bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterior dental evolution in theAustralopithecus anamensis–afarensislineage
Authors: Ward Carol V. , Plavcan J. Michael , Manthi Fredrick K.
Published: September 2010

Australopithecus anamensisis the earliest known species of theAustralopithecus–human clade and is the likely ancestor ofAustralopithecus afarensis. Investigating possible selective pressures underlying these changes is key to understanding the patterns of selection shaping the origins and early evolution of theAustralopithecus–human clade. During the course of theAu. anamensis–afarensislineage, significant changes appear to occur particularly in the anterior dentition, but also in jaw structure and molar form, suggesting selection for altered diet and/or food processing. Specifically, canine tooth crown height does not change, but maxillary canines and P3s become shorter mesiodistally, canine tooth crowns become more symmetrical in profile and P3s less unicuspid. Canine roots diminish in size and dimorphism, especially relative to the size of the postcanine teeth. Molar crowns become higher. Tooth rows become more divergent and symphyseal form changes. Dietary change involving anterior dental use is also suggested by less intense anterior tooth wear inAu. afarensis. These dental changes signal selection for altered dietary behaviour and explain some differences in craniofacial form between these taxa. These data identifyAu. anamensisnot just as a more primitive version ofAu. afarensis, but as a dynamic member of an evolving lineage leading toAu. afarensis, and raise intriguing questions about what other evolutionary changes occurred during the early evolution of theAustralopithecus–human clade, and what characterized the origins of the group.
Retrieving chronological age from dental remains of early fossil hominins to reconstruct human growth in the past
Authors: Dean M. Christopher
Published: September 2010

A chronology of dental development inPan troglodytesis arguably the best available model with which to compare and contrast reconstructed dental chronologies of the earliest fossil hominins. Establishing a time scale for growth is a requirement for being able to make further comparative observations about timing and rate during both dento-skeletal growth and brain growth. The absolute timing of anterior tooth crown and root formation appears not to reflect the period of somatic growth. In contrast, the molar dentition best reflects changes to the total growth period. Earlier initiation of molar mineralization, shorter crown formation times, less root length formed at gingival emergence into functional occlusion are cumulatively expressed as earlier ages at molar eruption. Things that are similar in modern humans andPan, such as the total length of time taken to form individual teeth, raise expectations that these would also have been the same in fossil hominins. The best evidence there is from the youngest fossil hominin specimens suggests a close resemblance to the model forPanbut also hints thatGorillamay be a better developmental model for some. A mosaic of great ape-like features currently best describes the timing of early hominin dental development.
Stable isotopes in fossil hominin tooth enamel suggest a fundamental dietary shift in the Pliocene
Authors: Lee-Thorp Julia A. , Sponheimer Matt , Passey Benjamin H. , de Ruiter Darryl J. , Cerling Thure E.
Published: September 2010

Accumulating isotopic evidence from fossil hominin tooth enamel has provided unexpected insights into early hominin dietary ecology. Among the South African australopiths, these data demonstrate significant contributions to the diet of carbon originally fixed by C
4
photosynthesis, consisting of C
4
tropical/savannah grasses and certain sedges, and/or animals eating C
4
foods. Moreover, high-resolution analysis of tooth enamel reveals strong intra-tooth variability in many cases, suggesting seasonal-scale dietary shifts. This pattern is quite unlike that seen in any great apes, even ‘savannah’ chimpanzees. The overall proportions of C
4
input persisted for well over a million years, even while environments shifted from relatively closed (
ca
3 Ma) to open conditions after
ca
1.8 Ma. Data from East Africa suggest a more extreme scenario, where results for
Paranthropus boisei
indicate a diet dominated (approx. 80%) by C
4
plants, in spite of indications from their powerful ‘nutcracker’ morphology for diets of hard objects. We argue that such evidence for engagement with C
4
food resources may mark a fundamental transition in the evolution of hominin lineages, and that the pattern had antecedents prior to the emergence of
Australopithecus africanus
. Since new isotopic evidence from Aramis suggests that it was not present in
Ardipithecus ramidus
at 4.4 Ma, we suggest that the origins lie in the period between 3 and 4 Myr ago.
In search of the last common ancestor: new findings on wild chimpanzees
Authors: McGrew W. C.
Published: September 2010

Modelling the behaviour of extinct hominins is essential in order to devise useful hypotheses of our species' evolutionary origins for testing in the palaeontological and archaeological records. One approach is to model the last common ancestor (LCA) of living apes and humans, based on current ethological and ecological knowledge of our closest living relations. Such referential modelling is based on rigorous, ongoing field studies of the chimpanzee (Pan troglodytes) and the bonobo (Pan paniscus). This paper reviews recent findings from nature, focusing on those with direct implications for hominin evolution, e.g. apes, using elementary technology to access basic resources such as food and water, or sheltering in caves or bathing as thermoregulatory adaptations. I give preference to studies that directly address key issues, such as whether stone artefacts are detectible before the Oldowan, based on the percussive technology of hammer and anvil use by living apes. Detailed comparative studies of chimpanzees living in varied habitats, from rainforest to savannah, reveal that some behavioural patterns are universal (e.g. shelter construction), while others show marked (e.g. extractive foraging) or nuanced (e.g. courtship) cross-populational variation. These findings allow us to distinguish between retained, primitive traits of the LCA versus derived ones in the human lineage.
The cranial base of
Australopithecus afarensis
: new insights from the female skull
Authors: Kimbel William H. , Rak Yoel
Published: September 2010

Cranial base morphology differs among hominoids in ways that are usually attributed to some combination of an enlarged brain, retracted face and upright locomotion in humans. The human foramen magnum is anteriorly inclined and, with the occipital condyles, is forwardly located on a broad, short and flexed basicranium; the petrous elements are coronally rotated; the glenoid region is topographically complex; the nuchal lines are low; and the nuchal plane is horizontal.
Australopithecus afarensis
(3.7–3.0 Ma) is the earliest known species of the australopith grade in which the adult cranial base can be assessed comprehensively. This region of the adult skull was known from fragments in the 1970s, but renewed fieldwork beginning in the 1990s at the Hadar site, Ethiopia (3.4–3.0 Ma), recovered two nearly complete crania and major portions of a third, each associated with a mandible. These new specimens confirm that in small-brained, bipedal
Australopithecus
the foramen magnum and occipital condyles were anteriorly sited, as in humans, but without the foramen's forward inclination. In the large male A.L. 444-2 this is associated with a short basal axis, a bilateral expansion of the base, and an inferiorly rotated, flexed occipital squama—all derived characters shared by later australopiths and humans. However, in A.L. 822-1 (a female) a more primitive morphology is present: although the foramen and condyles reside anteriorly on a short base, the nuchal lines are very high, the nuchal plane is very steep, and the base is as relatively narrow centrally. A.L. 822-1 illuminates fragmentary specimens in the 1970s Hadar collection that hint at aspects of this primitive suite, suggesting that it is a common pattern in the
A. afarensis
hypodigm. We explore the implications of these specimens for sexual dimorphism and evolutionary scenarios of functional integration in the hominin cranial base.
Price Wars and the Stability of Collusion: A Study of the Pre‐World War I Bromine Industry
Authors: Levenstein Margaret C.
Published: September 2010

Between 1885 and 1914 US bromine producers colluded to raise prices and profits. This collusion was disrupted by price wars. Bromine price wars are compared with Green/Porter and Abreu/Pearce/Stacchetti models. Some price wars resulted from the imperfect monitoring problems which motivate these models. Several empirical implications of the APS model are borne out, but the bromine industry's price wars were generally milder than contemplated by APS. More severe price wars were part of a bargaining process, in which firms tried to force renegotiation to a new collusive equilibrium with a different distribution of rents.
Partial Ownership Arrangements and Collusion in the Automobile Industry
Authors: Alley Wilson A.
Published: September 2010

This paper develops a conjectural variation model that allows for partial ownership arrangements and foreign trade. This model is applied to the Japanese and US automobile industries. Although collusion is found to occur in the Japanese automobile industry, it is found to be more competitive than the US automobile industry. The effect imports have on firms' price–cost margins in both countries is also found to be different.
Foreign Direct Investment in the UK 1985–1994: The Impact on Domestic Management Practice
Authors: Child John , Faulkner David , Pitkethly Robert
Published: September 2010

Foreign direct investment (FDI) into the UK has grown considerably in recent years. US, French, German and Japanese companies have generally accounted for the largest share of this FDI. In addition to greenfield and expansion investment, a major vehicle for inward FDI has been the acquisition of UKcompanies.

This paper examines whether nationally distinct approaches to management were introduced, following acquisition, among a sample of 201 UK subsidiaries of French, German, Japanese,US and UK companies. It provides data on the extent of changes and the post‐acquisition influence of the new parent, comparing changes between the four foreign nationalities and a UK control group.

The study indicates that the process of being acquired and controlled by a foreign parent company was often followed by significant changes in management practice. Some changes were common to all acquisitions, including those by UK companies. A shift towards performance‐related rewards and a stronger quality emphasis in operations are two examples. In addition, there was also evidence of effects which differed between nationalities. These conformed to accepted characterizations of national management practice in the case of Japanese and US acquirers, but less so in the case of French and German acquisitions. The findings suggest that present views of French and German management practice require further investigation.
Predicting the Performance of International Joint Ventures: An Investigation in China*
Authors: Child John , Yan Yanni
Published: September 2010

ABSTRACTOrganizational learning, resourcing and control have been identified in the literature as potential firm‐level influences on the performance of international joint ventures (IJVs). The study reported here examines the impact of these factors on the performance of Sino‐foreign IJVs. Their performance is assessed in terms of both ‘goal’ and ‘system’ criteria. The hypothesized performance determinants are found to be more strongly associated with variance in system performance than in goal performance. The main performance predictors are the parent companies’ experience with international business and joint ventures, and the quality of resources they provide to the joint ventures in respect of capital investment, new facilities and operational inputs. When good quality resourcing is provided, the sharing of control with local partners also predicts higher IJV performance. The performance effects of these factors appears to be cumulative, implying that further research should examine them together rather than singularly.
On the narrative vs non‐narrative functions of reported speech: A socio‐pragmatic study
Authors: Vincent Diane , Perrin Laurent
Published: September 2010

Reported utterances have often been analyzed with regard to their narrative function. While it is true that this narrative function applies to a large group of cases, we have observed that reported speech can fulfil other functions, which are incompatible with the properties of a narrative utterance. This study, based on spontaneous discourse, will focus on the non‐narrative functions of reported speech, that is, the appreciative, the support and the authority functions. We will first define the semantico‐pragmatic properties of these functions of reported speech, on the basis of examples that are univocal in their contexts. Next, we will turn to examples more complex, in which there seems to be a conflict between functions considered to be incompatible. Finally, we will present the results of a distributional analysis, relating the functions of reported speech to linguistic and extralinguistic factors. The results will lead us to propose hypotheses concerning the strategic diversification of discourse behaviours by speakers.
Alternative ideologies of la francophonie
Authors: Heller Monica
Published: September 2010

This paper concerns current transformations in the relationship between political and linguistic ideologies of la francophonie based on a sociolinguistic ethnographic study in a French‐language minority school in Canada. A dominant modernist orientation, focussing on unilingual social spaces and the authenticity and integrity of French, is being confronted by an emerging globalizing orientation which emphasizes the value of French as an economic resource, or commodity, and which values both pluralism and a common language. The result is a crisis of legitimacy for francophone institutions, struggles for voice among old and new elites, and the marginalization of the working class speakers of the ‘authentic’ vernacular.
Scapegoats: the killing of kings and ordinary people
Authors: Quigley Declan
Published: September 2010

This article uses the example of royal ritual to examine the idea that underlying structures can be abstracted from particular cultural settings. It is argued that African material on kingship and scapegoats can be used to elucidate South Asian material on pollution beliefs and caste.
Cogealing divinity: time, worship and kinship in South Indian Hinduism
Authors: Good Anthony
Published: September 2010

Daily worship in Hindu temples is characterized by regular repetition. This article juxtaposes iconography and mythology; field data on worship in a Murukan temple in Kalugumalai, South India; and analytic concepts from western and Indian metaphysics, to examine what Gell termed the ‘ritual manipulation of time’. In Hindu cosmology, the materialization of divinity – a prerequisite for worship – is inseparably linked not only to the emergence of time but also to the devolution of divinity into gendered forms. Because gender differences play a central role in iconography, mythology and worship, Hinduism provides a rich cultural resource for debating the morality and practice of human kinship, sexuality and procreation. Not only are there significant homologies between human and divine kinship behaviour, but human marriage patterns in South India display the same blend of repetitive yet changing oscillation as do daily and annual temple liturgies.
Inalienable ethnography: keeping‐while‐giving and the Trobriand case
Authors: Mosko Mark S.
Published: September 2010

In Inalienable possessions, Annette Weiner (1992) focuses on the paradox of ‘keeping‐while‐giving’ rather than the ‘norm of reciprocity’ as the central issue of social life, drawing heavily on Trobriand examples. In this article, key elements of Weiner’s theory are contrasted with prevailing views of Melanesian personhood and agency and with canonical Western notions of exchange, and her use of the Trobriand materials is juxtaposed with previously published ethnographic accounts of the same practices. It is argued that Weiner’s ethnographic illustrations do not lend support to her theory of inalienable possessions; that her conceptual framework is at considerable variance with well‐founded understandings of Melanesian sociality; and that the paradox of keeping‐while‐giving is more appropriately seen as deriving from Western presuppositions of individual boundedness, subjectivity, possession, ownership, and hierarchy, and the need to establish permanence in an entropic world.
Migration, Money and Masculinity in Kerala
Authors: Osella Filippo , Osella Caroline
Published: September 2010

This article examines migration, styles of masculinity and male trajectories through the life‐cycle in Kerala, South India, in a region with a long history of high migration, most lately to the Persian Gulf states. Ethnography suggests that migration may be integrated into wider identity projects and form part of local subjectivities. The article considers four important local categories: the gulfan migrant, typically an immature unmarried male; the kallan, a self‐interested maximizer or individualistic anti‐social man; the pavam, an innocent good‐guy, generous to the point of self‐destruction; mature householder status, a successful, social, mature man holding substantial personal wealth, supporting many dependents and clients. Another theme to emerge is the relationship between masculinity and cash: migration appears as particularly relevant to masculinity in its enhanced relationship with money, an externalizable (detachable) form of masculine potency: maturity means being able to use such resources wisely.
Creating Difference: A Contemporary Affiliation Drama in the Highlands of New Guinea
Authors: Strathern Andrew , Stewart Pamela J.
Published: September 2010

Issues of affiliation to groups, important in Papua New Guinea Highlands ethnography during the 1960s and 1970s, have since been overshadowed by other analytical concerns. But the issues have never gone away and they resound clearly in the life of people there, who are dealing with situations of rapid change that make the crafting of affiliations problematic and strategically important. We examine a case in which an affiliation event was staged in order to mediate between inter‐ethnic claims on a child and to refurbish practices of securing these claims in the absence of brideprice payments or virilocal residence. The analysis points out how transactions that the actors engaged in fell ambiguously between the categories of gift and commodity, and how ties of nurturance and food‐giving continue to play a crucial part in representations and negotiations. At the core of the event was the extent to which the parties involved shared in the understandings of the event at hand. This underlines the fact that transactions and meanings are always inextricably liinked together. Strategies ar made meaningfully and meanings are made strategically.
MOBILITY AND ACCESSIBILITY EFFECTS OF B2C E‐COMMERCE: A LITERATURE REVIEW
Authors: Visser Evert‐Jan , Lanzendorf Martin
Published: September 2010

This paper explores the mobility and accessibility effects of business‐to‐consumer (b2c) e‐commerce by means of a literature review. The main questions are how b2c e‐commerce affects (a) individual activity patterns and travel behaviour, (b) the freight transport and logistic decisions of firms, and (c) the location decisions of households and firms. The review shows that the direct (short‐term) mobility effects of b2c e‐commerce are relatively clear, and that an overall increase in both individual travel and freight transport can be expected. The indirect (long‐term) changes for physical accessibility and mobility, however, are less clear and harder to deal with, due to the complex relationships, time lags, data problems and methodological (attribution) problems. Still, it appears that processes of decentralisation and sub‐urbanisation of distribution systems for b2c e‐commerce may gradually extend and shift, respectively, towards more remote and less densely populated areas in the Netherlands. This would reinforce the ongoing process of retail store closures in these areas, i.e., the spatial redistribution in retailing facilities, thus limiting physical accessibility. As a result, average trip lengths and car use for shopping trips may on the whole increase. With freight transport also increasing due to b2c e‐commerce, its overall long‐term effect may be an increase in motorised mobility, with urban consumers saving trips for shopping purposes and consumers elsewhere adding to their travel burden. Only certain products are feasible for e‐commerce, however. Hence, the impact of b2c e‐commerce on mobility and accessibility varies between product categories.
RECENT EMPLOYMENT TRENDS IN THE CULTURAL INDUSTRIES IN AMSTERDAM, ROTTERDAM, THE HAGUE AND UTRECHT: A FIRST EXPLORATION
Authors: Kloosterman Robert C.
Published: September 2010

Cultural industries are becoming in general more important in advanced economies as sources of employment and economic growth. In this paper, a quantitative exploration is given of recent trends in cultural industries in the Netherlands. The data show a rapid rise of employment in the cultural industries in the last decade. Moreover, the four largest cities, although losing some terrain, are important sites for cultural production. Furthermore, in terms of employment Amsterdam still turns out to be the undisputed cultural capital of the Netherlands. The Dutch capital clearly has the edge in all but one of the selected cultural industries. The one notable exception is architectural services. Rotterdam, home base of many famous international architectural firms, is asserting its status as the most important place for this kind of cultural industry in the Netherlands.
Advertising dynamics and competitive advantage
Authors: Doraszelski Ulrich , Markovich Sarit
Published: September 2010

Can advertising lead to a sustainable competitive advantage? To answer this question, we propose a dynamic model of advertising competition where firms repeatedly advertise, compete in the product market, and make entry as well as exit decisions. Within this dynamic framework, we study two different models of advertising: in the first model, advertising influences the goodwill consumers extend toward a firm (“goodwill advertising”), whereas in the second model it influences the share of consumers who are aware of the firm (“awareness advertising”). We show that asymmetries may arise and persist under goodwill as well as awareness advertising. The basis for a strategic advantage, however, differs greatly in the two models of advertising. We show that tighter regulation or an outright ban of advertising may have anticompetitive effects and discuss how firms use advertising to deter and accommodate entry and induce exit in a dynamic setting.
The economics of earnings manipulation and managerial compensation
Authors: Crocker Keith J. , Slemrod Joel
Published: September 2010

This article examines managerial compensation in an environment where managers may take a hidden action that affects the actual earnings of the firm. When realized, these earnings constitute hidden information that is privately observed by the manager, who may expend resources to generate an inflated earnings report. We characterize the optimal managerial compensation contract in this setting, and demonstrate that contracts contingent on reported earnings cannot provide managers with the incentive both to maximize profits and to report those profits honestly. As a result, some degree of earnings management must be tolerated as a necessary part of an efficient agreement.
The boundaries of firms as information barriers
Authors: Chou Eric S.
Published: September 2010

When contracts are incomplete, the property‐rights theory of firms suggests that ownership of physical assets provides better outside options, which in turn strengthen the owner's incentives to invest in the enterprise. This approach is less suitable for human capital firms such as management consulting that lack physical assets. This article develops an alternative theory for integration that sheds light on the boundaries of human capital firms. In particular, when a relationship between parties includes large potential externalities, reducing the outside option of each party will be beneficial. Integration provides this reduction by blurring the contribution of individual parties within the firm, and thus lowering their independent market valuation. Unlike some results in the property‐rights literature, the results here are robust to variations in ex post bargaining solution.
Do buyer‐size discounts depend on the curvature of the surplus function? Experimental tests of bargaining models
Authors: Normann Hans‐Theo , Ruffle Bradley J. , Snyder Christopher M.
Published: September 2010

A number of recent theoretical papers have shown that, for buyer‐size discounts to emerge in a bargaining model, the total surplus function over which parties bargain must have certain nonlinearities. We test the theory in an experimental setting in which a seller bargains with a number of buyers of different sizes. Nonlinearities in the surplus function are generated by varying the shape of the seller's cost function. Consistent with the theory, we find that quantity discounts emerge only in the case of increasing marginal cost, corresponding to a concave surplus function. We provide additional structural estimates to help identify the source of remaining discrepancies between experimental behavior and theoretical predictions (whether due to preferences for fairness or other factors such as computation errors).
Implantable Cardioverter‐Defibrillators for Primary Prevention: How Do the Data Pertain to the Aged?
Authors: Daubert James P. , Sesselberg Henry W. , Huang David T.
Published: September 2010

The incidence of sudden cardiac death increases with age and the proportion of the US population in progressively more advanced age strata is dramatically increasing. While several randomized controlled trials support the use of implantable cardioverter‐defibrillators (ICDs) to reduce sudden cardiac death, no randomized trials have been done to evaluate whether there is a mortality benefit of ICDs in an elderly population. In the current review, the authors examined six of the major primary prophylaxis ICD trials for evidence pertaining to the elderly. A majority of these trials suggest a mortality benefit in the elderly patients who have met the stringent inclusion and exclusion criteria to be eligible for enrollment. Subset analysis seems to support ICD implantation in a highly select elderly subgroup, but a prospective randomized trial may be warranted.
Complications of Pacemakers and Defibrillators in the Elderly
Authors: Bailey Shane M. , Wilkoff Bruce L.
Published: September 2010

Within the United States, the elderly population is projected to increase 126% by 2050, making those over the age of 65 the most rapidly growing segment in the population. Permanent pacemakers and defibrillators are important therapies with expanding indications for their use, and older persons constitute the majority of recipients of these devices. Recognizing complications associated with these cardiac devices is essential in caring for patients with them. Complications can be related to the implantation procedure and are most commonly lead dislodgement, pneumothorax, lead perforation, hematoma, and infection. Intrinsic device programming can also result in complications such as pacemaker syndrome, pacemaker‐mediated tachycardia, and inappropriate shocks. Extrinsic factors, such as electromagnetic interference and physically manipulating the device, can also result in problems. Recent work suggests that older age, by itself, is not associated with a significant increase in the complication rates from these devices and should not preclude their use.
Implantable Cardioverter‐Defibrillators for Secondary Prevention: Is It Worth It in the Elderly?
Authors: Traub Darren , Ganz Leonard
Published: September 2010

Aging is associated with structural alterations in the heart that predispose the elderly to life‐threatening ventricular arrhythmias. The majority of sudden cardiac deaths occur in people aged 65 and older. As the proportion of elderly in our population continues to grow, a greater number of elderly patients with malignant ventricular arrhythmias will require appropriate medical management. Clinical outcome trials have demonstrated that implantable cardioverter‐defibrillators (ICDs) improve overall survival compared with pharmacologic therapy when used for the secondary prevention of cardiac arrest. Despite proven efficacy, physicians may be reluctant to implant a defibrillator in an older patient. This review summarizes the data pertaining to the use of defibrillators for secondary prevention in the elderly. ICD use for secondary prevention reduces all‐cause mortality and appears to be economically advantageous in an older patient population. Currently, there is no convincing data to suggest that ICD therapy should be withheld from a patient based on age alone.
Cardiac Pacing in the Elderly
Authors: Kaszala Karoly , Kalahasty Gautham , Ellenbogen Kenneth A.
Published: September 2010

Sinus node disease and atrioventricular block are common etiologies of symptomatic bradyarrhythmias in the elderly and remain the leading indications for permanent pacemaker implantation. In fact, the vast majority (>80%) of all pacemakers are implanted in the elderly. Whereas indications of pacemaker therapy have been largely unchanged over the past several years, several questions, such as differences in pacemaker mode selection, remained unanswered. Recent large, randomized, multicenter trials have evaluated the benefits of pacemaker therapy in sinus node dysfunction and acquired atrioventricular block and have provided us with further insights into the difference between atrial‐ and ventricular‐based pacing in these syndromes. Further evaluation of the most appropriate pacing mode in the elderly as well as the outcome of pacing in the elderly are addressed in this review.
Pacemakers and Defibrillators: Recent and Ongoing Studies That Impact the Elderly
Authors: Martinez Claudia , Tzur Assaf , Hrachian Hakop , Zebede Joseph , Lamas Gervasio A.
Published: September 2010

Since the first implantation of a cardiac pacemaker in the second half of the 20th century, there have been evolutionary and revolutionary advances in the technology developed for patients with heart rhythm disturbances. These advances, however, have instead failed to demonstrate that mimicry of physiology by a pacing system would deliver a longer and better life to its recipient. Indeed, we are just now in the process of developing a new paradigm in pacing that may finally deliver physiology to the hyperbolically named “physiologic pacing.” This article will discuss the reasons for the discrepancy between the earlier studies and the more recent ones, as well as a review of implantable cardioverter‐defibrillator trials, keeping in focus the special needs of aged heart rhythm device recipients.
Cardiac Resynchronization Therapy and Other New Approaches for the Treatment of Heart Failure in the Elderly
Authors: Kocovic Dusan Z.
Published: September 2010

Approximately 15% to 20% of patients with systolic heart failure have a QRS duration greater than 120 ms, which is most commonly seen as left bundle‐branch block (LBBB). In LBBB, the left ventricle is activated through the septum from the right ventricle, resulting in a significant delay between the onset of right (RV) and left ventricular (LV) contraction. In patients with LV dysfunction, ventricular dyssynchrony caused by LBBB places the already failing left ventricle at an additional mechanical disadvantage. Ventricular dyssynchrony appears to have a deleterious impact on the natural history of heart failure, as a wide QRS complex has been associated with increased mortality in patients experiencing heart failure. On the basis of these observations, investigators hypothesized that patients with LV dysfunction and delayed ventricular conduction would benefit from pacing at sites that achieve a more favorable contraction pattern, and correct interatrial and/or interventricular conduction delays to maintain optimal atrial‐ventricular (AV) synchrony. Multiple clinical trials of cardiac resynchronization therapy have demonstrated that it is safe and effective, with patients achieving significant improvement in both clinical symptoms as well as multiple measures of functional status and exercise capacity. Moreover, it has reduced measures of morbidity and mortality in several studies. Thus, cardiac resynchronization therapy should be routinely offered to eligible patients experiencing heart failure.
Extracorporeal Antibody Elimination in Neuroimmunological Diseases
Authors: Toepfer M. , Schiffl H. , Sitter T. , Pongratz D. , Müller‐Felber W.
Published: September 2010

Extracorporeal procedures for the elimination of autoantibodies are an important therapeutic option in various neuroimmunological diseases, especially those with neuromuscular involvement. Recent advances with the development of selective apheresis methods have given extracorporeal therapeutic procedures a new perspective. In this article, we review the therapeutic use of plasma exchange and immunoadsorption therapy in different neuroimmunological diseases.
C1q: A Multifunctional Ligand for a New Immunoadsorption Treatment
Authors: Hiepe Falk , Pfüller Barbara , Wolbart Karsten , Bruns Anne , Leinenbach Hans‐Peter , Hepper Martin , Schößler Werner , Otto Veit
Published: September 2010

C1q is a highly conserved protein with multiple functions involved in innate and adaptive immunity. It plays an important role in the activation of the classical pathway of the complement system to mediate the scavenging of infectious agents, apoptotic products, and immune complexes by the mononuclear phagocyte system (MPS). Exhibiting this function, C1q is able to bind various molecules (complexed IgG, IgM, fibrinogen, fibronectin, lipopolysaccharides, DNA, C‐reactive protein [CRP], and viral proteins). Moreover, the collagen‐like region of C1q is a target of autoantibodies. Immune complexes and anti‐C1q autoantibodies are known to be involved in the pathogenesis of autoimmune diseases. Therefore, C1q is a promising candidate to extract waste material from the circulation. Following the development of the C1q immunoadsorbent, 8 patients with systemic lupus erythematosus (SLE) were treated in a first clinical trial. These preliminary results indicate that C1q immunoadsorption is a safe, compatible, and effective treatment for these patients.
Oral zinc sulfate in the treatment of Behcet's disease: A double blind cross‐over study
Authors: SHARQUIE Khalifa E. , NAJIM Rafid A. , AL‐DORI Wisam S. , AL‐HAYANI Raafa K.
Published: September 2010

This was a randomized, controlled, double‐blind trial of zinc sulfate in the treatment of Behcet's disease. Patients with Behcet's disease were recruited in this study between November 2001 and February 2003. A clinical manifestations index (CMI) was calculated for each patient. Serum zinc was estimated in all patients both at the beginning and monthly throughout the trial. Serum zinc levels were estimated from 30 healthy normal subjects matched for age and sex as a control group. Patients were randomly allocated to receive either 100 mg zinc sulfate or identical placebo tablet three times daily in a double‐blind manner. After 3 months of starting treatment, patients were crossed over, that is, patients on placebo received zinc sulfate and vice versa. Mean serum zinc level in Behcet's disease patients was statistically significantly lower than mean serum zinc levels in healthy the control. In group A (started with zinc sulfate), the mean CMI started to decline directly after the first month of therapy with zinc sulfate to significantly lower levels. After shifting to placebo treatment in the fourth month, the mean of CMI started to rise again gradually but remained significantly lower than levels before therapy for the fourth and fifth months. In group B (started with placebo), the mean of CMI remained high for the first 3 months. After crossing over to zinc sulfate in the fourth month, the mean of CMI started to decrease after the fourth month. An inverse correlation between CMI and serum zinc level was found. No side‐effects were seen in either group. In conclusion, zinc sulfate was found to be a good option in the treatment of Behcet's disease.
Negative evaluation of a pathergy test in hepatitis B surface antigen carriers
Authors: ENGIN Burhan , GÜNER Özgür R
Published: September 2010

The different cutaneous manifestations of hepatitis B virus infection have been described in different studies. We proposed to evaluate the frequency of skin pathergy positivity in hepatitis B surface antigen carriers. The study group consisted of 92 hepatitis B surface antigen carriers and 76 healthy individuals as a control group. The pathergy test was applied intradermally to both forearms of the patients and the control subjects. The results of the pathergy test were evaluated. Papule or pustule formation was noted as positive. Four and one of the 92 hepatitis patients and 76 control subjects, respectively, were positive for the pathergy reaction. Evidently, this pathergy test that shows non‐specific skin hyper‐reactivity cannot be used as a clinical marker to indicate hepatitis B surface antigen carriers. The test cannot be used to predict the cutaneous manifestations of hepatitis B infection either.
Necrolytic migratory erythema without glucagonoma in a patient with short bowel syndrome
Authors: NAKASHIMA Hiroko , KOMINE Mayumi , SASAKI Kiyo , MITSUI Hiroshi , FUJIMOTO Manabu , HN Hironobu I , ASAHINA Akihiko , KIKUCHI Kanako , TAMAKI Kunihiko
Published: September 2010

Necrolytic migratory erythema (NME) is an uncommon inflammatory dermatosis with a distinctive clinical and histological appearance. It shows irregular erythema, bullae, erosion, crusts and pigmentation. While it is typically associated with glucagonoma, some cases of NME without glucagonoma have been reported. Herein, we report a case of necrolytic migratory erythema associated with malabsorption 30 years after ileocolectomy. She presented erosive erythema with scale or partly flaccid bullae on her intergluteal cleft, buttock and extremities. Her laboratory data revealed essential amino acid deficiency and a slightly decreased serum zinc level, while her plasma glucagon level was low. With diagnosis of non‐glucagonoma‐associated NME with malabsorption due to short‐bowel syndrome, she was treated and improved by i.v. amino acid supplement. Histological findings of NME include necrotic changes of keratinocytes in the upper epidermis, proliferation of those in the lower epidermis and inflammatory cell infiltration of upper dermis. We also examined the expression pattern of epidermal keratins (K6, K10) and Ki‐67, one of the markers of proliferative activity, to assess the proliferation and differentiation of keratinocytes in a NME lesion by immunostaining. The findings with these immunostainings support the characteristics of HE‐staining, and suggest hyponutrition may induce changing differentiation/proliferation of keratinocytes.
Amnia for intractable skin ulcers with recessive dystrophic epidermolysis bullosa: Report of three cases
Authors: HASEGAWA Toshio , MIZOGUCHI Masayuki , HARUNA Kunitaka , MIZUNO Yuki , MURAMATSU Shigenori , SUGA Yasushi , OGAWA Hideoki , IKEDA Shigaku
Published: September 2010

Recessive dystrophic epidermolysis bullosa (RDEB) is a disease characterized by recurrent blistering and chronic ulceration of the skin. In these patients, recurrent blisters frequently result in intractable skin ulcers due to impaired wound healing caused by mutations in the type VII collagen gene and malnutrition as well as by increased collagenase activity. To evaluate the efficacy of amnia for intractable ulcers in RDEB, we treated RDEB patients with amnia. The amniotic membrane was simply placed on the cleansed wound surface. The procedure was repeated once a week for up to 10 weeks. As a result, wound conditions improved remarkably after treatment with amnia for 2–10 weeks in all the patients, resulting in total re‐epithelization of the ulcers. Amnia could be an effective therapy for intractable skin ulcers in RDEB patients, and should be considered as a re‐emerging therapeutic option for the disease.
Dermatofibrosarcoma protuberans with atrophic appearance at early stage of the tumor
Authors: HANABUSA Makiko , KAMO Riei , HARADA Teruichi , ISHII Masamitsu
Published: September 2010

We report a case of dermatofibrosarcoma protuberans (DFSP) which had looked like an atrophic plaque on the face for 20 years and been diagnosed as morphea. At the late stage after subsequent development of a nodule, histopathological examinations including immunohistochemical stainings revealed the final diagnosis of DFSP. While DFSP is given typical “protuberant” morphology, our case indicates that DFSP sometimes appears as a non‐protuberant lesion. Some reported variants of non‐protuberant DFSP are suspected to be preceding features at the early stage of DFSP before the protuberant feature occurs. We should take this preprotuberant stage of DFSP into consideration of different diagnoses with non‐protuberant lesions. Histopathological examination and immunohistochemical stainings are necessary for an accurate and early diagnosis of DFSP.
Juvenile psoriatic arthritis carrying familial Mediterranean fever gene mutations in a 14‐year‐old Turkish girl
Authors: YENIAY Betul Sozeri , KARACA Neslihan Edeer , YUKSEL Seciye Eda , MIDYAT Levent , KUTUKCULER Necil
Published: September 2010

Juvenile psoriatic arthritis (JPsA) is characterized by asymmetric arthritis of big and small joints, enthesitis, dactylitis, psoriatic skin lesions and nail pitting. Investigators agree that JPsA is a relatively common chronic arthropathy of childhood that differs clinically, serologically, and genetically from both juvenile idiopathic arthritis and juvenile ankylosing spondylitis. Familial Mediterranean fever (FMF) is a multisystemic autosomal recessive disease occasionally accompanied by sacroiliitis. This is characterized by recurrent self‐limited attacks of fever and accompanying abdominal, chest and arthricular pain. We present a 14‐year‐old Turkish girl with JPsA and carrying FMF gene mutations. In this patient, JPsA was diagnosed according to her physical, laboratory and skin biopsy findings and a treatment with methotrexate and sulfasalazine was started. As an inadequate clinical and laboratory response was obtained after the first month of therapy, the patient was investigated for FMF, and was diagnosed by molecular analyses of related gene (E148Q heterozygous/V726A homozygous mutation) besides clinical findings. After 2 weeks of the colchicine treatment, symptoms of the patient regressed and acute phase reactants decreased. To our knowledge, this is the first case presenting with psoriatic arthritis and FMF gene mutations together and responds to colchicine, methotrexate and sulfasalazine dramatically in clinical and laboratory findings. This case has been presented to remind that cases with psoriatic arthritis may also carry mutations in the MEFV gene.
Successful treatment of disseminated superficial actinic porokeratosis with Q‐switched ruby laser
Authors: ITOH Munenari , NAKAGAWA Hidemi
Published: September 2010

Porokeratosis, a cutaneous disorder that is characterized histologically by the presence of a “cornoid lamella”, is a progressive disease with limited therapeutic modalities. We report a case of a 61‐year‐old man suffering from disseminated superficial actinic porokeratosis, one of the clinical types of porokeratosis, treated with Q‐switched ruby laser, commonly used for the treatment of pigmented skin diseases. The laser therapy provided striking improvement and no clinical recurrence was noted.
Recurrent sarcoidosis on a scar associated with vitiligo
Authors: DEMIRKÖK Sevtap Sipahi , ARZUHAL Nurcan , DEVRANOĞLU Gevher , DEMIRKESEN Cuyan , TÜZÜN Yalçın
Published: September 2010

We report a case of systemic sarcoidosis, diagnosed 13 years ago by transbronchial biopsy. Our patient had a spontaneous resolution of hilar and mediastinal lymphadenopathy 6 months after diagnosis. She presented with a skin rash on her thyroidectomy scar after a period of 4 years of complete remission. The patient complained that her thyroidectomy incision scar rose up, reddened and hardened. Biopsy of the skin lesion revealed non‐caseating epithelioid granulomas with histiocytes and multinucleated giant cells. She was successfully treated with oral prednisone. Scar sarcoidosis recurred twice in a 7‐year follow‐up period without accompanying systemic sarcoidosis. Vitiligo appeared with the last relapse of scar sarcoidosis. The case we present is of interest due to the recurrent attacks of scar sarcoidosis in a patient during the remission period of systemic sarcoidosis. Another aspect of this case is the association of the disease with vitiligo without any sign of an autoimmune disease.
Knuckle pads associated with clubbed fingers
Authors: KOBA Shinichi , MISAGO Noriyuki , NARISAWA Yutaka
Published: September 2010

The patient was a 37‐year‐old male who visited us for the chief complaints of severely keratinized elastic soft nodules with normal skin color or slightly glossy pale brown color at the distal interphalangeal joints of the bilateral second, third, fourth and fifth fingers associated with bilateral clubbed fingers. The nodules were histopathologically diagnosed as knuckle pads. Clubbed fingers were also noted, but no cardiopulmonary disorder was observed. Knuckle pads are circumscribed fibromatous thickenings of the skin overlying the finger joints. External factors are considered to be the cause, but many cases may be idiopathic such as this case. Many patients with clubbed fingers have underlying cardiopulmonary disorders, and idiopathic development, such as in this case, does not frequently occur. Our patient had the complications of knuckle pads and clubbed fingers, which has not previously been reported.
Establishment of grading criteria for acne severity
Authors: HAYASHI Nobukazu , AKAMATSU Hirohiko , KAWASHIMA Makoto ,   Acne Study Group
Published: September 2010

For the epidemiological surveys and evaluations of therapy, it is essential to evaluate the severity of diseases. There are several reported methods of assessment for acne severity including lesion counting, comparison of the patient's to a photographic standard and comparison of the patient's to a text description. But all of these are based on opinions of specialists. In this study, we attempted to make an evidence‐based grading criteria for acne severity, which was expected to yield consents from most dermatologists. The dermatologists consulted classified the global severity of acne patients without any standard and then counted the numbers of eruptions. Three independent expert dermatologists graded the photographs of these patients. We compared the verdicts of the consulted dermatologist and three experienced dermatologists, and analyzed the relationships between these classifications and numbers of eruptions. Our results showed that most of the dermatologists have similar latent recognitions of acne severity. We selected representative photographs as standards, which would contribute to making adjustments for judgments. Global classifications of dermatologists correlated with numbers of inflammatory eruptions (papules plus pustules), but did not with numbers of comedones. The appropriate divisions of inflammatory eruptions of half of the face to decide classifications were: 0–5, “mild”; 6–20, “moderate”; 21–50, “severe”; and more than 50, “very severe”.