bluuebunny/crossref_metadata_2025 huggingface dataset:
Increasing efficiency of parallel imaging for 2D multislice acquisitions
Authors: Honal Matthias , Bauer Simon , Ludwig Ute , Leupold Jochen
Published: April 2009

Parallel imaging algorithms require precise knowledge about the spatial sensitivity variation of the receiver coils to reconstruct images with full field of view (FOV) from undersampled Fourier encoded data. Sensitivity information must either be given a priori, or estimated from calibration data acquired along with the actual image data. In this study, two approaches are presented, which require very little or no additional data at all for calibration in two‐dimensional multislice acquisitions. Instead of additional data, information from spatially adjacent slices is used to estimate coil sensitivity information, thereby increasing the efficiency of parallel imaging. The proposed approaches rely on the assumption that over a small range of slices, coil sensitivities vary smoothly in slice direction. Both methods are implemented as variants of the GRAPPA algorithm. For a given effective acceleration, superior image quality is achieved compared to the conventional GRAPPA method. For the latter calibration lines for coil weight computation must be acquired in addition to the undersampled k‐spaces for coil weight computation, thus requiring higher k‐space undersampling, that is, a higher reduction factor to achieve the same effective acceleration. The proposed methods are particularly suitable to speed up parallel imaging for clinical applications where the reduction factor is limited to two or three. Magn Reson Med 2009 © 2009 Wiley‐Liss, Inc.
Analysis of partial volume effects on arterial input functions using gradient echo: A simulation study
Authors: Kjølby Birgitte F. , Mikkelsen Irene K. , Pedersen Michael , Østergaard Leif , Kiselev Valerij G.
Published: April 2009

Absolute blood flow and blood volume measurements using perfusion weighted MRI require an accurately measured arterial input function (AIF). Because of limited spatial resolution of MR images, AIF voxels cannot be placed completely within a feeding artery. We present a two‐compartment model of an AIF voxel including the relaxation properties of blood and tissue. Artery orientations parallel and perpendicular to the main magnetic field were investigated and AIF voxels were modeled to either include or be situated close to a large artery. The impact of partial volume effects on quantitative perfusion metrics was investigated for the gradient echo pulse sequence at 1.5 T and 3.0 T. It is shown that the tissue contribution broadens and introduces fluctuations in the AIF. Furthermore, partial volume effects bias perfusion metrics in a nonlinear fashion, compromising quantitative perfusion estimates and profoundly effecting local AIF selection. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
Short echo spectroscopic imaging of the human brain at 7T using transceiver arrays
Authors: Avdievich N.I. , Pan J.W. , Baehring J.M. , Spencer D.D. , Hetherington H.P.
Published: April 2009

Recent advances in magnet technology have enabled the construction of ultrahigh‐field magnets (7T and higher) that can accommodate the human head and body. Despite the intrinsic advantages of performing spectroscopic imaging at 7T, increased signal‐to‐noise ratio (SNR), and spectral resolution, few studies have been reported to date. This limitation is largely due to increased power deposition and B1 inhomogeneity. To overcome these limitations, we used an 8‐channel transceiver array with a short TE (15 ms) spectroscopic imaging sequence. Utilizing phase and amplitude mapping and optimization schemes, the 8‐element transceiver array provided both improved efficiency (17% less power for equivalent peak B1) and homogeneity (SD(B1) = ±10% versus ±22%) in comparison to a transverse electromagnetic (TEM) volume coil. To minimize the echo time to measure J‐modulating compounds such as glutamate, we developed a short TE sequence utilizing a single‐slice selective excitation pulse followed by a broadband semiselective refocusing pulse. Extracerebral lipid resonances were suppressed with an inversion recovery pulse and delay. The short TE sequence enabled visualization of a variety of resonances, including glutamate, in both a control subject and a patient with a Grade II oligodendroglioma. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
Can arterial spin labeling detect white matter perfusion signal?
Authors: van Osch Matthias J.P. , Teeuwisse Wouter M. , van Walderveen Marianne A.A. , Hendrikse Jeroen , Kies Dennis A. , van Buchem Mark A.
Published: April 2009

Since the invention of arterial spin labeling (ASL) it has been acknowledged that ASL does not allow reliable detection of a white matter (WM) perfusion signal. However, recent developments such as pseudo‐continuous labeling and background suppression have improved the quality. The goal of this research was to study the ability of these newer ASL sequences to detect WM perfusion signal. Background suppressed pseudo‐continuous ASL was implemented at 3T with multislice 2D readout after 1525 ms. In five volunteers it was shown that 10 min scanning resulted in significant perfusion signal in 70% of WM voxels. Increasing the labeling and delay time did not lead to a higher percentage. In 27 normal volunteers it was found that 35 averages are necessary to detect significant WM signal, but 150 averages are needed to detect signal in the deep WM. Finally, it was shown in a patient with a cerebral arteriovenous malformation that pseudo‐continuous ASL enabled the depiction of hypointense WM perfusion signal, although dynamic susceptibility contrast MRI showed that this region was merely showing delayed arrival of contrast agent than hypoperfusion. It can be concluded that, except within the deep WM, ASL is sensitive enough to detect WM perfusion signal and perfusion deficits. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
Tin oxide coating on polytetrafluoroethylene films in aqueous solutions
Authors: Masuda Yoshitake , Kato Kazumi
Published: April 2009

Polytetrafluoroethylene (PTFE) films were successfully coated with tin oxide in aqueous solutions. Tin oxide was crystallized in the solution and formed nanocrystal coatings on the polymer films. The coatings consisted of SnO2 and SnO crystals. They were assemblies of tin oxide nanosheet of about 10 to 50 nm in size and about 5 nm in thickness. The nanocrystal films can be exfoliated from the PTFE substrates. Tin oxide nanocrystal films had a rough liquid surface and a dense substrate‐side surface. Transparency of PTFE films coated with tin oxide was same as that of bare PTFE films in the range from 400 to 800 nm. The PTFE films coated with tin oxide nanocrystals can be pasted on desired substrates. Copyright © 2009 John Wiley & Sons, Ltd.
Patterning of cells on a PVC film surface functionalized by ion irradiation
Authors: Jung Chan‐Hee , Hwang In‐Tae , Kwon Ho‐Je , Nho Young‐Chang , Choi Jae‐Hak
Published: April 2009

Micropatterns of cells on a poly(vinyl chloride) (PVC) film surface were created by using ion irradiation. A PVC film was irradiated with H+ ions through a pattern mask in order to create patterns of the hydrophilic/hydrophobic regions on the PVC surface. The effect of ion irradiation on the surface properties of the PVC film was characterized by using Fourier transform‐infrared spectroscopy (FT‐IR), water contact angle measurement, and X‐ray photoelectron spectroscopy (XPS). The results revealed that the chemical environment of the PVC film surface was effectively changed by ion irradiation due to dehydrochlorination and oxidation. The in vitro cell culture on the patterned PVC film surface showed selective adhesion and proliferation of the cells on the ion‐irradiated regions. Well‐defined 50 µm patterns of the cells were obtained on the PVC film surface irradiated to 1 × 1015 ions/cm2. Copyright © 2009 John Wiley & Sons, Ltd.
Mediastinal hemangiopericytoma
Authors: Horikawa‐Kyo Youko , Tanaka Takeo , Tanano Hirofumi , Kitayama Yasuhiro , Karakawa Shuhei , Taniyama Kiyomi
Published: April 2009

Mediastinal hemangiopericytoma (HPC) was diagnosed in a 3‐year‐old female. The incidence of this tumor is rare in children, and few data are available to guide clinical management. The surgical resection was incomplete and she received adjuvant radiation therapy and chemotherapy. The patient is alive without adverse events 6 years after diagnosis. Pediatr Blood Cancer 2009;53:206–207. © 2009 Wiley‐Liss, Inc.
The influence of chain‐ends on the thermal and rheological properties of some 40/60 PES/PEES copolymers
Authors: Abate Lorenzo , Blanco Ignazio , Cicala Gianluca , Recca Giuseppe , Scamporrino Andrea
Published: April 2009

Four random, differently ended (Cl, NH2, OH, and COO−), polyethersulfone/polyetherethersulfone (PES/PEES) copolymers were studied to investigate the influence of chain ends on thermal and rheological behaviors. The number average molar mass (Mn ≈ 9500 g·mol−1) and the PES/PEES ratio (40/60) of all copolymers investigated were checked by 1H NMR spectra. Thermal degradations were carried out in the scanning mode and initial decomposition temperatures (Ti) and activation energy values of degradation (Ea) were obtained. Glass transition temperature (Tg) was determined by differential scanning calorimetry and complex viscosity (η*) by rheological measurements in isothermal heating conditions (T = 270°C). All parameters determined were largely affected by copolymer chain ends and decreased according to the same order, OH > NH2 > Cl > COO−. The results were discussed and interpreted. POLYM. ENG. SCI., 2009. © 2009 Society of Plastics Engineers
Impact properties and microhardness of double‐gated glass‐reinforced polypropylene injection moldings
Authors: Gamba Matias Martinez , Pouzada António Sergio , Frontini Patricia María
Published: April 2009

Injection moldings with weld lines were produced in glass reinforced polypropylene grades differing in filler content using a two‐gated hot runner injection mold. The skin‐core microstructure developed during injection molding was qualitatively analyzed by means of optical and scanning electronic microscopy techniques. The load bearing capacity of the moldings was assessed by uniaxial tensile‐impact and biaxial instrumented falling dart impact tests. Microhardness was also used to ascertain the possibility of using it as a simple nondestructive technique for characterizing glass fiber‐reinforced injection moldings. The properties were monitored at various points to evaluate their variation at the bulk and the knit region. The biaxial impact test highlights the 10‐fold reduction of the impact strength caused by the weld line. POLYM. ENG. SCI., 2009. © 2009 Society of Plastics Engineers
Differential action of chlorinated polycyclic aromatic hydrocarbons on aryl hydrocarbon receptor‐mediated signaling in breast cancer cells
Authors: Ohura Takeshi , Morita Maki , Kuruto‐Niwa Ryoko , Amagai Takashi , Sakakibara Hiroyuki , Shimoi Kayoko
Published: April 2009

Chlorinated polycyclic aromatic hydrocarbons (ClPAHs), which are a series of halogenated aromatic hydrocarbons, have been found in the environment. The primary step in their metabolic activation seems to be associated with aryl hydrocarbon receptor (AhR)‐mediated induction of the cytochrome P450 (CYP) 1 family, although the evidence remains unclear. In this study, we first investigated the effects of five ClPAHs with three to five rings and the corresponding parent PAHs on the expression of CYP1A1 and 1B1 in human breast cancer MCF‐7 cells. For the targeted ClPAHs, Western blot analysis of ClPAH‐induced CYP1A1 and 1B1 showed an enhancement in activities in comparison with induction by the corresponding parent PAHs, and the effects of chlorination were especially prominent in phenanthrene. In a further study, using 6‐chlorobenzo[a]pyrene (6‐ClBaP), cotreatment with 17β‐estradiol showed an increase in the expression of CYP1B1 mRNA but not CYP1A1 mRNA. Since the AhR ligand has been reported to induce formation of an AhR‐estrogen receptor (ER) complex, which stimulates transcription of ER target genes, the effects of ClPAHs in MCF‐7 cells transfected with estrogen response elements‐regulated green fluorescent protein (GFP) reporter genes were also investigated in this study. 6‐ClBaP induced a dose‐dependent increase in GFP expression related to ER signaling through AhR activation in the cells, but 3,9,10‐trichlorophenanthrene (3,9,10‐Cl3ClPhe) did not, despite its ability to activate AhR. Furthermore, we investigated the effect of ClPAHs on the expression of the endogenous ER‐responsive genes, cathepsin D, in MCF‐7 cells. 6‐ClBaP stimulated expression of the ER‐responsive genes but 3,9,10‐Cl3ClPhe did not, as in the GFP expression system. These results suggest that estrogenic action mediated ER signaling through AhR activation does not necessarily occur for every ligand that can activate AhR. © 2009 Wiley Periodicals, Inc. Environ Toxicol, 2010.
Inducibility of metallothionein biosynthesis in the whole soft tissue of zebra mussels Dreissena polymorpha exposed to cadmium, copper, and pentachlorophenol
Authors: Ivanković Dušica , Pavičić Jasenka , Beatović Vanja , Klobučar Roberta Sauerborn , Klobučar Göran Igor Vinko
Published: April 2009

Freshwater mussels Dreissena polymorpha (Pallas, 1771) were exposed to the elevated concentrations of Cd (10, 50, 100, and 500 μg/L), Cu (10, 30, 50, and 80 μg/L), and an organochlorinated pesticide, pentachlorophenol (PCP) (1, 10, and 100 μg/L). Induced synthesis of biomarker metallothionein (MT) and changes in concentrations of cytosolic Cd, Cu, and Zn in the whole soft tissue of mussels were monitored after a 7‐day laboratory exposure to the contaminants. A clear dose‐dependent elevation in the MT concentration was observed after exposure to Cd at doses of 10–100 μg/L, and this increase of MT content was accompanied with a linear increase of cytosolic Cd. Cd concentration of 500 μg/L caused no additional increase of MT and Cd in mussel cytosol, suggesting possible toxic effects due to exceeding cellular inducible/defense capacity. Cu exposure resulted with variable changes in MT concentrations, with no clear linear relationship between MT and Cu concentrations in water, although a progressive dose‐dependent accumulation of Cu in the soluble fraction of mussel tissues was recorded. A decrease of cytosolic Zn was evident at higher exposure concentrations of both metals used. PCP in concentrations applied was unable to induce MT synthesis, but the higher concentrations of PCP influenced the cytosolic metal concentrations. In conclusion, the results obtained confirm the specificity of MT induction in D. polymorpha as an biological response on metal stimulation, especially by cadmium, being more closely correlated to MT than copper within the ecologically relevant concentration range. The strong induction potential of cadmium as well as an absence of MT induction following exposure to PCP as an organic chemical contaminant are supporting evidences for usage of zebra mussel MT as a specific biomarker of Cd exposure in biomonitoring programs. © 2009 Wiley Periodicals, Inc. Environ Toxicol, 2010.
Prevalence of treated autism spectrum disorders in Aruba
Authors: van Balkom Ingrid D. C. , Bresnahan Michaeline , Vogtländer Marrit F. , van Hoeken Daphne , Minderaa Ruud B. , Susser Ezra , Hoek Hans W.
Published: April 2009

To study autism outside of a narrow range of settings previously studied, and in a particularly distinctive setting in the Caribbean. The aim of the Aruba Autism Project was to determine the prevalence of autism spectrum disorders (ASDs) in birth years 1990–1999 in Aruba. A record review study was conducted; cases were ascertained from children treated at the Child & Adolescent Psychiatry Clinic of Aruba, the first and only child psychiatry service on the island. In these 10 birth years we found a prevalence for autistic disorder (AD) of 1.9 per 1,000 (95% CI 1.2–2.8) and for autism spectrum disorders of 5.3 per 1,000 (95% CI 4.1–6.7). Comparison analysis with a cumulative incidence report from the UK, showed a similar cumulative incidence to age five in Aruba. Prevalence of ASDs in birth years 1990–1999 and cumulative incidence to age five in Aruba are similar to recent reports from the United Kingdom and the United States.
XAP2 inhibits glucocorticoid receptor activity in mammalian cells
Authors: Laenger Anna , Lang-Rollin Isabelle , Kozany Christian , Zschocke Jürgen , Zimmermann Nicole , Rüegg Joëlle , Holsboer Florian , Hausch Felix , Rein Theo
Published: April 2009

XAP2 is member of a protein family sharing the TPR protein interaction motif. It displays close homology to the immunophilins FKBP51 and FKBP52 that act via the Hsp90 folding machinery to regulate the glucocorticoid receptor (GR). We show that XAP2 inhibits GR by reducing its responsiveness to hormone in transcriptional activation. The effect of XAP2 on GR requires its interaction with Hsp90 through the TPR motif. The PPIase‐like region turned out to be enzymatically inactive. Thus, PPIase activity is not essential for the action of XAP2 on GR, similarly to FKBP51 and FKBP52.
Hypoxia alters contractile protein homeostasis in L6 myotubes
Authors: Caron Marc-André , Thériault Marie-Eve , Paré Marie-Ève , Maltais François , Debigaré Richard
Published: April 2009

Since hypoxia might contribute to the development of muscle atrophy, we wished to provide direct evidence linking hypoxia to muscle atrophy. By evaluating protein degradation and synthesis in hypoxic myotubes we found a significant reduction in total protein content. Using functional assays we observed protein degradation elevation in the first 24 h while synthesis was maintained during this period and then significantly decrease at 48 h. These results demonstrate a temporal regulation of protein homeostasis, whereby elevated protein degradation is followed by a reduction in synthesis. These results are comparable to the cellular adaptation seen during development of muscle atrophy.
The pattern of cognitive symptoms predicts time to dementia onset
Authors: Sacuiu Simona , Gustafson Deborah , Johansson Boo , Thorvaldsson Valgeir , Berg Stig , Sjögren Magnus , Guo Xinxin , Östling Svante , Skoog Ingmar
Published: April 2009

Background

Few studies have examined whether cognitive symptom patterns differ by age and length of time before dementia onset. Our objective was to investigate whether different patterns of cognitive symptoms at ages 70, 75, and 79 years predict short‐term (≤5 years) and long‐term (>5 years) dementia onset.

Methods

A representative sample of 382 nondemented 70‐year‐olds from Gothenburg, Sweden was examined periodically up to age 90 years. Information on dementia in those lost to follow‐up was obtained from medical records. Cognitive assessments at ages 70, 75, and 79 years included psychiatric and psychometric examinations. Four patterns of cognitive performance were examined in relation to dementia onset: (1) unimpaired cognition, (2) isolated low memory, (3) low non‐memory, and (4) global low cognitive performance.

Results

Short‐term onset was predicted by global low performance at ages 70, 75, and 79 years and by low non‐memory performance at ages 70 and 75. Isolated low memory was not a short‐term predictor at any examination, but it predicted long‐term onset at ages 70 and 75 years.

Conclusions

A global pattern of low cognitive performance predicts short‐term but not long‐term onset of dementia, whereas isolated low memory performance predicts dementia only in the long‐term. Our findings also suggest that preclinical symptoms of dementia might differ by age.
Fourteen‐year longitudinal study of vascular risk factors, APOE genotype, and cognition: The ARIC MRI Study
Authors: Knopman David S. , Mosley Thomas H. , Catellier Diane J. , Coker Laura H. ,   Atherosclerosis Risk in Communities Study Brain MRI Study
Published: April 2009

Background

Strokes, vascular risk factors, and apolipoprotein E (APOE) genotype are associated with cognitive decline in the elderly, but definitive evidence that these affect cognition as early as middle age is limited.

Objective

We describe the relationships of APOE genotype, stroke, and vascular risk factors with cognitive change over a 14‐year follow‐up in the Atherosclerosis Risk in Communities (ARIC) Study cohort recruited while in middle age.

Methods

Participants included a subset of the ARIC Study who underwent assessments of cognitive function and vascular risk factors. Four cognitive assessments were performed between 1990–1992 and 2004–2006. Cognitive assessments included the Delayed Word Recall (DWR) Test, the Digit Symbol Substitution (DSS) Test, and the Word Fluency (WF) Test. Vascular risk factors were assessed during the baseline visit in 1990–1992. Incident stroke was recorded over the 14 years of follow‐up.

Results

There were 1130 participants (mean age, 59 ± 4.3 [SD] years; 62% women; 52% African‐American) with longitudinal data. In multivariate, random‐effects linear models adjusted for age, education, gender, and race, the risk factors diabetes and APOE ɛ4 genotype were independently associated with a decline in performance on the DSS test (both P < .005), whereas hypertension and stroke were not. For DWR, stroke and APOE ɛ4 genotype were independent predictors of decline (both P < .001). For the WF test, metabolic syndrome, hypertension, and stroke were independently associated with decline (all P < .005). No evidence of differential effects of risk factors on cognitive decline by race, gender, or interactions between risk factors was found.

Conclusions

The vascular risk factors diabetes and hypertension, a history of stroke itself, and APOE ɛ4 genotype independently contribute to cognitive decline in late middle age and early elderly years.
Maximizing the Alzheimer's Disease Neuroimaging Initiative II
Authors: Carrillo Maria C. , Sanders Charles A. , Katz Russell G.
Published: April 2009

The Alzheimer's Disease Neuroimaging Initiative is the largest public‐private partnership on brain research underway at the National Institutes of Health. This 6‐year study tracks cognitive and brain changes in normal subjects, those with mild cognitive impairment, and individuals with Alzheimer's disease. It was designed to provide better tools for performing effective clinical trials, and is slated to run until 2010. While data are being generated and analyzed, researchers involved in the study are developing an extension, i.e., the Alzheimer's Disease Neuroimaging Initiative II. The Foundation for the National Institutes of Health and the Alzheimer's Association convened a meeting to review the progress, evaluate future directions, and obtain the United States Food and Drug Administration's perspective on how the Alzheimer's Disease Neuroimaging Initiative could affect the drug‐approval process.
Pauci‐Immune Lupus Nephritis: A Case Report
Authors: Li Fei‐Ching , Hwang Daw‐Yang , Hung Chi‐Chih , Chen Hung‐Chun
Published: April 2009

A 26‐year‐old female with systemic lupus erythematosus was admitted because of dyspnea and progressive lower extremity edema. Laboratory testing showed blood urea nitrogen levels of 147 mg/dL, creatinine of 6.7 mg/dL, serum albumin of 1.7 g/dL and the daily protein loss was 12.7 g. Her C3 level was 60.4 mg/dL and C4 level was 10.2 mg/dL. The antinuclear antibody titer was 1:320, with a homogeneous pattern, but she was negative for anti‐dsDNA. ELISA testing for anti‐PR3 antibodies and anti‐MPO antibodies were all negative. She was also negative for circulating lupus anticoagulant. Renal biopsy revealed diffuse proliferation of glomerular cells, but immunofluorescent microscopy showed no immune deposits and electron microscopy revealed only scanty electron‐dense deposits. She received 1 g/day of methylprednisolone intravenously for 3 days, followed by 60 mg/day of prednisolone. She was discharged with serum creatinine decreased to 4.7mg/dL, and a great improvement in dyspnea. Diffuse proliferative lupus nephritis that contains little or no subendothelial deposits is rare. The differential diagnosis, possible mechanisms and treatment are discussed.
Adrenal Schwannoma Treated with Laparoscopic Adrenalectomy: A Case Report
Authors: Hsiao Hsi‐Lin , Li Ching‐Chia , Lin Han‐Ching , Yeh Hsin‐Chih , Huang Chun‐Hsiung , Wu Wen‐Jeng
Published: April 2009

Schwannoma of the adrenal gland is extremely rare. Here, we report a 49‐year‐old patient with an adrenal tumor noted incidentally by abdominal ultrasonography while undergoing regular health examination. Retroperitoneal laparoscopic adrenalectomy was performed and the schwannoma was diagnosed by histologic findings and immunohistochemistry. Five months after surgery, the patient remained well and without evidence of recurrence or metastasis.
Differential CCR4 Expression And Function in Cutaneous T‐Cell Lymphoma Cell Lines
Authors: Wu Chieh‐Shan , Wang Sin‐Ting , Liao Chai‐Yu , Wu Meng‐Tse
Published: April 2009

Cutaneous T cell lymphoma (CTCL) is a clonal epidermotropic malignancy of memory T cells primarily involving the skin. However, the mechanisms governing migration of CTCL cells have not been fully clarified. It has been shown that certain chemokine receptors are upregulated in CTCL cells, but it remains unanswered whether these chemokine receptors play a critical role in the migration dynamics of CTCL. Using cell lines originally derived from patients with different subtypes of CTCL, we have shown higher CCR4 expression in the line derived from the mycosis fungoides (MJ), compared with the line derived from Sézary syndrome (Hut78). In specific responses to CCL22 (a CCR4 ligand) treatments, MJ cells showed significant chemotactic migration, enhanced activation and adhesion of certain integrins (CD49d and CD29) in vitro, while the control cells (Hut78, CD4+CD45RO+ memory T cells, and Jurkat cells) did not. Furthermore, compared with Hut78 cells, MJ cells manifested significantly more transendothelial migration in responses to treatments with either CCL22 or conditioned medium from dendritic cells in vitro. These results provide further dynamic evidence, in line with the multistep cascade paradigm for leukocyte transendothelial migration, to support a critical role for CCR4 in CTCL migration.
Treatment Course of Recurrent Malignant Glaucoma Monitoring by Ultrasound Biomicroscopy: A Report of Two Cases
Authors: Shen Chia‐Jung , Chen Ying‐Ying , Sheu Shwu‐Jiuan
Published: April 2009

To study the mechanism underlying malignant glaucoma examined by ultrasound biomicroscopy (UBM) combined with axial scan and to observe the course of cilio‐lens block in living eyes in real time, when malignant glaucoma occurs and remises, two cases of malignant glaucoma are reviewed. The two cases have common characteristics, such as short axial length, pseudophakia, and patent peripheral iridotomy. Both cases eventually achieved intraocular pressure control without surgical intervention during their management courses. UBM and axial scan were used for early detection, to confirm the diagnosis of these cases, and to observe the course of treatment. This method allows patients at risk for the disease to be identified and successfully treated before irreversible damage to the nerve occurs. These cases accentuate the importance of cycloplegic drugs in long‐term malignant glaucoma treatments.
The Experience of an Objective, Structured Clinical Examination at Kaohsiung Medical University
Authors: Lee Kun‐Tai , Liu Wei‐Ting , Yen Jeng‐Hsien , Liu Ching‐Kuan , Liu Keh‐Min , Lai Chung‐Sheng
Published: April 2009

The objective, structured clinical examination (OSCE) is a method to assess clinical competency based on objective testing, through direct observation in a formal setting. The Kaohsiung Medical University (KMU) has pioneered OSCEs in Taiwan. In KMU, three groups of examinees—medical students in years 3 and 4, medical students in years 5 and 6, and medical students in year 7—were assessed using different OSCEs. Each OSCE was set up using the following five steps: (1) create cases; (2) decide on the items or clinical skills to be evaluated; (3) train standardized patients; (4) run the OSCE and (5) review videos to improve the curriculum. We expect that KMU will become the premier OSCE center in Taiwan.
Evaluation of the Effectiveness of Postgraduate General Medicine Training by Objective Structured Clinical Examination—Pilot Study and Reflection on the Experiences of Kaohsiung Medical University Hospital
Authors: Tsai Jer‐Chia , Liu Keh‐Min , Lee Kun‐Tai , Yen Jo‐Chu , Yen Jeng‐Hsien , Liu Ching‐Kuan , Lai Chung‐Sheng
Published: April 2009

Objective structured clinical examination (OSCE) is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1) residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman) with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five‐point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self‐evaluation on performance by examinees revealed significantly lower global ratings on post‐course OSCE (4.14 ± 0.80vs. 3.68 ± 0.66;p< 0.02). Surveys from tutors and standardized patients (SPs) completed at pre‐ and post‐course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 ± 0.17vs. 4.0 ± 0.12, nonsignificant). However, a survey of the examinees completed at preand post‐course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 ± 0.09vs. 3.7 ± 0.18;p< 0.05). Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news) and self‐confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a rational and feasible assessment method for evaluating the effectiveness of our PGY general medicine training program. The quantitative data and qualitative information provide a foundation to improve the quality of the program design and evaluation in implementing postgraduate general medicine training.
Training Standardized Patients for a High‐Stakes Clinical Performance Examination in the California Consortium for the Assessment of Clinical Competence
Authors: May Win
Published: April 2009

The use of standardized patients in teaching and assessment of clinical skills has become more ubiquitous in medical schools in the United States and Canada since Dr Howard Barrows introduced the first standardized patient at the University of Southern California in 1963. This increased usage is also due to the fact that the national licensing examination in the United States, includes a component to assess the clinical skills of the learners (United States Medical Licensure Examination Step 2 CS). The eight medical schools in California form a Consortium for the Assessment of Clinical Competence, which enables them to develop and implement a common clinical assessment tool, the Clinical Performance Examination (CPX), for final year medical students across the state. All medical schools in the Consortium share the same standardized patient cases and checklists. The standardization of training across the eight medical schools is presented. This paper describes the methods that have been used to train the SPs so that they can portray the gestalt of the patient, provide effective feedback, and reliably evaluate the students at the Keck School of Medicine of the University of Southern California. Quality assurance measures to ensure both performance and checklist accuracy are also described.
Setting Pass Scores for Clinical Skills Assessment
Authors: Liu Min , Liu Keh‐Min
Published: April 2009

In a clinical skills assessment, the decision to pass or fail an examinee should be based on the test content or on the examinees' performance. The process of deciding a pass score is known as setting a standard of the examination. This requires a properly selected panel of expert judges and a suitable standard setting method, which best fits the purpose of the examination. Six standard setting methods that are often used in clinical skills assessment are described to provide an overview of the standard setting process.
Children Presenting at the Emergency Department With Right Lower Quadrant Pain
Authors: Lin Chien‐Heng , Chen Jeon‐Hor , Li Tsai‐Chung , Ho Yung‐Jen , Lin Wei‐Ching
Published: April 2009

Right lower quadrant (RLQ) pain is a common complaint in children presenting at emergency departments. This study analyzed the etiologies of RLQ pain, and compared the clinical presentations, laboratory test results and imaging findings in patients with appendicitis with those in other groups of patients. We also investigated if active observation resulted in delayed diagnosis, to the detriment of patients. Medical records for the period January 2006 to July 2006 were reviewed for children (age < 18 years) who presented to the emergency department of one medical center, complaining of RLQ pain. Out of a total of 100 patients (age range: 2–17 years; mean: 11 years), 46 patients presented with only one symptom of RLQ pain, while 32 patients had ≥ 2 associated signs or symptoms, including fever, nausea/vomiting, diarrhea, or rebound tenderness. Imaging studies, including abdominal sonography and/or computed tomography, were performed in 73 patients; 44 underwent surgery for presumed appendicitis and one received surgery for a right paraduodenal hernia. Eleven patients underwent surgery because of peritoneal signs, and eight because of persistent or aggravated RLQ pain. Postoperative pathologic examinations revealed 53 cases of appendicitis, six normal appendices, and other morbidities (1 perforated peptic ulcer, 1 pelvic inflammatory disease, 1 ovarian cyst, 1 diverticulitis, and 1 right paraduodenal hernia). Thirty‐three patients were discharged after several hours of observation (range: 0.5–18 hours; mean: 4 hours), and three patients were admitted for further observations. All were discharged without operation. There were significant differences in the incidences of fever (p = 0.004) and rebound tenderness (p = 0.019), and in white cell counts (p < 0.001), neutrophil percentages (p < 0.001), and C‐reactive protein levels (p < 0.001) between patients with appendicitis and patients with other causes of RLQ pain. Clinical signs and symptoms, laboratory tests, and imaging studies can be used to differentiate between the causes of RLQ pain. Patients without the classical features of appendicitis or peritonitis can be safely managed by active observation and repeated physical examinations.
Reappraisal of the Management and Outcome of Emphysematous Pyelonephritis
Authors: Lin Wei‐Ching , Chen Yung‐Fang , Lin Chien‐Heng , Ho Yung‐Jen , Tzeng Yuan‐Hong , Chiang Hsein‐Jar , Chang Chao‐Hsiang , Cheng Yi‐Chang , Shen Wu‐Chung , Chen Jeon‐Hor
Published: April 2009

This study compared the management, prognostic factors and outcomes of patients with emphysematous pyelonephritis (EPN). Twenty‐one patients with EPN were studied between September 1996 and August 2005, and were assigned to two groups. Patients in Group 1 received conservative treatment with/without percutaneous catheter drainage (PCD) while patients in Group 2 underwent nephrectomy following medical treatment and PCD. A post hoc analysis of the prognostic factors was performed between survivors and nonsurvivors, and between the survivors in Group 1 and Group 2. There were 14 patients in Group 1, and seven in Group 2. The mortality in Group 1 was 35.7% (5/14) and in Group 2 was 0% (p = 0.12). There were no statistically significant differences in prognostic factors between the two groups, though patients in Group 1 had relatively lower platelet counts (p = 0.07) and Group 2 patients had a higher incidence of dialysis after nephrectomy (p = 0.03). Comparing the survivors and nonsurvivors, patients with comorbid congestive heart failure and patients initially presenting with consciousness disturbances had higher mortalities (p = 0.02 and p < 0.01, respectively). Nonsurvivors also had lower platelet counts (p = 0.06). In conclusion, medical treatment with/without PCD can be used to manage patients with EPN. More aggressive drainage is needed in patients with congestive heart failure who initially present with consciousness disturbances or thrombocytopenia.
Cerebellar Hemorrhage After Multiple Manual Pumping Tests of a Ventriculoperitoneal Shunt: A Case Report
Authors: Huang Chih‐Yuan , Hung Yu‐Chang , Tai Shih‐Huang , Lee E‐Jian
Published: April 2009

A manual pumping test is commonly used to verify the patency of a ventriculoperitoneal (V‐P) shunt. Complications occurring after manual pumping of the reservoir are rare. Here, we report a 73‐year‐old male hydrocephalic patient who had undergone uneventful V‐P shunt surgery 9 years ago. He developed a cerebellar hemorrhage after repetitive pressing of the shunt reservoir. The clinical manifestations, characteristic radiologic images, treatment outcome, and possible mechanisms of this late complication are presented. The risk of massive cerebrospinal fluid over‐drainage after repetitive manual pumping of the V‐P shunt reservoir, which can contribute to the formation of a cerebellar hemorrhage, warrants special attention and hydrocephalic patients and their caregivers should be informed and educated about this potential complication.
Real hypersurfaces of a complex projective space II
Authors: Maeda Sadahiro
Published: April 2009

We consider a certain real hypersurface M of a complex projective space. The purpose of this paper is to characterize M in terms of Ricci curvatures.
Coproducts of algebras and derivations on categories
Authors: Day B. J.
Published: April 2009

Coproducts and tensor products of algebras for essentially algebraic theories are exhibited as Kan extensions and relationships with derivations on monoidal closed categories are described.
Metric spaces which cannot be isometrically embedded in Hilbert space
Authors: Lu Yang , Jing-Zhong Zhang
Published: April 2009

Let A1A2A3A4, be a planar convex quadrangle with diagonals A1A3 and A2A4. Is there a quadrangle B1B2B3B4 in Euclidean space such that A1A3 < B1B3, A2A4 < B2B4 but AiAj > BiBj for other edges?

The answer is “no”. It seems to be obvious but the proof is more difficult. In this paper we shall solve similar more complicated problems by using a higher dimensional geometric inequality which is a generalisation of the well-known Pedoe inequality (Proc. Cambridge Philos. Soc.38 (1942), 397–398) and an interesting result by L.M. Blumenthal and B.E. Gillam (Amer. Math. Monthly50 (1943), 181–185).
Does the Frobenius endomorphism always generate a direct summand in the endomorphism monoids of fields of prime characteristic?
Authors: Pröhle Péter
Published: April 2009

Letrbe a given prime. Then a monoidMis the endomorphism monoid of a field of characteristicrif and only if eitherMis a finite cyclic group orMis a right cancellative monoid andMhas an element of infinite order in its centre. The main lemma is the technical base of the present and other papers.
An oscillation theorem for sublinear elliptic differential inequalities
Authors: Yoshida Norio
Published: April 2009

Sublinear elliptic differential inequalities with variable coefficients are studied. Sufficient conditions are given that all solutions are oscillatory in exterior domains. Riccati inequalities are used to establish sublinear oscillation criteria.
Elementary properties of vector space graphs
Authors: Orzech Grace
Published: April 2009

Let SΓ be a vector space graph. A graphic subspace of SΓ need not be a direct summand with a graphic complement. A necessary and sufficient condition for the existence of a graphic complement is given. Also, it is shown that every graphic subspace possesses an o-special basis which extends to an o-special basis of SΓ.
On the spectrum of the biharmonic operator in a bounded domain
Authors: Leung Pui-Fai , Li Luen-Chau
Published: April 2009

We obtain an asymptotically sharp lower bound for the sum of the first k eigenvalues of the biharmonic operator.
The minimal number of periodic orbits of periods guaranteed in Sharkovskii's theorem
Authors: Du Bau-Sen
Published: April 2009

Let f(x) be a continuous function from a compact real interval into itself with a periodic orbit of minimal period m, where m is not an integral power of 2. Then, by Sharkovskii's theorem, for every positive integer n with m → n in the Sharkovskii ordering defined below, a lower bound on the number of periodic orbits of f(x) with minimal period n is 1. Could we improve this lower bound from 1 to some larger number? In this paper, we give a complete answer to this question.
A note on positive semigroups
Authors: Yamamuro Sadayuki
Published: April 2009

A theorem of T. Ando, R. Nagel and H. Uhlig on the positivity of generators of some positive semigroups in Banach lattices can not be generalized to general ordered Banach spaces.
On a subclass of Bazilevic functions
Authors: Elhosh M.M.
Published: April 2009

Integral mean and coefficient bounds for some Bazilevic functions are determined.
On near-rings in which the constants form an ideal
Authors: Fuchs Peter
Published: April 2009

Let C denote the class of all near-rings which have the property that the subnear-ring of constants forms an ideal. Prominent examples are abstract affine near-rings and a generalisation of these by Feigelstock [1]. In this note we show C forms a variety and construct a proper sub-class such that every N ε C can be embedded into some . It turns out that near-rings have an ideal structure which is similar to the ideal structure of abstract affine near-rings, in contrast to the situation for arbitrary elements of C.
Nearest points to closed sets and directional derivatives of distance functions
Authors: Fitzpatrick Simon
Published: April 2009

We investigate the circumstances under which the distance function to a closed set in a Banach space having a one-sided directional derivative equal to 1 or −1 implies the existence of nearest points. In reflexive spaces we show that at a dense set of points outside a closed set the distance function has a directional derivative equal to 1.
Directional wave fronts of reaction-diffusion systems
Authors: Sabina J.
Published: April 2009

In this work, we study types of undulatory solutions, that we term Directional Wave Fronts (DWF), of non scalar reaction diffusion systems. The DWFs are a natural extension of the well known Plane Wave Fronts (PWFs) solutions. However, the DWFs admit a certain type of boundary conditions. In the present work we show, under suitable conditions on the reaction term, that DWFs also exhibit typical behaviour of PWFs: we just prove the existence of heteroclinic, homoclinic and periodic families of DWFs. Essentially, we require the reaction term to be linearly uncoupled. These results are the generalization of a previous work, concerning the scalar case.
Transcendence measures by Mahler's transcendence method
Authors: Becker-Landeck Paul-Georg
Published: April 2009

Let f(z) be an analytic function in the unit circle satisfying the functional equation f(z) = a(z) f(zρ) + b(z), where ρ is a natural number and a(z), b(z) are polynomials. If α is an algebraic number, we give a transcendence measure for f(α). This improves earlier results of Galochkin and Miller.
Positioning matrices with respect to the boundary of the maximal group
Authors: DeFranza J. , Fleming D.J.
Published: April 2009

Let Δ denote the Banach algebra of all conservative triangular matrics, M the maximal group of invertible elements of Δ, B the boundary of M and . In this note little Nörlund means are located with respect to the disjoint decomposition M u B u N of Δ in terms of the zeros of the generating power series. Further, corridor matrices of finite type, that is, conservative methods with finitely many convergent diagonals, are located with respect to M u B u N.
Lambek's operational categories
Authors: Jay C. B.
Published: April 2009

An operational category is a category of models for an equational theory where the interpretation of some operations is predetermined. Examples include the equational and co-equational categories of Linton, categories of functors preserving some class of limits, and algebras for a prop as defined by MacLane. The chief result is a characterisation of the operational categories and functors in terms of their internal structure.
A note on containment of operators
Authors: Loebl Richard I.
Published: April 2009

Two new types of containment of operators on Hilbert space, namely partial containment and semi-containment are introduced. We show in Proposition 11 that A is semi-contained in B if and only if the map P(B) → P(A) for polynomials P extends to be an ultra-weakly continuous completely positive map from all bounded operators on the underlying Hilbert space of B. We show in Theorem 15 that if an isometry is semi-contained in a contraction T, then T has a non-zero invariant subspace on which T is isometric. The semi-equivalence class of the simple unilateral shift is characterized in Theorem 18, and we show that a unilateral positive-weighted shift semi-contains the unilateral shift if and only the weights are eventually 1.
Sur les cones (faiblement complets) contenus dans le dual d'un espace de Banach non-reflexif
Authors: Becker Richard
Published: April 2009

Let B be a Banach space. consider the convex proper weakly complete cones X contained in B′ with σ(B′, B) such that X ∩ B′, is conic in the sense of Asimow: that is, there exists α ≥ 0 and f ∈ B″ such that ‖ ‖B ≤ f ≤ α·‖ ‖B on X. This class arises in the theory of integral representations.

If B is reflexive, such a cone has a weakly-compact basis. This paper considers the converse problem:- if one requires that X ∩ B′1 be σ(B′, B) metrisable, the existence of X (without a compact σ(B′, B) basis) is equivalent to the statement that B is not a Grothendieck space.

However, in every space C(K) with infinitely compact K, one can find such a cone X. If two such cones in B′ are not too far apart, their sum belongs to this class.
Weakly compact operators and the strict topologies
Authors: Aguayo José , Sánchez José
Published: April 2009

Let X be a completely regular space. We denote by Cb(X) the Banach space of all real-valued bounded continuous functions on X endowed with the supremum-norm.

In this paper we prove some characterisations of weakly compact operators defined from Cb(X) into a Banach space E which are continuous with respect to fit, βt, βr and βσ introduced by Sentilles.

We also prove that (Cb,(X), βi), i = t, τσ , has the Dunford-Pettis property.
Nearly integral homomorphisms of commutative rings
Authors: Dobbs David E.
Published: April 2009

A unital homomorphism f: R → T of commutative rings is said to be nearly integral if the induced map R/I → T/IT is integral for each ideal I of R which properly contains ker (f). This concept leads to new characterisations of integral extensions and fields. For instance, if R is not a field, then an inclusion R → T is integral if and only if it is nearly integral and (R, T) is a lying-over pair. It is also proved that each overring extension of an integral domain R is nearly integral if and only if dim (R) ≤ 1 and the integral closure of R is a Prüfer domain. Related properties and examples are also studied.