bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic arsenic toxicity from Ayurvedic medicines
Authors: Khandpur Sujay , Malhotra Amit K. , Bhatia Vidhyut , Gupta Subandhu , Sharma Vinod K. , Mishra Rakesh , Arora Narendra K.
Published: May 2008

Background  Ayurvedic medicines are known to contain arsenic and concentrations up to toxic levels have been reported in certain formulations. However, clinical disease due to arsenic containing ayurvedic medicines has rarely been reported. We seek to highlight the existence of toxic levels of arsenic in certain ayurvedic preparations that can produce serious systemic manifestations.

Methods  An 11‐year‐old girl developed manifestations of arsenical keratosis (punctuate palmoplantar keratoderma and leucomelanoderma) and non‐cirrhotic portal hypertension, 6 months and 18 months respectively after intake of ayurvedic medications, prescribed for epilepsy. The eight ayurvedic preparations consumed by the patient and her serum levels were analyzed for arsenic content.

Results  Arsenic content of ayurvedic medicines ranged from 5 mg/L to 248 mg/L. The serum arsenic level was 202.20 µg/L (normal < 60 µg/L). Skin manifestations improved after the discontinuation of ayurvedic medications.

Conclusions  Ayurvedic medications should be consumed under strict guidance and supervision of qualified practitioners to prevent such catastrophies.
Ulcerative lichen planus of the sole: excellent response to topical tacrolimus
Authors: Al‐Khenaizan Sultan , Al Mubarak Luluah
Published: May 2008

Ulcerative lichen planus of the sole is a rare variant of lichen planus, characterized by chronic painful disabling ulceration of the soles. Despite many treatment modalities used to treat ulcerative lichen planus, it is still considered a resistant disease. We report a Saudi female patient with ulcerative lichen planus of the soles resistant to many systemic and topical agents. We used topical tacrolimus 0.1% ointment with excellent response and complete healing in a few weeks as well as good maintenance during a follow‐up period of more than 2 years.
Isolation and identification of stem cells from adult cashmere goat skin
Authors: Liu Yingchun , Zhou Huanmin , Gao Feng
Published: May 2008

Background  Continuously renewing epithelia are maintained by stem cells that slowly proliferate and remain in the tissues for life. It has been known for decades that mouse epithelial stem cells can be selected by adherence to specific integrins.

Methods  The adherence of cashmere goat epidermal cells to collagen type IV for 10 min was used to obtain enriched epidermal stem cells. The characteristics of the rapidly adherent epidermal cells were determined.

Results  The rapidly adherent epidermal cells exhibited the stem cell characteristics of immaturity, were quiescent, showed a high colony formation efficiency, and expressed candidate surface markers for epidermal stem cells (keratin 15, keratin 19, p63, CD34, and β1‐integrin).

Conclusions  The rapidly adherent epidermal cells represented the epidermal stem cell population.
Impact of pruritus on quality of life in sulfur mustard‐exposed Iranian veterans
Authors: Panahi Yunes , Davoudi Seyyed Masoud , Sadr Seyyed Bardia , Naghizadeh Mohammad Mehdi , Mohammadi‐Mofrad Mostafa
Published: May 2008

Background  Sulfur mustard, a chemical warfare agent, has various verified chronic effects on the skin. One of the foremost negative impacts of this agent is chronic pruritus, which plagues chemically injured veterans for life and can downgrade their quality of life.

Aim  To assess the association between the quality of life and pruritus severity in chemically injured veterans.

Methods  One hundred and twenty‐five consecutive chemically injured veterans suffering from pruritus were assessed via the Dermatology Life Quality Index (DLQI) and pruritus score. Pruritus scores less than 15, between 16 and 30, and more than 30 were considered as mild, moderate, and severe pruritus, respectively. Patients with different levels of pruritus were compared with respect to their DLQI and its subscores.

Results  All subjects were male with a mean age of 44.3 ± 8.0 years; 11.2% had mild, 35.2% moderate, and 53.6% severe itching. The DLQI median scores in the mild, moderate, and severe cases were 16, 20, and 21, respectively (P = 0.014). The DLQI subscores of symptoms and feelings (P = 0.015), personal relationships (P = 0.002), and daily activities (P = 0.036) were worst in patients with severe itching.

Conclusion  Chemically injured veterans suffering from severe itching have a significantly poorer quality of life than do patients with milder symptoms.
Epidemiologic and clinicomycologic profile of onychomycosis from north India
Authors: Sarma Smita , Capoor Malini R. , Deb Monorama , Ramesh V. , Aggarwal Pushpa
Published: May 2008

Background  Onychomycosis is an important public health problem because of the increase in immunosuppressive states. Large‐scale studies in India are scarce, and so the baseline incidence of onychomycosis is not firmly established.

Methods  Three hundred and two clinically suspected cases of onychomycosis were included in this study. Nail samples were collected for direct microscopic examination and culture. Clinical patterns and associated relevant factors were noted according to a predetermined protocol.

Results  The associated predisposing conditions included diabetes mellitus (3.9%) and systemic lupus erythematosus (2.3%). Distal and lateral subungual onychomycosis was the most common clinical pattern (62%), followed by total dystrophic onychomycosis (20.2%). The most common fungal isolates were dermatophytes (49.5%), followed by Candida spp. (40.4%) and nondermatophyte molds (10.1%). Of the dermatophytes, Trichophyton rubrum (47%) was the most common isolate, followed by Trichophyton tonsurans (20.4%). Of the Candida spp., Candida albicans was the most common (60%).

Conclusions  Until recently, yeasts and nondermatophyte molds were regarded as contaminants, but their emergence as a significant cause of onychomycosis in immunocompromised patients calls for mycologic diagnosis and antifungal susceptibility testing in onychomycosis. The recognition of the changing patterns of onychomycosis will aid in the therapeutic approach and the implementation of control measures.
The role of the armadillo and sooty mangabey monkey in human leprosy
Authors: Hamilton Heather K. , Levis William R. , Martiniuk Frank , Cabrera Aloys , Wolf John
Published: May 2008

Background  The armadillo was the first animal model of leprosy. Its role in the transmission of leprosy remains controversial. The sooty mangabey model of leprosy led to the discovery that rhesus monkeys were more susceptible to leprosy when coinfected with simian immunodeficiency virus (SIV), but that leprosy may play a protective role against acquired immunodeficiency syndrome (AIDS) mortality. Recently, molecular methods have been developed for leprosy and may help resolve the role of zoonoses in leprosy.

Observations  The recent identification of a case of leprosy in a native‐born American on the east coast of the USA and the identification of leprosy as an immunologic reconstitution inflammatory syndrome (IRIS) in human immunodeficiency virus (HIV)‐positive cases raise the question of what role zoonoses may play in leprosy.

Conclusions  Leprosy in armadillos and sooty mangabeys has been manipulated by human experimentation. In the case of the armadillo, further study, including molecular techniques, is required to elucidate the role of the armadillo as a zoonosis in human leprosy. Experimentation with the sooty mangabey led to the discovery of an interaction between SIV and leprosy in rhesus monkeys, and prompted the continued investigation of the relationship between HIV and leprosy.
Lymphocutaneous nocardiosis and cutaneous pheohyphomycosis in a liver transplant recipient
Authors: Parra Isabel Hidalgo , Galimberti Ricardo , Galimberti Gastón , Guanella Barbara , Kowalczuk Alicia
Published: May 2008

Background  Infections are the leading cause of morbidity and mortality in transplanted patients. The increasing number of immunocompromised patients has not only augmented infections by specific pathogens, but also by opportunistic microbial agents.

Methods  A mixed cutaneous infection caused by Nocardia brasiliensis and Exophiala jeanselmei is reported in a liver transplant patient.

Results  The cutaneous lesions were painful nodules which drained purulent material. They were located on the right lower limb, with lymphadenopathies in the groin.

Conclusions  The patient was treated with itraconazole (600 mg/day) plus trimethoprim (1600 mg/day)–sulfamethoxazole (320 mg/day) for 8 weeks, with complete remission of the lesions.
Characterization of sirolimus metabolites in pediatric solid organ transplant recipients
Authors: Filler Guido , Bendrick‐Peart Jamie , Strom Tobin , Zhang Yan Ling , Johnson Gillian , Christians Uwe
Published: May 2008

Abstract: Potential age‐dependent changes of sirolimus metabolite patterns in pediatric renal transplant recipients remain elusive. Thirteen pediatric solid organ transplant recipients (10 kidney, one combined liver–kidney, two liver, mean age 8.0 ± 5.0 yr) underwent a sirolimus pharmacokinetic profile in steady‐state with 10 samples drawn over 12 h post‐intake to calculate the AUC0–12 h. Concentrations of sirolimus and metabolite were quantified using a validated LC‐MS/MS assay and metabolite structures were identified directly in blood extracts using LC‐MS/iontrap. Average sirolimus AUC0–12 hwas 64.9 ± 29.7 ng h/mL. Median (range) AUC0–12 hfor each metabolite (ng h/mL) was: 12‐hydroxy‐sirolimus 7.6 (0.2–18.8), 46‐hydroxy sirolimus 3.1 (0.0–12.4), 24‐hydroxy sirolimus 4.3 (0.0–12.6), piperidine‐hydroxy sirolimus 3.5 (0.0–8.3), 39‐O‐desmethyl sirolimus 3.6 (0.0–11.3), 16‐O‐desmethyl sirolimus 5.0 (0.1–9.9), and di‐hydroxy sirolimus 4.3 (0.0–32.5). The metabolites reached a median total AUC0–12 hof 60% of that of sirolimus. The range was 2.6–136%, indicating significant variability. In all, 77.5% of the metabolites were hydroxylated, while 39‐O‐desmethyl sirolimus accounted for only 8.4% of the AUC0–12 h. This is clinically relevant as 39‐O‐desmethyl sirolimus shows 86–127% cross‐reactivity with the antibody of the widely used Abbott sirolimus immunoassay. The metabolism of sirolimus in the children included in our study differed from that reported in adults, which should be considered when monitoring sirolimus exposure immunologically.
Daclizumab therapy for children with corticosteroid‐resistant acute graft‐vs.‐host disease
Authors: Schechter Tal , Afzal Samina , Finkelstein Yaron , Koren Gideon , Doyle John , Dupuis L. Lee
Published: May 2008

Abstract:  MAbs such as daclizumab have shown promising results in the treatment of corticosteroid‐resistant aGVHD. Data describing the efficacy of MAbs in children are limited. We describe the efficacy of daclizumab in children with corticosteroid‐resistant aGVHD. Seventeen children (0.4–16.2 yr) received daclizumab for aGVHD. Safety was evaluated in all 17. Response was evaluated in the 15 children who received a full course of daclizumab. A PR was defined as improvement of aGVHD symptoms in at least one organ without worsening in other organs. We observed an overall response rate (CR plus PR) of 40% (6/15). Four children had a CR and two had a PR. aGVHD involving the gut had the highest response rate (five of 10; 50%). Adverse effects attributed to daclizumab were limited to an episode of reactive arthritis. Mortality was high (47%; eight of 17) though five of the six responders to daclizumab survived. The mean length of follow‐up in the surviving nine patients was 32 months (range seven to 48). We conclude that daclizumab is effective in the treatment of children with corticosteroid‐resistant aGVHD, especially in patients with gut involvement.
Macroscopic and Microscopic Anatomy of the Oviduct in the Sexually Mature Rhea (Rhea americana)
Authors: Parizzi R. C. , Santos J. M. , Oliveira M. F. , Maia M. O. , Sousa J. A. , Miglino M. A. , Santos T. C.
Published: May 2008

The morphological characteristics of the oviduct of 12 sexually mature rheas (Rhea americana) were studied. Only the left oviduct is developed as a long tube with a length of 122 ± 23.1 cm, and is subdivided into infundibulum (15.2 ± 4.0 cm), magnum (63.3 ± 9.4 cm), isthmus (5.6 ± 3.1 cm), uterus (16.0 ± 4.2 cm) and vagina (11.5 ± 1.4 cm). The mucous membrane of the oviduct, as a whole, possesses luminal folds covered by ciliated columnar epithelium with secretory cells. The infundibulum part presents a cranial opening with thin and long fimbriae with few tubular glands in caudal tubular portion. In the magnum, the largest portion of the oviduct, the folds are thicker and are filled with tubular glands. The isthmus is short and presents less bulky folds and a few tubular glands. A bag‐shaped uterus in the cranial area shows thin folds, and in the caudal region (shell gland) more ramified folds with few tubular glands. The vagina has long luminal folds and a thick muscular tunic; no glands with sperm‐storage characteristics have been observed. In conclusion, the oviduct in sexually mature rhea has morphological similarities with the other species of birds already described; however it presents its own characteristics to produce a big egg.
Sustained Release Carriers Used to Delivery Bone Morphogenetic Proteins in the Bone Healing Process
Authors: Issa J. P. M. , Bentley M. V. L. B. , Iyomasa M. M. , Sebald W. , De Albuquerque R. F.
Published: May 2008

Bone morphogenetic proteins (BMPs) are multi‐functional growth factors belonging to the transforming growth factor β superfamily, especially BMP‐2, induce bone formation in vivo, and clinical application in repair of bone fractures and defects is expected. However, appropriate systems to delivery BMPs for practical use need to be developed with the objective to heal cartilage and bone‐related diseases in medical, dental and veterinary practice. Thus, the aim of this article was to present an overview of the principals carriers used to delivery BMPs and alternative delivery systems for these proteins.
Immunohistochemical Localization of Haptoglobin in Porcine Lungs
Authors: Hiss S. , Schulze Willbrenning G. , Suntz M. , Reinacher M. , Sauerwein H.
Published: May 2008

The extravasation of erythrocytes into the lower respiratory tract occurs in numerous lung injuries and may lead to oxidative damages in lung tissues. Haptoglobin (Hp), the major haemoglobin‐binding protein, is known to reduce lung injury associated with exposure to blood in mice. In pigs, Hp is a major acute phase protein and its serum concentrations are elevated in various infections of the respiratory tract. However, information on the porcine Hp response towards inflammatory stimuli is restricted to blood. We herein investigated the presence of Hp in lung tissues from pigs with acute and chronic bronchopneumonia via immunohistochemistry. Hp was localized in airway epithelial cells and immigrated leucocytes whereas in alveolar epithelial cells there was no distinct signal. Unaltered lungs showed less Hp‐positive cells compared with lungs from pigs with acute or chronic bronchopneumonia.
Histological Evaluation of the Sheep’s Cervical Spine Segment 3/4 – A Histomorphological and Histomorphometrical Study
Authors: Koch C. , Kandziora F. , Huenigen H. , Plendl J.
Published: May 2008

The 2‐year‐old sheep is a frequently used model in spinal orthopaedic research; however, so far no investigations have been performed on physiological tissue of untreated animals. In this study, the cervical spine segment 3/4 of eight 2‐year‐old female Merino sheep was evaluated histologically and histomorphometrically. Specimens were stained with Masson‐Goldner‐Trichrome, Safranin‐Orange/Lightgreen, Safranin‐Orange/von Kossa and Astrablue. Analysis of bone mass, mass of cartilage and mineralized cartilage in a defined region of interest was performed. A new finding of the study was that – although 2‐year‐old sheep is regarded as adult – tissue of the growth plate was still detected. Moreover, this study revealed that in the nucleus pulposus of the 2‐year‐old sheep notochordal cells are still existent, suggesting a complex remodelling of the nucleus pulposus in sheep.
Aberrant MAD2 expression in soft‐tissue sarcoma
Authors: Hisaoka Masanori , Matsuyama Atsuji , Hashimoto Hiroshi
Published: May 2008

Soft‐tissue sarcomas can be divided into translocation‐associated (TA) and non‐TA sarcomas, the latter of which is often characterized by pleomorphic cytomorphology and aneuploidy. The aberrant expression of MAD2, an essential component of the mitotic spindle checkpoint, has been recently shown to promote aneuploidy. The aim of the present paper was to assess MAD2 status on immunohistochemistry in 50 TA sarcomas with known fusion genes and 50 non‐TA pleomorphic sarcomas. MAD2 was overexpressed in 26 TA (52%) and 33 non‐TA sarcomas (66%). Notably, the MAD2 overexpression was frequently detected in TA sarcomas with atypical or high‐grade morphology, such as round cell liposarcoma and fibrosarcomatous dermatofibrosarcoma protuberans. The MAD2 overexpression was significantly frequent in non‐TA sarcomas compared with TA tumors without such atypical or high grade morphology (P = 0.012). In addition, sarcomas with MAD2 overexpression were significantly rich in abnormal mitotic figures, including multipolar mitoses and anaphase bridges, compared to MAD2‐negative tumors (P = 0.003), although the overall mitotic activity was equivalent between the sarcomas with or without the MAD2 overexpression. These data suggest that the aberrant MAD2 expression is potentially associated with pleomorphic morphology and abnormal mitosis in soft‐tissue sarcomas, as well as with high‐grade tumor progression in its TA subset.
Downregulation of Krüppel‐like factor 9 in human colorectal cancer
Authors: Kang Ling , Lü Bingjian , Xu Jing , Hu Hu , Lai Maode
Published: May 2008

Mammalian Sp and Krüppel‐like factors (KLF), a family of zinc finger‐containing transcription factors, are involved in growth control, proliferation, apoptosis and angiogenesis of a wide variety of tissues and cells. Several KLF have been linked to various types of human cancers, but the relationship between Krüppel‐like factor 9 (KLF9) and colorectal cancer has not been explored. The purpose of the present study was to investigate KLF9 expression in human colorectal cancer tissue. KLF9 mRNA was detected on quantitative real‐time reverse transcriptase–polymerase chain reaction (Q‐PCR). Of the 50 cancerous tissues examined, 86% (43/50) expressed lower levels of KLF9 mRNA than individually matched normal mucosa (P < 0.0001). On western blot, reduced or absent expression of KLF9 protein was observed in 65% (13/20) of the samples (P < 0.01). A total of 81% (35/43) of normal samples had expression of KLF9 protein, whereas its protein was detected in only 9% (4/43) of tumor tissues (P < 0.001) on tissue microarray. These results indicate that KLF9 may be involved in the carcinogenesis of human colorectal cancer.
Characterization of myelodysplastic syndrome and aplastic anemia by immunostaining of p53 and hemoglobin F and karyotype analysis: Differential diagnosis between refractory anemia and aplastic anemia
Authors: Iwasaki Takashi , Murakami Masashi , Sugisaki Chiho , Sobue Sayaka , Ohashi Haruhiko , Asano Haruhiko , Suzuki Motoshi , Nakamura Shigeo , Ito Masafumi , Murate Takashi
Published: May 2008

P53 mutation has been reported in various solid tumors, acute leukemia and myelodysplastic syndrome (MDS), but the diagnostic significance of p53 in MDS remains to be determined. The purpose of the present paper was to examine p53 mutation and immunostaining of the same patients, because there have been few reports of simultaneous analysis of these markers. Seven p53 mutations were observed among 37 MDS and 11 cases of overt leukemia transformed from MDS (MDS‐OL). Mutated p53 mainly observed in high‐risk MDS had more intense p53 staining than in MDS with wild‐type p53 overexpression. Aplastic anemia (AA) produced no p53 staining. The percentage of p53 staining in MDS (71%) was higher than that of mutated p53 (11%) but did not reach 100% of MDS cases studied, therefore the authors attempted to differentiate MDS, especially refractory anemia (RA) and AA, using a combination of p53 immunostaining, hemoglobin F (HbF) immunostaining and chromosome abnormality, because HbF of erythroblasts was reportedly observed in MDS RA but not in AA. Most MDS/MDS‐OL (47/48) had at least one positive marker. Among 11 AA cases, only two were positive for HbF. The present results suggest that the combination of these three markers is useful to discriminate MDS from AA.
New rat model induced by anti‐glomerular basement membrane antibody shows severe glomerular adhesion in early stage and quickly progresses to end‐stage renal failure
Authors: Nakano Yoshimasa , Hirano Takahiro , Uehara Kenji , Nishibayashi Seiji , Hattori Katsuji , Aihara Miki , Yamada Yoshihisa
Published: May 2008

The aim of the present study was to introduce a new anti‐glomerular basement membrane nephritis model in which plasma creatinine levels dramatically increased only 4 weeks after a single administration of rabbit antirat glomerular basement membrane antibody in Sprague–Dawley rats. According to renal morphology, glomerular lesions characterized by mesangial expansion and adhesion of the glomerular tuft to Bowman's capsule were observed in the early stage at day 7 after disease induction; adhesion was detected in approximately 90% of glomeruli 14 days after antibody injection. After 21 days the rats exhibited pronounced glomerulosclerosis/hyalinosis and severe tubulointerstitial lesions characterized by interstitial fibrosis. Urinary podocytes excreted in nephritis rats were studied and it was found that urinary podocyte loss might be closely related to progression of renal injury. Because this new model simply and reproducibly demonstrates development of end‐stage renal disease, it will be beneficial for elucidating mechanisms by which chronic renal injury irreversibly progresses, as well as for developing therapeutic agents for chronic renal failure.
Immunohistochemistry of gliosarcoma with liposarcomatous differentiation
Authors: Fukuda Takeaki , Yasumichi Kasuya , Suzuki Toshimitsu
Published: May 2008

A case of gliosarcoma composed of glioblastoma and liposarcoma is presented. A 70‐year‐old Japanese man was admitted to hospital because of dysarthria and aphasia. Magnetic resonance imaging indicated a brain tumor located in the temporal–parietal area of the left hemisphere. He rejected any therapy and died of respiratory failure. At autopsy the tumor was well‐demarcated with firm consistency and myxoid appearance, accompanied by necrosis and hemorrhage. Microscopically the tumor consisted of both glial and sarcomatous components, compatible with a gliosarcoma. Lipoblast‐like tumor cells were identified in the sarcomatous area. Glial component was observed in the periphery and was diffusely positive for CD56 and S100 protein and focally for glial fibrillary acidic protein. Only a small number of tumor cells in the sarcomatous area expressed neurogenic markers. Lipoblast‐like tumor cells were positive for S100 protein but negative for any other neurogenic markers. A significant number of tumor cells were positive for retinoblastoma protein (pRB) in the glial area, whereas only a few of them were positive in the sarcomatous area, indicating alteration of pRB in sarcomatous component. The present tumor is a rare gliosarcoma with liposarcomatous differentiation; alteration of pRB may play a role in sarcomatous transformation of glial component.
One hundred times the intended dose of caudal clonidine in three pediatric patients
Authors: MEYER CARI , CAMBRAY RACHEL
Published: May 2008

We report three sequential cases in which children received 100 times the intended dose of clonidine in their single shot caudals. Although all experienced excessive somnolence for up to 24 h, none had respiratory depression, oxygen desaturation, supplemental oxygen requirement, or hemodynamic instability. These cases suggest a large margin of safety exists for caudally administered clonidine in healthy children.
Dose–response study of intrathecal fentanyl added to bupivacaine in infants undergoing lower abdominal and urologic surgery
Authors: BATRA YATINDRA KUMAR , LOKESH VANAJAKSHI C. , PANDA NIDHI BIDYUT , RAJEEV SUBRAMANYAM , RAO KATRAGADDA L.N.
Published: May 2008

Background:  Intrathecal (IT) adjuncts often are used to enhance the duration of spinal bupivacaine. Fentanyl is a spinal analgesic that could be a useful adjunct, and enhances the duration and quality of sensory block in adult surgical and obstetric population. However, no data exist to assess the dose–response characteristics of IT fentanyl when added to bupivacaine in infants.

Methods:  Fifty‐eight infants undergoing lower abdominal and urologic procedures were randomized into four groups to receive plain 0.5% hyperbaric bupivacaine F0 (<5 kg = 0.5 mg·kg−1; 5–10 kg = 0.4 mg·kg−1). Groups F0.25, F0.5, and F1 groups received bupivacaine added with 0.25, 0.5, and 1 μg·kg−1 of fentanyl, respectively. Duration of spinal anesthesia (SA) as assessed by the recovery of hip flexion in the postoperative period was the primary variable analyzed. In addition, the duration of analgesia in the postoperative period, rescue postoperative analgesic requirements and hemodynamic changes were recorded.

Results:  Fifty‐six infants were studied. The four groups were similar for age, weight, duration of surgery, onset of sensory, motor block, and the highest level of analgesia attained. The addition of 1 μg·kg−1 fentanyl (F1) significantly increased the duration of SA (74.27 ± 6.1 min) compared to the control group (51.21 ± 5.2 min) (P = 0.001). Postoperative pain‐free interval was prolonged (P = 0.004) and significantly less rescue analgesics were required after 1 μg·kg−1 IT fentanyl (P = 0.032). These parameters did not show any significant difference among groups F0, F0.25, and F0.5.

Conclusions:  The addition of 1 μg·kg−1 IT fentanyl to spinal bupivacaine prolonged the duration of spinal block in infants undergoing lower abdominal and urologic procedures.
Effect of sitagliptin, a dipeptidyl peptidase‐4 inhibitor, on beta‐cell function in patients with type 2 diabetes: a model‐based approach
Authors: Xu L. , Man C. Dalla , Charbonnel B. , Meninger G. , Davies M. J. , Williams‐Herman D. , Cobelli C. , Stein P. P.
Published: May 2008

Purpose:  The purpose of this exploratory analysis was to assess the effect of sitagliptin, a dipeptidyl peptidase‐4 inhibitor, on pancreatic beta‐cell function using a model‐based analysis.

Methods:  Data for this analysis were from three large, placebo‐controlled clinical studies that examined sitagliptin 100 mg q.d. as add‐on to metformin therapy or as monotherapy over 18 or 24 weeks. In these studies, subsets of patients consented to undergo extensive blood sampling as part of a nine‐point meal tolerance test performed at baseline and study end‐point. Blood samples were collected at −10, 0, 10, 20, 30, 60, 90, 120 and 180 min relative to the start of a meal and subsequently were assayed for plasma glucose and serum C‐peptide concentrations. Parameters for beta‐cell function were calculated using the C‐peptide minimal model, which estimates insulin secretion rate (ISR) and partitions the ISR into basal (Φb; ISR at basal glucose concentrations), static (Φs; ISR at above basal glucose concentrations following a meal) and dynamic (Φd; ISR in response to the rate of increase in above basal glucose concentrations following a meal) components. The total responsivity index (Φtotal; average ISR over the average glucose concentration) is calculated as a function of Φs, Φd and Φb. Insulin sensitivity was assessed with a validated composite index (ISI). Disposition indices (DI), which assess insulin secretion in the context of changes in insulin sensitivity, were calculated as the product of Φand ISI.

Results:  When administered in combination with ongoing metformin therapy or as monotherapy, sitagliptin was associated with substantial reductions in postprandial glycaemic excursion following a meal challenge relative to placebo. Sitagliptin produced significant (p < 0.05 vs. placebo) improvements in Φs and Φtotal, regardless of treatment regimen (add‐on to metformin or as monotherapy). For Φd, there was a numerical, but not statistically significant, improvement with sitagliptin relative to placebo. Treatment with sitagliptin increased Φb, but the difference relative to placebo was only significant with monotherapy. ISI was not significantly different between sitagliptin and placebo. The DIs for the static, dynamic and total measures were significantly (p < 0.05) increased with sitagliptin treatment relative to placebo.

Conclusions:  In this model‐based analysis, sitagliptin improved beta‐cell function relative to placebo in both fasting and postprandial states in patients with type 2 diabetes.
Association of lower urinary tract symptoms and chronic ischaemia of the lower urinary tract in elderly women and men: assessment using colour Doppler ultrasonography
Authors: Pinggera Germar‐Michael , Mitterberger Michael , Steiner Eberhard , Pallwein Leo , Frauscher Ferdinand , Aigner Friedrich , Bartsch Georg , Strasser Hannes
Published: May 2008

OBJECTIVES

To investigate, using transrectal colour Doppler ultrasonography, (TRCDUS) whether perfusion of the bladder and prostate is reduced in elderly patients with lower urinary tract symptoms (LUTS), common in later life, as experimental data suggest that chronic ischaemia has a key role in the development of LUTS.

PATIENTS, SUBJECTS AND METHODS

In 32 elderly patients with LUTS (12 women, mean age 82.3 years, group 1; and 20 men, 79.4 years, group 2) perfusion of the bladder neck (in women) and of the bladder neck and prostate (in men) was measured using TRCDUS and the resistive index (RI) and colour pixel density (CPD) determined, assessed by a TRUS unit and special software. To assess the age‐related effect two control groups of 10 young healthy women (mean age 42.3 years, group 3) and 10 age‐matched healthy men (mean age 41.5 years, group 4) were also enrolled.

RESULTS

Irrespective of gender, there was markedly lower bladder perfusion in elderly patients with LUTS than in the younger subjects. The mean (sd) RI of the bladder neck in group 1, of 0.88 (0.06), and group 2, of 0.80 (0.08), was higher than in control groups 3, of 0.62 (0.05), and group 4, of 0.64 (0.09). The results were similar for the CPD measurements. The frequency of daily and nightly micturition showed a strong negative correlation with perfusion in the urinary bladder.

CONCLUSION

In elderly patients with LUTS there was decreased perfusion of the bladder neck and prostate when assessed using TRCDUS. Therefore, decreased perfusion in the urinary bladder might be responsible for the development of LUTS with advancing age.
Is there a relationship between prostate volume and Gleason score?
Authors: Mir Maria Carmen , Planas Jacques , Raventos Carles Xavier , De Torres Ines Maria , Trilla Enrique , Cecchini Lluis , Orsola Anna , Morote Juan
Published: May 2008

OBJECTIVES

To review the relationship between the Gleason grade and prostate volume in biopsy and radical prostatectomy (RP) specimens, and thus assess the hypothesis that smaller prostates have a greater incidence of high‐grade tumours.

PATIENTS AND METHODS

We selected 390 patients who had RP at our institution, with a prostate‐specific antigen (PSA) level of <10 ng/mL and who had not had hormonal therapy. We retrospectively reviewed the data for transrectal ultrasonography (TRUS)‐guided prostate biopsies from these patients and the RP specimens. Indications for biopsy included a PSA level of ≥4 ng/mL or an abnormal digital rectal examination. High‐grade tumours were defined as having a Gleason score of ≥7.

RESULTS

The TRUS volume was statistically related to the rate of high‐grade tumours at biopsy and RP. On multivariate analyses, TRUS volume was a significant predictor of high‐grade tumour for biopsy and RP specimens, with an inverse relationship between high‐grade tumours and prostate volume for biopsy and RP specimens.

CONCLUSIONS

Our data suggest that there is a relationship between the rate of high‐grade tumours and prostate volume even in biopsy and RP specimens and it is not an artefact related to the biopsy.
Microarray gene‐expression profiling to predict lymph node metastasis in penile carcinoma
Authors: Kroon Bin K. , Leijte Joost A.P. , Van Boven Hester , Wessels Lodewijk F.A. , Velds Arno , Horenblas Simon , Van’t Veer Laura J.
Published: May 2008

OBJECTIVE

To determine the value of gene‐expression profiling as a predictor of the status of the regional nodes in patients with penile carcinoma.

PATIENTS AND METHODS

Tumour samples of 56 patients with penile squamous cell carcinoma were analysed for the gene expression on 35 k oligoarrays; 32 were from patients with histopathologically confirmed lymph node metastases and 24 from those with no lymph node involvement. The 56 patients were divided into a training and validation set. For the training set, 15 patients with histopathologically confirmed nodal metastases and 15 without were selected. The validation set consisted of the remaining 26 patients, containing 17 node‐positive and nine with no nodal metastases.

RESULTS

A 44‐probe classifier had the best performance within the training set; this classifier correctly assigned 29 of 30 specimens in the training set to the two outcome groups. In the validation set of 26 tumours, the classifier correctly assigned 14 of the 26 (54%) specimens to the two outcome groups. Of the 17 specimens with histologically confirmed nodal involvement, 12 were classified as node‐positive and five as node‐negative, resulting in a sensitivity of 71%. Of the nine specimens from node‐negative patients, two were correctly classified as node‐negative and seven as node positive, resulting in a specificity of 22%.

CONCLUSIONS

In this series, gene expression profiling did not produce a useful classifier to predict nodal involvement in patients with penile carcinoma.
Why a combined intracavernosal injection with trimix and oral sildenafil is reliable therapy in the ultrasonographic evaluation of erectile dysfunction
Authors: Park Jong Kwan , Park Jung Sun , Jeon Sang Bong , Cui Wan Shou , Kim Sung Zoo , Kang Kyung Koo , Lee Sung Won
Published: May 2008

OBJECTIVE

To evaluate prospectively and compare the clinical response and the change in nucleotides correlating with haemodynamic changes in the cavernosal arteries after an intracavernosal injection (ICI) with vasoactive agents with or without oral sildenafil in men with erectile dysfunction (ED).

PATIENTS AND METHODS

In all, 80 patients with ED were prospectively evaluated by clinical assessments, measuring nucleotides in blood plasma and haemodynamics in cavernosal arteries. All patients had colour Doppler ultrasonography (CDU) twice with an interval of 5 h. First, each patient had CDU after ICI with trimix (0.25 mL) or prostaglandin E1 (PGE1, 5 µg), and the second CDU was after ICI trimix given 1 h after oral placebo (group I), sildenafil 25 mg (group II) or 100 mg (group III) and after ICI with PGE1 at 1 h after oral placebo (group IV) or 100 mg sildenafil (group V). Levels of cGMP and cAMP in peripheral venous and penile cavernosal blood plasma were measured at 15 min after ICI.

RESULTS

The mean peak systolic velocity (PSV) at 5, 10, 15 min, and resistive index at 10 min in the second CDU after ICI with trimix, were significantly increased in group III. The mean (sem) levels of cavernosal cGMP were significantly increased in group III and V, from 1130.1 (313.5) to 2056.7 (580.4) and 1017.0 (214.2) to 1905.2 (915.0) fmol/mL, respectively. cAMP was significantly increased in group V, from 9533.1 (2068.4) to 12150 (3684.2) fmol/mL.

CONCLUSIONS

The haemodynamic changes and cGMP and cAMP production in the cavernosum were improved by trimix plus sildenafil more than with than PGE1 plus sildenafil or one ICI with trimix or PGE1. The results suggest that ICI with trimix and sildenafil is the best combination for a pharmacological erection test.
Narcissistic Subtypes and Contingent Self‐Esteem: Do All Narcissists Base Their Self‐Esteem on the Same Domains?
Authors: Zeigler‐Hill Virgil , Clark C. Brendan , Pickard Jessica D.
Published: May 2008

ABSTRACTIt has been suggested that there are two forms of narcissism: agrandiosesubtype and avulnerablesubtype. Although these forms of narcissism share certain similarities, it is believed that these subtypes may differ in the domains upon which their self‐esteem is based. To explore this possibility, the present study examined the associations between these narcissistic subtypes and domain‐specific contingencies of self‐worth. The results show that vulnerable narcissism was positively associated with contingencies of self‐worth across a variety of domains. In contrast, the associations between grandiose narcissism and domain‐specific contingencies of self‐worth were more complex and included both positive and negative relationships. These results provide additional support for the distinction between grandiose and vulnerable narcissism by showing that the domains of contingent self‐esteem associated with grandiose narcissism may be more limited in scope than those associated with vulnerable narcissism.
Property Rights and Natural Resource Management Incentives: Do Transferability and Formality Matter?
Authors: Omura Makiko
Published: May 2008

This article examines how property rights expectations affect resource management incentives. It utilizes expected property rights over different timespans and of different strengths, corresponding to (a) investments of different intensities and (b) farmers' sense of security regarding their often de facto property rights. The results suggest that property rights and their alienability in ten‐year time matter to intensive infrastructural investments, although not to lighter investments. Formality of property rights is shown to be insignificant to investment incentives, indicating that there is no functional difference between formal rights and customary rights at present in indigenous communities of the Philippines.
Spatio‐Temporal Modeling of Agricultural Yield Data with an Application to Pricing Crop Insurance Contracts
Authors: Ozaki Vitor A. , Ghosh Sujit K. , Goodwin Barry K. , Shirota Ricardo
Published: May 2008

This article presents a statistical model of agricultural yield data based on a set of hierarchical Bayesian models that allows joint modeling of temporal and spatial autocorrelation. This method captures a comprehensive range of the various uncertainties involved in predicting crop insurance premium rates as opposed to the more traditional ad hoc, two‐stage methods that are typically based on independent estimation and prediction. A panel data set of county‐average yield data was analyzed for 290 counties in the State of Paraná (Brazil) for the period of 1990 through 2002. Posterior predictive criteria are used to evaluate different model specifications. This article provides substantial improvements in the statistical and actuarial methods often applied to the calculation of insurance premium rates. These improvements are especially relevant to situations where data are limited.
The Value of Variable Rate Technology: An Information‐Theoretic Approach
Authors: Bullock David S. , Ruffo Matías L. , Bullock Donald G. , Bollero Germán A.
Published: May 2008

We present a theoretical treatment of the economics of variable rate technology and its interplay with information. The framework facilitates description of on‐farm empirical profitability studies of variable rate nitrogen application on Illinois cornfields. We estimate site‐specific ex ante economically optimal nitrogen application rates, and the value of site‐specific information in the management of variable rate technology. We find that with site‐specific information provided free, variable rate nitrogen application would have been profitable in six of eight fields. Because private markets are unlikely to provide such information sufficiently, more public funding of long‐term, multiregion, multiyear experimentation is appropriate.
Removing Distortions in the U.S. Ethanol Market: What Does It Imply for the United States and Brazil?
Authors: Elobeid Amani , Tokgoz Simla
Published: May 2008

We analyze the impact of trade liberalization and removal of the federal tax credit in the United States on ethanol markets using a multimarket international ethanol model. We find that U.S. trade barriers have been effective in protecting the ethanol industry. Under current policy, there is separability of the U.S. ethanol market from world markets. With trade liberalization, the ethanol market deepens, making it less susceptible to price volatility. The effect of trade liberalization extends beyond ethanol markets, affecting agricultural markets. The results show that the impact of removal of the tax credit overrides the impact of the tariff removal.
The Demand for Food Quality in Rural China
Authors: Yu Xiaohua , Abler David
Published: May 2008

Many studies of food demand do not use actual prices but unit values, obtained by dividing expenditures by the quantity consumed. This can bias empirical analyses because unit values are not exogenous market prices; they reflect household food quality choices within each food category. This article develops a framework for assessing the resulting bias in income and price elasticities of demand and applies the framework to data for rural China. Empirical results indicate that households in rural China tend to consume higher‐quality food as income increases, with a greater sensitivity to income for basic foods than for luxury foods.
Semiparametric Inference for ROC Curves with Censoring
Authors: LIANG HUA , ZHOU YONG
Published: May 2008

Abstract.  Comparison of two samples can sometimes be conducted on the basis of analysis of receiver operating characteristic (ROC) curves. A variety of methods of point estimation and confidence intervals for ROC curves have been proposed and well studied. We develop smoothed empirical likelihood‐based confidence intervals for ROC curves when the samples are censored and generated from semiparametric models. The resulting empirical log‐likelihood function is shown to be asymptotically chi‐squared. Simulation studies illustrate that the proposed empirical likelihood confidence interval is advantageous over the normal approximation‐based confidence interval. A real data set is analysed using the proposed method.
Non‐parametric Estimation of a Survival Function with Two‐stage Design Studies
Authors: LI GANG , TSENG CHI‐HONG
Published: May 2008

Abstract. The two‐stage design is popular in epidemiology studies and clinical trials due to its cost effectiveness. Typically, the first stage sample contains cheaper and possibly biased information, while the second stage validation sample consists of a subset of subjects with accurate and complete information. In this paper, we study estimation of a survival function with right‐censored survival data from a two‐stage design. A non‐parametric estimator is derived by combining data from both stages. We also study its large sample properties and derive pointwise and simultaneous confidence intervals for the survival function. The proposed estimator effectively reduces the variance and finite‐sample bias of the Kaplan–Meier estimator solely based on the second stage validation sample. Finally, we apply our method to a real data set from a medical device postmarketing surveillance study.
Entering a New Peer Group in Ethnically and Linguistically Diverse Childcare Classrooms
Authors: Howes Carollee , Sanders Kay , Lee Linda
Published: May 2008

This short‐term longitudinal study examined changes over time in social competence with peers as a function of child and classroom characteristics. One hundred and seventy ethnically diverse low‐income children, all new to their peer groups, entered childcare classrooms with heterogeneous entry policies and ethnic/racial compositions. We observed them with their teachers and peers at entry and again six months later. Observers rated aggressive, anxious/withdrawn, and prosocial behavior with peers and observed complexity of peer play. Children who lacked peers with a shared ethnic heritage and children who spoke a different language at home than the language most often used in the classrooms appeared to be struggling with peer interaction six months after entry into the peer group. Children who had a peer who shared their ethnic heritage and entered the most ethnically diverse classrooms increased their complex peer play more than other children.
Effects of Group Norms on Children's Intentions to Bully
Authors: Nesdale Drew , Durkin Kevin , Maass Anne , Kiesner Jeff , Griffiths Judith A.
Published: May 2008

A minimal group study examined the effect of peer group norms on children's direct and indirect bullying intentions. Prior to an inter‐group drawing competition, children (N = 85) aged seven and nine years were assigned to a group that had a norm of out‐group dislike or out‐group liking. Results indicated that, regardless of group norms, the children's attitudes were more positive towards the in‐group vs. the out‐group. Children's bullying intentions were greater when the in‐group had a norm of out‐group dislike vs. out‐group liking, the children were younger rather than older, and the bullying was indirect vs. direct. A three‐way interaction showed that the in‐group norms had a larger effect on the younger children's direct rather than indirect bullying intentions, but a larger effect on the older children's indirect rather than direct bullying intentions. Implications for understanding school bullying intentions and behaviour are discussed.
Maternal Sensitivity Moderates the Relation between Negative Discipline and Aggression in Early Childhood
Authors: Alink Lenneke R. A. , Mesman Judi , Van Zeijl Jantien , Stolk Mirjam N. , Juffer Femmie , Bakermans‐Kranenburg Marian J. , Van IJzendoorn Marinus H. , Koot Hans M.
Published: May 2008

Three models regarding the relation between maternal (in)sensitivity, negative discipline, and child aggression were examined in a sample of 117 mother–child pairs with high scores on child externalizing behavior: (1) Sensitivity and discipline are uniquely related to child aggression (the additive model); (2) the relation between discipline and aggression is moderated by maternal sensitivity (the moderating model); (3) the relation between sensitivity and aggression is mediated by maternal discipline (the mediating model). Parenting and child aggression were observed when the children were on average 26.71 months old (range of 13.58 to 41.91 months) and again one year later. Results supported the moderating model. More negative discipline was related to more child aggression one year later, but only when mothers were insensitive. This finding supports the idea that the affective context is important for the impact of negative discipline on child development.