bluuebunny/crossref_metadata_2025 huggingface dataset:
PAX2 is reactivated in urinary tract obstruction and partially protects collecting duct cells from programmed cell death
Authors: Cohen Tiffany , Loutochin Oleg , Amin Moamen , Capolicchio John-Paul , Goodyer Paul , Jednak Roman
Published: December 2006

Obstruction of the urinary tract activates apoptotic pathways in collecting duct cells and leads to loss of renal parenchyma before surgical intervention. It has been suggested that developmental pathways may be reactivated to offset acute organ damage. One such molecule, PAX2, is expressed throughout the fetal collecting duct and was recently shown to suppress apoptosis during kidney development. We hypothesized that acute unilateral urinary tract obstruction (UUO) reactivates PAX2 expression in the mature kidney and partially suppresses apoptosis. If so, animals with PAX2 mutations should have increased susceptibility to parenchymal damage. Wild-type and heterozygous Pax2 mutant (C3H/ Pax21Neu) mice underwent unilateral ureteric ligation or sham operation at 6 wk of age; kidneys were examined after 5, 10, and 15 days. Whereas PAX2 protein levels fell to low levels in the first weeks of life, it was sharply reactivated by day 10 in collecting duct cells of wild-type but not in Pax21Neumutant mice with UUO. Wild-type mice with UUO had marked TUNEL and cleaved spectrin staining in tubular cells and reduced kidney weight after 10–15 days. Mutant mice had exaggerated increases in markers of apoptosis and exaggerated loss of renal parenchymal loss in the obstructed kidney. These observations suggest that PAX2 is rapidly reactivated in UUO and that mice with genetically limited PAX2 expression have heightened susceptibility to apoptosis.
Toxicant Exposure in Cigarette Reducers versus Light Smokers
Authors: Hatsukami Dorothy K. , Le Chap T. , Zhang Ying , Joseph Anne M. , Mooney Marc E. , Carmella Steven G. , Hecht Stephen S.
Published: December 2006

Background: The extent of exposure to tobacco toxicants in smokers who have reduced their cigarette intake compared with smokers who are light smokers is relatively unknown. The goal of this study is to investigate the occurrence of compensatory smoking in reducers compared with light smokers by measuring toxicant exposure.

Methods: Participants in two smoking reduction intervention studies (N = 64) were selected for comparison with a group of light smokers (N = 62) who smoked the same number of cigarettes as the reducers. A compensatory smoking score was defined (biomarker level for reducer/biomarker level for light smoker) and calculated for urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (total NNAL), metabolites of the tobacco-specific lung carcinogen 4-(methylnitrosamino)-I-(3-pyridyl)-1-butanone, to measure the degree of smoking compensation in reducers when compared with the light smokers.

Results: The mean level of creatinine-adjusted total NNAL for reducers was over twice that of light smokers even when they smoked about the same number of cigarettes per day. The difference of the mean total NNAL concentrations between light smokers and reducers was highly significant (P < 0.0001). Wide variability in total NNAL concentrations was also observed in reducers, with the extent of this variability between light smokers and reducers being significantly different (P = 0.0005). The level of individual reduction was shown to be a consistent predictor of compensatory smoking (r = 0.50; adjusted Ps = 0.002), with greater cigarette reduction associated with more compensation.

Conclusions: Compensatory smoking limits the harm reduction value of decreased smoking of cigarettes. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2355–8)
Mass Spectrometric Quantitation of Nicotine, Cotinine, and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol in Human Toenails
Authors: Stepanov Irina , Feuer Rachel , Jensen Joni , Hatsukami Dorothy , Hecht Stephen S.
Published: December 2006

Numerous studies have quantified total cotinine (the sum of cotinine and cotinine-N-glucuronide) and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL; the sum of NNAL and its O- and N-glucuronides (NNAL-Glucs)] in the urine and blood of smokers, smokeless tobacco users, and nonsmokers exposed to environmental tobacco smoke. Analysis of hair and nails has several advantages over blood and urine testing, such as accumulation of xenobiotics during long-term exposure, ease of collection, and indefinite stability of samples. We developed sensitive methods for quantitation of nicotine, cotinine, and NNAL in human toenails. Nicotine and cotinine were analyzed by gas chromatography-mass spectrometry-selected ion monitoring. NNAL was assayed using liquid chromatography-electrospray ionization-tandem mass spectrometry-selected reaction monitoring. The detection limits of the methods were 0.01 ng/mg toenail for nicotine, 0.012 ng/mg toenail for cotinine, and 0.02 pg/mg toenail for NNAL. In 35 smokers, the mean nicotine level was 5.9 ± 5.6 ng/mg toenail, mean cotinine was 1.6 ± 1.3 ng/mg toenail, and mean NNAL was 0.41 ± 0.67 pg/mg toenail. Samples collected from six nonsmokers were negative for NNAL. In smokers, NNAL correlated with cotinine (r = 0.77; P < 0.0001). The results of this study for the first time show the presence of cotinine and NNAL in human toenails. These sensitive and quantitative methods should be useful in epidemiologic studies of the role of chronic tobacco smoke exposure, including environmental tobacco smoke exposure, in human cancer. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2378–83)
Cancer Incidence and Mortality and Vitamin D in Black and White Male Health Professionals
Authors: Giovannucci Edward , Liu Yan , Willett Walter C.
Published: December 2006

Blacks have been documented to have low vitamin D levels. We thus examined whether total cancer incidence and mortality rates differ between Blacks and Whites in a population of male health professionals, and particularly for digestive system cancers (oral, esophagus, stomach, pancreas, and colorectum), which have been most consistently linked to poor vitamin D status. Second, we examined whether Blacks might be more susceptible to these cancers if they concurrently had other risk factors for hypovitaminosis D. In the Health Professionals Follow-up Study, from 1986 to 2002, 99 of 481 Black men and 7,019 of 43,468 White men were diagnosed with cancer. Adjusting for multiple dietary, lifestyle, and medical risk factors, using Cox modeling, Black men were at higher risk of total cancer incidence [relative risk (RR), 1.32; 95% confidence interval (95% CI), 1.08-1.61; P = 0.007] and total cancer mortality (RR, 1.89; 95% CI, 1.40-2.56; P < 0.0001) and especially digestive system cancer mortality (RR, 2.24; 95% CI, 1.35-3.70). Compared with Whites with relatively few risk factors for hypovitaminosis D, Blacks also with few risk factors for hypovitaminosis D were not at appreciably higher risk of total cancer incidence (RR, 0.95; 95% CI, 0.60-1.51) or mortality (RR, 1.55; 95% CI, 0.91-2.62), but Black men with additional risk factors for poorer vitamin D status had a much higher cancer incidence (RR, 1.57; 95% CI, 1.16-2.11) and mortality risk (RR, 2.27; 95% CI, 1.57-3.28). This pattern was even more pronounced for digestive system cancer. Our results suggest that the high frequency of hypovitaminosis D in Blacks may be an important, and easily modifiable, contributor to their higher risk of cancer incidence and mortality. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2467–72)
Usefulness of Body Mass Index as a Sufficient Adiposity Measurement for Sex Hormone Concentration Associations in Postmenopausal Women
Authors: Mahabir Somdat , Baer David J. , Johnson Laura L. , Hartman Terry J. , Dorgan Joanne F. , Campbell William S. , Clevidence Beverly A. , Taylor Philip R.
Published: December 2006

Background: Both obesity and sex hormones are known risk factors for postmenopausal breast cancer. Although adiposity and sex hormones have been studied in the past, previous reports in postmenopausal women have not been conducted under carefully controlled dietary conditions. In this study, we investigated the usefulness of body mass index (BMI) as a sufficient adiposity measurement to assess associations with sex hormone levels.

Methods: This study was conducted as a cross-sectional analysis within the control segment (0 g alcohol group) of a randomized, crossover design, in which 51 postmenopausal women consumed 0 (control), 15 (one drink), and 30 (two drinks) g alcohol (ethanol)/d for 8 weeks each as part of a controlled diet. Dual-energy X-ray absorptiometry scans were administered to the women during the control (0 g alcohol) segment, and a blood sample was drawn at the end of that diet period for hormone analysis.

Results: In multivariate analysis (adjusted for age, race, family history of breast cancer, parity, and menarche <12 years), women who were overweight or obese had significantly higher serum concentrations of estradiol, bioavailable estradiol, estrone, and estrone sulfate and lower sex hormone-binding globulin than normal weight women (all P < 0.05). In models adjusted for BMI and the covariates above, none of the dual-energy X-ray absorptiometry adiposity measures added further information (all P > 0.10) for these five analytes beyond that of BMI alone.

Conclusions: In this population of postmenopausal women, under carefully controlled dietary conditions, we confirmed previous findings that higher levels of adiposity were associated with higher concentrations of estrogens and lower sex hormone-binding globulin, and we found that the use of the epidemiology-friendly BMI seems sufficient to assess associations with these hormone levels. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2502–7)
Prostate Cancer Risk in Relation to Selected Genetic Polymorphisms in Insulin-like Growth Factor-I, Insulin-like Growth Factor Binding Protein-3, and Insulin-like Growth Factor-I Receptor
Authors: Chen Chu , Freeman Robert , Voigt Lynda F. , Fitzpatrick Annette , Plymate Stephen R. , Weiss Noel S.
Published: December 2006

We conducted a nested case-control study within a cohort of elderly Americans to examine the role of the insulin-like growth factor (IGF) signaling pathway in prostate cancer etiology. The distribution of genotypes of IGF-I (CA)n, IGF binding protein-3 (IGFBP-3) A-202C, and of the 2-bp deletion and (AGG)n polymorphisms in IGF-I receptor (IGF-IR) was compared between men with prostate cancer (n = 213) and equal number of controls matched on year of blood draw, survival until the date of diagnosis, race, and age. Among controls, the number of CA repeats in IGF-I was not correlated to any appreciable degree with plasma IGF-I concentration, whereas the IGFBP-3 CC genotype was associated with a relatively low level of plasma IGFBP-3. There was no association between prostate cancer risk and the number of CA repeats in IGF-I, IGFBP-3 genotype, or the presence of the 2-bp deletion in IGF-IR. There was a small increased risk among men who did not carry two copies of the (AGG)7 allele of IGF-IR. These results add to the evidence that the number of IGF-I CA repeats is not associated with prostate cancer risk. Our observation that men who do not carry two copies of the IGF-IR (AGG)7 allele are at increased risk of prostate cancer merits further investigation. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2461–6)
Obesity, High Energy Intake, Lack of Physical Activity, and the Risk of Kidney Cancer
Authors: Pan Sai Yi , DesMeules Marie , Morrison Howard , Wen Shi Wu ,   The Canadian Cancer Registries Epidemiology Research Group
Published: December 2006

The authors conducted a population-based case-control study of 810 cases with histologically confirmed incident kidney cancer and 3,106 controls to assess the effect of obesity, energy intake, and recreational physical activity on renal cell and non–renal cell cancer risk in Canada from 1994 to 1997. Compared with normal body mass index (BMI; 18.5 to <25.0 kg/m2), obesity (BMI, ≥30.0 kg/m2) was associated with multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95% CI) of 2.57 (2.02-3.28) for renal cell cancer and 2.79 (1.70-4.60) for non–renal cell cancer. The OR (95% CI) associated with the highest quartiles of calorie intake was 1.30 (1.02-1.66) for renal cell cancer and 1.53 (0.92-2.53) for non–renal cell cancer. Compared with the lowest quartile of total recreational physical activity, the highest quartile of total activity was associated with an OR (95% CI) of 1.00 (0.78-1.28) and 0.79 (0.46-1.36) for the two subtypes. There were no apparent differences between men and women about these associations. The influence of obesity and physical activity on the risk of renal cell and non–renal cell cancer did not change by age, whereas the effect of excess energy intake was stronger among older people. No significant effect modifications of physical activity on BMI among both genders and of energy intake on BMI among men were observed, with a synergic effect of obesity and high energy intake on renal cell cancer risk found among women. This study suggests that obesity and excess energy intake are important etiologic risk factors for renal cell and non–renal cell cancer. The role of physical activity needs further investigation. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2453–60)
A NAD(P)H:Quinone Oxidoreductase 1 Polymorphism Is a Risk Factor for Human Colon Cancer
Authors: Begleiter Asher , Hewitt Donna , Maksymiuk Andrew W. , Ross David A. , Bird Ranjana P.
Published: December 2006

Colon cancer is one of the most common cancers in North America and generally develops from colonic epithelial cells following initiation by carcinogens. We have shown that the phase II detoxifying enzyme, NAD(P)H:quinone oxidoreductase 1 (NQO1) contributes to the inhibition of carcinogen-induced colon cancer in rats at both the initiation and postinitiation stages. An inactivating polymorphism at base 609 of the NQO1 gene, 609C (NQO1 *1) → 609T (NQO1 *2), occurs at high frequency in the human population. Thus, we carried out a case-control study to determine if this polymorphism is associated with an increased risk of developing colon cancer. A total of 298 patients with colon cancer and 349 healthy controls matched for age, gender, and ethnic origin were enrolled in the study. There was an increased incidence of the NQO1 *2/*2 genotype in patients with colon cancer, with a gender and age-adjusted odds ratio of 2.68 (95% confidence intervals, 1.14-6.28). However, the incidence of the NQO1 *1/*2 genotype was not increased in patients with colon cancer compared with controls. When the patient and control groups were stratified by tobacco and alcohol use, the incidences of the NQO1 *2/*2 genotype were increased in patients with colon cancer for tobacco and alcohol users and nonusers, suggesting that there is no interaction between the NQO1 base 609 polymorphism and tobacco or alcohol use. These results strongly suggest that NQO1 plays a significant role in preventing the development of colon cancer, and individuals with an NQO1 *2/*2 genotype are at an increased risk of developing this disease. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2422–6)
Polymorphisms in the DNA Repair GenesXPC, XPD, andXPGand Risk of Cutaneous Melanoma: a Case-Control Analysis
Authors: Li Chunying , Hu Zhibin , Liu Zhensheng , Wang Li-E , Strom Sara S. , Gershenwald Jeffrey E. , Lee Jeffrey E. , Ross Merrick I. , Mansfield Paul F. , Cormier Janice N. , Prieto Victor G. , Duvic Madeleine , Grimm Elizabeth A. , Wei Qingyi
Published: December 2006

Sunlight causes DNA damage, including bulky lesions that are removed effectively by the nucleotide-excision repair (NER) pathway. There are at least eight core NER proteins participating in the pathway, and genetic variations in their genes may alter NER functions. We hypothesized that some NER variants are associated with risk of cutaneous melanoma. In a hospital-based case-control study of 602 non-Hispanic White patients with cutaneous melanoma and 603 age- and sex-matched cancer-free controls, we genotyped five common non-synonymous single-nucleotide polymorphisms identified to date and assessed their associations with risk of cutaneous melanoma. We found that a significantly increased risk of cutaneous melanoma was associated with XPD 751Lys/Gln [adjusted odds ratio (OR), 1.55 and 95% confidence interval (95% CI), 1.12-2.16] and XPD 751Gln/Gln (OR, 1.66; 95% CI, 1.03-2.68) genotypes compared with the XPD 751Lys/Lys genotype as well as XPD312Asp/Asn (OR, 1.54; 95% CI, 1.11-2.12) and XPD312Asn/Asn (OR, 1.75; 95% CI, 1.05-2.90) genotypes compared with the XPD 312Asp/Asp genotype. This increased risk was not observed in the other three XPC and XPG single-nucleotide polymorphisms. Moreover, the number of the observed XPD at-risk genotypes (i.e., 312Asn/Asn+Asn/Asp and 751Gln/Gln+Lys/Gln) was associated with cutaneous melanoma risk in a dose-response manner (OR, 1.47; 95% CI, 0.97-2.23 for one at-risk genotype; OR, 1.83; 95% CI, 1.29-2.61 for two at-risk genotypes; Ptrend < 0.001). However, we found no evidence of any interaction between XPD genotypes with XPC and XPG genotypes or the known risk factors. We concluded that genetic variants of the XPD gene might serve as biomarkers for susceptibility to cutaneous melanoma. (Cancer Epidemiol Biomarkers Prev 2006;15(12):2526–32)
Enhanced Flow Velocity after Stenting of Renal Arteries Is Associated with Decreased Renal Function
Authors: Girndt Matthias , Kaul Harald , Maute Carla , Kramann Bernhard , Köhler Hans , Uder Michael
Published: December 2006

Background: Atherosclerotic renal artery stenosis (RAS) is frequently treated by angioplasty and stent placement. Duplex sonography is an established noninvasive technique for patient follow-up. There is lack of evidence that routine monitoring of asymptomatic patients with stable blood pressure is needed. Methods: Renal duplex sonography was performed in 64 patients who had received percutaneous angioplasty and stenting of an atherosclerotic RAS. Duplex sonographic diagnosis was made by a combination of direct flow measurement in the renal artery and evaluation of intrarenal resistive indices. Renal function was determined by serum creatinine and calculated glomerular filtration rate (GFR). Results: With a mean follow-up of 28 months after angioplasty, a flow velocity of >2.0 m/s was detected within the stented arteries in 11/64 patients. While the initial blood pressure and GFR as well as the influence of angioplasty on these parameters were not different, the decrease in renal function over time was significantly higher in patients with flow enhancement (annual GFR decrease, 8.0 ml/min vs. 0.8 ml/min; p < 0.05). Conclusion: Follow-up duplex sonography in patients after renal artery stenting detected an unexpectedly high rate of in-stent restenosis associated with enhanced loss of renal function. Routine duplex sonographic follow-up may detect patients at risk of more rapidly declining renal function.
Prevalence of Anti-Erythropoietin Antibodies in Hemodialysis Patients without Clinical Signs of Pure Red Cell Aplasia
Authors: Stoffel Markus P. , Haverkamp Heinz , Kromminga Arno , Lauterbach Karl W. , Baldamus Conrad A.
Published: December 2006

Background/Aims: The prevalence of anti-erythropoietin antibodies in renal patients without clinical evidence of pure red cell aplasia (PRCA) who respond poorly to epoetin is unknown. This study tested for anti-erythropoietin antibodies in hemodialysis patients who were either hypo- or normoresponsive to epoetin treatment. Methods: Epoetin hyporesponsiveness (hemoglobin ≤10.5 g/dl and epoetin ≧9,000 IU/week) and normoresponsiveness (hemoglobin >10.5 g/dl and epoetin <7,000 IU/week) were arbitrarily defined. Prevalence of anti-erythropoietin antibodies in hemodialysis patients without symptoms of PRCA was determined by screening sera of 536 patients from 35 German KfH dialysis units, using enzyme-linked immunosorbent assay (ELISA). Positive results were verified by radioimmunoprecipitation assay (RIP) and neutralizing activity was determined by bioassay. Results: Anti-erythropoietin antibodies were detected in 3 hyporesponsive and 3 normoresponsive patients using ELISA. One patient per group was verified as borderline by RIP testing; the other 4 were negative. The bioassay was negative for 1 patient; the other died unrelated to PRCA before testing. Follow-up with RIP testing after 15 months under continuous epoetin treatment was negative (4 patients, 2 deceased). Conclusion: This survey did not identify anti-erythropoietin antibodies in hemodialysis patient’s hyporesponsive to epoetin and does not support presumptive antibody screening as a routine work-up in these patients.
The Short Prolactin Receptor Predominates in Endothelial Cells of Micro- and Macrovascular Origin
Authors: Ricken Albert M. , Traenkner Anja , Merkwitz Claudia , Hummitzsch Katja , Grosche Jens , Spanel-Borowski Katharina
Published: December 2006

Background: Controversial reports on prolactin receptors (PRL-R), the long and short form, on endothelial cells (EC) may be explained by the choice of EC derived from the micro- and macrovascular bed of either endocrine and non-endocrine organs. Methods: We studied here PRL-R expression in organs [bovine corpus luteum (CL), umbilical vein, aorta] and in organ-derived EC cultures. Results: In the intact CL, both PRL-R forms were present at mRNA and protein level throughout the oestrous cycle stages. The short form prevailed as protein. PRL-R-positive EC were noted by immunofluorescent staining in arterial blood vessels of CL septa, in the umbilical vein and the aorta. In EC cultures of micro- and macrovascular origin, transcripts of both PRL-R forms were shown; again the short-form protein prevailed. Blocking experiments with anti-prolactin (PRL) antibody led to a 60% decrease in cell growth. Treatment with PRL had no effect. Conclusion: PRL-R expression in micro- and macrovascular EC is associated with the predominant short form.
Postcholecystectomy Benign Biliary Strictures – Long-Term Results
Authors: Sikora S.S. , Pottakkat B. , Srikanth G. , Kumar A. , Saxena R. , Kapoor V.K.
Published: December 2006

Background: Cholecystectomy is the most frequently performed general surgical procedure. Bile duct injury is a dreaded complication and is associated with serious long-term morbidity. Patients and Methods: Three hundred patients with postcholecystectomy benign biliary strictures were managed from January 1989 to February 2004 at a tertiary care unit in northern India. Demographic data, clinical presentation, and immediate- and long-term results of surgical repair are analyzed from a prospective database. Results: The time from cholecystectomy (open, n = 262; laparoscopic, n = 38) to stricture repair ranged from 0.2 to 360 (median 7) months. Thirty-six patients (12%) had prior stricture repair. Bismuth classification of the bile duct strictures was 32 type I, 113 type II, 126 type III, 18 type IV, and 11 type V. Two hundred and ninety-two patients (97%) underwent repair by a Roux-en-Y hepaticojejunostomy. One hundred patients (33.3%) had postoperative morbidity following stricture repair. Four patients (1.3%) died during the postoperative period. Of the 149 patients with a minimum available follow-up period of 5 years (mean 9.5, median 9.4 years; range 5–15.4 years), 134 (90%) had an excellent outcome (grade A, n = 122; grade B, n = 12); only 8 patients (5.4%) had a poor outcome. Conclusion: Excellent long-term outcomes with minimal morbidity and mortality can be achieved in the subgroup of benign biliary strictures managed in dedicated units with meticulous attention to the central tenets of biliary surgery.
Clinicopathological Characteristics and Prognosis of Carcinoma of the Gastric Cardia
Authors: Kim Dong Yi , Joo Jae Kyoon , Ryu Seong Yeob , Park Young Kyu , Kim Young Jin , Kim Shin Kon
Published: December 2006

Objective: The prognosis of patients with carcinoma of the gastric cardia (CGC) is poorer than that of patients with distal third gastric carcinoma (DTGC). The main aim of this study is to investigate whether the tumor location is an important prognostic factor. Methods: 312 patients (8.1%) were diagnosed with CGC and reviewed retrospectively. Results: T1 stage tumors were less common in patients with CGC than in those with DTGC (p< 0.001). Lymph node invasion was more common in CGC patients than in DTGC patients (p< 0.01). Multivariate analysis showed that patient age, lymph node status, and resection with curative intent were significant prognostic factors for the survival of CGC patients. Of the patients who underwent tumor resection with curative intent, the 5-year survival rate of CGC patients was lower than that of DTGC patients (57.4 vs. 63.1%), but no significant difference was observed between the two groups (p> 0.05). When the CGC group was divided into patients who underwent resection with or without curative intent, the 5-year survival rates were 52.8 and 6.0%, respectively (p< 0.001). Conclusion: According to our results, curative resection itself, rather than tumor location, was the determining factor in improving 5-year survival.
Current Role of Portosystemic Shunt Surgery in the Management of Hepatic Venous Outflow Obstruction
Authors: Singhal Dinesh , de Castro Steve , Goyal Neerav , Gouma Dirk J. , Chaudhary A. , van Gulik Thomas M.
Published: December 2006

Background: Hepatic venous outflow obstruction (HVOO) is a rare disorder that occurs predominantly due to a hypercoagulable state. The syndrome may result from hepatic vein obstruction, inferior vena cava obstruction or a combination of both and manifests with post-sinusoidal portal hypertension. The presentation may be fulminant with poor prognosis or as either acute, subacute or chronic forms with relatively better prognosis. Portosystemic shunt surgery (PSS) has thus far been the mainstay of treatment for HVOO. However, over the last decade, transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation have emerged as viable options. This review aims to evaluate the available treatment options and the current relevance of PSS for the management of HVOO. Methods: A literature review on investigations and treatment was performed using Medline and additional library searches. Results: Portosystemic shunts form the mainstay of treatment for patients with subacute presentation (preserved liver function) with medically intractable ascites or recurrent variceal hemorrhage. Excellent results with 5-year survival of more than 90% have been reported from specialized centers. The main limitation for PSS is the reported perioperative mortality of 10–20% and a declining technical expertise for such surgery. Liver transplantation with disease-specific 5-year survival between 50 and 95% is presently the treatment of choice for patients with fulminant presentation, end-stage liver disease (ESLD), unshuntable anatomy or decompensation after PSS. TIPS may be preferable for sick patients with acute presentation with isolated hepatic vein thrombosis or as a temporizing measure for those with ESLD awaiting transplantation. The drawback of TIPS is late shunt dysfunction that occurs in more than 50% of patients at 1 year. Conclusions: Due to rarity of the disorder there is a lack of trials comparing the different treatment modalities. Hence, the current treatment recommendations are based on retrospective studies. In a select group of HVOO patients (subacute presentation with preserved liver function), PSS remains the treatment of choice with excellent long-term results.
Antireflux Contrivance in Jejunal Pouch Reconstruction after Total and Proximal Gastrectomies
Authors: Ichikura Takashi , Chochi Kentaro , Sugasawa Hidekazu , Mochizuki Hidetaka
Published: December 2006

Background/Aim: In the reconstruction after gastrectomy, a jejunal pouch may be inferior as a gastric substitute to an isoperistaltic jejunum in terms of preventing reflux. We have developed an antireflux contrivance. Methods:A jejunal pouch was made by side-to-side anastomosis of both limbs of the jejunum folded into an inverted U, leaving a bridge of the jejunum 15 cm long at the top of the jejunal pouch (apical bridge). The apical bridge is cut near its oral end, and esophagojejunostomy is done, leaving the isoperistaltic jejunum 6–8 cm long positioned between esophagus and jejunal pouch. Results:This antireflux contrivance was performed in 37 patients undergoing total gastrectomy and in 22 patients undergoing proximal gastrectomy. There were no operative deaths in this series. Neither anastomotic bleeding nor anastomotic leakage were observed. In a questionnaire survey, 5 patients answered that they had had heartburn twice a week or more often, but the answer was not repeated by any patient. On endoscopic examination, all patients but 1 had normal findings for the esophagus. Mild esophagitis was observed in 1 patient. Conclusion:The antireflux contrivance reported here can be easily, safely, and uniformly done, and it is a useful technique.
Effect of Berberine on Monocyte Chemotactic Protein-1 and Cytokine-Induced Neutrophil Chemoattractant-1 Expression in Rat Lipopolysaccharide-Induced Uveitis
Authors: Cui Hu-Shan , Hayasaka Seiji , Zheng Lian-Shun , Hayasaka Yoriko , Zhang Xue-Yun , Chi Zai-Long
Published: December 2006

Purpose: The aims of this study were to examine the in vivo effects of berberine, an alkaloid isolated from some medicinal herbs, on monocyte chemotactic protein-1 (MCP-1) and cytokine-induced neutrophil chemoattractant-1 (CINC-1) expression in rat lipopolysaccharide (LPS)-induced uveitis. Methods: LPS was injected intraperitoneally. Berberine was orally administered. MCP-1 mRNA and CINC-1 mRNA were measured by semiquantitative reverse-transcription polymerase chain reaction and real-time polymerase chain reaction. MCP-1 and CINC-1 protein concentration in the aqueous humor were measured by enzyme-linked immunosorbent assay. Histopathologic study was performed in the anterior ocular segments. Results: Berberine dose-dependently inhibited LPS-induced MCP-1 mRNA and CINC-1 mRNA expression of the iris-ciliary body. The alkaloid inhibited chemokines, protein and cell levels in the aqueous humor in rats stimulated with LPS. On histopathologic study, the inflammatory cell infiltration was diminished by the berberine treatment. Conclusions: These findings indicate that berberine dose-dependently inhibited the expression of MCP-1 and CINC-1 induced by LPS and diminished the anterior uveitis.
Effect of Lipid-Hydroperoxide-Induced Oxidative Stress on Vitamin E, Ascorbate and Glutathione in the Rabbit Retina
Authors: Kamegawa Maki , Nakanishi-Ueda Takako , Iwai Shinichi , Ueda Toshihiko , Kosuge Shotaro , Ogura Hirotsugu , Sasuga Keiko , Inagaki Masahiro , Watanabe Masanobu , Oguchi Katsuji , Yasuhara Hajime , Armstrong Donald , Koide Ryohei
Published: December 2006

Background: It is possible that oxidative stress causes several retinal diseases. However, the natural biogenic role of antioxidants in the retina is not clear. Purpose: This study investigates the change in concentration of vitamin E (VE), ascorbate and glutathione (GSH) in the retina following vitreous injection of 600 µg 18:2 linoleic acid hydroperoxide (LHP) in male New Zealand rabbits. Method: LHP was injected above the retinal surface. The animals were sacrificed and the eyes enucleated before LHP injection, 1, 3, 6, 12, 24 h and 4 and 7 days after LHP injection. Retinas were removed, VE and ascorbate measured by HPLC, and GSH determined by a fluorometric method. Results: The concentration of VE in the retina decreased from pretreatment levels of 154.6 ± 29.7 nmol/g wet weight (n = 7) and was lowest at 6 h (61.1 ± 18.1 nmol/g wet weight, n = 4, p < 0.05), then increased gradually, returning slowly to pre-LHP levels by 7 days. The concentration of ascorbate in control retinas decreased at 6 h from pretreatment levels of 7.33 ± 0.93 µmol/g wet weight (n = 7) to 2.74 ± 0.16 µmol/g wet weight (n = 4, p < 0.05) and returned to pretreatment levels rapidly by 24 h after injection. The concentration of GSH in retinas decreased from baseline levels of 109.53 ± 8.19 µg/g wet weight (n = 9), was lowest at 12 h (72.40 ± 11.17 µg/g wet weight, n = 5, p < 0.05) and returned to pretreatment levels by 7 days. Conclusion: The results suggest that intravitreous LHP injection is a contributor to oxidative stress in the rabbit retina by causing a reduction in antioxidant capacity.
Stereotactic Accuracy of a Compact Intraoperative MRI System
Authors: Salas Sussan , Brimacombe Michael , Schulder Michael
Published: December 2006

Objective: To analyze the stereotactic accuracy of the PoleStar N-20, a compact intraoperative magnetic resonance imaging (iMRI) system, based on a 0.15-Tesla (T) magnet. Methods: An MRI-compatible phantom was scanned after being positioned in both the center of the magnetic field (COF) and the periphery of the field (POF) of the PoleStar N-20 magnet. Scans were acquired at various slice thicknesses in 3 sequences: T1 weighted, T2 weighted and Esteady (reversed fast imaging with steady-state precession, also known as ‘PSIF’). The distance between the actual location of the probe tip in space and the location of the target on the image was measured on the axial, coronal, and sagittal planes for 9 points on each image. Each measurement was repeated 3 times. We also compared the structural features of the PoleStar N-20 to those of its predecessor. Results: T1-weighted scans yielded the most accurate measurements. There was no statistically significant difference between scans acquired at thicknesses of 2, 3, 4 and 8 mm; all were accurate for clinical purposes. Comparison of COF with POF measurements using T1-weighted scans did not demonstrate a statistically significant difference in accuracy. Conclusions: The PoleStar N-20 0.15-T iMRI system provides surgical navigation that is at least as accurate as the first generation model of this system, which employed a 0.12-T magnet. Further analysis of stereotactic accuracy on clinical cases using the PoleStar N-20 is needed to confirm that these results will bear out in surgical reality.
Correlation between the Anatomical and Functional Human Subthalamic Nucleus
Authors: Nowinski Wieslaw L. , Thirunavuukarasuu A. , Liu Jimin , Benabid Alim Louis
Published: December 2006

This work addresses the spatial correlation between the anatomical and functional human subthalamic nucleus (STN). The anatomical STN (A-STN), derived from the Schaltenbrand-Wahren brain atlas, is histology based. The functional STN (F-STN) is probabilistic, constructed from neuroelectrophysiological and neuroimaging data of 184 Parkinson’s disease patients. The A-STN and F-STN are placed in the same space and compared in terms of mutual relative overlapping of anatomy with function. The F-STN and A-STN correlate well for medium and high probabilities of the F-STN. For probability p ≧ 0.3, >95% of F-STN is inside the A-STN, and for p ≧ 0.5, the complete F-STN is inside the A-STN for each left and right STN. Therefore, the F-STN for p = 0.5 can potentially be used for identification of the STN in neuroimages.
Persistent and Aggressive Treatment for Thymic Carcinoma
Authors: Maruyama Riichiroh , Suemitsu Ryuichi , Okamoto Tatsuro , Kojo Miyako , Aoki Yoshiro , Wataya Hiroshi , Eguchi Takashi , Nishiyama Kenichi , Seto Takashi , Ichinose Yukito
Published: December 2006

Objectives: The aim of this study is to retrospectively evaluate the role of several therapies, mainly chemotherapy, for thymic carcinoma (TC). Methods: From July 1973 to July 2005, 25 patients (15 males and 10 females) with histologically proven TC were treated at our department. The median age of the patients was 59 years, with a range of from 30 to 78 years. According to Masaoka’s staging system, there was 1 stage I patient, 3 stage II, 7 stage III, 6 stage IVa, and 8 stage IVb patients. The histological subtype was in all cases squamous cell carcinoma, nonkeratinizing type. Results: There were 6 complete surgical resections, 1 incomplete resection followed by chemoradiotherapy, 6 with radiotherapy alone, 3 with radiotherapy plus chemotherapy, and 9 with chemotherapy alone as the initial treatment. Eighteen patients were administered second-line therapy. The regimen obtaining the best response rate was doublet chemotherapy consisting of carboplatin (CBDCA) and paclitaxel. The median survival time and survival rate at 5 years for the patients excluding surgical cases with stage I/II disease were 32 months and 31%, respectively. Conclusion: The doublet of CBDCA and paclitaxel thus appears to be a promising regimen for TC and further investigation in a multi-institutional phase II trial is, therefore, strongly called for.
A Clinical Phase II Study of a Non-Anthracycline Sequential Combination of Cisplatin-Vinorelbine Followed by Docetaxel as First-Line Treatment in Metastatic Breast Cancer
Authors: Shamseddine Ali I. , Otrock Zaher K. , Khalifeh Mohamad J. , Yassine Hanan R. , Charafeddine Maya , Abdel-Khalek Zeina , Chehal Aref , Bitar Nizar , Jalloul Rahif , Dheiny Moussa , Dandashi Azzam , Wehbeh Mahmoud , El-Saghir Nagi S.
Published: December 2006

Background: We tested a sequential combination regimen using cisplatin and vinorelbine (PVn) followed by docetaxel as first-line chemotherapy in a phase II clinical trial in metastatic breast cancer (MBC). Patients and Methods: Thirty-five patients were enrolled. Cisplatin 80 mg/m2 was given on day 1 and vinorelbine 30 mg/m2 on days 1 and 8 every 3 weeks for 4 cycles. Responding patients received docetaxel 75 mg/m2 every 21 days for a maximum of 4 cycles. Three patients were excluded from analysis because of death unrelated to treatment. Results: After a median follow-up of 14 months, 32 patients completed the study. The overall response rate was 53.1%. Complete remission was seen in 5 patients (15.6%), partial response in 12 (37.5%), stable disease in 6 (18.75%), and progressive disease in 9 patients (28.1%). Median time to disease progression was 8 months (range 1–24). At 24 months, 12 (37.5%) patients were alive. A total of 183 cycles were administered. Febrile neutropenia was observed in 4 patients (2.2%). Grade II nephrotoxicity occurred in 12 cycles (6.5%) and grade III vomiting in 31/183 cycles (16.9%). Discussion: PVn is a feasible non-anthracycline option as first-line chemotherapy in patients with metastatic breast cancer and has acceptable toxicity. The sequential addition of 4 cycles of docetaxel following 4 cycles of PVn did not improve the overall response rate and results.
What Is the Difference between Proximal and Total Gastrectomy Regarding Postoperative Bile Reflux into the Oesophagus?
Authors: Katsoulis I.E. , Robotis J.F. , Kouraklis G. , Yannopoulos P.A.
Published: December 2006

Background: Tumours of the oesophagogastric junction and the gastric cardia can be treated either with proximal or with total gastrectomy. Reflux of bile and other duodenal contents into the oesophagus following proximal gastrectomy has generally been considered worse than reflux after total gastrectomy. The aim of the present study was to test this assumption given that there is limited literature regarding objective evaluation of the postoperative duodeno-oesophageal reflux. Patients and Methods: We carried out bilirubin monitoring with the ambulatory spectrophotometer Bilitec 2000 in two groups of patients and in one group of healthy volunteers matched in age and sex. The proximal gastrectomy group consisted of 8 patients who underwent proximal gastrectomy and an end-to-side oesophagogastrostomy without pyloric drainage procedure. The total gastrectomy group consisted of 11 patients who underwent total gastrectomy and Roux-en-Y reconstruction with a 50-cm-long jejunal limb. The control group consisted of 8 healthy volunteers. In all cases, an absorption value of 0.14 was used as the threshold for reflux episodes. Results: The median fraction of time that bilirubin absorbance was >0.14 in the proximal versus total gastrectomy group was 47.4 and 13.4%, respectively (p = 0.02). The difference between the two groups was significant in the supine position (p = 0.03), whilst the upright position, meal and postprandial periods were not found to have significant difference. Likewise, no significant difference was found in the number of reflux episodes. The median fraction of time in the proximal gastrectomy group compared with controls was 47.4 versus 3.95% (p < 0.001), whilst in the total gastrectomy group compared with controls, itwas 13.4 versus 3.95% (p > 0.05). The number of reflux episodes in the proximal gastrectomy group compared with controls was 74 versus 21 (p = 0.02), whilst in the total gastrectomy group compared with controls, it was 103 versus 21 (p > 0.05). Conclusions: Total gastrectomy with Roux-en-Y reconstruction reduces the time of oesophageal exposure to duodenal juices as compared with proximal gastrectomy. This effect seems to be more prominent in the supine position.
Making Environmental Self-Regulation Mandatory
Authors: Arnold Richard , Whitford Andrew B.
Published: December 2006

We describe a simple mechanism for achieving two goals: (1) to encourage firms to take environmentally friendly action, and (2) to make environmental protection impervious to political change. We assert that there is wide evidence now that firms adopting an environmental management system (EMS) like ISO 14001 improve their environmental performance. This is because ISO 14001's third-party audits reduce the chance firms will fully fail to comply with regulations, and the EMS procedure reduces the chances firms will be in noncompliance due to ignorance. Our mechanism is intended to harness the power of EMS systems within firms, while reducing the chances that political change will nullify our solution. We argue that to achieve these goals, governments should make firms' participation in public procurement programs contingent on their adoption of an EMS such as ISO 14001.
The Surat Castle Revolutions: Myths of an Anglo-Bania Order and Dutch Neutrality, C. 1740-1760
Authors: Kuiper Jitske , Gommans Jos
Published: December 2006

In 1759 the British captured Surat Castle. This later turned out to be one of the first steps towards what would soon become their Indian empire. This paper aims to re-examine the history of events leading to this Castle Revolution on the basis of the altogether neglected Dutch sources at the National Archives in The Hague. To make sense of what appears to be a decade of ongoing revolutions and endless jockeying for power, the paper proposes the existence of an underlying mechanism of highly flexible networks that connected and encompassed the various political and commercial, local and interregional, maritime and continental spheres of Surat's open-ended political economy. With this in mind, the paper also briefly reassesses the current idea of the so-called Anglo-Bania order and takes a critical look at the neutralist discourse of the Dutch sources.
The Impact of GEM and MM5 Modeled Meteorological Conditions on CMAQ Air Quality Modeling Results in Eastern Canada and the Northeastern United States
Authors: Smyth Steven C. , Yin Dazhong , Roth Helmut , Jiang Weimin , Moran Michael D. , Crevier Louis-Philippe
Published: December 2006

The fifth-generation Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model (MM5) is currently the meteorological model most widely used as input into the Community Multiscale Air Quality (CMAQ) modeling system. In this study, meteorological fields produced by the Global Environmental Multiscale (GEM) meteorological model were compared with those from MM5, and the impact of using the two different modeled datasets as inputs to CMAQ was investigated. Two CMAQ model runs, differing only in meteorological inputs and meteorologically influenced emissions, were conducted for a domain covering eastern Canada and the northeastern United States for a 9-day period in July 1999. Comparison of the two modeled meteorological datasets with surface measurements revealed that GEM and MM5 gave comparable results. For a direct comparison of the two meteorological datasets the differences were small for pressure and temperature but larger for wind speed and relative humidity (RH). The variations in meteorological fields affect emissions and air quality results in differing ways and to differing degrees. The most influential meteorological field on emissions was temperature, which had a minor impact on on-road mobile emissions and a larger impact on biogenic emissions. Performance statistics for O3 and for particulate matter less than 10 μm and less than 2.5 μm (PM10, and PM2.5, respectively) show that GEM-based and MM5-based CMAQ results compare similarly to hourly measurement data, with minor statistical differences. A direct comparison of O3, PM10, PM2.5, and speciated PM2.5 showed that the results correlate to varying degrees and that the differences in RH affect total particulate matter (PM) mass and aerosol species concentrations significantly. Relative humidity affects total particle mass and particle diameters, which in turn affect PM2.5 and PM10 concentrations.
Validation of Improved TAMANN Neural Network for Operational Satellite-Derived Rainfall Estimation in Africa
Authors: Coppola E. , Grimes D. I. F. , Verdecchia M. , Visconti G.
Published: December 2006

Real-time rainfall monitoring in Africa is of great practical importance for operational applications in hydrology and agriculture. Satellite data have been used in this context for many years because of the lack of surface observations. This paper describes an improved artificial neural network algorithm for operational applications. The algorithm combines numerical weather model information with the satellite data. Using this algorithm, daily rainfall estimates were derived for 4 yr of the Ethiopian and Zambian main rainy seasons and were compared with two other algorithms—a multiple linear regression making use of the same information as that of the neural network and a satellite-only method. All algorithms were validated against rain gauge data. Overall, the neural network performs best, but the extent to which it does so depends on the calibration/validation protocol. The advantages of the neural network are most evident when calibration data are numerous and close in space and time to the validation data. This result emphasizes the importance of a real-time calibration system.
Improvement of Advanced Microwave Sounding Unit Tropical Cyclone Intensity and Size Estimation Algorithms
Authors: Demuth Julie L. , DeMaria Mark , Knaff John A.
Published: December 2006

Previous work, in which Advanced Microwave Sounding Unit (AMSU) data from the Atlantic Ocean and east Pacific Ocean basins during 1999–2001 were used to provide objective estimates of 1-min maximum sustained surface winds, minimum sea level pressure, and the radii of 34-, 50-, and 64-kt (1 kt ≡ 0.5144 m s−1) winds in the northeast, southeast, southwest, and northwest quadrants of tropical cyclones, is updated to reflect larger datasets, improved statistical analysis techniques, and improved estimation through dependent variable transforms. A multiple regression approach, which utilizes best-subset predictor selection and cross validation, is employed to develop the estimation models, where the dependent data (i.e., maximum sustained winds, minimum pressure, wind radii) are from the extended best track and the independent data consist of AMSU-derived parameters that give information about retrieved pressure, winds, temperature, moisture, and satellite resolution. The developmental regression models result in mean absolute errors (MAE) of 10.8 kt and 7.8 hPa for estimating maximum winds and minimum pressure, respectively. The MAE for the 34-, 50-, and 64-kt azimuthally averaged wind radii are 16.9, 13.3, and 6.8 n mi (1 n mi ≡ 1852 m), respectively.