bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of geographic variance in stroke prevalence using Internet search engine analytics
Authors: Walcott Brian P. , Nahed Brian V. , Kahle Kristopher T. , Redjal Navid , Coumans Jean-Valery
Published: June 2011

Object

Previous methods to determine stroke prevalence, such as nationwide surveys, are labor-intensive endeavors. Recent advances in search engine query analytics have led to a new metric for disease surveillance to evaluate symptomatic phenomenon, such as influenza. The authors hypothesized that the use of search engine query data can determine the prevalence of stroke.

Methods

The Google Insights for Search database was accessed to analyze anonymized search engine query data. The authors' search strategy utilized common search queries used when attempting either to identify the signs and symptoms of a stroke or to perform stroke education. The search logic was as follows: (stroke signs + stroke symptoms + mini stroke − heat) from January 1, 2005, to December 31, 2010.

The relative number of searches performed (the interest level) for this search logic was established for all 50 states and the District of Columbia. A Pearson product-moment correlation coefficient was calculated from the statespecific stroke prevalence data previously reported.

Results

Web search engine interest level was available for all 50 states and the District of Columbia over the time period for January 1, 2005–December 31, 2010. The interest level was highest in Alabama and Tennessee (100 and 96, respectively) and lowest in California and Virginia (58 and 53, respectively). The Pearson correlation coefficient (r) was calculated to be 0.47 (p = 0.0005, 2-tailed).

Conclusions

Search engine query data analysis allows for the determination of relative stroke prevalence. Further investigation will reveal the reliability of this metric to determine temporal pattern analysis and prevalence in this and other symptomatic diseases.
Utility of CT perfusion scanning in patient selection for acute stroke intervention: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital
Authors: Kan Peter T. , Snyder Kenneth V. , Yashar Parham , Siddiqui Adnan H. , Hopkins L. Nelson , Levy Elad I.
Published: June 2011

Computed tomography perfusion scanning generates physiological flow parameters of the brain parenchyma, allowing differentiation of ischemic penumbra and core infarct. Perfusion maps, along with the National Institutes of Health Stroke Scale score, are used as the bases for endovascular stroke intervention at the authors' institute, regardless of the time interval from stroke onset. With case examples, the authors illustrate their perfusion-based imaging guidelines in patient selection for endovascular treatment in the setting of acute stroke.
Endovascular stroke therapy: a single-center retrospective review
Authors: Day Jason S. , Hurley Michael C. , Chmayssani Mohamad , Rahme Rudy J. , Alberts Mark J. , Bernstein Richard A. , Dabus Guilherme , Shaibani Ali , Bendok Bernard R.
Published: June 2011

Object

Endovascular treatment of acute ischemic stroke delivers direct therapy at the site of an occluded cerebral artery and can be employed beyond the 3–4.5-hour window limit set for intravenous recombinant tissue plasminogen activator. In this paper, the authors report their experience with various endovascular therapies in acute ischemic stroke.

Methods

The authors conducted a retrospective review of their clinical database for acute ischemic stroke in large-vessel cerebral territories that underwent endovascular treatment between May 2005 and February 2009. Endovascular treatment was defined as pharmacological and/or mechanical intervention, angioplasty, stenting, or a combination of these methods. Admission National Institutes of Health Stroke Scale and the modified Rankin Scale scores were recorded. Thrombolysis in Myocardial Infarction (TIMI) scores of 0, 1, 2A, 2B, and 3 were used to define recanalization.

Results

Forty procedures were performed in 39 patients, with 1 patient having sequential bilateral strokes. Nine patients were lost to follow-up after discharge. Strokes in the carotid artery circulation occurred in 82.5% of cases, and those in the vertebral-basilar territory occurred in 17.5%. The Merci device was used in 22 (55%) of 40 procedures, and the Penumbra device in 9 (22.5%) of 40. Angioplasty was performed in 15 (37.5%) of 40 procedures, and intraarterial recombinant tissue plasminogen activator was administered in 23 (57.5%) of 40 procedures. In 23 (57.5%) of 40 cases, multiple recanalization methods were used. The recanalization rate for all methods was 60%. The recanalization rate from TIMI Score 0/1 occlusions was 71.4% (20 of 28). An estimated modified Rankin Scale score of ≤ 2 was obtained in 11 (36.7%) of 30 cases. The overall mortality rate was 26.7% (8 of 30). Intracerebral hemorrhage at 24 hours postprocedure was noted in 17 (42.5%) of 40 cases, 3 (7.5%) of which were symptomatic.

Conclusions

The authors' institution performs endovascular stroke treatment with a safety and efficacy profile comparable to those of other major endovascular stroke therapy studies. Recanalization was associated with an improved clinical outcome. Protocols to maximize efficient triage of patients and better documentation of stroke treatments can assist in further studies.
Advanced neuroimaging in acute ischemic stroke: extending the time window for treatment
Authors: Duffis E. Jesus , Al-Qudah Zaid , Prestigiacomo Charles J. , Gandhi Chirag
Published: June 2011

Early treatment of ischemic stroke with thrombolytics is associated with improved outcomes, but few stroke patients receive thrombolytic treatment in part due to the 3-hour time window. Advances in neuroimaging may help to aid in the selection of patients who may still benefit from thrombolytic treatment beyond conventional time-based guidelines. In this article the authors review the available literature in support of using advanced neuroimaging to select patients for treatment beyond the 3-hour time window cutoff and explore potential applications and limitations of perfusion imaging in the treatment of acute ischemic stroke.
Applications of stenting for intracranial atherosclerosis
Authors: Ding Dale , Liu Kenneth C.
Published: June 2011

Intracranial atherosclerosis presents a therapeutic challenge to medical and surgical physicians alike. Despite maximal medical therapy, the stroke rate from this disease is still high, especially when arterial stenosis is severe and patients are symptomatic. Open surgical therapy has yet to be shown to be a more efficacious treatment than medical therapy alone, largely due to the relatively high rates of perioperative complications. Angioplasty has a similar fate, with the risk of periprocedural complications outweighing the overall benefit of treatment. With the advent of stents for use in intracranial vasculature, new hope has arisen for the treatment of intracranial atherosclerosis. The NEUROLINK system, the drug-eluting stents Taxus and Cypher, the flexible Wingspan stent, the Apollo stent, and the Pharos stent have all been used in various prospective and retrospective clinical studies with varying technical and clinical results. The authors' objective is to review and loosely compare the data presented for each of these stenting systems. While the Wingspan stent appears to have somewhat of an advantage with regard to technical success in comparison with the other stenting systems, the clinical follow-up time of its studies is too short to properly compare its complication rates with those of other stents. Before we continue to move forward with stenting for intracranial stenosis, a randomized prospective trial is ultimately needed to directly compare intracranial stenting to medical therapy.
Decompressive hemicraniectomy after malignant middle cerebral artery infarction: rationale and controversies
Authors: Arnaout Omar M. , Aoun Salah G. , Batjer H. Hunt , Bendok Bernard R.
Published: June 2011

Malignant middle cerebral artery stroke carries a very poor prognosis. Significant retrospective data support the hypothesis that decompressive hemicraniectomy decreases mortality rates due to this disease entity. Recently, 3 randomized controlled studies have been published and shed light on these issues and enhance the quality of evidence revolving around this procedure. In this review, the rationale, risks, benefits, and unanswered questions related to hemicraniectomy for acute ischemic stroke are reviewed with an emphasis on how 3 randomized trials have influenced knowledge on this life-saving yet controversial procedure. Further randomized studies are needed to clarify lingering questions regarding age indications and impact on quality of life.
The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy
Authors: Ridgway Emily B. , Berry-Candelario John , Grondin Ronald T. , Rogers Gary F. , Proctor Mark R.
Published: June 2011

Object

Suturectomy as a treatment for craniosynostosis was largely replaced in the late twentieth century by more extensive, but predictable, cranial remodeling procedures. Recent technical innovations, such as using the endoscope combined with postoperative orthotic reshaping, have led to a resurgence of interest in suturectomy as a safer, less invasive method.

Methods

A retrospective chart review was performed for all cases of sagittal synostosis treated with endoscopic sagittal suture strip craniectomy and helmet therapy between 2004 and 2008. Data collected included gestational age, genetic evaluations and syndromic status, age at operation, duration of procedure, need for blood transfusions, length of hospital stay, preoperative and postoperative head circumference percentile and cranial index, duration of helmet use, length of follow-up, complications, and revisions.

Results

Fifty-six patients with isolated sagittal synostosis were treated using endoscopic suturectomy and completed helmet therapy. Mean age at time of procedure was 3.24 months. Mean operative duration was 45.32 minutes. Mean hospital stay was 1.39 days. There were 2 transfusions and no deaths. The mean length of follow-up was 2.34 years. Helmet therapy was instituted for a mean of 7.47 months. Head circumference percentile increased from 61.42% to 89.27% over 2 years of follow-up. Cranial index increased from a preoperative mean of 0.69 to 0.76 over 2 years of follow-up. Reoperations for synostosis included 1 sagittal suture refusion and 2 cases in which other sutures fused.

Conclusions

Sagittal synostosis can be safely treated with endoscopic suturectomy and helmet therapy. Improvements in cranial volume and shape are comparable to open procedures and are enduring.
Intracranial yolk sac tumor in a patient with Down syndrome
Authors: Maeda Yoshihiko , Yoshikawa Koichi , Kajiwara Koji , Ideguchi Makoto , Amano Takayuki , Saka Makoto , Nomura Sadahiro , Fujii Masami , Suzuki Michiyasu
Published: June 2011

The authors report a rare case of intracranial yolk sac tumor in a 13-year-old boy with Down syndrome who presented with left hemiparesis. Admission MR imaging revealed a tumor in the right basal ganglia. Serum α-fetoprotein was markedly elevated. Yolk sac tumor was diagnosed radiologically and serologically. The standard therapy for intracranial yolk sac tumor is platinum-based chemotherapy with concomitant radiotherapy. However, the authors used reduced-dose chemotherapy and asynchronized radiotherapy because of the well-known low tolerance of patients with Down syndrome to chemotherapy. This treatment was successful with no complications. Blood cancers are frequently associated with Down syndrome, whereas solid tumors occur less frequently in these patients, and the risk of chemoradiotherapy is unclear. The results indicate that dose-reduction therapy can be effective for treatment of a brain tumor in a patient with Down syndrome.
Intracranial suppuration complicating sinusitis among children: an epidemiological and clinical study
Authors: Piatt Joseph H.
Published: June 2011

Object

Intracranial abscess is a very infrequent complication of sinusitis among children. Case series, mostly small and focusing on surgical treatment, have appeared in the literature, but there has been no study on the epidemiology of this condition, nor has there been any large-scale study on the intensity of therapy or outcomes.

Methods

Data were drawn from the Kids' Inpatient Databases for 1997, 2000, 2003, and 2006 and the National Inpatient Sample for 2001. Cases were defined by the conjunction between the diagnostic codes for intracranial abscess and those for acute or chronic sinusitis or mastoiditis.

Results

Eight hundred forty-seven hospital admissions were captured. Over the 10 years of the study, admission rates ranged between 2.74 and 4.38 per million children per year. Boys were affected much more commonly than girls. Black children were affected out of proportion to their presence in the population. The overall incidence seemed to peak in early adolescence. Sinogenic cases had a marked seasonal pattern peaking in winter, but no seasonal variation was seen for otogenic cases. Asthma comorbidity was more prevalent among sinogenic cases. The mortality rate was 2%, and death occurred only among sinogenic cases. Moreover, sinogenic cases tended to require more intensive therapy, as measured by the number of procedures, and there was a trend toward less favorable discharge dispositions. Older patients and black patients were less likely to be discharged directly to home. At least a quarter of the cases were managed without neurosurgical intervention. White patients were treated without neurosurgery more often than others.

Conclusions

Analysis of administrative data sets has yielded a descriptive picture of intracranial abscess complicating sinusitis among children, but the very low incidence of this condition impedes prospective clinical research directed at practical management issues.
Coagulation abnormalities in children undergoing epilepsy surgery
Authors: Pacione Donato , Blei Francine , Devinsky Orrin , Weiner Howard L. , Roth Jonathan
Published: June 2011

Object

Surgery is increasingly used to treat children with refractory epilepsy. Before surgery, the authors routinely evaluated the coagulation profile to identify coagulation abnormalities not established by personal and family history, physical examination, and routine screening tests.

Methods

Thirty-nine consecutive children undergoing testing prior to epilepsy surgery were prospectively evaluated. The authors evaluated a detailed hematological history and an elaborative hematological panel including complete blood count, hepatic panel, anticoagulant levels, coagulation profile (prothrombin time, partial thromboplastin time, international normalized ratio, fibrinogen, thrombin time, von Willebrand antigen, ristocetin cofactor, factor VIII, and individual factor assays when indicated) and platelet aggregation studies (in the presence of adenosine diphosphate, epinephrine, collagen, and ristocetin). Patient variables included tuberous sclerosis complex (TSC), age at epilepsy onset, age at surgery, seizure frequency, number and type of antiepileptic drugs, recent or present ketogenic diet, and use of selective serotonin reuptake inhibitors.

Results

Ten children (25.6%) had either coagulation or platelet function abnormalities. Abnormal coagulation was identified in 5 children, and abnormal platelet function was discovered in 6. A diagnosis of TSC was associated with a platelet function abnormality (p = 0.012), whereas children without TSC had a higher rate of coagulopathy (p = 0.041). None of the other characteristics reached statistical significance. In 2 patients (5.1%) with TSC and platelet aggregation abnormalities, the authors noted normal standard screening laboratory studies and an uneventful detailed personal and family history. One of these 2 patients developed a significant intraoperative bleeding complication.

Conclusions

A preoperative screening with standard laboratory studies and detailed history may not be adequate to fully examine underlying coagulation abnormalities in children with refractory epilepsy. Platelet aggregation studies should be considered in patients with TSC.
Undeveloped semiconic posterosuperior ligament and susceptibility to avulsion of the C-7 spinal nerve in Erb palsy
Authors: Huang Yi-gang , Chen Liang , Gu Yu-dong , Yu Guang-rong
Published: June 2011

Object

In Erb palsy, the C-7 spinal nerve has been found to be more subject to avulsion than the C-5 and C-6 spinal nerves. This study investigated the morphological and biomechanical characteristics of the semiconic posterosuperior ligaments (SPLs) at the C-5, C-6, and C-7 spinal nerves in neonates.

Methods

Twenty-four brachial plexuses from 12 fresh neonate cadavers were used in this study. In 12 brachial plexuses from 6 cadavers, the following studies were performed with respect to the SPLs at the C-5, C-6, and C-7 spinal nerves: gross observation of morphological and histological characteristics; measurement of length, thickness, and width; and a semiquantitative analysis of collagen. In the other 6 cadavers, biomechanical tension testing was performed bilaterally on the C5–7 SPLs to assess the tensile strength of the ligaments.

Results

The C5–7 spinal nerves are fixed to the transverse process through the SPL, a structure not observed at the C-8 and T-1 spinal nerves. Except for the width of the SPL insertion on the spinal nerve, which was found to increase gradually from C-5 to C-7, there was no statistically significant difference in the dimensions of the C-5, C-6, and C-7 SPLs. The sectional area percentage of collagen was 51% ± 10% in SPLs for C-5, 51% ± 11% for C-6, and 41% ± 10% for C-7; and this percentage was significantly lower in SPLs for C-7 than for C-5 or C-6 (1-way ANOVA, F = 4.3, p = 0.02; Tukey honestly significant difference test, p = 0.04 and 0.04, respectively). Sharpey fibers were observed at the transverse process origin of the SPL at C-5 and C-6 but not at C-7. Biomechanical tension testing showed that the mean failure load was 6.6 ± 0.9 N for the C-5 SPL, 6.4 ± 1.0 N for the C-6 SPL, and 5.4 ± 0.9 N for the C-7 SPL, and the failure load was significantly lower in SPLs at C-7 than in those at C-5 or C-6 (1-way ANOVA, F = 5.1, p = 0.01; Tukey honestly significant difference, p = 0.01 and 0.048, respectively). Nine of 12 C-7 SPLs failed at their origin from the transverse process, while only 4 of 12 C-5 SPLs and 3 of 12 C-6 SPLs failed at the origin site.

Conclusions

These findings suggest that the lower density of collagen and absence of Sharpey fibers decrease the biomechanical properties of the C-7 SPL, and this may account for the higher frequency of avulsion of the C-7 spinal nerve (in comparison with the C-5 or C-6 nerve) in Erb palsy.
Contrast stasis on noncontrast computed tomography as a predictor of stroke postthrombolysis
Authors: Ghobrial George M. , Nair Anil K. , Dalyai Richard T. , Jabbour Pascal , Tjoumakaris Stavropoula I. , Dumont Aaron S. , Rosenwasser Robert H. , Gonzalez L. Fernando
Published: June 2011

Multimodal endovascular intervention is becoming more commonplace for the acute intervention of ischemic stroke. Hyperdensity in a portion of the treated territory is a common finding on postthrombolytic noncontrast CT (NCCT), but its significance is poorly understood. The authors conducted a single-institution, retrospective chart review of patients who had intraarterial thrombolysis of the anterior circulation between 2010 and 2011 with evidence of hyperdensity on NCCT following recanalization. Eighteen patients had evidence of postoperative contrast stasis causing hyperdensity on NCCT. One hundred percent of the patients had MR imaging evidence of completed strokes postoperatively in the same distribution as the stasis. Stasis on NCCT after intervention had a sensitivity and specificity of 82% and 0% for predicting stroke, respectively. Furthermore, the positive predictive value was 100%. The presence of contrast stasis on postthrombolytic NCCT correlates well with stroke seen on subsequent MR imaging.
Temporoparietooccipital disconnection in children with intractable epilepsy
Authors: Mohamed Ahmad R. , Freeman Jeremy L. , Maixner Wirginia , Bailey Catherine A. , Wrennall Jacquie A. , Harvey A. Simon
Published: June 2011

Object

Temporoparietooccipital (TPO) disconnection is described mainly in children with diffuse posterior quadrant lesions and concordant electroencephalography (EEG) findings. The authors report on 16 children who underwent TPO surgery, including 4 with no definite epileptogenic lesion and 8 with generalized electroclinical manifestations.

Methods

The authors conducted a retrospective review of clinical, neuropsychological, EEG, imaging, and histopathological data in 16 children with intractable epilepsy who underwent TPO disconnection and/or resection at their center between December 1998 and March 2010.

Results

Seizure onset occurred between the ages of 1 and 24 months, and TPO surgery was performed between the ages of 0.2 and 17 years. All children had refractory seizures, including epileptic spasms in 10 and tonic seizures in 7, and all had developmental delay. Twelve children had epileptogenic lesions on MR imaging, including 6 with posterior quadrant dysplasia. Four children had only subtle white matter signal change or unusual sulcation on MR imaging, associated with subtle but concordant EEG and functional imaging abnormalities. After a mean follow-up of 52 months (range 12–114 months), 9 children (56%) are seizure-free and 5 (31%) experienced seizure reduction of greater than 50%. Focal or regional background slowing on EEG was correlated with favorable seizure outcome. Five children showed developmental progress and 3 had acceleration in development following surgery. None of the children developed new motor deficits postoperatively.

Conclusions

Temporoparietooccipital disconnection is an effective, motor-sparing epilepsy surgery procedure for selected children with refractory focal or generalized seizures with localization to the posterior quadrant on 1 side, with or without a discrete lesion on MR imaging.
Erfassung struktureller Waldparameter mithilfe von flugzeuggetragenem Laserscanning | Deriving structural forest parameters using airborne laser scanning
Authors: Morsdorf Felix
Published: June 2011

Airborne laser scanning is a relatively young and precise technology to directly measure surface elevations. With today's high scanning rates, dense 3-D pointclouds of coordinate triplets (xyz) can be provided, in which many structural aspects of the vegetation are contained. The challenge now is to transform this data, as far as possible automatically, into manageable information relevant to the user. In this paper we present two such methods: the first extracts automatically the geometry of individual trees, with a recognition rate of over 70% and a systematic underestimation of tree height of only 0.6 metres. The second method derives a pixel map of the canopy density from the pointcloud, in which the spatial patterns of vegetation cover are represented. These patterns are relevant for habitat analysis and ecosystem studies. The values derived by this method correlate well with field measurements, giving a measure of certainty (R2) of 0.8. The greatest advantage of airborne laser scanning is that it provides spatially extensive, direct measurements of vegetation structure which show none of the extrapolation errors of spot measurements. A large challenge remains in integrating these new products into the user's processing chains and workflows, be it in the realm of forestry or in that of ecosystem research.
Beitrag des terrestrischen Laserscannings zur Erfassung der Struktur von Baumkronen | Application of terrestrial laser scanning for measuring tree crown structures
Authors: Pretzsch Hans , Seifert Stefan , Huang Peng
Published: June 2011

This paper addresses the potential of terrestrial laser scanning (TLS) for describing and modelling of tree crown structure and dynamics. We first present a general approach for the metabolic and structural scaling of tree crowns. Out of this approach we emphasize those normalization and scaling parameters which become accessible by TLS. For example we show how the individual tree leaf area index, convex hull, and its space-filling by leaves can be extracted out of laser scan data. This contributes to a theoretical and empirical substantiation of crown structure models which were missing so far for e.g. quantification of structural and species diversity in forest stands, inventory of crown biomass, species detection by remote sensing, and understanding of self- and alien-thinning in pure and mixed stands. Up to now works on this topic delivered a rather scattered empirical knowledge mainly by single inventories of trees and stands. In contrast, we recommend to start with a model approach, and to complete existing data with repeated TLS inventories in order to come to a consistent and theoretically based model of tree crowns.
The Impact of In-group/Out-group Stereotypes: The Image of Foreign Cultures in Flemish Youth Literature in the Nineteenth Century
Authors: Jan Van Coillie
Published: June 2011

Which image of other cultures did Flemish youth literature in the nineteenth century disseminate? Which linguistic features supported and communicated this image in the texts? And what was the relationship between this image and the (social) context? To answer these questions, a text corpus is screened for linguistic expressions influencing the image of foreign cultures. The theoretical framework is inspired by recent insights from imagology and post-colonial studies. The linguistic analysis is based on models taken from critical linguistics and discourse analysis. In order to interpret the results of the analysis, I explore how the image of other cultures in youth literature materialized in close interaction with the colonial and pedagogical discourse. A major finding is that the image transferred Western bourgeois norms and values as part of education. Furthermore, this image is characterized by input-output stereotypes, whose effect is to indirectly glorify one's own culture by rejecting foreign mores. The bourgeois values that resulted in these stereotypes were aspects of the Western conception of civilization, which was constantly set off against the uncivilized ways of ‘savage’ peoples. This ethnocentric stance, which was never questioned, served as primary justification for colonization and exploitation of foreign peoples.
The Case of the Flat Rectangles: Children's Literature on Page and Screen The Francelia Butler Lecture, Children's Literature Association, June 2010 Ann Arbor, Michigan
Authors: Mackey Margaret
Published: June 2011

Children's literature has long been dominated by the flat rectangle of the page, and more recently, of the screen. It is easy to assume that the recent flood of literary-related commodities and collectibles represents something very new. But popular culture has spawned a similar industry of multimodal materials for well over a century, and children's authors such as Beatrix Potter and L. Frank Baum mastered the art of the spin-off and the collectible in the very early days of the twentieth century. This article investigates questions about changes in children's literary culture through the lens of past, present, and future, and explores a shifting future world where texts become ever more hybrid, porous, slippery, and unfinished.
An Ecologic Analysis of County-Level PM2.5 Concentrations and Lung Cancer Incidence and Mortality
Authors: Vinikoor-Imler Lisa C. , Davis J. Allen , Luben Thomas J.
Published: June 2011

Few studies have explored the relationship between PM2.5 and lung cancer incidence. Although results are mixed, some studies have demonstrated a positive relationship between PM2.5 and lung cancer mortality. Using an ecologic study design, we examined the county-level associations between PM2.5 concentrations (2002–2005) and lung cancer incidence and mortality in North Carolina (2002–2006). Positive trends were observed between PM2.5 concentrations and lung cancer incidence and mortality; however, the R2 for both were
Environmental Surveillance. An Additional/Alternative Approach for Virological Surveillance in Greece?
Authors: Kokkinos Petros , Ziros Panos , Meri Danai , Filippidou Sevasti , Kolla Stella , Galanis Alexis , Vantarakis Apostolos
Published: June 2011

The detection of viruses in the sewage of an urban city by nucleic acid amplification techniques allows the identification of the viral strains that are circulating in the community. The aim of the study was the application of such detection which gives useful data on the distribution, spread, and frequency of these viruses, supporting epidemiological studies of the related viral infections. A two year (2007–2009) survey was conducted in order to evaluate the presence of human adenoviruses (hAdV), hepatitis A viruses (HAV), hepatitis E viruses (HEV), noroviruses (NoV), and human polyomaviruses (hPyV) in sewage samples collected from the inlet of a municipal biological wastewater treatment plant located in southwestern Greece. PCR methods were used for this survey. In total, viruses have been detected in 87.5% (42/48) of the analyzed sewage samples. Analytically, DNA viruses, hAdVs and hPyVs have been detected in 45.8% (22/48) and 68.8% (33/48) of the samples, respectively. As it concerns RNA viruses, HAV was detected in 8.3% (4/48), NoVs in 6.3% (3/48), while HEV has not been detected at all. After sequencing, AdVs were typed as Ad8, Ad40 and Ad41, while both JC and BK hPyVs have been recognized. All NoVs have been identified as GII4, while HAV was typed as genotype IA. Similar long-term studies could be undertaken in countries such as Greece in order to offer a valuable and complementary tool to current problematic epidemiological surveillance systems. This study demonstrates the advantages of environmental surveillance as a tool to determine the epidemiology of viruses circulating in a given community. To our knowledge this was the first of its kind study performed in Greece in order to establish this new way of surveillance.
An Optimized Protocol for DNA Extraction from Wheat Seeds and Loop-Mediated Isothermal Ampliﬁcation (LAMP) to Detect Fusarium graminearum Contamination of Wheat Grain
Authors: Abd-Elsalam Kamel , Bahkali Ali , Moslem Mohamed , Amin Osama E. , Niessen Ludwig
Published: June 2011

A simple, rapid, and efficient method for isolating genomic DNA from germinated seeds of wheat that is free from polysaccharides and polyphenols is reported. DNA was extracted, treated with RNase, measured and tested for completeness using agarose gel electrophoresis. DNA purification from wheat grains yielded abundant, amplifiable DNA with yields typically between 100 and 200 ng DNA/mg. The effectiveness and reliability of the method was tested by assessing quantity and quality of the isolated DNA using three PCR-based markers. Inter-simple sequence repeats (ISSRs) were used to assess the genetic diversity between different wheat varieties. Specific PCR primer pair Tox5-1/Tox5-2 and a loop-mediated isothermal ampliﬁcation (LAMP) procedure were used to detect genomic DNA of Fusarium graminearum in contaminated wheat seeds. In this method there is no need to use liquid nitrogen for crushing germinated seedlings. The protocol takes approximately one hour to prepare high quality DNA. In combination with the LAMP assay it is a fast and cost-effective alternative to traditional diagnostic methods for the early detection of toxigenic fusaria in cereals.
Proteomic Analysis Identified DJ-1 as a Cisplatin Resistant Marker in Non-Small Cell Lung Cancer
Authors: Zeng Hua-Zong , Qu Yi-Qing , Zhang Wen-Jun , Xiu Bing , Deng An-Mei , Liang Ai-Bin
Published: June 2011

The aim of study is to identify cisplatin-resistance associated biomarkers for non-small cell lung cancers (NSCLC). We use two-dimensional electrophoresis (2-DE) combined with MALDI-TOF mass spectrometry to compare the proteome between lung cancer cell line A549 and its cisplatin-resistant subline A549/DDP. Nine cisplatin resistance-related proteins were identiﬁed, and DJ-1, one of the differently expressed proteins, was selected for further validation and evaluation. Immunohistochemical results demonstrated that high expression level of DJ-1 was associated with cisplatin resistance and a predictor for poor prognosis in 67 locally advanced NSCLC patients. Furthermore, in vitro results showed that silencing DJ-1 increased the proliferation inhibitory effect of cisplatin to A549/DDP cells. In conclusion, DJ-1 might play an important role in the resistibility to cisplatin, and it could also act as a novel candidate biomarker for predicting the response of NSCLC patients to cisplatin-based chemotherapy.
Prolinethioamides versus Prolinamides in Organocatalyzed Aldol Reactions—A Comparative Study
Authors: Gryko Dorota , Chromiński Mikołaj , Pielacińska Dominika J.
Published: June 2011

Various organocatalysts have been developed for the aldol reaction but particular attention has been paid to prolinamide derivatives. They are easy to prepare and their catalytic activity can be readily tuned through structural modification. In this review, the comparison of catalytic activities between prolinethioamides and their respective amides in direct asymmetric aldol reactions is presented.
Characterization of a Full-Length Endogenous Beta-Retrovirus, EqERV-Beta1, in the Genome of the Horse (Equus caballus)
Authors: Van der Kuyl Antoinette C.
Published: June 2011

Information on endogenous retroviruses fixed in the horse (Equus caballus) genome is scarce. The recent availability of a draft sequence of the horse genome enables the detection of such integrated viruses by similarity search. Using translated nucleotide fragments from gamma-, beta-, and delta-retroviral genera for initial searches, a full-length beta-retrovirus genome was retrieved from a horse chromosome 5 contig. The provirus, tentatively named EqERV-beta1 (for the first equine endogenous beta-retrovirus), was 10434 nucleotide (nt) in length with the usual retroviral genome structure of 5’LTR-gag-pro-pol-env-3’LTR. The LTRs were 1361 nt long, and differed approximately 1% from each other, suggestive of a relatively recent integration. Coding sequences for gag, pro and pol were present in three different reading-frames, as common for beta-retroviruses, and the reading frames were completely open, except that the env gene was interrupted by a single stopcodon. No reading frame was apparent downstream of the env gene, suggesting that EqERV-beta1 does not encode a superantigen like mouse mammary tumor virus (MMTV). A second proviral genome of EqERV-beta1, with no stopcodon in env, is additionally integrated on chromosome 5 downstream of the first virus. Single EqERV-beta1 LTRs were abundantly present on all chromosomes except chromosome 24. Phylogenetically, EqERV-beta1 most closely resembles an unclassified retroviral sequence from cattle (Bos taurus), and the murine beta-retrovirus MMTV.
Use of Peritoneal Dialysis after Surgery for Congenital Heart Disease in Children
Authors: Santos Catarina R. , Branco Patrícia Q. , Gaspar Augusta , Bruges Margarida , Anjos Rui , Gonçalves Margarida S. , Abecasis Miguel , Meneses Carlos , Barata José D.
Published: June 2011

Acute kidney injury (AKI) is a common complication in children after surgery for congenital heart disease, and peritoneal dialysis (PD) is usually the renal replacement therapy (RRT) of choice, especially in very young children. The aim of the present study was to describe our experience of using PD to treat AKI after cardiac surgery.

We retrospectively analyzed children 1 week to 16 years of age undergoing cardiac surgery during 2000 – 2008 and found the incidence of AKI treated with PD to be 2.3%. In the 23 patients treated with PD (13 male; average age: 29 ± 48.4 months; weight: 9.1 ± 8.1 kg), the indications for PD initiation were oliguria ( n = 13), anuria ( n = 9), and acidosis ( n = 1). The average time between cardiac surgery and AKI was 4.8 ± 16.8 hours, and between AKI and PD initiation, it was 12 ± 16.8 hours. Patients were treated for a mean of 4.8 ± 3.8 days. Two patients developed peritonitis, and mechanical dysfunction of the PD catheter occurred in 1 patient. In-hospital mortality was 43.4%. Patients treated with PD weighed less ( p = 0.004) and had longer bypass time ( p = 0.004), inotrope use ( p = 0.000), and mechanical ventilation ( p = 0.000). However, in a regression analysis, only cardiopulmonary bypass time (odds ratio: 1.021; 95% confidence interval: 0.998 to 1.027; p = 0.032) remained predictive of a subsequent need for PD.

We conclude that PD is an efficacious RRT for AKI in children undergoing cardiac surgery and that, in this setting, bypass time is the strongest predictor of a subsequent need for RRT.
“NEPP” Peritoneal Dialysis Regimen has Beneficial Effects on Plasma Cel and 3-DG, but not Pentosidine, CML, and MGO
Authors: le Poole Caatje Y. , van Ittersum Frans J. , Valentijn Rob M. , Teerlink Tom , Lindholm Bengt , Wee Piet M. Ter , Schalkwijk Casper G.
Published: June 2011

Background

Standard peritoneal dialysis (PD) solutions contain high levels of glucose and glucose degradation products (GDPs), both contributing to the formation of advanced glycation end products (AGEs). We studied the contribution to plasma GDP and AGE levels of 2 PD regimens that differ in glucose and GDP loads: high load [standard PD (sPD) using 4 glucose-lactate exchanges] and low load [1 amino acid exchange, 1 icodextrin exchange, and 2 glucose-bicarbonate/lactate exchanges (“NEPP”)].

Methods

In a prospective crossover study (2 periods of 24 weeks), new continuous ambulatory PD patients were randomized to NEPP-sPD ( n = 23) or to sPD-NEPP ( n = 27).

Results

After the start of PD, absolute increases were observed in plasma levels of 3-deoxyglucosone (3-DG, 220.4 nmol/L, p < 0.0001) and in Nε-(carboxymethyl) lysine (CML) in plasma proteins (0.02 μmol/L CML per 1 mol/L lysine, p < 0.0001). During the first 6 weeks, 3-DG tended to increase more with sPD treatment (p = 0.08), and CML, with NEPP treatment (p = 0.002). In both groups, Nε-(carboxyethyl)lysine (CEL) in plasma proteins declined significantly with the start of PD. Treatment with NEPP resulted in higher levels of methylglyoxal (MGO) and lower levels of 3-DG and CEL. Pentosidine in the albumin fraction tended to increase less during NEPP treatment.

Conclusions

A low glucose and GDP PD regimen (NEPP) resulted in plasma levels of 3-DG and CEL that were lower than those with a glucose-based sPD regimen. Starting PD with NEPP was associated with a steeper increase in CML, and continuing treatment with NEPP resulted in higher MGO levels.
Assessment of Oral Health in Peritoneal Dialysis Patients with and without Diabetes Mellitus
Authors: Eltas Abubekir , Tozoğlu Ümmühan , Keleş Mustafa , Canakci Varol
Published: June 2011

The incidence of chronic renal failure continues to rise worldwide, and although the oral and dental changes in individuals with this condition have been examined, investigations with diabetic peritoneal dialysis (PD) patients are limited. We therefore examined salivary pH, dry mouth, taste change, and mucosal ulceration in diabetic and nondiabetic uremic patients receiving PD. A total of 49 patients undergoing PD therapy were allocated to either the diabetic or the nondiabetic group. Salivary pH, dry mouth, taste change, and mucosal ulceration were determined for both groups. Salivary flow rate and pH were both lower in the diabetic group. Buffer capacity, dry mouth, taste change, and mucosal ulceration were all increased in that group. These findings were associated with level of glycosylated hemoglobin A1c. Our observations indicate that, compared with nondiabetic PD patients, patients with diabetes exhibit more severe oral uremic symptoms, including dry mouth, burning mouth syndrome, taste change, and mucosal ulcerations. The oral health in these patients should be followed.
Compared with Younger Peritoneal Dialysis Patients, Elderly Patients have Similar Peritonitis-Free Survival and Lower Risk of Technique Failure, but Higher Risk of Peritonitis-Related Mortality
Authors: Lim Wai H. , Dogra Gursharan K. , McDonald Stephen P. , Brown Fiona G. , Johnson David W.
Published: June 2011

Background

The number of elderly patients with end-stage kidney disease (ESKD) is increasing worldwide, but the proportion of elderly patients commencing peritoneal dialysis (PD) is falling. The reluctance of elderly ESKD patients to consider PD may be related to a perception that PD is associated with greater rates of complications. In the present study, we compared outcomes between younger and older PD patients.

Methods

Using Australia and New Zealand Dialysis Registry data, all adult ESKD patients commencing PD between 1991 and 2007 were categorized into under 50, 50 – 64.9, and 65 years of age or older groups. Time to first peritonitis, death-censored technique failure, and peritonitis-associated and all-cause mortality were evaluated by multivariate Cox proportional hazards model analysis.

Results

Of the 12932 PD patients included in the study, 3370 (26%) were under 50 years of age, 4386 (34%) were 50 – 64.9 years of age, and 5176 (40%) were 65 years of age or older. Compared with younger patients (<50 years), elderly patients (≥65 years) had a similar peritonitis-free survival and a lower risk of death-censored technique failure [hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.79 to 0.93], but they had higher peritonitis-related (HR: 2.31; 95% CI: 1.68 to 3.18) and all-cause mortality (HR: 2.90; 95% CI: 2.60 to 3.23).

Conclusions

Not unexpectedly, elderly patients have higher peritonitis-related and all-cause mortality, which is likely a consequence of a greater prevalence of comorbid disease. However, compared with younger patients, elderly patients have superior technique survival and similar peritonitis-free survival, suggesting that PD is a viable renal replacement therapy in this group of patients.
Experiences with Assisted Peritoneal Dialysis in China
Authors: Xu Rong , Zhuo Min , Yang Zhikai , Dong Jie
Published: June 2011

Objective

About half the patients on peritoneal dialysis (PD) in China need to be assisted by family members or home assistants. We explored whether these patients have a higher risk for peritonitis and death compared with self-care PD patients.

Methods

We prospectively followed 313 incident PD patients until death or censoring. This cohort was divided into assisted and self-care PD groups according to the independence of bag exchange. Data on baseline demographics, Charlson comorbidity index, biochemistry, and residual renal function were recorded during the first 3 – 6 months. The outcome variables were first episode of peritonitis and all-cause mortality.

Results

Of the 313 patients in this cohort study, 122 needed assistance in performing bag exchanges (86 from a family member, 36 from a home assistant); the remaining 191 patients did not need assistance. During a follow-up period averaging 44.5 months, 122 patients developed a first episode of peritonitis, and 135 patients died. Compared with patients having a family assistant, those with a home assistant had similar peritonitis-free and survival times, but a higher risk of mortality after adjustments for variables such as age, sex, Charlson comorbidity score, hemoglobin, serum albumin, and residual renal function. Furthermore, compared with self-care patients, assisted patients overall had a similar peritonitis-free time, but a higher risk of mortality, even after adjusting for covariates.

Conclusions

Based on our single-center experience in China, we conclude that assisted PD is a good option for patients with poor self-care ability. This result provides evidence for recruiting patients who need assistance to PD programs in China.
The Fluid Study Protocol: A Randomized Controlled Study on the Effects of Bioimpedance Analysis and Vitamin D on Left Ventricular Mass in Peritoneal Dialysis Patients
Authors: Su Winnie S. , Gangji Azim S. , Margetts Peter M. , Bosch Jackie , Yusuf Salim , Clase Catherine M. , Ganame Javier , Noseworthy Michael , Lonn Eva , Jain Arsh K. , McCormick Brendan , Brimble K. Scott
Published: June 2011

Objectives

We will evaluate the effects of bioimpedance analysis–guided fluid management to reduce volume expansion, of vitamin D3 supplementation, and of the combination of those techniques on decrease of left ventricular mass in peritoneal dialysis (PD) patients.

Design

This multicenter randomized controlled trial, with a 2×2 factorial design, will be conducted at PD clinics affiliated with 3 Canadian teaching hospitals. Consenting PD patients 18 years of age or older will be included. Patients will be excluded if they have contraindications to bioimpedance or magnetic resonance imaging, life or technique expectancy of less than 1 year, peritonitis within the preceding 3 months, or serum calcium above 2.55 mmol/L.

Intervention

The study will randomize 70 patients to bio-impedance–guided volume management or to usual care and to vitamin D3 50,000 U weekly for 8 doses, and then 10,000 U weekly or to matching placebo.

Main Outcome Measures

The primary outcome will be change in left ventricular mass at 1 year as determined by cardiac magnetic resonance imaging. The secondary outcome will be a composite endpoint of death, nonfatal cardiovascular event, and transfer to hemodialysis for dialysis inadequacy or ultrafiltration failure. Other outcome measures will include blood pressure, quality of life, 6-minute walk test, inflammatory and fibrotic markers and their association with peritoneal membrane transport properties, and residual renal function. Patients will be followed for clinical outcomes for up to 3 years.

Conclusions

This study will assess whether bioimpedance-directed volume management and vitamin D3 supplementation can improve left ventricular mass in PD patients.
A racemic formal total synthesis of clavukerin A using gold(I)-catalyzed cycloisomerization of 3-methoxy-1,6-enynes as the key strategy
Authors: Cheong Jae Youp , Rhee Young Ho
Published: June 2011

An efficient formal total synthesis of (±)-clavukerin A was accomplished via a gold-catalyzed cycloisomerization of a 3-methoxy-1,6-enyne 5 as the key strategy followed by Rh-catalyzed stereoselective hydrogenation of the cycloheptenone 4.