bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Complex, Surgically Intractable Intracranial Aneurysms: The Option for Intentional Reconstruction of Aneurysm Neck Followed by Endovascular Coiling
Authors: Chen Lukui , Kato Yoko , Sano Hirotoshi , Watanabe Sadayoshi , Yoneda Minoru , Hayakawa Motoharu , Sadato Akiyo , Irie Keiko , Negoro Makoto , Karagiozov Kostadin L. , Kanno Tetsuo
Published: April 2007

Background: A limited series of patients with aneurysm were reviewed retrospectively to analyze strategies for integrating microsurgical and endovascular techniques in the management of complex, surgically intractable aneurysms. Methods: Four patients were managed in Fujita Health University with a multimodality approach: intentional reconstruction of the aneurysm neck followed by endovascular coiling. Results: A total of 5 aneurysms were treated, of which 3 were large or giant in size, and 3 were fusiform or multilobulated. Complete angiographic obliteration was confirmed in 4 aneurysms (80%). All patients had a good outcome (Glasgow Outcome Scale score 5; mean follow-up, 64 months). Conclusion: As for complex, surgically intractable aneurysms, the intentional reconstruction of the aneurysm neck followed by endovascular coiling should be considered more often.
Paraoxonase 2 Gene C311S Polymorphism Is Associated with a Risk of Large Vessel Disease Stroke in a Polish Population
Authors: Slowik Agnieszka , Wloch Dorota , Szermer Pawel , Wolkow Pawel , Malecki Maciej , Pera Joanna , Turaj Wojciech , Dziedzic Tomasz , Klimkowicz-Mrowiec Aleksandra , Kopec Grzegorz , Figlewicz Denise A. , Szczudlik Andrzej
Published: April 2007

Background: Oxidative stress plays a role in atherosclerosis. Human paraoxonase (PON) gene products exhibit antioxidant properties. We studied the significance of the Q192R and M55L polymorphisms of the PON1 gene and the C311S polymorphism of the PON2 gene in different etiologies of ischemic stroke. Methods: One hundred and thirty-six patients with large vessel disease (LVD) stroke, 140 with small vessel disease stroke, 272 with cardioembolic stroke, and their age- and sex-matched controls were included. PON genotypes were evaluated by PCR-RFLP analyses. Results: The distribution of PON1 polymorphisms was similar in each stroke group and in the respective controls. Genotypes with the C allele of the PON2 gene C311S polymorphism were overrepresented in LVD stroke patients as compared with their controls, both in univariate and multivariate (dominant model: OR = 1.58, 95% CI: 1.006–2.48) analyses. Conclusion: The genotype with the C allele of the PON2 gene is a risk factor for LVD stroke in a Polish population.
Coping Strategies as Determinants of Quality of Life in Stroke Patients: A Longitudinal Study
Authors: Darlington Anne-Sophie E. , Dippel Diederik W.J. , Ribbers Gerard M. , van Balen Romke , Passchier Jan , Busschbach Jan J.V.
Published: April 2007

Background: Quality of life (QoL) is reduced for stroke patients and coping strategies have been suggested as determinants of QoL. Thus far the relationship between coping and QoL has only been examined in small-scale cross-sectional designs. Therefore, the current study set out to examine this relationship in a longitudinal setting. Methods: Stroke patients who were discharged home were interviewed at 4 different time points; just before discharge (T1), and 2 months (T2), 5 months (T3) and 9–12 months after discharge (T4). QoL was measured by the EQ-5D index score and the SF-36 utility score and coping expressed in terms of tenacious goal pursuit and flexible goal adjustment. Modified Rankin scale was assessed as a measure of general functioning. Results: Eighty stroke patients were included. Coping was not predictive of QoL at T1 and T2 but rather at T3 and T4. At T4 both coping strategies determined the levels of QoL as measured with the EQ-5D index score; higher levels of tenacious goal pursuit as well as flexible goal adjustment were associated with higher levels of QoL. This regression model explained 44% of the variance. Conclusions: Coping is a powerful determinant of QoL, but only more than 5 months after discharge; before this time QoL is mainly determined by general functioning. Both coping strategies were important determinants of QoL.
Cognitive Disorders in Acute Stroke: Prevalence and Clinical Determinants
Authors: Nys G.M.S. , van Zandvoort M.J.E. , de Kort P.L.M. , Jansen B.P.W. , de Haan E.H.F. , Kappelle L.J.
Published: April 2007

Background: Although cognitive impairment early after stroke is a powerful predictor of long-term functional dependence and dementia, little is known about the characteristics and determinants of cognitive dysfunction in acute stroke. Methods: We administered a neuropsychological examination covering 7 cognitive domains to 190 patients within 3 weeks after a first stroke. We also assembled lesion characteristics, clinical factors at admission, demographic characteristics and vascular risk factors. Multivariate logistic regression adjusted for age, gender and education was performed to examine determinants of acute cognitive impairment. Results:Overall, 74% of patients with a cortical stroke, 46% with a subcortical stroke and 43% with an infratentorial stroke demonstrated acute cognitive impairment.Disorders in executive functioning (39%) and visual perception/construction (38%) were the most common. The prevalence and severity of deficits in executive functioning, language, verbal memory and abstract reasoning was more pronounced following left compared to right cortical stroke (all p < 0.05). Intracerebral haemorrhage (OR = 5.6; 95% CI = 1.2–25.4) and cortical involvement of the stroke (OR = 3.6; 95%, CI = 1.3–9.9) were independent determinants of acute cognitive impairment, whereas premorbid moderate alcohol consumption exerted a protective effect (OR = 0.4; 95% CI = 0.1–1.1). Conclusions:Cognitive impairment is common in the first weeks after stroke, with executive and perceptual disorders being the most frequent. Intracerebral haemorrhage, cortical involvement of the lesion and premorbid moderate alcohol consumption are independently associated with acute cognitive impairment.
Quality of Life 6 Months after Acute Stroke: Impact of Initial Treatment in a Stroke Unit and General Medical Wards
Authors: Stavem Knut , Rønning Ole Morten
Published: April 2007

Background and Purpose: Few studies have assessed the influence of the organization of stroke care on health-related quality of life (HRQoL). The present study compared HRQoL 6 months after stroke between subjects who had been treated in an acute stroke unit (SU) and those treated in general medical wards (GMW). Methods: In total 550 subjects≧60 years of age with acute stroke were prospectively allocated according to date of birth (day of the month) to treatment in an SU with short length of stay or GMWs. In the present study, 325 survivors at 5 days with Scandinavian stroke scale (SSS) orientation score >5 and SSS speech score >5 were included. We assessed HRQoL with the Short Form 36 (SF-36) questionnaire 6 months after stroke onset and estimated utility values from the SF-36 scores. Results: Of the 325 eligible subjects, 158 were allocated to an SU and 167 to GMWs. Among 296 survivors at 6 months, 115 subjects (79% of survivors) in the SU group completed the questionnaire and 121 (80%) in the GMW group. There was no statistically significant difference between the treatment groups on any of the 8 SF-36 scales or the 2 component summary scales. After integrating death in the comparison of HRQoL, there was still no difference in outcome between the groups. Conclusion: An acute SU with a short length of stay, offering early treatment and rehabilitation, could not show an improvement in the HRQoL of stroke patients ≧60 years 6 months after stroke compared with initial treatment in GMWs.
Knowledge and Understanding of Disease Process, Risk Factors and Treatment Modalities in Patients with a Recent TIA or Minor Ischemic Stroke
Authors: Maasland Lisette , Koudstaal Peter J. , Habbema J. Dik F. , Dippel Diederik W.J.
Published: April 2007

Background: Patients with acute stroke often have a striking lack of knowledge of causes, warning signs, and risk factors. Lack of knowledge may lead to inappropriate secondary prevention behavior. We investigated the knowledge of patients with a TIA or minor stroke about specific aspects of their disease 3 months after the event. Methods: Patients with a TIA or minor stroke who participated in a randomized controlled trial of the effect of health education by an individualized multimedia computer program (IMCP) were included. All patients received information about their disease from their treating neurologist and half of the patients received extra information through the IMCP. The patients’ knowledge was tested after 3 months by means of a questionnaire that contained items on pathogenesis, warning signs, vascular diseases, risk factors, lifestyle and treatment. The highest possible score was 71 points. Results: The 57 patients had a mean total score of 41.2 points (SD 10.4) of the maximum 71. Only 15 (26%) correctly identified the brain as the affected organ in stroke and TIA, and only 21 (37%) could give a correct description of a TIA or stroke. In contrast, 80–90% of the patients identified hypertension and/or obesity as vascular risk factors. Knowledge of various treatment modalities of hypertension, hypercholesterolemia and obesity was moderate to high (40–91% adequate responses). Conclusion: The vast majority of patients with TIA or stroke lack specific knowledge about their disease, but they do have a reasonable knowledge of general vascular risk factors and treatment. This suggests that counseling by neurologists of patients with a TIA or stroke can be improved.
Testing a Method for Quantifying the Output of Implantable Middle Ear Hearing Devices
Authors: Rosowski J.J. , Chien W. , Ravicz M.E. , Merchant S.N.
Published: April 2007

This report describes tests of a standard practice for quantifying the performance of implantable middle ear hearing devices (also known as implantable hearing aids). The standard and these tests were initiated by the Food and Drug Administration of the United States Government. The tests involved measurements on two hearing devices, one commercially available and the other home built, that were implanted into ears removed from human cadavers. The tests were conducted to investigate the utility of the practice and its outcome measures: the equivalent ear canal sound pressure transfer function that relates electrically driven middle ear velocities to the equivalent sound pressure needed to produce those velocities, and the maximum effective ear canal sound pressure. The practice calls for measurements in cadaveric ears in order to account for the varied anatomy and function of different human middle ears.
Comparison of Incidence of Peritonitis between Peritoneal Dialysis Solution Types
Authors: Duranay Murat , Kanbay Mehmet , Turgut Faruk , Altay Mustafa , Akcay Ali
Published: April 2007

Background: Peritonitis is an important cause of morbidity and mortality in patients receiving peritoneal dialysis (PD). However, there are no data about the comparison of the incidence of peritonitis among PD solution types. The aim of the present study was to compare the incidence of peritonitis among PD solutions in PD patients treated either with Nutrineal or with Extraneal or with conventional glucose solutions. Materials and Methods: A total of 147 patients (60 female and 87 male) who underwent PD were included in the study. Of these patients, 47 used only glucose solutions (group I), 79 used glucose solutions combined with Extraneal (group II) and 21 used glucose solutions combined with Nutrineal (group III). The laboratory values and demographics of the patients were noted. Results: There was no significant difference in the frequency of peritonitis among the three groups. Peritonitis occurred in 14 of 47 patients (29.8%) in group I, in 28 of 79 patients (35.4%) in group II and in 6 of 21 patients (28.6%) in group III. Patients with serum albumin levels below 3 g/dl had a significantly higher peritonitis rate than patients with serum albumin levels above 3 g/dl (p < 0.05). Conclusion: We have shown that a low serum albumin level is an important risk factor for the development of peritonitis in CAPD patients. The PD solution does not appear to be a risk factor for the development of peritonitis in CAPD patients, although this question should be studied further with larger numbers.
Effect of Renal Ischemia/Reperfusion on Gene Expression of a pH-Sensitive K+ Channel
Authors: Garcia M.A. , Meca R. , Leite D. , Boim M.A.
Published: April 2007

Background: Sodium reabsorption depends on the Na/K/ATPase activity coupled to basolateral K+ recycling through K+ channels. ATP depletion reduces pump activity and increases K+ leak resulting in transport dysfunction. Kir4.1 is a pH-sensitive K+ channel expressed in the basolateral membrane of distal tubules. In this study, we evaluated whether Kir4.1 is also expressed in proximal tubules (PTs) and whether renal ischemia alters Kir4.1 mRNA expression levels. Methods: The presence of Kir4.1 mRNA was evaluated in PTs microdissected from collagenase-treated rat kidneys. Kir4.1 expression levels were estimated in the renal cortex by multiplex RT-PCR after 30 or 60 min of renal ischemia followed by 1, 24, 48 or 72 h of reperfusion. Results: The PCR product obtained from isolated tubules was sequenced and showed ∼98% homology with rat Kir4.1 cDNA. Ischemia/reperfusion for 30 min induced a time-dependent reduction in Kir4.1 mRNA expression in parallel with plasma creatinine, however recovery was delayed after 60 min of ischemia, remaining reduced after 72 h of reperfusion when plasma creatinine was already normalized. Conclusion: Kir4.1 mRNA expression was decreased by renal ischemia. The ischemia-induced cellular K+ loss may be minimized by Kir4.1 downregulation and may contribute to the mechanism by which cellular acidification induces cell protection against ATP depletion.
Novel PHEX Mutation Associated with Hypophosphatemic Rickets
Authors: Roetzer Katharina M. , Varga Franz , Zwettler Elisabeth , Nawrot-Wawrzyniak Kamilla , Haller Joerg , Forster Ernst , Klaushofer Klaus
Published: April 2007

Background: X-linked hypophosphatemia (XLH) is the most prevalent heritable form of rickets. It is a dominantly inherited disorder, characterized by renal phosphate wasting, abnormal vitamin D and PTH metabolism, and defective bone mineralization. Inactivating mutations in the gene encoding PHEX (phosphate-regulating gene with homologies to endopeptidases on the X chromosome) have been found to be associated with XLH. Methods: We report about a 54-year-old male patient who exhibited the typical features of XLH, and in whom mutational analysis using PCR and sequencing was performed. Additionally, extensive laboratory and radiological investigations were carried out. Results: A 1-bp deletion in exon 2 of the PHEX gene was detected (177delC), which, to the best of our knowledge, has not been reported yet. This deletion results in a premature stop codon (C59X), suggesting a truncation of the PHEX protein. Furthermore, elevated FGF23 and PTH levels as well as an increased axial bone mineral density score were measured. Conclusions: We present a male patient with XLH, who harbors a novel mutation in the PHEX gene, which might be the cause for his disease. Our data support previous findings and therefore contribute to the decipherment of the pathogenetic pathways of XLH.
Efficacy and Safety of Galantamine in Patients with Dementia with Lewy Bodies: A 24-Week Open-Label Study
Authors: Edwards Keith , Royall Donald , Hershey Linda , Lichter David , Hake Ann , Farlow Martin , Pasquier Florence , Johnson Stewart
Published: April 2007

Background: Dementia with Lewy bodies (DLB) is a common dementia of the elderly. A significant cholinergic deficit has been demonstrated that may be responsive to treatment by cholinesterase inhibitors (ChEIs). Methods: A 24-week, open-label study was designed to assess the efficacy and safety of a ChEI, galantamine, in 50 patients with DLB. Results: This study showed beneficial effects with galantamine in 2 of the 3 primary efficacy parameters. The scores on the Neuropsychiatric Inventory (NPI-12) improved by 8.24 points from baseline (p = 0.01) especially in visual hallucinations and nighttime behaviors (p = 0.004). The scores on the Clinician’s Global Impression of Change improved by 0.5 points from baseline (p = 0.01). The third primary efficacy parameter, the Cognitive Drug Research Computerized Cognitive Assessment System, was unchanged from baseline. Adverse events were generally mild and transient. Conclusion: Galantamine appears to be an effective and safe therapy for patients with DLB.
Effects of Mitemcinal (GM-611), an Acid-Resistant Nonpeptide Motilin Receptor Agonist, on the Gastrointestinal Contractile Activity in Conscious Dogs
Authors: Ozaki Ken-ichi , Yogo Kenji , Sudo Hirokazu , Onoma Mitsu , Kamei Kenshi , Akima Michitaka , Koga Hiroshi , Itoh Zen , Ōmura Satoshi , Takanashi Hisanori
Published: April 2007

The effects of mitemcinal (GM-611) on the gastrointestinal contractile activity were investigated using chronically implanted force transducers in conscious dogs and were compared with the effects of porcine motilin (pMTL), EM-523 and EM-574. In the interdigestive state, intravenous and oral administration of mitemcinal, EM-523 and EM-574 induced the gastrointestinal contractile activity in a manner similar to pMTL. The contractile activity caused by mitemcinal was suppressed by continuous intravenous infusion of a motilin receptor antagonist. In the digestive state, intravenous and oral administration of mitemcinal, EM-523 and EM-574 also stimulated the gastrointestinal contractile activity. Mitemcinal, EM-523 and EM-574 given intravenously increased the gastric contractile activity in a similar dose range; however, mitemcinal was approximately 10 times more potent than EM-523 and EM-574 when administered orally in the digestive state. These results indicate that the mitemcinal-induced gastrointestinal contractile activity operates via motilin receptors and possesses a higher activity than EM-523 and EM-574 when administered orally in conscious dogs in the digestive state. Mitemcinal may therefore be useful in the treatment of several gastrointestinal disorders involving dysmotility, such as gastroparesis and functional dyspepsia, even when administered orally.
Olfactory Dysfunction in Nasal Polyposis: Correlation with Computed Tomography Findings
Authors: Konstantinidis Iordanis , Triaridis Stefanos , Printza Athanasia , Vital Victor , Ferekidis Eleftherios , Constantinidis Jannis
Published: April 2007

Aims: This study evaluates if a computed tomography (CT) scan is useful to assess the olfactory loss in sinonasal disease, and if a preoperative CT scan has a predictive value for the long-term outcome regarding olfaction. Methods: Thirty-one patients with nasal polyposis were included. Olfactory function was assessed with the ‘Sniffin’ Sticks’ test and subjective perception recorded with a visual analogue scale. CT scans were assessed with the Lund-Mackay system and the Damm nasal segmentation. Patients were retested after endoscopic sinus surgery in a follow-up appointment at least 1 year later. Results: Disease in the upper meatus and the posterior portion of the middle meatus strongly affects olfactory function. Lund-Mackay scores were significantly correlated with preoperative olfactory test results. Preoperative subjective ratings had a significant correlation only with present disease in the anterior upper meatus. Postoperative results were significantly decreased. Their relative percentage change was correlated only with the preoperative presence of disease in the anterior upper meatus. No correlation was found between the Lund-Mackay score and the postoperative olfactory results. Conclusions: Olfactory dysfunction in nasal polyposis is strongly related to specific obstructed nasal areas. A CT scan has no predictive value for the long-term surgical outcome regarding olfaction.
NK Cell Increase in Neonates from the Preterm to the Full-Term Period of Gestation
Authors: Pérez Alicia , Gurbindo María Dolores , Resino Salvador , Aguarón Ángel , Muñoz-Fernández María Ángeles
Published: April 2007

Background: Several studies have reported differences in lymphocyte phenotype in preterm and full-term neonates as compared to children and adults. However, a detailed description of the immunologic cell populations of neonates corresponding to the gestational age is needed. This will be helpful for clinical practice to find the best way to prevent neonatal infections or strengthen the immune system of newborns with some kind of immunodeficiency. Objective: To study maturation of the immune system throughout gestation, describing the variations of the lymphocyte populations in function of the gestational week when born. Methods: We performed a descriptive study in 134 healthy newborns (gestation age 25–42 weeks), quantifying the relative and absolute counts of cell populations in umbilical cord blood obtained during delivery, by a four-color flow cytometry single platform. Results: We first compared the very-preterm (25–30 weeks), preterm (31–36 weeks) and full-term (37–42 weeks) neonates. We found higher absolute counts of all cell populations in the full-term group and lower absolute and relative values of NK cells in the very-preterm group. After that, we analyzed the lymphocyte populations week to week (from week 31 to 41) and found the lowest values of T cells (CD4+ and CD8+) for week 36. However, lower percentages of CD4+ T cells and higher percentages of NK cells were observed in week 38 and 41. Conclusion: We found an increase in cord blood NK cells with gestational age, both in terms of absolute counts and of percentage values. Moreover, the %NK cells showed a pattern opposite to %CD4+ T cells along the studied period.
Is There Nystagmus Habituation to Angular Acceleration in Man?
Authors: Toglia Joseph U. , Suranyi Leslie , Kosmorsky Gregory S.
Published: April 2007

10 healthy volunteers, ranging in age from 20 to 30 years, were subjected to rotatory stimulation at 1°, 2° and 4°/s2 acceleration and deceleration, repeated four times at weekly intervals. Nystagmus was recorded with electronystagmography. Slowphase velocity and the total numbers of nystagmic spikes were analyzed. There was no evidence for habituation in this experiment, which is in agreement with the majority of previous publications.
Selective Limbotomy
Authors: Picaza J.A. , Hunter S.E.
Published: April 2007

A method is designed dividing the limbic system into sectors. The method was tested by analyzing 50 procedures carried out by the authors. Rostral limbotomies, performed either by open techniques (cingulectomy) or by stereotactic surgery, showed similar results, although recurrence was more frequent with stereotaxis. Comparison with other described procedures on the same areas revealed similar results. Analysis suggests that the interruption of the cingulum was responsible for the permanent behavior modification and not the interruption of intersecting anatomical systems.
Effects of Haemodialysis on Circulating Endothelial Progenitor Cell Count
Authors: Sturiale Alessio , Coppolino Giuseppe , Loddo Saverio , Criseo Manila , Campo Susanna , Crascì Eleonora , Bolignano Davide , Nostro Lorena , Teti Diana , Buemi Michele
Published: April 2007

During haemodialysis (HD) the endothelium is the first organ to sense and to be impaired by mechanical and immunological stimuli. We hypothesized that a single HD session induces mobilization of endothelial progenitor cells (EPCs) and that cardiovascular risk factors may influence this process. We quantified EPCs at different maturational stages (CD34+, CD133+/VEGFR2+) in blood samples from 30 patients, during HD and on the interdialytic day, and in 10 healthy volunteers. Samples were drawn at the start of HD, 1, 2 and 3 h after, at the end of HD and at 24 h on the interdialytic day. Patients were divided into two groups based on a recent risk scoring system (SCORE project): low-risk (LR) and high-risk groups (HR). HD patients showed a significantly reduced basal number of EPCs with respect to healthy volunteers. In contrast, we observed increasing EPCs during HD whereas they diminished on the interdialytic day. The EPC number was directly correlated with HD time progression. The EPC number during HD was increased in the HR group with respect to the LR group. We had a direct correlation between risk score and number of EPCs. Cardiovascular risk factors influenced the mobilization of stem cells from the bone marrow. This feature could be the direct consequence of an augmented request of stem cells to respond to the most important endothelial impairment but could also show a defective capacity of EPCs to home in and repair the sites of vascular injury.
Metabolic Syndrome Predicts Hospitalization in Hemodialysis Patients: A Prospective Asian Cohort Study
Authors: Yang Shao-Yu , Chiang Chih-Kang , Hsu Shih-Ping , Peng Yu-Sen , Pai Mei-Fen , Ho Tai-I , Hung Kuan-Yu , Wu Kwan-Dun
Published: April 2007

Background/Aims: Metabolic syndrome (MS) increases morbidity and mortality in the general population. The effects of individual components of MS differ in hemodialysis (HD) patients, but the composite effects of MS in this population are unknown. Methods: We performed a prospective, cohort study including 235 HD patients who were followed up for 3 years. We used modified Asian criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) to define the presence of MS, and compared the hospitalizations and deaths in patients with and without MS. Results: Patients with MS had a lower hospitalization-free ratio, greater annual hospitalization days and frequency than those without MS. The relative risk of the presence of MS was 1.669 in predicting first hospitalization for all causes. Conclusion: The modified Asian criteria for MS successfully predicted the risk of hospitalization as compared with NCEP ATP III criteria in HD patients.
Decreased Treatment Failure Rates following Duodenal Release Ferrous Glycine Sulfate in Iron Deficiency Anemia Associated with Autoimmune Gastritis and Helicobacter pylori Gastritis
Authors: Hershko Chaim , Ianculovich Mara , Souroujon Moshe
Published: April 2007

Background and Objectives: Since gastric acidity and ascorbate play a critical role in the solubilization and reduction of iron for subsequent absorption, the achlorhydria associated with autoimmune and Helicobacter pylori gastritis may explain the poor response of such patients to oral iron treatment. In order to circumvent this problem, we explored the therapeutic potential of a duodenal formulation of ferrous glycine sulfate consisting of micropellets that do not dissolve at the acid environment of the stomach but, owing to their solubility at a higher pH, discharge their content directly into the duodenum. Design and Methods: In a case-control study, the treatment results of 39 patients with iron deficiency anemia receiving a duodenal formulation of ferrous glycine sulfate (group A) were compared with the results of 39 patients receiving other oral iron compounds (group B). Autoimmune gastritis, H. pylori gastritis or both were present in over 75% of patients in each group. Results: After 1 and 3 months of treatment, mean hemoglobin in group A increased from 9.5 ± 1.2 to 11.2 ± 1.3 and 12.8 ± 1.3 g/dl, respectively. By comparison, in group B, the corresponding values increased from 9.3 ± 1.3 to 10.2 ± 1.5 (p = 0.019) and 11.1 ± 1.7 g/dl (p = 0.022). A favorable response, defined as a more than 2 g/dl increase in basal hemoglobin or hemoglobin exceeding 12 g/dl, was obtained in 33 of 39 patients in group A compared with only 18 of 39 in group B (p = 0.009). Because of treatment failure, 14 patients in group B were subsequently referred for intravenous ferric sucrose therapy versus only 3 in group A (p < 0.0001). Conversely, of 5 patients in group A managed by intravenous iron prior to referral, 4 became independent of parenteral iron after starting the duodenal formulation of ferrous glycine sulfate. Interpretation and Conclusions: In patients with iron deficiency anemia associated with autoimmune and H. pylori gastritis with a high rate of refractoriness to oral iron treatment, satisfactory response to a duodenal formulation of ferrous glycine sulfate can be elicited in the vast majority of cases, obviating the need for expensive, inconvenient and occasionally risky intravenous iron administration.
Long-Term Outcomes of Cinacalcet and Paricalcitol Titration Protocol for Treatment of Secondary Hyperparathyroidism
Authors: Lazar Eric , Hebert Katrina , Poma Tammy , Stankus Nicole
Published: April 2007

Long-term outcomes of combined cinacalcet and paricalcitol therapy for secondary hyperparathyroidism (SHPT) in patients failing traditional therapies with phosphate binders and active vitamin D compound analogs are not well described. We implemented a titration protocol for cinacalcet and paricalcitol and assessed its long-term effects on bone metabolism and disease in hemodialysis (HD) patients. Thirty-five patients were started on 30 mg of cinacalcet daily. After 12 months, median cinacalcet dose was 60 mg. There was a 33% increase in number of patients receiving paricalcitol. Average corrected serum calcium (Ca) decreased from 9.5 to 8.8 mg/dl (p = 0.003, 95% CI 0.34–1.04); phosphorus (P) from 6.2 to 5.5 mg/dl (p = 0.047, 95% CI 0.01–1.34); Ca × P product from 58 to 48 (p = 0.001, 95% CI 4.2–15.7); and intact PTH (iPTH) from 426 ± 274 to 300 ± 228 pg/ml (p = 0.03, 95% CI 19.3–401.7). Number of patients achieving three or more K/DOQI criteria increased by 29% (p = 0.009).
cAMP-Specific Phosphodiesterase-4 Enzymes in the Cardiovascular System
Authors: Houslay Miles D. , Baillie George S. , Maurice Donald H.
Published: April 2007

Cyclic AMP regulates a vast number of distinct events in all cells. Early studies established that its hydrolysis by cyclic nucleotide phosphodiesterases (PDEs) controlled both the magnitude and the duration of its influence. Recent evidence shows that PDEs also act as coincident detectors linking cyclic-nucleotide– and non–cyclic-nucleotide–based cellular signaling processes and are tethered with great selectively to defined intracellular structures, thereby integrating and spatially restricting their cellular effects in time and space. Although 11 distinct families of PDEs have been defined, and cells invariably express numerous individual PDE enzymes, a large measure of our increased appreciation of the roles of these enzymes in regulating cyclic nucleotide signaling has come from studies on the PDE4 family. Four PDE4 genes encode more than 20 isoforms. Alternative mRNA splicing and the use of different promoters allows cells the possibility of expressing numerous PDE4 enzymes, each with unique amino-terminal-targeting and/or regulatory sequences. Dominant negative and small interfering RNA–mediated knockdown strategies have proven that particular isoforms can uniquely control specific cellular functions. Thus the protein kinase A phosphorylation status of the β
2
adrenoceptor and, thereby, its ability to switch its signaling to extracellular signal-regulated kinase activation, is uniquely regulated by PDE4D5 in cardiomyocytes. We describe how cardiomyocytes and vascular smooth muscle cells selectively vary both the expression and the catalytic activities of PDE4 isoforms to regulate their various functions and how altered regulation of these processes can influence the development, or resolution, of cardiovascular pathologies, such as heart failure, as well as various vasculopathies.
In Vivo Thrombus Formation in Murine Models
Authors: Sachs Ulrich J.H. , Nieswandt Bernhard
Published: April 2007

Platelets play a central role in hemostasis, but also in atherothrombosis, as they rapidly adhere to tissue and to one another as a response to any vascular injury. This process involves a large number of surface receptors, signaling pathways, and enzymatic cascades as well as their complex interplay. Although in vitro experiments proved successful in both identifying new receptors and pathways and developing potent and selective antithrombotic drugs, in vitro research cannot mimic the myriad hemodynamic and spatiotemporal cellular and molecular interactions that occur during the generation and propagation of thrombi in vivo. Animal models, and, with the availability of genetically modified mouse strains and of modern intravital imaging techniques, mouse models in particular, have opened new ways to identify both individual roles and the interplay of platelet proteins in complex in vivo settings. In vivo models revealed the important role of, eg, Gas6 or blood coagulation factor XII in thrombus formation, and results obtained in in vivo models raised the interesting possibility that (physiologic) hemostasis and (pathologic) thrombosis might represent 2 mechanistically different processes. This review summarizes in vivo findings that contributed significantly to our understanding of hemostatic and thrombotic processes and which may help to guide future research.
Vascular Remodeling in Transplant Vasculopathy
Authors: Mitchell Richard N. , Libby Peter
Published: April 2007

As therapeutic strategies to prevent acute rejection progressively improve, transplant vasculopathy (TV) constitutes the single most important limitation for long-term functioning of solid organ allografts. In TV, allograft arteries characteristically develop severe, diffuse intimal hyperplastic lesions that eventually compromise luminal flow and cause ischemic graft failure. Traditional immunosuppressive strategies that check acute allograft rejection do not prevent TV; indeed 50% of transplant recipients will have significant disease within five years of organ transplantation, and 90% will have significant TV a decade after their surgery. TV can involve the entire length of the transplanted arterial bed, including penetrating intraorgan arterioles. Indeed, the luminal narrowing of such penetrating vessels may be the most functionally significant because arterioles represent the major contributors to tissue vascular resistance. Because of the diffuseness of TV involvement in the allograft vascular bed, the only currently definitive therapy requires re-transplantation. Nevertheless, as we better understand the pathogenesis and critical mediators of these lesions, pharmacological advances can be anticipated. Other articles in this thematic review series focus on the specifics of the inciting injury, the cytokines and chemokines that drive TV development, and the nature of the recruited cells in TV lesions, as well as the pathogenic similarities between TV and other vascular lesions such as atherosclerosis. This review focuses on the mechanisms of vascular wall remodeling in TV, including the intimal accumulation of smooth muscle–like cells and associated extracellular matrix, medial smooth muscle cell degeneration, and adventitial fibrosis. A brief overview highlights the aneurysmal changes that can accrue when vessel wall inflammation has a cytokine profile distinct from the typical proinflammatory interferon-γ–dominated milieu.
Seasonal and diurnal variation in the proportions of female morphs of the damselfly Enallagma cyathigerum
Authors: Bots Jessica , De Bruyn Luc , Adriaens Tim , Dumont Henri , Stoks Robby , Van Gossum Hans
Published: April 2007

In many damselfly species a female-limited colour polymorphism is encountered which is assumed to be the result of sexual conflict. Typically, one morph resembles the male's body colouration (andromorph), while the other is dissimilar (heteromorph). Little is known about the extent of temporal variation in female morph proportions at the water where mating occurs. Knowledge about such variation should help to identify the factors that affect female morph proportion and the scales at which these factors operate. The objective of this study is to assess the occurrence of diurnal and seasonal variation in female morph proportions at the water for the damselfly Enallagma cyathigerum. Diurnal variation was evaluated at six nearby populations, while seasonal variation was examined at one of these populations. Furthermore, we considered temporal variation in female morph proportion in relation to proxies of male harassment (i.e., male density and operational sex ratio). Our findings indicate that female morph proportion varies throughout a day but is uniform on a seasonal scale. Variation in female morph proportions could not be explained by concomitant variation in male density or operational sex ratio. We suggest future study of male mate choice may consider temporal variation in female morph proportions at the water.
Anti-predation behaviour of Dickerson's collared lizard, Crotaphytus dickersonae
Authors: Plasman Melissa , Duchateau Marie José , Macedonia Joseph
Published: April 2007

Males of Dickerson's collared lizard (Crotaphytus dickersonae) are conspicuously bright blue in colour and can be detected at great distances. In contrast, females are brown and much less conspicuous. Given the visibility of males to predators, the question arises how they avoid predation and whether the sexes differ in anti-predator behaviour. Using a slowly approaching human as a simulated predator, approach and flight distances were recorded, as were the presence of other anti-predation responses such as pursuit deterrence signalling, distraction behaviour and aggressive threat. The lizards were captured and physical data such as cloacal temperatures, weight and snout-vent length were obtained. To assess further the effect of coloration on predation pressure, test subjects were painted to make them inconspicuous (brown) or conspicuous (blue) and recaptured after a week. After shedding their painted skin, subjects were approached one final time. Few direct relationships were found between anti-predation displays and body weight, size or temperature. Exhibition of pursuit deterrence signalling or distraction behaviour was rare, and no subject displayed aggressive behaviour (except when caught). Interestingly, males fled sooner, and tended to use more refuge than females, which probably indicates stronger predation pressure on males. However, an overall low use of refuge, the observer's ability to approach most subjects closely before they fled, and few sightings of potential predators, suggest that weak local predation pressure helps to explain why sexually selected conspicuous male coloration has been able to evolve in C. dickersonae.
Aspects of body size and mate choice in the simultaneously hermaphroditic pond snail Lymnaea stagnalis
Authors: Koene Joris , Montagne-Wajer Kora , Maat Andries Ter
Published: April 2007

Body size can be a good indicator of the quality of a potential mate in terms of fecundity. In many hermaphrodites, egg production is positively correlated with body size. Especially when donating sperm is costly, a preference for larger partners might be expected. Here we test this prediction for the great pond snail Lymnaea stagnalis. As expected, we find a clear effect of body size on egg production, and show that shell height can be used as a reliable predictor of body size. Additionally, behavioural observations reveal that these snails are not physically limited in mating with a much larger or smaller partner. Nonetheless, both in a choice experiment as well as in spontaneous copulations, we find no evidence of mate choice based on body size. These results contribute to a growing field of research which attempts to understand the evolution of the wide variation in the ways that hermaphroditic species respond to the size of potential mating partners.
Tracking sperm of a donor in a recipient: an immunocytochemical approach
Authors: Schärer Lukas , Zaubzer Johanna , Salvenmoser Willi , Seifarth Christof , Ladurner Peter
Published: April 2007

In order to study the mechanisms of sperm competition and cryptic female choice we require an understanding of the patterns of sperm storage, sperm removal and sperm digestion. Current studies infer these patterns mainly from paternity data, which only reveal the ultimate outcomes of the interactions between male and female reproductive processes. However, only with a mechanistic understanding of the fate of received sperm, and the involved patterns of postcopulatory sexual selection, can we understand the evolution of male and female reproductive morphology and physiology. The currently available approaches for tracking donor sperm in a recipient are either very time consuming, spatially imprecise or limited to model organisms for which considerable genetic knowledge and molecular know-how is available. Using the free-living flatworm Macrostomum lignano we here present a novel sperm tracking approach that uses DNA-labelling with a halogenated pyrimidine and localisation of the label using immunocytochemistry. We first outline modifications to established protocols to allow visualisation of gametic cells, in addition to somatic cells, determine the duration and patterns of spermatogenesis, and then show that labelled sperm from labelled donors can be observed in unlabelled recipients. We further show that labelled worms have a mating behaviour that is comparable to that of unlabelled worms except in one parameter. We suggest ways in which this approach can be optimised, and that it should be readily transferable to other taxa. We conclude that this approach will be a valuable tool to study postcopulatory sexual selection.
Mating behaviour in the terrestrial slug Deroceras gorgonium: is extreme morphology associated with extreme behaviour?
Authors: Reise Heike , Visser Stefanie , Hutchinson John
Published: April 2007

Mating in Deroceras consists of an investigation phase (precourtship), then a long courtship involving mutual stroking with the extruded sarcobelum, then sperm exchange (copulation). The penial gland, if present, everts over the partner's skin during copulation: this is hypothesised to apply a secretion manipulating the partner to use received sperm. Deroceras gorgonium has a particularly large penial gland divided into many finger-like branches. We studied D. gorgonium mating behaviour in the hope of further indications of the gland's function. Precourtship and courtship together last longer than in other Deroceras (ca. 6 h to >9 h); precourtship is highly variable, often with many bouts of different behaviours, including seemingly inactive phases. During most of the courtship partners remain apart waving their particularly long, pointed sarcobela; only at a later stage do the tips of these contact the partner. This waving alternates with circling for half a turn. For the first time in Deroceras we observed the sarcobelum transferring a secretion. The copulation is amongst the fastest: genital eversion and sperm exchange occur within 1 s, and slugs separate 18-25 s later. The penial gland is everted immediately after sperm exchange, but, surprisingly, is often spread underneath the partner rather than over its back and, if on top, is not always fully spread over the partner's body. We discuss these observations with respect to penial gland morphology and in the light of possible sexual conflicts. The long courtship and distant sarcobelum waving might reflect attempts to transfer, but not receive, secretion, and the circling might serve for size assessment.
The QAG-a
Authors: Buton Fabrice , Fontayne Paul , Heuzé Jean-Philippe , Bosselut Grégoire , Raimbault Nicolas
Published: April 2007

The present study provides a summary of five investigations undertaken to develop a French short visual analog measure of cohesion. Based on the conceptual model of cohesion and the Questionnaire sur l'Ambiance du Groupe (QAG), this instrument, QAG-a, is designed to capture the dynamic nature of cohesion when it is assessed with repeated and frequent measures during a period of time. The QAG-a consists of eight items assessing the four dimensions of the conceptual model. The rating is performed using a numeric visual analog scale on a 10-cm line. The psychometric analyses undertaken provided support for the content, construct, and predictive validity and the reliability of the QAG-a (Studies 1 to 4). They also indicated that this instrument is well suited for measuring cohesion with a repeated, frequent design across a period of time (Study 5)
The Effect of Type of Screening on the Satisfaction of Students in Experiential Counseling Training Groups
Authors: Laux John M. , Smirnoff Jennifer B. , Ritchie Martin H. , Cochrane Wendy S.
Published: April 2007

Students' participation in training groups as a function of enrollment in a group counseling course is almost a universal requirement in counselor education programs. The skill of screening for group membership is an essential component to the development of effective group leadership. Guided by the functional theoretical perspective, this study investigated the role that type of screening (verbal or written) plays in determining student satisfaction with the group and the group counseling class in general, the degree of satisfaction with the groups' success and goal attainment, and the composition of the group membership. The results suggest that both types of screening methods produce neutral to favorable responses; however, students screened using face-to-face verbal screening methods reported significantly greater satisfaction with the group and the group counseling course. Specifically, students screened using the face-to-face verbal method reported that their groups were more successful and reached their goals to a greater degree than those screened using a written approach.
Store-refilling involves both L-type calcium channels and reverse-mode sodium–calcium exchange in airway smooth muscle
Authors: Hirota S. , Janssen L. J.
Published: April 2007

The aim of the present study was to examine the relative contributions to store-refilling of the two following voltage-regulated calcium ion influx pathways: 1) L-type-Ca2+channels; and 2) the reverse-mode of the sodium–calcium exchanger (NCX).

Successive acetylcholine-induced contractions, triggered in bovine tracheal smooth muscle strips, were measured to determine the effect of intervention on contractions as an indication of the extent of store-refilling.

Pre-treating the tissues with cromakalim significantly reduced the magnitude of successive contractions. Zero-Ca2+bathing media abolished the contractions, an effect that was completely reversed upon reintroduction of Ca2+. Inhibition of L-type Ca2+channels, with nifedipine, significantly reduced the magnitude of the contractions. Similarly, inhibition of the reverse-mode of the NCX, with KB-R7943, significantly reduced the magnitude of the contractions. However, neither nifedipine nor KB-R7943 alone reduced contractions to the same extent as observed under zero-Ca2+conditions. Concurrent treatment with nifedipine and KB-R7943 almost abolished successive contractions. Furthermore, concurrent treatment with nifedipine and zero-Na+bathing media displayed a significantly greater effect than nifedipine alone. Probing the expression of NCX1 isoforms by Western blotting revealed the presence of three bands of 160, 120 and 110 kDa. The 120- and 110-kDa bands were identified as variably spliced NCX isoforms, NCX1.1 and NCX1.3, respectively.

Taken together, these data suggest that influx of calcium ions through both L-type calcium channels and the reverse-mode of the sodium–calcium exchanger is necessary for complete store-refilling in airway smooth muscle.