 patients with 54 fractures were treated with a palmar wrist splint and immediate mobilisation of all finger joints. All fractures united. Extension lag of fractured fingers was initially seen in all fingers, but eventually recovered. Grip strength progressively increased to reach a mean of 94% of the contralateral hand by 1 year after injury.
MT1-MMP collagenolytic activity is regulated through association with tetraspanin CD151 in primary endothelial cells
Authors: Yañez-Mó María , Barreiro Olga , Gonzalo Pilar , Batista Alicia , Megías Diego , Genís Laura , Sachs Norman , Sala-Valdés Mónica , Alonso Miguel A. , Montoya María C. , Sonnenberg Arnoud , Arroyo Alicia G. , Sánchez-Madrid Francisco
Published: July 2008

MT1-MMP plays a key role in endothelial function, as underscored by the angiogenic defects found in MT1-MMP deficient mice. We have studied the molecular interactions that underlie the functional regulation of MT1-MMP. At lateral endothelial cell junctions, MT1-MMP colocalizes with tetraspanin CD151 (Tspan 24) and its associated partner α3β1 integrin. Biochemical and FRET analyses show that MT1-MMP, through its hemopexin domain, associates tightly with CD151, thus forming α3β1 integrin/CD151/MT1-MMP ternary complexes. siRNA knockdown of HUVEC CD151 expression enhanced MT1-MMP-mediated activation of MMP2, and the same activation was seen in ex vivo lung endothelial cells isolated from CD151-deficient mice. However, analysis of collagen degradation in these experimental models revealed a diminished MT1-MMP enzymatic activity in confined areas around the cell periphery. CD151 knockdown affected both MT1-MMP subcellular localization and its inclusion into detergent-resistant membrane domains, and prevented biochemical association of the metalloproteinase with the integrin α3β1. These data provide evidence for a novel regulatory role of tetraspanin microdomains on the collagenolytic activity of MT1-MMP and indicate that CD151 is a key regulator of MT1-MMP in endothelial homeostasis.
Expression patterns of transcribed human endogenous retrovirus HERV-K(HML-2) loci in human tissues and the need for a HERV Transcriptome Project
Authors: Flockerzi Aline , Ruggieri Alessia , Frank Oliver , Sauter Marlies , Maldener Esther , Kopper Bernd , Wullich Bernd , Seifarth Wolfgang , Müller-Lantzsch Nikolaus , Leib-Mösch Christine , Meese Eckart , Mayer Jens
Published: July 2008

Background

A significant proportion of the human genome is comprised of human endogenous retroviruses (HERVs). HERV transcripts are found in every human tissue. Expression of proviruses of the HERV-K(HML-2) family has been associated with development of human tumors, in particular germ cell tumors (GCT). Very little is known about transcriptional activity of individual HML-2 loci in human tissues, though.

Results

By employing private nucleotide differences between loci, we assigned ~1500 HML-2 cDNAs to individual HML-2 loci, identifying, in total, 23 transcriptionally active HML-2 proviruses. Several loci are active in various human tissue types. Transcription levels of some HML-2 loci appear higher than those of other loci. Several HML-2 Rec-encoding loci are expressed in GCT and non-GCT tissues. A provirus on chromosome 22q11.21 appears strongly upregulated in pathologic GCT tissues and may explain high HML-2 Gag protein levels in GCTs. Presence of Gag and Env antibodies in GCT patients is not correlated with activation of individual loci. HML-2 proviruses previously reported capable of forming an infectious HML-2 variant are transcriptionally active in germ cell tissue. Our study furthermore shows that Expressed Sequence Tag (EST) data are insufficient to describe transcriptional activity of HML-2 and other HERV loci in tissues of interest.

Conclusion

Our, to date, largest-scale study reveals in greater detail expression patterns of individual HML-2 loci in human tissues of clinical interest. Moreover, large-scale, specialized studies are indicated to better comprehend transcriptional activity and regulation of HERVs. We thus emphasize the need for a specialized HERV Transcriptome Project.
The frequency of CD127low expressing CD4+CD25high T regulatory cells is inversely correlated with human T lymphotrophic virus type-1 (HTLV-1) proviral load in HTLV-1-infection and HTLV-1-associated myelopathy/tropical spastic paraparesis
Authors: Michaëlsson Jakob , Barbosa Hugo Marcelo R , Jordan Kimberley A , Chapman Joan M , Brunialti Milena KC , Neto Walter Kleine , Nukui Youko , Sabino Ester C , Chieia Marco Antonio , Oliveira Acary Souza Bulle , Nixon Douglas F , Kallas Esper G
Published: July 2008

Background

CD4+CD25highregulatory T (TReg) cells modulate antigen-specific T cell responses, and can suppress anti-viral immunity. In HTLV-1 infection, a selective decrease in the function of TRegcell mediated HTLV-1-tax inhibition of FOXP3 expression has been described. The purpose of this study was to assess the frequency and phenotype of TRegcells in HTLV-1 asymptomatic carriers and in HTLV-1-associated neurological disease (HAM/TSP) patients, and to correlate with measures of T cell activation.

Results

We were able to confirm that HTLV-I drives activation, spontaneous IFNγ production, and proliferation of CD4+ T cells. We also observed a significantly lower proportion of CTLA-4+TRegcells (CD4+CD25highT cells) in subjects with HAM/TSP patients compared to healthy controls. Ki-67 expression was negatively correlated to the frequency of CTLA-4+TRegcells in HAM/TSP only, although Ki-67 expression was inversely correlated with the percentage of CD127lowTRegcells in healthy control subjects. Finally, the proportion of CD127lowTRegcells correlated inversely with HTLV-1 proviral load.

Conclusion

Taken together, the results suggest that TRegcells may be subverted in HAM/TSP patients, which could explain the marked cellular activation, spontaneous cytokine production, and proliferation of CD4+T cells, in particular those expressing the CD25highCD127lowphenotype. TRegcells represent a potential target for therapeutic intervention for patients with HTLV-1-related neurological diseases.
Spx mediates oxidative stress regulation of the methionine sulfoxide reductases operon in Bacillus subtilis
Authors: You CongHui , Sekowska Agnieszka , Francetic Olivera , Martin-Verstraete Isabelle , Wang YiPing , Danchin Antoine
Published: July 2008

Background

All aerobically grown living cells are exposed to oxidative damage by reactive oxygen species (ROS). A major damage by ROS to proteins is caused by covalent modifications of methionine residues giving methionine sulfoxide (Met-SO). Methionine sulfoxide reductases are enzymes able to regenerate methionine and restore protein function after oxidative damage.

Results

We characterized the methionine sulfoxide reductase genesmsrAandmsrBinBacillus subtilis, forming an operon transcribed from a single sigma A-dependent promoter. ThemsrABoperon was specifically induced by oxidative stress caused by paraquat (PQ) but not by H2O2. Spx, a global oxidative stress regulator inB. subtilis, is primarily responsible for this PQ-specific induction ofmsrABexpression. In support of this finding, anspxdeletion mutant is extremely sensitive to PQ, and increased expression ofmsrAwas identified in aclpXmutant in which Spx accumulated. However, the Spx effect was also visible under conditions where the protein did not accumulate (PQ treatment), suggesting a specific molecular effect at the level of the Spx protein. Indeed, the CXXC motif of Spx was found essential for its function in the PQ-specific induction ofmsrABexpression. PQ caused a modification of Spx requiring at least one of the cysteines of the CXXC motif of Spx. The PQ modified form of Spx showed a dynamic changein vivo.

Conclusion

The Spx mediated PQ-specific regulation pathway of themsrABoperon inB. subtilisis reported. Our results suggest that PQ induced the expression ofmsrABpartially through an oxidation on Spx via modification of its CXXC motif.
Creatine kinase B deficient neurons exhibit an increased fraction of motile mitochondria
Authors: Kuiper Jan WP , Oerlemans Frank TJJ , Fransen Jack AM , Wieringa Bé
Published: July 2008

Background

Neurons require an elaborate system of intracellular transport to distribute cargo throughout axonal and dendritic projections. Active anterograde and retrograde transport of mitochondria serves in local energy distribution, but at the same time also requires input of ATP. Here we studied whether brain-type creatine kinase (CK-B), a key enzyme for high-energy phosphoryl transfer between ATP and CrP in brain, has an intermediary role in the reciprocal coordination between mitochondrial motility and energy distribution. Therefore, we analysed the impact of brain-type creatine kinase (CK-B) deficiency on transport activity and velocity of mitochondria in primary murine neurons and made a comparison to the fate of amyloid precursor protein (APP) cargo in these cells, using live cell imaging.

Results

Comparison of average and maximum transport velocities and global transport activity showed that CK-B deficiency had no effect on speed of movement of mitochondria or APP cargo, but that the fraction of motile mitochondria was significantly increased by 36% in neurons derived from CK-B knockout mice. The percentage of motile APP vesicles was not altered.

Conclusion

CK-B activity does not directly couple to motor protein activity but cells without the enzyme increase the number of motile mitochondria, possibly as an adaptational strategy aimed to enhance mitochondrial distribution versatility in order to compensate for loss of efficiency in the cellular network for ATP distribution.
Quantitative analysis of changes in actin microfilament contribution to cell plate development in plant cytokinesis
Authors: Higaki Takumi , Kutsuna Natsumaro , Sano Toshio , Hasezawa Seiichiro
Published: July 2008

Background

Plant cells divide by the formation of new cross walls, known as cell plates, from the center to periphery of each dividing cell. Formation of the cell plate occurs in the phragmoplast, a complex structure composed of membranes, microtubules (MTs) and actin microfilaments (MFs). Disruption of phragmoplast MTs was previously found to completely inhibit cell plate formation and expansion, indicative of their crucial role in the transport of cell plate membranes and materials. In contrast, disruption of MFs only delays cell plate expansion but does not completely inhibit cell plate formation. Despite such findings, the significance and molecular mechanisms of MTs and MFs remain largely unknown.

Results

Time-sequential changes in MF-distribution were monitored by live imaging of tobacco BY-2 cells stably expressing the GFP-actin binding domain 2 (GFP-ABD2) fusion protein, which vitally co-stained with the endocytic tracer, FM4-64, that labels the cell plate. During cytokinesis, MFs accumulated near the newly-separated daughter nuclei towards the emerging cell plate, and subsequently approached the expanding cell plate edges. Treatment with an actin polymerization inhibitor caused a decrease in the cell plate expansion rate, which was quantified using time-lapse imaging and regression analysis. Our results demonstrated time-sequential changes in the contribution of MFs to cell plate expansion; MF-disruption caused about a 10% decrease in the cell plate expansion rate at the early phase of cytokinesis, but about 25% at the late phase. MF-disruption also caused malformation of the emerging cell plate at the early phase, indicative of MF involvement in early cell plate formation and expansion. The dynamic movement of endosomes around the cell plate was also inhibited by treatment with an actin polymerization inhibitor and a myosin ATPase inhibitor, respectively. Furthermore, time-lapse imaging of the endoplasmic reticulum (ER) revealed that MFs were involved in ER accumulation in the phragmoplast at the late phase.

Conclusion

By expression of GFP-ABD2 and vital staining with FM4-64, the dynamics of MFs and the cell plate could be followed throughout plant cytokinesis in living cells. Pharmacological treatment and live imaging analysis also allowed us to quantify MF contribution to cell plate expansion during cytokinesis. Our results suggest that MFs play significant roles in cell plate formation and expansion via regulation of endomembrane dynamics.
Mycobacterium tuberculosisspoligotypes and drug susceptibility pattern of isolates from tuberculosis patients in peri-urban Kampala, Uganda
Authors: Asiimwe Benon B , Ghebremichael Solomon , Kallenius Gunilla , Koivula Tuija , Joloba Moses L
Published: July 2008

Background

The poor peri-urban areas of developing countries with inadequate living conditions and a high prevalence of HIV infection have been implicated in the increase of tuberculosis (TB). Presence of different lineages of Mycobacterium tuberculosis has been described in different parts of the world. This study determined the predominant strain lineages that cause TB in Rubaga division, Kampala, Uganda, and the prevalence of resistance to key anti-tuberculosis drugs in this community.

Methods

This was a cross-sectional study of newly diagnosed sputum smear-positive patients aged ≥ 18 years. A total of 344 isolates were genotyped by standard spoligotyping and the strains were compared with those in the international spoligotype database (SpolDB4). HIV testing and anti-tuberculosis drug susceptibility assays for isoniazid and rifampicin were performed and association with the most predominant spoligotypes determined.

Results

A total of 33 clusters were obtained from 57 spoligotype patterns. According to the SpolDB4 database, 241 (70%) of the isolates were of the T2 family, while CAS1-Kili (3.5%), LAM9 (2.6%), CAS1-Delhi (2.6%) were the other significant spoligotypes. Furthermore, a major spoligotype pattern of 17 (4.5%) strains characterized by lack of spacers 15–17 and 19–43 was not identified in SpolDB4. A total of 92 (26.7%) of the patients were HIV sero-positive, 176 (51.2%) sero-negative, while 76 (22.1%) of the patients did not consent to HIV testing. Resistance to isoniazid was found in 8.1% of strains, while all 15 (4.4%) strains resistant to rifampicin were multi-drug resistant. Additionally, there was no association between any strain types in the sample with either drug resistance or HIV sero-status of the patients.

Conclusion

The TB epidemic in Kampala is localized, mainly caused by the T2 family of strains. Strain types were neither associated with drug resistance nor HIV sero-status.
The value of some Corsican sub-populations for genetic association studies
Authors: Latini Veronica , Sole Gabriella , Varesi Laurent , Vona Giuseppe , Ristaldi Maria Serafina
Published: July 2008

Background

Genetic isolates with a history of a small founder population, long-lasting isolation and population bottlenecks represent exceptional resources in the identification of disease genes. In these populations the disease allele reveals Linkage Disequilibrium (LD) with markers over significant genetic intervals, therefore facilitating disease locus identification. In a previous study we examined the LD extension on the Xq13 region in three Corsican sub-populations from the inner mountainous region of the island. On the basis of those previous results we have proposed a multistep procedure to carry out studies aimed at the identification of genes involved in complex diseases in Corsica. A prerequisite to carry out the proposed multi-step procedure was the presence of different degrees of LD on the island and a common genetic derivation of the different Corsican sub-populations. In order to evaluate the existence of these conditions in the present paper we extended the analysis to the Corsican coastal populations.

Methods

Samples were analyzed using seven dinucleotide microsatellite markers on chromosome Xq13-21: DXS983, DXS986, DXS8092, DXS8082, DXS1225, DXS8037 and DXS995 spanning approximately 4.0 cM (13.3 Mb). We have also investigated the distribution of the DXS1225-DXS8082 haplotype which has been recently proposed as a good marker of population genetic history due to its low recombination rate.

Results

the results obtained indicate a decrease of LD on the island from the central mountainous toward the coastal sub-populations. In addition the analysis of the DXS1225-DXS8082 haplotype revealed: 1) the presence of a particular haplotype with high frequency; 2) the derivation from a common genetic pool of the sub-populations examined in the present study.

Conclusion

These results indicate the Corsican sub-populations useful for the fine mapping of genes contributing to complex diseases.
Divergent mechanisms underlie Smad4-mediated positive regulation of the three genes encoding the basement membrane component laminin-332 (laminin-5)
Authors: Zboralski Dirk , Böckmann Miriam , Zapatka Marc , Hoppe Sabine , Schöneck Anna , Hahn Stephan A , Schmiegel Wolff , Schwarte-Waldhoff Irmgard
Published: July 2008

Background

Functional inactivation of the tumor suppressor Smad4 in colorectal and pancreatic carcinogenesis occurs coincident with the transition to invasive growth. Breaking the basement membrane (BM) barrier, a prerequisite for invasive growth, can be due to tumor induced proteolytic tissue remodeling or to reduced synthesis of BM molecules by incipient tumor cells. Laminin-332 (laminin-5), a heterotrimeric BM component composed of α3-, β3- and γ2-chains, has recently been identified as a target structure of Smad4 and represents the first example for expression control of an essential BM component by a tumor and invasion suppressor. Biochemically Smad4 is a transmitter of signals of the TGFβ superfamily of cytokines. We have reported previously, that Smad4 functions as a positive transcriptional regulator of constitutive and of TGFβ-induced transcription of all three genes encoding Laminin-332, LAMA3, LAMB3 and LAMC2.

Methods

Promoter-reporter constructs harboring 4 kb upstream regions, each of the three genes encoding Laminin-322 as well as deletion and mutations constructs were established. Promoter activities and TGFβ induction were assayed through transient transfections in Smad4-negative human cancer cells and their stable Smad4-positive derivatives. Functionally relevant binding sites were subsequently confirmed through chromatin immunoprecipitation.

Results

Herein, we report that Smad4 mediates transcriptional regulation through three different mechanisms, namely through Smad4 binding to a functional SBE site exclusively in the LAMA3 promoter, Smad4 binding to AP1 (and Sp1) sites presumably via interaction with AP1 family components and lastly a Smad4 impact on transcription of AP1 factors. Whereas Smad4 is essential for positive regulation of all three genes, the molecular mechanisms are significantly divergent between the LAMA3 promoter as compared to the LAMB3 and LAMC2 promoters.

Conclusion

We hypothesize that this divergence in modular regulation of the three promoters may lay the ground for uncoupled regulation of Laminin-332 in Smad4-deficient tumor cells in response to stromally expressed cytokines acting on budding tumor cells.
Obliteration of radical cavities with autogenous cortical bone; long-term results
Authors: Abdel-Rahman Akram M , Pietola Matti , Kinnari Teemu J , Ramsay Hans , Jero Jussi , Aarnisalo Antti A
Published: July 2008

Background

To evaluate the long-term surgical outcome(s) in patients who have undergone canal-wall-down operation with mastoid and epitympanic obliteration using autologous cortical bone chips, bone pate and meatally-based musculoperiosteal flap technique.

Method

Retrospective evaluation of seventy patients operated during 1986–1991 due to a cholesteatoma. An otomicroscopy was performed to evaluate the postoperative outer ear canal configuration with a modified Likert scale (1 – 4). The outer ear canal physical volume was assessed by tympanometry. The hearing outcome and a patient-filled questionnaire were also analyzed.

Results

The posterior wall results were 1.8 (± 0.9 SD) and the attic region 1.8 (± 0.9 SD) (ns., p > 0.05). These values show either no cavity formation or minor formation of a cavity, with a good functional result. The mean volume of the operated ear canal was 1.7 (± 0.5 SD) ml. The volume of the contralateral ear canal was 1.2 (± 0.3 SD) ml (*** p < 0.0001). A comparison of the current mean ABG to the preoperative mean ABG and to the ABG at one-year postoperatively, 5-years postoperatively or 10-years postoperatively showed no statistical significance (p > 0.05).

Conclusion

ABG does not significantly change in the long-term. The configuration of the cavity tends to change, however, the obliteration material is stable in the long-term and clinically significant cavitation rarely occurs.
A survey of community members' perceptions of medical errors in Oman
Authors: Al-Mandhari Ahmed S , Al-Shafaee Mohammed A , Al-Azri Mohammed H , Al-Zakwani Ibrahim S , Khan Mushtaq , Al-Waily Ahmed M , Rizvi Syed
Published: July 2008

Background

Errors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored. The aim of this study is to assess community members' perceptions about medical errors and to analyse the factors affecting this perception in one Middle East country, Oman.

Methods

Face to face interviews were conducted with heads of 212 households in two villages in North Al-Batinah region of Oman selected because of close proximity to the Sultan Qaboos University (SQU), Muscat, Oman. Participants' perceived knowledge about medical errors was assessed. Responses were coded and categorised. Analyses were performed using Pearson's χ2, Fisher's exact tests, and multivariate logistic regression model wherever appropriate.

Results

Seventy-eight percent (n = 165) of participants believed they knew what was meant by medical errors. Of these, 34% and 26.5% related medical errors to wrong medications or diagnoses, respectively. Understanding of medical errors was correlated inversely with age and positively with family income. Multivariate logistic regression revealed that a one-year increase in age was associated with a 4% reduction in perceived knowledge of medical errors (CI: 1% to 7%; p = 0.045). The study found that 49% of those who believed they knew the meaning of medical errors had experienced such errors. The most common consequence of the errors was severe pain (45%). Of the 165 informed participants, 49% felt that an uncaring health care professional was the main cause of medical errors. Younger participants were able to list more possible causes of medical errors than were older subjects (Incident Rate Ratio of 0.98; p < 0.001).

Conclusion

The majority of participants believed they knew the meaning of medical errors. Younger participants were more likely to be aware of such errors and could list one or more causes.
Seasonality of primary care utilization for respiratory diseases in Ontario: A time-series analysis
Authors: Moineddin Rahim , Nie Jason X , Domb Gabrielle , Leong Alan M , Upshur Ross EG
Published: July 2008

Background

Respiratory diseases represent a significant burden in primary care. Determining the temporal variation of the overall burden of respiratory diseases on the health care system and their potential causes are keys to understanding disease dynamics in populations and can contribute to the rational management of health care resources.

Methods

A retrospective, cross-sectional time series analysis was used to assess the presence and strength of seasonal and temporal patterns in primary care visits for respiratory diseases in Ontario, Canada, for a 10-year period from January 1, 1992 to December 31, 2002. Data were extracted from the Ontario Health Insurance Plan database for people who had diagnosis codes for chronic obstructive pulmonary disease, asthma, pneumonia, or upper respiratory tract infections.

Results

The results illustrate a clear seasonal pattern in visits to primary care physicians for all respiratory conditions, with a threefold increase in visits during the winter. Age and sex-specific rates show marked increases in visits of young children and in female adults. Multivariate time series methods quantified the interactions among primary care visits, and Granger causality criterion test showed that the respiratory syncytial virus (RSV) and influenza virus influenced asthma (p = 0.0060), COPD (p = 0.0038), pneumonia (p = 0.0001), and respiratory diseases (p = 0.0001).

Conclusion

Primary care visits for respiratory diseases have clear predictable seasonal patterns, driven primarily by viral circulations. Winter visits are threefold higher than summer troughs, indicating a short-term surge on primary health service demands. These findings can aid in effective allocation of resources and services based on seasonal and specific population demands.
Human resource development and antiretroviral treatment in Free State province, South Africa
Authors: van Rensburg Dingie HCJ , Steyn Francois , Schneider Helen , Loffstadt Les
Published: July 2008

Background

In common with other developing countries, South Africa's public health system is characterised by human resource shortfalls. These are likely to be exacerbated by the escalating demand for HIV care and a large-scale antiretroviral therapy (ART) programme. Focusing on professional nurses, the main front-line providers of primary health care in South Africa, we studied patterns of planning, recruitment, training and task allocation associated with an expanding ART programme in the districts of one province, the Free State.

Methods

Data collection included an audit of professional nurse posts created and filled following the introduction of the ART programme, repeated surveys of facilities providing ART over two years to assess the deployment of staff, and secondary data analysis of government personnel databases to track broader patterns of recruitment and training.

Results

Although a substantial number of new professional nurse posts were established for the ART programme in the Free State, nearly 80% of these posts were filled by nurses transferring from other programmes within the same facility or from facilities within the same district, rather than by new recruits. From the beginning, ART nurse posts tended to be graded at a senior level, and later, in an effort to recruit professional nurses for the ART programme, the majority (54.6%) of nurses entering the programme were promoted to a senior level. The vacancy rate of nurse ART posts was significantly lower than that of other posts in the primary health care (PHC) system (15.7% vs 37.1%). Nursing posts in urban ART facilities were more easily filled than those in rural areas, exacerbating existing imbalances. The shift of nurses into the ART programme was partially compensated for by the appointment of additional support staff, task shifting to community health workers, and a large investment in training of PHC workers. However, the use of less-trained, mid-level enrolled nurses and nursing assistants in the ART programme remained low.

Conclusion

The introduction of the ART programme has revealed both strengths and weaknesses of human resource development in one province of South Africa. Without concerted efforts to increase the supply of key health professionals, accompanied by changes in the deployment of health workers, the core goals of the ART programme – i.e. providing universal access to ART and strengthening the health system – will not be achieved.
Intra-articular knee haemangioma originating from the anterior cruciate ligament: a case report
Authors: Tzurbakis Mathaios , Mouzopoulos George , Morakis Emmanouil , Nikolaras Gerogios , Georgilas Ioannis
Published: July 2008

Introduction

Synovial haemangioma is a rare intra-articular benign tumour, which may arise from any synovium-lined surface, but particularly in the knee joint. Synovial haemangioma originating from the anterior cruciate ligament has not been reported previously.

Case presentation

A 34-year-old man presented with a history of intermittent knee pain, locking and swelling.

Conclusion

Knee intra-articular haemangioma, a very rare benign tumour, is often misdiagnosed. Magnetic resonance imaging is effective in detecting this lesion and should be performed in cases of persistent knee swelling and pain.
Detection of NPM1 exon 12 mutations and FLT3 – internal tandem duplications by high resolution melting analysis in normal karyotype acute myeloid leukemia
Authors: Tan Angela YC , Westerman David A , Carney Dennis A , Seymour John F , Juneja Surender , Dobrovic Alexander
Published: July 2008

Background

Molecular characterisation of normal karyotype acute myeloid leukemia (NK-AML) allows prognostic stratification and potentially can alter treatment choices and pathways. Approximately 45–60% of patients with NK-AML carry NPM1 gene mutations and are associated with a favourable clinical outcome when FLT3-internal tandem duplications (ITD) are absent. High resolution melting (HRM) is a novel screening method that enables rapid identification of mutation positive DNA samples.

Results

We developed HRM assays to detect NPM1 mutations and FLT3-ITD and tested diagnostic samples from 44 NK-AML patients. Eight were NPM1 mutation positive only, 4 were both NPM1 mutation and FLT3-ITD positive and 4 were FLT3-ITD positive only. A novel point mutation Y572C (c.1715A>G) in exon 14 of FLT3 was also detected. In the group with de novo NK-AML, 40% (12/29) were NPM1 mutation positive whereas NPM1 mutations were observed in 20% (3/15) of secondary NK-AML cases. Sequencing was performed and demonstrated 100% concordance with the HRM results.

Conclusion

HRM is a rapid and efficient method of screening NK-AML samples for both novel and known NPM1 and FLT3 mutations. NPM1 mutations can be observed in both primary and secondary NK-AML cases.
Collision tumour of the stomach with a cancer to cancer metastasis: a case report
Authors: Strofilas Alexandros , Dalianoudis Ioannis G , Lagoudianakis Emmanuel E , Genetzakis Michael , Tsekouras Dimitrios , Chrysikos John , Koronakis Nikolaos , Katergiannakis Vaggelogiannis , Manouras Andreas
Published: July 2008

Introduction

Coexistence of a primary gastric lymphoma and a gastric adenocarcinoma is a rare event. The diagnosis is suspected after the pathologic examination of the endoscopic biopsies and definitely documented with the examination of the surgical specimen.

Case presentation

We are presenting a rare case of a 77-year-old Greek man with epigastric pain of one and a half month duration, nausea, anorexia and weight loss. The pathologic examination of the endoscopic biopsies and a lymph node biopsy excised at laparotomy, presented the interpenetration of synchronous occurring primary gastric lymphoma and a gastric adenocarcinoma with a documented cancer to cancer metastasis.

Conclusion

Prognosis of these rare tumours is largely dependent on the stage of the adenocarcinoma at presentation but due to lack of large series there are no data on the biological behavior of these tumours in comparison to adenocarcinoma.
Human palatine tonsil: a new potential tissue source of multipotent mesenchymal progenitor cells
Authors: Janjanin Sasa , Djouad Farida , Shanti Rabie M , Baksh Dolores , Gollapudi Kiran , Prgomet Drago , Rackwitz Lars , Joshi Arjun S , Tuan Rocky S
Published: July 2008

Introduction

Mesenchymal progenitor cells (MPCs) are multipotent progenitor cells in adult tissues, for example, bone marrow (BM). Current challenges of clinical application of BM-derived MPCs include donor site morbidity and pain as well as low cell yields associated with an age-related decrease in cell number and differentiation potential, underscoring the need to identify alternative sources of MPCs. Recently, MPC sources have diversified; examples include adipose, placenta, umbilicus, trabecular bone, cartilage, and synovial tissue. In the present work, we report the presence of MPCs in human tonsillar tissue.

Methods

We performed comparative and quantitative analyses of BM-MPCs with a subpopulation of adherent cells isolated from this lymphoid tissue, termed tonsil-derived MPCs (T-MPCs). The expression of surface markers was assessed by fluorescent-activated cell sorting analysis. Differentiation potential of T-MPCs was analyzed histochemically and by reverse transcription-polymerase chain reaction for the expression of lineage-related marker genes. The immunosuppressive properties of MPCs were determined in vitro in mixed lymphocyte reactions.

Results

Surface epitope analysis revealed that T-MPCs were negative for CD14, CD31, CD34, and CD45 expression and positive for CD29, CD44, CD90, and CD105 expression, a characteristic phenotype of BM-MPCs. Similar to BM-MPCs, T-MPCs could be induced to undergo adipogenic differentiation and, to a lesser extent, osteogenic and chondrogenic differentiation. T-MPCs did not express class II major histocompatibility (MHC) antigens, and in a similar but less pronounced manner compared with BM-MPCs, T-MPCs were immunosuppressive, inhibiting the proliferation of T cells stimulated by allogeneic T cells or by non-specific mitogenic stimuli via an indoleamine 2,3-dioxygenase-dependent mechanism.

Conclusion

Human palatine T-MPCs represent a new source of progenitor cells, potentially applicable for cell-based therapies.
Circulating angiopoietin-1 and angiopoietin-2 in critically ill patients: development and clinical application of two new immunoassays
Authors: Lukasz Alexander , Hellpap Julian , Horn Rüdiger , Kielstein Jan T , David Sascha , Haller Hermann , Kümpers Philipp
Published: July 2008

Introduction

In critically ill patients, the massive release of angiopoietin-2 (Ang-2) from endothelial Weibel–Palade bodies interferes with constitutive angiopoietin-1 (Ang-1)/Tie2 signaling in endothelial cells, thus leading to vascular barrier breakdown followed by leukocyte transmigration and capillary leakage. The use of circulating Ang-1 and Ang-2 as novel biomarkers of endothelial integrity has therefore gained much attention. The preclinical characteristics and clinical applicability of angiopoietin immunoassays, however, remain elusive.

Methods

We developed sandwich immunoassays for human Ang-1 (immunoradiometric sandwich assay/immunoluminometric sandwich assay) and Ang-2 (ELISA), assessed preanalytic characteristics, and determined circulating Ang-1 and Ang-2 concentrations in 30 healthy control individuals and in 94 critically ill patients. In addition, Ang-1 and Ang-2 concentrations were measured in 10 patients during a 24-hour time course with respect to interference by intravenous antibiotic treatment and by extended daily dialysis.

Results

The assays had detection limits of 0.12 ng/ml (Ang-1) and 0.2 ng/ml (Ang-2). Inter-assay and intra-assay imprecision was ≤8.8% and 3.7% for Ang-1 and was ≤4.6% and 5.2% for Ang-2, respectively. Angiopoietins were stable for 24 hours and were resistant to four freeze–thaw cycles. Angiopoietin concentrations were not associated with age, body mass index or renal function in healthy individuals. Ang-1 and Ang-2 concentrations correlated with severity of illness in critically ill patients. Angiopoietin concentrations were not influenced by antibiotic treatment or by extended daily dialysis.

Conclusion

Ang-1 and Ang-2 might serve as a novel class of biomarker in critically ill patients. According to preclinical and clinical validation, circulating Ang-1 and Ang-2 can be reliably assessed by novel immunoassays in the intensive care unit setting.
The IL-10 and IFN-γ pathways are essential to the potent immunosuppressive activity of cultured CD8+NKT-like cells
Authors: Zhou Li , Wang Hongjie , Zhong Xing , Jin Yulan , Mi Qing-Sheng , Sharma Ashok , McIndoe Richard A , Garge Nikhil , Podolsky Robert , She Jin-Xiong
Published: July 2008

Background

CD8+ NKT-like cells are naturally occurring but rare T cells that express both T cell and natural killer cell markers. These cells may play key roles in establishing tolerance to self-antigens; however, their mechanism of action and molecular profiles are poorly characterized due to their low frequencies. We developed an efficient in vitro protocol to produce CD8+ T cells that express natural killer cell markers (CD8+ NKT-like cells) and extensively characterized their functional and molecular phenotypes using a variety of techniques.

Results

Large numbers of CD8+ NKT-like cells were obtained through culture of naïve CD8+ T cells using anti-CD3/anti-CD28-coated beads and high dose IL-2. These cells possess potent activity in suppressing the proliferation of naïve responder T cells. Gene expression profiling suggests that the cultured CD8+ NKT-like cells and the naïve CD8+ T cells differ by more than 2-fold for about 3,000 genes, among which 314 are upregulated by more than 5-fold and 113 are upregulated by more than 10-fold in the CD8+ NKT-like cells. A large proportion of the highly upregulated genes are soluble factors or surface markers that have previously been implicated in immune suppression or are likely to possess immunosuppressive properties. Many of these genes are regulated by two key cytokines, IL-10 and IFN-γ. The immunosuppressive activities of cells cultured from IL-10-/- and IFN-γ-/- mice are reduced by about 70% and about 50%, respectively, compared to wild-type mice.

Conclusion

Immunosuppressive CD8+ NKT-like cells can be efficiently produced and their immunosuppressive activity is related to many surface and soluble molecules regulated by IL-10 and IFN-γ.
An engineered monomer of CCL2 has anti-inflammatory properties emphasizing the importance of oligomerization for chemokine activity in vivo
Authors: Handel Tracy M , Johnson Zoë , Rodrigues David H , dos Santos Adriana C , Cirillo Rocco , Muzio Valeria , Riva Simona , Mack Matthias , Déruaz Maud , Borlat Frédéric , Vitte Pierre-Alain , Wells Timothy N C , Teixeira Mauro M , Proudfoot Amanda E I
Published: July 2008

We demonstrated recently that P8A-CCL2, a monomeric variant of the chemokine CCL2/MCP-1, is unable to induce cellular recruitment in vivo, despite full activity in vitro. Here, we show that this variant is able to inhibit CCL2 and thioglycollate-mediated recruitment of leukocytes into the peritoneal cavity and recruitment of cells into lungs of OVA-sensitized mice. This anti-inflammatory activity translated into a reduction of clinical score in the more complex inflammatory model of murine experimental autoimmune encephalomyelitis. Several hypotheses for the mechanism of action of P8A-CCL2 were tested. Plasma exposure following s.c. injection is similar for P8A-CCL2 and wild-type (WT) CCL2, ruling out the hypothesis that P8A-CCL2 disrupts the chemokine gradient through systemic exposure. P8A-CCL2 and WT induce CCR2 internalization in vitro and in vivo; CCR2 then recycles to the cell surface, but the cells remain refractory to chemotaxis in vitro for several hours. Although the response to P8A-CCL2 is similar to WT, this finding is novel and suggests that despite the presence of the receptor on the cell surface, coupling to the signaling machinery is retarded. In contrast to CCL2, P8A-CCL2 does not oligomerize on glycosaminoglycans (GAGs). However, it retains the ability to bind GAGs and displaces endogenous JE (murine MCP-1) from endothelial surfaces. Intravital microscopy studies indicate that P8A-CCL2 prevents leukocyte adhesion, while CCL2 has no effect, and this phenomenon may be related to the mechanism. These results suggest that oligomerization-deficient chemokines can exhibit anti-inflammatory properties in vivo and may represent new therapeutic modalities.