bluuebunny/crossref_metadata_2025 huggingface dataset:
Persistent Hepatic Venous Plexus in a Patient with Sturge–Weber Syndrome
Authors: Gajinov Z. , Mišić‐Pavkov G. , Matić M. , Đuran V. , Ađić O. , Đuran B. , Ivkov M. , Poljački M.
Published: August 2008

Abstract:  A patient with extensive facial and intracranial features of Sturge–Weber syndrome was found to have a persistent primitive hepatic venous plexus, characterized by three additional vessels arising from the inferior vena cava, circulating between liver segments, which formed a common trunk in the supra‐hepatic region that flowed into the right atrium. To the best of our knowledge, this hepatic finding has not been previously described in association with Sturge–Weber syndrome.
Segmental Odontomaxillary Dysplasia Presenting with Facial Hypertrichosis, Commissural Lip Clefting, and Hyperlinear Palms
Authors: KOENIG LISA J. , LYNCH DENIS P. , YANCEY KIM B.
Published: August 2008

Abstract:  Segmental odontomaxillary dysplasia is a rare disorder that unilaterally affects the maxilla causing facial asymmetry and presenting with hypertrichosis and hypoplastic or missing teeth in the affected area. Lip clefting has only been reported in one other case. We report a case of segmental odontomaxillary dysplasia presenting with hypertrichosis of the face, hyperlinear palms with faint erythema, and commissural lip clefting.
Poliosis as the First Clue of Tuberous Sclerosis
Authors: APIBAL YINGLUCK , REAKATANAN WASUTHIDA , CHUNHARAS AMORNSRI
Published: August 2008

Abstract:  Ash leaf hypopigment macules, until now, was known as earliest signs of tuberous sclerosis, unfortunately not always visible at birth. We reported herein a case of tuberous sclerosis presented with a tuft of white hair (poliosis) at birth for recommended poliosis as a useful earliest sign for detection of tuberous sclerosis in the newborn.
LEOPARD Syndrome: What Are Café Noir Spots?
Authors: Bujaldón Alfonso Rodríguez
Published: August 2008

Abstract:  Lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retarded growth, and deafness syndrome (multiple lentigines syndrome) is most often characterized by multiple lentigines and cardiac conduction defects. Café noir spot is a term proposed, by analogy to café au lait spots, for the larger and darkly pigmented patches that are frequently observed in patients with this syndrome. Although presumed by some authors to represent lentigines, the histologic features of café noir spots have not been well documented in the literature. Only two previous cases have been reported in which a biopsy of the café noir spots than melanocytic nevi. We describe the histologic characteristics of seven café noir spots in six patients with lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retarded growth, and deafness syndrome. Three lesions represented melanocytic nevi (one with dysplastic features), and four were compatible with lentigo simplex. These findings help our understanding of the histologic spectrum of pigmented lesions in lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retarded growth, and deafness syndrome.
Mastocytosis in Children: A Protocol for Management
Authors: HEIDE ROGIER , BEISHUIZEN AUKE , DE GROOT HANS , DEN HOLLANDER JAN C. , VAN DOORMAAL JASPER J. , DE MONCHY JAN G. R. , PASMANS SUZANNE G. M. A. , VAN GYSEL DIRK , ORANJE ARNOLD P. ,   ON BEHALF OF THE DUTCH NATIONAL MASTOCYTOSIS WORK GROUP
Published: August 2008

Abstract:  Mastocytosis is characterized by an increased number of mast cells with an abnormal growth and accumulation in one or more organs. In most children mastocytosis is limited to the skin (cutaneous mastocytosis) and often transient as compared with that in adults in whom mastocytosis is usually progressive and systemic. Generally, we recognize three more common forms of cutaneous mastocytosis: maculopapulous mastocytosis (formerly urticaria pigmentosa), mastocytoma of skin, and diffuse cutaneous mastocytosis. Childhood mastocytosis can further be divided into cutaneous mastocytosis (nonpersisting and persisting) and systemic mastocytosis (extremely rare). An approach to management using a set protocol is described in table form. In most cases of mastocytosis, only yearly checkups are necessary and no treatment is required; preventive recommendations are warranted in those individuals with systemic disease and constitutional symptoms. Symptomatic therapy is advised in only a minority of cases. This article is meant as a guideline for physicians involved in the care of children with mastocytosis and their parents.
Is Erythromycin an Effective Treatment for Chronic Bullous Disease of Childhood? A National Survey of Members of the British Society for Paediatric Dermatology
Authors: Farrant Paul , Darley Charles , Carmichael Andrew
Published: August 2008

Abstract:  Chronic bullous disease of childhood is the commonest acquired blistering disorder of children. Erythromycin has been reported to be beneficial for this condition. A three question survey was e‐mailed to all members of the British Society for Paediatric Dermatology to assess the incidence, preferred treatments and experience of oral erythromycin in treating chronic bullous disease of childhood. A second, more detailed questionnaire was sent to members who had used erythromycin. Forty patients were reported to have been treated over the previous 2 years. The preferred treatment was dapsone. Erythromycin alone had been used in five children as first‐line oral treatment. In three of these patients the initial improvement was graded as either “good” or “complete resolution.” This benefit was only sustained in one child, with the other two relapsing between 4 and 12 weeks. In a further eight children, erythromycin had been used with other oral agents. In five of these children, erythromycin was associated with long‐term benefit. These results suggest that erythromycin is unlikely to produce sustained improvement in chronic bullous disease of childhood when used as a sole first‐line agent. However, erythromycin can cause an initial improvement, which may be useful whilst awaiting results of diagnostic tests and may confer benefit when used with other systemic treatments.
Popsicle Panniculitis in a 5‐Month‐Old Child on Systemic Prednisolone Therapy
Authors: HUANG FRANKLIN W. , BERK DAVID R. , BAYLISS SUSAN J.
Published: August 2008

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Chromosome 6 Abnormality with Associated Dysmorphological Features and Erythrokeratoderma
Authors: LEGLER ALLISON A.
Published: August 2008

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Severe Bullous Pemphigoid in an Infant— Successful Treatment with Rituximab
Authors: Schulze Johannes , Bader Peter , Henke Ulrike , Rose Markus A. , Zielen Stefan
Published: August 2008

Abstract:  Bullous pemphigoid (BP) is a disease typical of the elderly, and rare in children. With appropriate therapy, the clinical course is usually self‐limited. We report on a 5‐month‐old boy with a severe BP, unresponsive to systemic corticosteroids, intravenous immunoglobulins, dapsone, and cyclosporine A. There is growing evidence for rituximab as a treatment option in refractory autoimmune bullous diseases also in children. We saw a marked improvement in skin lesions within a couple of days after the first dose of rituximab, and blisters disappeared. Monitoring of CD19‐positive cells showed a fast decrease to almost zero and a slow recovery within 4 weeks. At this time, new blisters appeared and another dose of rituximab was given. After the second dose of rituximab a long‐lasting effect without development of new bullae was observed.
Severe Congenital Systemic Juvenile Xanthogranuloma in Monozygotic Twins
Authors: Chantorn Rattanavalai , Wisuthsarewong Wanee , Aanpreung Prapun , Sanpakit Kleebsabai , Manonukul Jane
Published: August 2008

Abstract:  Juvenile xanthogranuloma, a histiocyte disorder, usually presents with a solitary cutaneous lesion. Juvenile xanthogranuloma with extracutaneous involvement is a rare disease in which significant morbidity and occasional deaths may occur. Monozygotic twins with congenital systemic juvenile xanthogranuloma who presented with multiple skin lesions, hepatosplenomegaly, liver failure, and bone marrow involvement were reported. The diagnosis of systemic juvenile xanthogranuloma was confirmed by histology and immunohistochemical stains of the skin with liver biopsies revealing dense infiltration of lymphohistiocytes with typical Touton giant cells staining positive for CD68 and negative for CD1a and S‐100 protein. Both of them received systemic prednisolone 1 mg/kg/day which was gradually tapered off with time according to clinical and investigative responses. At the 17‐month follow‐up period, both patients showed remarkable regression in all symptoms and laboratory studies.
Acral Cutaneous Findings in Wrinkly Skin Syndrome: Are They Tripe Palms?
Authors: MÖHRENSCHLAGER MATTHIAS , RING JOHANNNES
Published: August 2008

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, typewritten double spaced, and must not exceed two pages of text including references. Two copies of all letters should be submitted along with one copy on disk. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
The Effect of Traditional Herbal Medicines; Uyakujunkisan on Trigeminal Neuralgia in an Elderly Patient—A Case Report and Literature Review
Authors: Kogure Toshiaki , Sato Hiroko , Kishi Daijiro , Tatsumi Takeshi
Published: August 2008

▪ Abstract:  This report describes the successful treatment of a 72‐year‐old female with refractory trigeminal neuralgia using a traditional herbal medicine, Uyakujunkisan (UJS). The case report is of a 65‐year‐old female who developed right‐sided trigeminal neuralgia that was partially responsive to carbamazepine (CZ). The pain gradually increased in intensity and at 72 years of age she presented for herbal medicine therapy. Cranial MRI demonstrated vascular compression of the right trigeminal nerve at the cerebellopontine angle by the anterior inferior cerebellar artery. Although microvascular decompression was considered, UJS was prescribed after informed consent. After 3 weeks of treatment with UJS, dramatic improvement of symptoms permitted a decrease in CZ dose. ▪
Refractory Headaches due to Multilevel Thoracic Cerebrospinal Fluid Leaks
Authors: Trentman Terrence L. , Chan Chiwai E. , Patel Naresh P. , Dodick David W. , Nelson Kent D. , Schwedt Todd J. , Seamans David P.
Published: August 2008

▪ Abstract:

Background:  Spontaneous cerebrospinal fluid leak is a well‐documented cause of postural headache. We report a medically refractory headache due to multilevel thoracic cerebrospinal fluid leaks.

Case report:  A 44‐year‐old male with an acute onset of postural headache failed to respond to bed rest, hydration, and analgesics. Magnetic resonance imaging demonstrated a large cerebrospinal fluid leak centered at the right T4 and left T11 to 12 levels, with bony pathology evident at the lower thoracic level. Lumbar (L4 to 5) and computed tomography guided T4 to 5 level epidural blood patches provided minimal pain relief. Percutaneous epidural fibrin glue injection at T4 followed by a repeat computed tomography guided epidural blood patch led to significant but incomplete symptom relief. Subsequent imaging demonstrated persistent fluid at the T11 to 12 level. Fibrin glue and epidural blood patches at this level reduced but did not eliminate the leak and residual symptoms. Extensive corrective surgery was offered but declined by the patient.

Conclusion:  Treatment of multifocal cerebrospinal fluid leaks can be challenging, particularly when at least part of the underlying etiology is fixed structural bony pathology. ▪
The determination of the fetal D status from maternal plasma for decision making on Rh prophylaxis is feasible
Authors: Müller Sina P. , Bartels Iris , Stein Werner , Emons Günther , Gutensohn Kai , Köhler Michael , Legler Tobias J.
Published: August 2008

BACKGROUND: Noninvasive fetal RHD genotyping might become a valuable tool in decision making on antenatal Rh prophylaxis, which is currently in routine practice for all D− pregnancies in several countries. This study provides a large‐scale validation study of this technology to address questions concerning feasibility and applicability of its introduction into clinical routine.

STUDY DESIGN AND METHODS: Real‐time polymerase chain reaction (PCR) targeting RHD Exons 5 and 7 was applied for the detection of fetal‐specific RHD sequences in maternal plasma. A total of 1113 women in 6 to 32 weeks (median, Week 25) of pregnancy were recruited. All of them were serologically typed as D− according to current German guidelines. DNA was extracted via a spin‐column method and a novel automated approach using magnetic tips. Real‐time PCR results were compared with postnatal serology and discrepancies further elucidated by DNA sequencing from a newborn's buccal swab.

RESULTS: Sensitivities of fetal RHD genotyping were 99.7 percent (spin columns) and 99.8 percent (magnetic tips), thus comparable with serology (99.5%). The detection of weak D variants was more reliable by real‐time PCR. Specificities of fetal RHD genotyping were 99.2 percent (spin columns) and 98.1 percent (magnetic tips), which is lower than serology (>99.7%). Automation achieved significantly higher yields of cell‐free fetal DNA.

CONCLUSION: This prospective clinical trial revealed that routine determination of the fetal D status from maternal plasma is feasible. Noninvasive fetal RHD genotyping can be considered as sensitive as the traditional postnatal serologic assay.
Human herpesvirus 7, Epstein–Barr virus and human cytomegalovirus in periodontal tissues of periodontally diseased and healthy subjects
Authors: Rotola Antonella , Cassai Enrico , Farina Roberto , Caselli Elisabetta , Gentili Valentina , Lazzarotto Tiziana , Trombelli Leonardo
Published: August 2008

Aims: To evaluate (i) the presence of human herpesvirus 7 (HHV‐7), Epstein–Barr virus (EBV) and human cytomegalovirus (HCMV), and (ii) the transcription pattern of HHV‐7 in gingival biopsies from patients affected by periodontitis (P) and periodontally healthy subjects (H).

Material and Methods: Thirty‐seven subjects (P: n=24; H: n=13) were included. Each P patient contributed two gingival biopsies (representative of a clinically affected and non‐affected site) and each H subject contributed one gingival biopsy. After DNA extraction, nested polymerase chain reaction was used to identify the viruses.

Results: HHV‐7 was detected in 91.7% of P patients and in 61.5% of H subjects (p=0.02), EBV in 50.0% samples of P patients and 7.7% of H subjects (p=0.005) and HCMV only in one sample from H group. EBV was more frequently detected in biopsies from affected sites (50.0%) than from non‐affected sites (16.7%) (p=0.008). HHV‐7 transcription was detected in 15.4% of affected and 15.4% of non‐affected sites.

Conclusions: The results indicate that (i) gingival tissues can be considered a potential reservoir for HHV‐7; (ii) when present, HHV‐7 persists in a latent state in the majority of cases; (iii) the presence of EBV seems to be associated with the diseased state of the patient and site.
Fluorescent Annexin A1 Reveals Dynamics of Ceramide Platforms in Living Cells
Authors: Babiychuk Eduard B. , Monastyrskaya Katia , Draeger Annette
Published: August 2008

Upon its genesis during apoptosis, ceramide promotes gross reorganization of the plasma membrane structure involving clustering of signalling molecules and an amplification of vesicle formation, fusion and trafficking. The annexins are a family of proteins, which in the presence of Ca2+, bind to membranes containing negatively charged phospholipids. Here, we show that ceramide increases affinity of annexin A1–membrane interaction. In the physiologically relevant range of Ca2+ concentrations, this leads to an increase in the Ca2+sensitivity of annexin A1–membrane interaction. In fixed cells, using a ceramide‐specific antibody, we establish a direct interaction of annexin A1 with areas of the plasma membrane enriched in ceramide (ceramide platforms). In living cells, the intracellular dynamics of annexin A1 match those of plasmalemmal ceramide. Among proteins of the annexin family, the interaction with ceramide platforms is restricted to annexin A1 and is conveyed by its unique N‐terminal domain. We demonstrate that intracellular Ca2+overload occurring at the conditions of cellular stress induces ceramide production. Using fluorescently tagged annexin A1 as a reporter for ceramide platforms and annexin A6 as a non‐selective membrane marker, we visualize ceramide platforms for the first time in living cells and provide evidence for a ceramide‐driven segregation and internalization of membrane‐associated proteins.
HIV‐1 Nef Induces a Rab11‐Dependent Routing of Endocytosed Immune Costimulatory Proteins CD80 and CD86 to the Golgi
Authors: Chaudhry Ashutosh , Das Suman Ranjan , Jameel Shahid , George Anna , Bal Vineeta , Mayor Satyajit , Rath Satyajit
Published: August 2008

The Nef protein of HIV‐1 removes the immune costimulatory proteins CD80 and CD86 from the cell surface by a unique clathrin‐ and dynamin‐independent, actin‐based endocytic pathway that deploys coupled activation of c‐src and Rac. In this study, we show that, similar to major histocompatibility complex class I (MHCI), Nef subsequently reroutes CD80 and CD86 to the Golgi region. However, not only are CD80/CD86 internalized by a different mechanism from MHCI but also the vesicular pathway of Golgi delivery for CD80/CD86 is distinct from that employed for MHCI. While MHCI passes through early endosomal and sorting compartments marked by Rab5/early embryonic antigen 1 and ADP ribosylation factor 6, respectively, CD80 and CD86 enter endocytic vesicles that do not acquire conventional early endosomal markers but remain accessible to fluid probes. Rather than being delivered to preexisting Rab11‐positive recycling compartments, these vesicles recruit Rab11 de novo. Rab11 activity is also necessary for the delivery of CD80/CD86 in these transitional vesicles to the Golgi region. These data reveal an unusual pathway of endocytic vesicular traffic to the Golgi and its recruitment in a viral immune evasion strategy.
The Syntaxins SYP31 and SYP81 Control ER–Golgi Trafficking in the Plant Secretory Pathway
Authors: Bubeck Julia , Scheuring David , Hummel Eric , Langhans Markus , Viotti Corrado , Foresti Ombretta , Denecke Jürgen , Banfield David K. , Robinson David G.
Published: August 2008

Overexpression of the Golgi and endoplasmic reticulum (ER) syntaxins SYP31 and SYP81 strongly inhibits constitutive secretion. By comparing the secreted reporter α‐amylase with the ER‐retained reporter α‐amylase‐HDEL, it was concluded that SYP81 overexpression inhibits both retrograde and anterograde transport, while SYP31 overexpression mainly affected anterograde transport. Of the other interacting SNAREs investigated, only the overexpression of MEMB11 led to an inhibition of protein secretion. Although the position of a fluorescent tag does not influence the correct localization of the fusion protein, only N‐terminal‐tagged SYP31 retained the ability of the untagged SNARE to inhibit transport. C‐terminal‐tagged SYP31 failed to exhibit this effect. Overexpression of both wild‐type and N‐terminal‐tagged syntaxins caused standard Golgi marker proteins to redistribute into the ER. Nevertheless, green fluorescent protein (GFP)–SYP31 was still visible as fluorescent punctae, which, unlike SYP31–GFP, were resistant to brefeldin A treatment. Immunogold electron microscopy showed that endogenous SYP81 is not only present at the ER but also in thecisGolgi, indicating that this syntaxin cycles between these two organelles. However, when expressed at non‐inhibitory levels, YFP–SYP81 was seen to locate principally to subdomains of the ER. These punctate structures were physically separated from the Golgi, suggesting that they might possibly reflect the position of ER import sites.
Growth hormone treatment in short children with chronic kidney disease
Authors: Mehls O , Wühl E , Tönshoff B , Schaefer F , Nissel R , Haffner D
Published: August 2008

Growth hormone (GH) has been used for treatment of impaired growth in children with chronic kidney disease (CKD) for nearly 17 years. Controlled and open‐label studies have shown that GH is highly effective in improving growth velocity and adult height. The growth response is negatively correlated with age and height at start and time spent on dialysis treatment; it is positively correlated with dose and duration of treatment and the primary renal disease (renal hypodysplasia). In children with renal transplants, corticosteroid treatment is an additional factor negatively influencing spontaneous growth rates. However, GH treatment is able to compensate corticosteroid‐induced growth failure. GH treatment improved final height by 0.5–1.7 standard deviation score (SDS) in various studies, whereas the control group lost about 0.5 SDS in comparable time intervals. These variable results are explained in part by the factors mentioned above. The adverse events are comparable to those in non‐CKD children treated with GH.

Conclusion: GH treatment is safe and highly effective in improving growth and final height of short children with all stages of CKD. The highest treatment success is obtained if treatment is started at an early age and with relatively well‐preserved residual renal function and continued until final height.
The fate of ductus arteriosus in infants at 23–27 weeks of gestation: from spontaneous closure to ibuprofen resistance
Authors: Dani Carlo , Bertini Giovanna , Corsini Iuri , Elia Serena , Vangi Venturella , Pratesi Simone , Rubaltelli Firmino F.
Published: August 2008

Background: Some extremely preterm infants experience spontaneous closure of the ductus arteriosus. On the other side, a high percentage (22–30%) of preterm infants born at the lower gestational age fail to respond to a single course of ibuprofen.

Aim: To assess if there are clinical characteristics effective as predictive factors for spontaneous closure of the ductus arteriosus, development of patent ductus arteriosus (PDA) and ibuprofen‐resistant PDA.

Methods: A cohort of inborn infants less than 28 weeks of gestation were prospectively studied. We distinguished infants who had spontaneous closure of ductus arteriosus, who developed PDA and who developed ibuprofen‐resistant PDA.

Results: We studied 34 infants. Eight infants (24%) had spontaneous closure of PDA, 17 infants (50%) had a closure of PDA following the first ibuprofen course, while 9 infants (26%) failed to respond to the first ibuprofen course. Infants born at 23–25 weeks of gestation were found to have lower likelihood of PDA spontaneous closure, and higher risk of developing PDA refractory to ibuprofen therapy. Sepsis was found to increase significantly the risk of ibuprofen failure in closing PDA.

Conclusion: An important percentage of extremely preterm infants exhibited spontaneous closure of PDA. Among clinical characteristics lowest gestational ages predict PDA and ibuprofen‐resistant PDA, while sepsis predicts only ibuprofen‐resistant PDA.
Activation of the right fronto‐temporal cortex during maternal facial recognition in young infants
Authors: Carlsson Jakob , Lagercrantz Hugo , Olson Linus , Printz Gordana , Bartocci Marco
Published: August 2008

Background/aim: Within the first days of life infants can already recognize their mother. This ability is based on several sensory mechanisms and increases during the first year of life, having its most crucial phase between 6 and 9 months when cortical circuits develop. The underlying cortical structures that are involved in this process are still unknown. Herein we report how the prefrontal cortices of healthy 6‐ to 9‐month‐old infants react to the sight of their mother's faces compared to that of an unknown female face.

Methods: Concentrations of oxygenated haemoglobin [HbO2] and deoxygenated haemoglobin [HHb] were measured using near infrared spectroscopy (NIRS) in both fronto‐temporal and occipital areas on the right side during the exposure to maternal and unfamiliar faces.

Results: The infants exhibited a distinct and significantly higher activation‐related haemodynamic response in the right fronto‐temporal cortex following exposure to the image of their mother's face, [HbO2] (0.75 μmol/L, p < 0.001), as compared to that of an unknown face (0.25 μmol/L, p < 0.001).

Conclusion: Event‐related haemodynamic changes, suggesting cortical activation, in response to the sight of human faces were detected in 6‐ to 9‐month old children. The right fronto‐temporal cortex appears to be involved in face recognition processes at this age.
The important role of deep attachment in the uniform drainage of breast milk from mammary lobe
Authors: Mizuno Katsumi , Nishida Yoshiko , Mizuno Noriko , Taki Motohiro , Murase Masahiko , Itabashi Kazuo
Published: August 2008

Aim: To determine if the degree of attachment affects uniformity in the drainage of breast milk from mammary lobe during breastfeeding.

Methods: Thirty‐seven pairs of healthy breast‐fed infants and mothers were the subjects. A total of 48 measurements were obtained. Foremilk was obtained from three nipple openings. After the breastfeeding session, hindmilk was sampled from the same three nipple openings and creamatocrit (CrCt) was measured. The difference in CrCt values of hindmilk, which corresponds to the degree of emptying of the lobe, and the difference in CrCt values between fore‐ and hindmilk samples (delta CrCt), which corresponds to the change in the degree of emptying among the lobe were calculated.

Results: The maximum difference in the CrCt value of hindmilk samples among nipple ducts was 7.0 ± 4.1% in the shallow attachment (S) group (n = 23) and 2.9 ± 1.2% in the deep attachment (D) group (n = 25) in the left breast and 5.4 ± 2.2% in the S group (n = 21) and 3.6 ± 1.9% in the D group (n = 27) in the right breast. The mean maximum difference in delta CrCt values among nipple ducts was 7.6 ± 2.9% and 2.6 ± 1.3% in the left and 5.8 ± 2.3% and 3.4 ± 1.4% in the right breast, in the S group and D group, respectively. These differences were significantly smaller in the D group than the S group (p < 0.01).

Conclusion: The results revealed that deep attachment is helpful in draining milk from all mammary lobe uniformly, which may contribute to successful breastfeeding.
Diagnosis on a positive fashion of nonorganic failure to thrive
Authors: Panetta Fabio , Magazzù Domenico , Sferlazzas Concetta , Lombardo Mariangela , Magazzù Giuseppe , Lucanto Maria Cristina
Published: August 2008

Aims: To study the predictive value of predefined symptoms and signs for allocating children into one of two groups: nonorganic and organic failure to thrive.

Patients and Methods: Two hundred eight outpatients (6 months–14 years old) suffering from failure to thrive (FTT) were included in the study. Predefined symptoms and signs were considered as potential predictors of organic/nonorganic failure to thrive. All patients underwent an established diagnostic work up in order to exclude organic causes of FTT.

Results: The percentage of patients without any organic symptom (negative predictive value), who were diagnosed as NOFTT was 92%; the percentage of patients having nonorganic symptoms only (positive predictive value), who were diagnosed as NOFTT was 96%, while their absence does not exclude a NOFTT diagnosis as well (negative predictive value = 41%).

Conclusion: The detection of at least one nonorganic symptom or sign, with the exclusion of any organic symptom, can support a diagnosis of nonorganic FTT and therefore only few laboratory investigations seem to be warranted.
Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge
Authors: Wallis Anne Baber , Brînzaniuc Alexandra , Cherecheş Razvan , Oprescu Florin , Şirlincan Emanuela , David Ioana , Dîrle Ioana Andreea , Dungy Claibourne I.
Published: August 2008

Aim: To describe the development and testing of the Romanian version of the Iowa Infant Feeding Attitude Scale (IIFAS‐R). The original instrument has well‐established psychometrics for use in English‐speaking countries.

Methods: Questionnaires including demographics and items about prior pregnancy and opinions about breastfeeding in public were administered to women in Cluj‐Napoca, Romania, attending antenatal clinic (n = 336) and to a separate cohort of mothers within 24 h of delivery (n = 276). Postpartum follow‐up was conducted with a sample of maternity cohort subjects who initiated breastfeeding in the hospital (n = 52).

Results: Internal consistency was adequate in both cohorts (antenatal α= 0.50; maternity α= 0.63), with improved reliability for antenatal multigravid (α= 0.60) and university‐educated women (α= 0.57). Score distributions were comparable and item means were approximately central across cohorts. Among pregnant women, higher scores (more positive towards breastfeeding) were associated with longer planned maternity leave (χ2= 17.8; p = 0.02). Higher maternity cohort scores were associated with age (r = 0.31, p = 0.003), urban residence (χ2= 10.2, p = 0.04), breastfeeding a prior infant for at least 6 weeks (χ2= 6.4, p = 0.04), and with intending to breastfeed for at least 6 weeks (χ2= 4.7, p = 0.03). Postpartum women still breastfeeding at follow‐up also scored higher (χ2= 9.3, p = 0.009).

Conclusion: This is the first study to report on use of the IIFAS in Eastern Europe. The IIFAS‐R is easy to administer, reliable and valid in Romania. The IIFAS‐R can support data collection to promote and assess breastfeeding initiatives consistent with World Health Organization recommendations.
Male circumcision through the ages: the role of tradition
Authors: Zampieri Nicola , Pianezzola Emanuela , Zampieri Cecilia
Published: August 2008

Aim: In this study, we examine the evolution of tradition concerning infant male circumcision, utilizing evidence from classical medical texts as well as information from literature, legal sources and art.

Methods: We examined the differences in the representation of male circumcision between ancient times and the modern era.

Results: Through the ages, male circumcision has been differently represented, and at present an interesting representation is born following the natural evolution of society.

Conclusion: Based on the fact that the foreskin is not a defect, the impact of male circumcision is on the child's rights and its role during first years of life still remains controversial.
Characteristics of Streptococcus pyogenes strains isolated from Chinese children with scarlet fever
Authors: Liang Yunmei , Shen Xuzhuang , Huang Guoying , Wang Chuanqing , Shen Ying , Yang Yonghong
Published: August 2008

Aim: To analyse the characteristics of Streptococcus pyogenes isolates from Chinese children with scarlet fever.

Methods: Minimal inhibitory concentration with nine antibiotics was performed on 145 Streptococcus pyogenes isolates acquired from Beijing and Shanghai in 2007. Their macrolide‐resistant genes (mefA, ermB and ermA– a subclass of ermTR), superantigens (speA and speC), and en‐coding mature M protein gene (emm gene) were amplified by PCR.

Results: A total of 97.9% of the isolates exhibited resistance to the macrolides, while 96.6% manifested resistance to tetracycline. All isolates were sensitive to chloramphenicol, penicillin, cefradine, and ofloxacin. Moreover, 94.5% exhibited a cMLSB phenotype, while 90.3% had the ermB gene. Five emm types (emm1.0, emm4.0, emm12.0, emm22.0 and st5240) were discovered, of which 9.7% carried the superantigen speA, 35.9% carried the speC, 42.8% carried both speA and speC and 11.7% carried neither speA nor speC. Finally, 85.5% of emm1.0 and 15.5% of emm12.0 isolates carried speA, while 79.0% of emm1.0 and 75.9% of emm12.0 isolates carried speC.

Conclusion: The Streptococcus pyogenes isolates had high resistance rates against macrolides and tetracycline. They mainly expressed the ermB gene type and cMLSB phenotype. Their common emm types are emm1.0 and emm12.0, which have different frequencies of speA and speC.
The Effect of Childhood Sexual Abuse on Adolescent Pregnancy: An Integrative Research Review
Authors: Francisco Melissa A. , Hicks Kasey , Powell Julianne , Styles Kristin , Tabor Jessica L. , Hulton Linda J.
Published: August 2008

PURPOSE.  This study aims to describe the current research literature on the relationship of childhood sexual abuse and adolescent pregnancy and highlight the potential cross‐cutting risk factors.

DESIGN AND METHODS.  Thirteen articles were identified as the basis of this review using

Cooper's methodology (1998)

for synthesizing research. Articles were categorized according to the levels of evidence proposed by

Melnyk and Fineout‐Overholt (2005

).

RESULTS.  The majority of the studies identified a relationship between childhood sexual abuse and adolescent pregnancy (n = 9). Cross‐cutting risk factors included female gender, younger age, substance use/abuse, family constellation, parent–child conflict, and mother disengagement.

PRACTICE IMPLICATIONS.  Strategies for nurses to identify pregnant and parenting adolescents who have been sexually victimized are important for early intervention. Resiliency factors of young people who report positive outcomes are highlighted.
Development of a Clinical Practice Guideline for Testing Nasogastric Tube Placement
Authors: Peter Sue , Gill Fenella
Published: August 2008

PURPOSE.  A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the “whoosh test” and litmus paper, and introduction of pH testing.

DESIGN AND METHODS.   Two audits were conducted: bedside data collection at a pediatric hospital and a point‐prevalence audit across seven hospitals.

RESULTS.   Aspirate was obtained for 97% of all tests and pH was ≤ 5.5 for 84%, validating the practice changes. However, patients on continuous feeds and/or receiving acid‐inhibiting medications had multiple pH testing fails.

PRACTICE IMPLICATIONS.  Nasogastric tube placement continues to present a challenge for those high‐risk patients on continuous feeds and/or receiving acid‐inhibiting medications.
Family‐Based Weight Management With Latino Mothers and Children
Authors: James Kathy Shadle , Connelly Cynthia D. , Rutkowski Elaine , McPherson Darlene , Gracia Luz , Mareno Nicole , Zirkle Dorothy
Published: August 2008

PURPOSE.  This paper aims to design a culturally appropriate weight management intervention for high‐risk Latino families and to examine the feasibility of recruiting program participants.

DESIGN AND METHODS.  A descriptive design using qualitative and quantitative data collected during preliminary phases of an ongoing intervention study.

RESULTS.  From the preliminary works, a curriculum was revised for Latino families who have overweight children. The curriculum was modified to include suggestions from the focus groups, including helping mothers set limits with their children and make the transition to lighter foods and a more active family life.

PRACTICE IMPLICATIONS.  The information will aid professionals in the process of program design for Latino families who have weight concerns.
Collaborating With Low‐Income Families and Their Overweight Children to Improve Weight‐Related Behaviors: An Intervention Process Evaluation
Authors: Tyler Diane O. , Horner Sharon D.
Published: August 2008

PURPOSE.  This paper aims to examine the collaborative negotiation process, an interventional approach being tested at a primary‐care school‐based clinic to help low‐income families improve lifestyle and weight‐related health indicators in their overweight children.

DESIGN AND METHODS.  Process evaluation of the intervention employed in an ongoing longitudinal pilot study. Descriptive analysis is from structured field notes and audiotapes of parent–child–provider interactions during intervention visits (n=  111).

RESULTS.  Activity levels and eating patterns were families’ main concerns in managing their children's weight. Challenges and facilitators of implementing health plans were explored.

PRACTICE IMPLICATIONS.  The collaborative negotiation intervention provides a family‐centered approach to engage families in management of children's weight.
The effect of tissue factor concentration on calibrated automated thrombography in the presence of inhibitor bypass agents
Authors: Van VEEN J. J. , GATT A. , BOWYER A. E. , COOPER P. C. , KITCHEN S. , MAKRIS M.
Published: August 2008

Thrombin generation has been suggested as a method to monitor treatment with factor eight inhibitor bypassing activity (FEIBA®) or recombinant FVIIa (rFVIIa). The sensitivity of the assay for individual coagulation factors is dependent on the tissue factor (TF) concentration. An inverse relation between the rFVIIa concentration needed to shorten the clotting time and TF concentration has been shown but the data on thrombin generation are inconsistent. Information on TF concentration in measurements with FEIBA® is limited. We studied the influence of TF concentration (1 and 5 pm) on thrombin generation through spiking experiments with rFVIIa and/or FEIBA® in the plasma of severe haemophilia A patients and after four and three treatment episodes, respectively, using the calibrated automated thrombin generation assay (CAT) in platelet poor plasma. Spiking with FEIBA® showed a linear relation with the endogenous thrombin potential (ETP)/peak at 1 pm but substrate depletion at 5 pm. Spiking with rFVIIa showed a near linear dose–response relation with the ETP/peak at 1 pm but only a shortening of the initiation phase at 5 pm. Similar effects were present in post‐treatment samples. FEIBA® acted synergistically with rFVIIa. This suggest a role for CAT in monitoring inhibitor bypass treatment but low TF concentrations are required to avoid substrate depletion with FEIBA® and to demonstrate the effect of rFVIIa.
The role of p53 in pigmentation, tanning and melanoma
Authors: Box Neil F. , Terzian Tamara
Published: August 2008

p53 has a central role in skin pigmentation and may impact on melanoma at all stages, however, as it’s mutation frequency in melanoma is low, it’s role has been somewhat under‐appreciated. During normal skin function, p53 in the keratinocyte is a transducer of the skin tanning signal and an essential component of what is effectively a keratinocyte‐melanocyte signaling cycle that regulates skin pigmentation. It is clear that this cycle functions optimally in skin of dark pigmentation. When melanin biosynthesis is genetically disrupted in skin of white complexion, we propose that this cycle operates as a promoter of melanocyte proliferation. The cell autonomous function of p53 in melanocytes is not well described, however, the balance of the evidence suggests that p53 is an effective tumor suppressor and the myriad of mechanisms by which the p53 pathway may be dysregulated in tumors attests to it importance as a tumor suppressor. In this review, we outline the known mechanisms that impair p53 itself and its immediate regulators or target genes during melanomagenesis. Due to the importance of this pathway, it is clear that p53 disruptions may relate directly to a patient’s prognosis. This pathway will continue to be a focus of investigation, particularly with respect to targeted experimental chemotherapeutics.
Cavity Growth Simulation in 2.25Cr–1Mo Steel Under Creep-Fatigue Loading
Authors: Ogata Takashi
Published: August 2008

High temperature components in thermal power plants are subjected to creep-fatigue loading where creep cavities initiate and grow on grain boundaries. Development of a quantitative evaluation method of cavity growth is important for reliable maintenance of these components. In this study, a creep-fatigue test was carried out at 600°C on 2.25Cr–1Mo steel in a scanning electron microscope, and continuous observation of cavity growth behavior during the test was made. Based on the cavity growth observation, existing cavity growth models were modified and the simulated results using the modified model were compared to the observed cavity growth behavior. From the observation, spherical shape cavities initiate and grow up to their length of 2μm on the grain boundaries at the initial stage of damage, and then these cavities change their shape to cracklike and grow until their length reaches around 10μm. Finally, cracklike cavities coalesce with each other to form one microcrack along a grain boundary. It can be concluded that cavity growth rates are controlled by diffusion and power law creep under constrained conditions, based on the theoretical consideration of cavity growth mechanism. Through these discussions, a new cavity growth model was proposed by modifying conventional models. Both spherical and cracklike cavity growth rate equations were derived from the modified cavity growth model. It was indicated that the measured cavity growth rate was well predicted by the growth rate equations, derived from the modified model, and a cavity growth simulation result corresponds to the change in the maximum cavity size with number of cycles under the creep-fatigue loading.
A Suggested Shell∕Plate Finite Element Nozzle Model Evaluation Procedure
Authors: Porter Michael A. , Martens Dennis H. , Caldwell S. M.
Published: August 2008

A procedure for evaluating the stress results of a finite element analysis employing shell∕plate elements is proposed based on several previous papers by the authors and a review of other related publications. This procedure relates the stress levels produced by the finite element software to the provisions of ASME Sec. VIII, Div. 2 (ASME, 2004, ASME Boiler and Pressure Vessel Code, Section VIII, Division 2, American Society of Mechanical Engineers, New York).
Use of Master Curve Technology for Assessing Shallow Flaws in a Reactor Pressure Vessel Material
Authors: Taylor N. , Minnebo P. , Bass B. R. , Siegele D. , Wallin K. , Kytka M. , Wintle J.
Published: August 2008

In the NESC-IV project, an experimental/analytical program was performed to develop validated analysis methods for transferring fracture toughness data to shallow flaws in reactor pressure vessels subject to biaxial loading in the lower-transition temperature region. Within this scope, an extensive range of fracture tests was performed on material removed from a production-quality reactor pressure vessel. The master curve analysis of these data is reported and its application to the assessment of the project feature tests on large beam test pieces is discussed.
Crack Growth Under Moving Temperature Field by the Example of Circumferential Crack in Steel Cylinder Specimen
Authors: Tereshin D. A.
Published: August 2008

High thermally loaded construction exploitation practice has shown that the destruction under the loading with the temperature field caused by a moving heat source can be much more dangerous than the one in case of a stationary heat source. The growth of long cracks in the first case occurs by means of the two main mechanisms specific to the describing loading conditions. They are the codirectional crack growth mechanism when a crack grows jointly with the thermal tension stresses zone and the oppositely directional mechanism realizing when a crack grows in the opposite direction relative to the stress field moving direction. In both cases, the ultimate crack extension will be limited only by the stress moving zone. However, an experimental proof of such a crack growth on ductile specimens was absent. To demonstrate the possibility of crack development under the action of the moving temperature field up to the length essentially greater than the temperature stress tension zone by the mechanisms peculiar to such loading, the experiment on steel thin-walled cylinder was carried out. The specimens were heated in the circular high-frequency current inductor. Cold-water jet falling on the specimen’s surface resulted in high temperature gradients and high local stresses. Automodel movement of the temperature field was achieved by means of the drive rotating the specimen about its longitudinal axis. The fatigue crack arose under the action of cyclically moving temperature field. Thereafter, the near-automodel fatigue crack growth proceeded. After several tens of cycles, the crack length essentially exceeded the thermal tension zone and became greater than half-circumference. The experimentally obtained crack growth rate was in good agreement with the calculated result by the developed calculation technique. It was proved that in addition to the codirectional and oppositely directional quasistatic mechanisms, the high-speed fatigue crack growth is also possible in constructions made of materials having a considerable fracture toughness. It can occur in the same and opposite directions relative to the temperature field moving direction. Although the fatigue crack growth rate is small in comparison with the quasistatic codirectional and opposite directional ones, the final crack length can also reach a great size. That length is limited only by the tensile stress moving region.
Godunov’s Method for Simulatinons of Fluid-Structure Interaction in Piping Systems
Authors: Gale Janez , Tiselj Iztok
Published: August 2008

Constant coefficient one-dimensional linear hyperbolic systems of partial differential equations (PDEs) are often used for description of fluid-structure interaction (FSI) phenomena during transient conditions in piping systems. In the past, these systems of equations have been numerically solved with method of characteristics (MOCs). The MOC method is actually the most efficient and accurate method for description of the single-phase transient in the cold liquid where the constant coefficient mathematical model describes phenomenon with sufficient accuracy. In energy production systems where hot pressurized liquid is used for heat transfer between the heat source and the steam generator, more complex and nonlinear mathematical models are needed to describe transient flow and these models cannot be solved with MOC method because the models are not constant. In addition, the MOC method can be used for pipes having discontinuities like elbows, geometrical changes, material properties changes, etc., but only with some extra numerical modeling. An interesting alternative is explicit characteristic upwind numerical method, known as Godunov’s method that is frequently used for nonlinear systems or systems where properties change with position. In the present study, applicability of the Godunov’s method for the FSI analyses is tested with eight first order PDEs mathematical model. The conventional linear mathematical model is improved with convective term that makes the system nonlinear and additional terms that enable simulations of the FSI in arbitrarily shaped piping systems located in a plane. Two PDEs describe pressure waves in the single-phase fluid and six PDEs describe axial, lateral, and rotational stress waves in the pipe. The applied system of equations has stiff source terms. This numerical problem is solved introducing implicit iterations. The proposed model is verified with a rod impact experiment that is carried out on single-elbow pipe hanging on wires. Godunov’s method is found as a very promising numerical method for simulations of the FSI problems.